Why You Don’t Feel Like Yourself with Cassie Milligan

HAYC Cassie Milligan - Why You Don’t Feel Like Yourself with Cassie Milligan Part 1 ​[00:00:00] Bree Allred: [00:00:05] [00:00:10] [00:00:15] [00:00:20] [00:00:25] I hear women say all the time that they don't feel like themselves anymore. [00:00:30] If you're exhausted and you're getting eight hours of sleep, you're waking up not feeling rested, you're not [00:00:35] sleeping through the night, you are struggling with just feeling [00:00:40] overwhelmed a lot of the time, maybe new anxiety when you've never struggled with that before, um, you're [00:00:45] getting unexpected weight gain without significant changes to your diet or to your activity levels, this is [00:00:50] a lot of what people are dealing with, and we're here to talk about your questions today. If you're one of those people [00:00:55] where you've gone to the doctor, you've gotten labs drawn, and you're told everything [00:01:00] is normal, this episode is for you so we have Cassie Milligan with us today. We're so excited to [00:01:05] chat with her. So Cassie, tell us a little bit about yourself. And she is the owner of Revive [00:01:10] Wellness and Aesthetics. Mm-hmm. And really an expert in hormones is really what your [00:01:15] practice focuses around, and helping women in these exact situations. Cassie Milligan: Exact, yes. Bree Allred: So tell us a little [00:01:20] bit about you and then what made you get into this area of [00:01:25] work. Cassie Milligan: I'm Cassie Milligan. Yes, I do own Revive Wellness and Aesthetics. So I am [00:01:30] a family nurse practitioner. I was a nurse for a really long time, and decided that I [00:01:35] wanted to go back and get my nurse practitioner, and I wanted to do family because it's such a [00:01:40] broader spectrum. I can see from infant to death, basically. So I got my [00:01:45] nurse practitioner, and I started in primary [00:01:50] care, and working in primary care really showed me how broken our system is. So [00:01:55] like even patients coming in when I did primary care would be like, "I went to another practitioner and they like [00:02:00] checked all my labs and everything was normal." And like normal's not optimal. Even doing the [00:02:05] primary care, I found that implementing more of like the [00:02:10] holistic part of primary care, I saw really good results. [00:02:15] Not with just hormones, but like young girls with anxiety or depression. And [00:02:20] so I decided that I wanted to do a lot more education in the functional [00:02:25] realm and hormone optimization 'cause you don't learn that deep in [00:02:30] nurse practitioner school. Yeah. Or medical school for that matter- Yeah ... Bree Allred: if you're going there Cassie Milligan: as well. Yeah. It's [00:02:35] very basic, and I always tell my patients I understand why, because I did do primary [00:02:40] care, that like when it's insurance-based practice you do have to [00:02:45] see a lot of patients in one day. And so whatever [00:02:50] labs I check whatever I do with them really I only have the time that I [00:02:55] have right? So if I'm checking a very basic panel, I can say, "Yeah, everything's normal," and send you on your [00:03:00] way so that I can see the next patient. , And I think that's where our system has failed us. [00:03:05] Yeah. So it's just a lot deeper. So even if I try to do more labs in [00:03:10] primary care, you know, insurance wouldn't cover it. They didn't think it was necessary. Part of insurance-based [00:03:15] practice. Yeah. So I did a... I've done a lot of education. I continue in [00:03:20] education. Like last weekend I was in Colorado doing education. So it's always getting the [00:03:25] up-to-date stuff- Bree Allred: Yeah ... Cassie Milligan: is what I, like, really love. Bree Allred: Being on that cutting edge, knowing exactly- [00:03:30] Mm-hmm what the research is saying or what's up and coming and being studied and the Cassie Milligan: research. Yeah, 100%. And so, like, I [00:03:35] even come back from conferences and I'm like, "Oh, I wanna implement this." Like, I think this is a really [00:03:40] cool, like, jump into this or, you know, the... It's always changing and there's always [00:03:45] updates, and I really love that, and taking the pearls that I learn at these [00:03:50] conferences. Even if it's, like, something I've heard 100 times, there's always, like, specific pearls that I'm [00:03:55] like, "Oh I need to do this. I need to implement this." That's a new way that I hadn't thought of implementing- Yeah ... this Bree Allred: before. Yeah. [00:04:00] I wanna implement this into my practice. And kind of fun in the cash-based world that we have the abilities- Yeah to do that, [00:04:05] like, immediately. It's not- Immediately ... "Oh, okay, let's go back through the system and jump through all these [00:04:10] hoops and get it approved." Cassie Milligan: Yeah. And I feel like my patients see the optimization- Mm-hmm ... uh, you know, of their [00:04:15] health. So with the continuing education that I've done I have done a lot [00:04:20] of continuing education on hormone optimization peptide [00:04:25] therapy IV therapy. Mm-hmm. I even do education in that, right? So it's... You know, [00:04:30] aesthetics, I also do education in that. It's just like there's always learning- Bree Allred: Yeah ... Cassie Milligan: [00:04:35] that can be had. So- And we can Bree Allred: keep going and learning and growing and- Yes ... and just becoming better [00:04:40] and better at what Cassie Milligan: we do. Yes, 100%. So after, like, [00:04:45] primary care, I'm... I really... I always wanted to kind of start my own practice, and [00:04:50] I had, like, all this whole vision. But doing, yes, doing hormone [00:04:55] optimization, and optimization is very different than you're in range. Mm. Right? So doing the [00:05:00] hormone optimization, but also, like- Continuing with the [00:05:05] aesthetics piece, the IV therapy piece Mm-hmm I do enjoy that stuff. That's [00:05:10] kind of like my fun stuff, where like the hormone optimization is like really [00:05:15] my, my bread and butter. Your passion. Mm-hmm. This is my passion, yes. So yeah, opening Revive [00:05:20] was really about bringing a service to Cache Valley [00:05:25] that like I wasn't seeing anywhere else. Now there's a lot of clinics that do hormone [00:05:30] optimization, and they're not doing anything wrong. I feel like what sets me apart is the [00:05:35] functional side of things and- Uh-huh ... and not just looking at just the hormones, but looking at [00:05:40] gut health, mindset your adrenals, right? It's just taking your [00:05:45] body as a whole, is kind of what- Bree Allred: Because hormones is this small little part Cassie Milligan: of it small little [00:05:50] part of it Bree Allred: And it can make a huge difference, but also if your gut isn't right, the hormones aren't gonna- Cassie Milligan: They're not [00:05:55] gonna regulate ... they're not gonna Bree Allred: optimize- Cassie Milligan: Yes ... the same way. Yes. So looking at the body as a [00:06:00] whole just kind of, I feel like sets me just a little bit apart from other [00:06:05] clinics that are doing... I feel like we all have the same goal. We want to have our [00:06:10] patients feel better, right? Yeah. So yeah, just including that, that functional [00:06:15] side of things is just kind of the optimization- Bree Allred: Yeah ... if Cassie Milligan: that makes sense. Bree Allred: That [00:06:20] gets that little bit of extra- Mm-hmm ... kind of what makes you unique- Yeah ... in what you're doing as well. Cassie Milligan: Yeah, yeah. Yeah. [00:06:25] And that, I mean, that functional piece also is the IV therapy. Bree Allred: Mm-hmm. Cassie Milligan: Right? So there are [00:06:30] certain IVs that really do help. Like, I am now offering [00:06:35] iron IVs infusions so that you don't have to go to the hospital, which is like a really big [00:06:40] piece of optimization when it comes to hormones and thyroid that- A lot of [00:06:45] people don't understand- Bree Allred: Oh, yes that piece. And especially in, like, perimenopause, right? Yes. Where we have [00:06:50] such big fluctuations in our- Mm-hmm ... menstrual cycle, and- Oh, Cassie Milligan: yeah ... Bree Allred: there are some that might [00:06:55] be on the, "I'm bleeding all the time." All the time. And you're losing so much iron when you're doing [00:07:00] that. Cassie Milligan: Yes. Bree Allred: And that can probably be a big factor of the fatigue. Cassie Milligan: Yeah. Right? A huge [00:07:05] factor of fatigue. Yeah. Yeah. So, like, looking at that, like, a lot of practitioners will just look at an iron, [00:07:10] and that's not what I'm looking at. I'm looking at a ferritin- Mm-hmm ... which is, like, the storage. [00:07:15] So, like, if you don't have that storage built up, you're gonna have symptoms of [00:07:20] iron like- Deficiency deficiency. Bree Allred: Because Cassie Milligan: you don't Bree Allred: have the, the backlog- Right ... that you need. You don't have the savings in the bank. Cassie Milligan: [00:07:25] Right, right. Where you have, yes, this little iron hanging out in your [00:07:30] blood, but not the storage- Yeah ... which is, like, the, the bigger piece, especially when it comes to [00:07:35] thyroid optimization. So- Bree Allred: Yeah Cassie Milligan: it's just kind of a whole- And Bree Allred: thyroid plays into [00:07:40] hormone, and- Cassie Milligan: 100%. Bree Allred: Like, oh my gosh, all Cassie Milligan: these great connections. And adrenal Bree Allred: then, yes. And lots of people aren't looking [00:07:45] at all of those components. It's like, "Oh, you may just be getting the hormone piece." And it's like, "I'm still exhausted." Well- Cassie Milligan: [00:07:50] Yeah, yeah ... Bree Allred: has anybody looked at your iron? Has anybody looked at your thyroid function? Cassie Milligan: Yeah. Like, all of that. It's like, and the whole [00:07:55] thyroid. Yeah. Like, not just a piece of your thyroid. There is- really a [00:08:00] benefit of looking at the entire thing, and understanding the entire thing- Bree Allred: Mm-hmm ... Cassie Milligan: and why you're not [00:08:05] feeling optimal based on optimal levels. Bree Allred: Yeah. Cassie Milligan: Right? Instead of just, like, in range. Bree Allred: [00:08:10] Yeah. Okay. So let's go into just a little bit of what are, you're mentioning [00:08:15] optimal levels. Yeah. What does that look like? D- in your practice, in your basis of, [00:08:20] like, what do you think is optimal for people? Cassie Milligan: So the funny thing is, is everybody's actually different. [00:08:25] Okay. So yes, I have this range where, you know, when I draw labs, there, [00:08:30] there are these ranges off to the side that basically are based off of [00:08:35] white males, is what they did their research off of. Bree Allred: Don't we love that, right? Yeah. Like, here we are, a [00:08:40] female, and my norms are based on a- Cassie Milligan: Yes ... a Bree Allred: white male. Cassie Milligan: But white male, but also the ethnicity [00:08:45] issue is, I mean, thing, is a piece. Oh, yeah. Right? That because even, like, certain ethnicities will [00:08:50] have a different range. And so, like, what is optimal for me may be different [00:08:55] than what op- is optimal for someone else with a different ethnicity. Yeah. So yes, I [00:09:00] do look at a specific range to optimize. It is a lot more narrow- Mm-hmm is what I'm [00:09:05] looking at. But I also base it on the patient's symptoms. So it's not [00:09:10] just, "Here's a lab, here's a pill." It's about, okay, this is the symptom you're having. [00:09:15] Let's look upstream. Is it something to do with your thyroid or your adrenals, or is it [00:09:20] just your estradiol's off? Like, I mean, it's usually everything is off, right? Yeah. But it's, [00:09:25] it's looking at the bigger Bree Allred: picture. So you're getting the whole pie rather than like, "Oh, we're just looking at one sliver of it." [00:09:30] Cassie Milligan: Right. Yeah. So optimization is very different for everybody, so [00:09:35] that's why... I do personalized wellness plans for my patients, that no [00:09:40] one's the same. And yes, I'm looking at labs kind of the same, a little [00:09:45] different, but it really is based on their symptoms also- Mm-hmm ... and not just this [00:09:50] lab that I looked at. What this number says. Yeah. 'Cause labs can be wrong, symptoms usually [00:09:55] aren't. Right? So if someone's like, "I'm so tired," and their ferritin comes [00:10:00] back at 60, that's not optimal, but- [00:10:05] optimizing that to a better place. Maybe someone at 60, maybe you at [00:10:10] 60, you would feel okay. Yeah. Where someone else at 60 is like, "I feel like garbage. My [00:10:15] brain fog." You know what I mean? Bree Allred: Yeah. So it's a different- This is, I see that number go up, and all of a sudden your symptoms decline. Yeah. Like, that's the [00:10:20] number I'm Cassie Milligan: chasing. That's, yes, that is your optimal. Yeah. So yes, there is optimization, but it [00:10:25] really is based on every- Mm-hmm ... individual person. Bree Allred: And did you see the research that came out that, like, [00:10:30] iron levels are, like, doubling than they're recommended? Or at least iron intake- Cassie Milligan: Oh ... Bree Allred: has [00:10:35] doubled. Is doubled. Like, the recommended Cassie Milligan: intake. Like, dose, like for- Yeah dietary iron? Yeah. I mean, I could see [00:10:40] that. I feel like a lot of people's gut is off because, like- So Bree Allred: they can't absorb it, and then- Yes ... Cassie Milligan: then [00:10:45] we've got an issue And not actually absorb it. Bree Allred: Yeah. Cassie Milligan: Mm-hmm. Yeah, so. Bree Allred: Feel like so fun- ... to just [00:10:50] look and talk at all of these. When you're taking labs, if you do have somebody that's still menstruating- Cassie Milligan: [00:10:55] Yeah Bree Allred: are you trained to get a lab on a certain day of their cycle? Cassie Milligan: Yes and [00:11:00] no. So if they're regular, then yes, I do try and get [00:11:05] labs mid-luteal phase, which is usually about days 19, 20, 21. [00:11:10] Bree Allred: Okay. Cassie Milligan: If they are still cycling I usually do saliva [00:11:15] testing for for hormones, if they're cycling regularly. Yeah. If they're not, [00:11:20] whatever, like, it's gonna be off anyways, right? But again, I take into account [00:11:25] symptoms and not necessarily, necessarily where their labs specifically [00:11:30] are but they usually line up with that. Nice. So yeah, I do saliva testing, and I do [00:11:35] serum testing. So not at the same time, like, I don't do... Like, if I'm doing saliva, I'm not gonna pool [00:11:40] it in the serum. But yes, I do, I do check during a certain time of their s- their [00:11:45] cycle if they're regular. Yeah. But most of the women that are coming in aren't, like, really that [00:11:50] regular- No ... when they come to see me. But yeah, it, it, it is- [00:11:55] usually during a certain time of their cycle. Okay. Bree Allred: Mm-hmm. So you may be hitting, or you're trying [00:12:00] to hit where maybe their symptoms are the worst. Is that, Cassie Milligan: or- No, so that's where actually, like, their levels [00:12:05] should be about level. Bree Allred: Okay. Cassie Milligan: Right? So I am looking at are your [00:12:10] numbers kind of all falling into place during this time? Mm-hmm. Most [00:12:15] everybody's isn't really especially during perimenopause. Bree Allred: Yeah. Cassie Milligan: [00:12:20] So yeah, yeah. Bree Allred: Okay. Let's kind of shift gears for just a little [00:12:25] bit. When we talk about perimenopause- Cassie Milligan: Mm-hmm ... Bree Allred: what are we talking about? [00:12:30] Cassie Milligan: It's so funny because, like, we've been told for so long, right? That like, [00:12:35] You're just a woman, this is what you get to go through. Mm-hmm. Like, deal [00:12:40] with it, right? Yes. Perimenopause, actually women are starting perimon- menopause as early [00:12:45] as 35. So it really is symptomatic. It's perimenopause is getting [00:12:50] your body ready for menopause. Mm-hmm. So it's basically your hormones are gonna start declining. [00:12:55] Your ovaries aren't gonna be releasing the estradiol from your ovaries. That's [00:13:00] menopause, right? Is when your estradiol is no longer- Right ... being, yeah. No [00:13:05] longer being released from the ovaries. But it takes time. Mm-hmm. Perimenopause is a, like, it can [00:13:10] be years of perimenopause. But it's not just the hormones that are fluctuate. I mean, [00:13:15] yes, the hormones are fluctuating, but it's really the symptoms, right? That you're looking at. Like, I don't feel like [00:13:20] myself. Bree Allred: Yeah. Cassie Milligan: I'm tired all the time. Like, I'm having heart palpitations, and I don't know [00:13:25] why. I'm feeling more anxious. I'm gaining weight, and it's around my belly. This is your [00:13:30] body preparing itself for menopause. What's to come. Yeah, what's to come. But [00:13:35] it's 2026. Like, we can gracefully go through menopause. Like, I'm [00:13:40] not trying to optimize someone, as a 20-year-old. Mm-hmm. That's not what I'm trying to do. Bree Allred: And there are [00:13:45] some- Lines of thought, right? Yes. In your field, that that is kind of their [00:13:50] theory. Yes. That's Cassie Milligan: where- Yes ... Bree Allred: and once again, our goal is all the same. We have different ways- All the same sometimes [00:13:55] of going about it. Cassie Milligan: Correct. Bree Allred: But you're like, that's not necessarily in your practice where you're trained optimally, Cassie Milligan: I assume. No, I'm just [00:14:00] trying to help kind of guide them- Mm-hmm ... through into menopause where they're not [00:14:05] feeling crummy, where we're really, like, focusing on those symptoms. Mm-hmm. And [00:14:10] again, like, just looking at labs is gonna tell me a lot, and then pairing it with their symptoms [00:14:15] is gonna Bree Allred: tell me- Is gonna be more. And I love, like, one of the things that I've reiterated on here is, like, [00:14:20] you know your body. Yes. Trust it. Mm-hmm. Like, you know and trust those instincts, and just like you're saying, [00:14:25] your symptoms are going to tell me- So much ... more, and those are more what we're looking at. So it's like- Cassie Milligan: Yes ... Bree Allred: [00:14:30] what you are struggling with, what you know something being wrong in your body, that's what you're working [00:14:35] to- Cassie Milligan: Yes Bree Allred: be your end all game of, like- Cassie Milligan: Yeah ... Bree Allred: that's what we want is your symptom control. Cassie Milligan: [00:14:40] Yes. And I can usually, like, when someone comes in for an initial consult, I can usually- [00:14:45] like figure out like- Mm ... what is off just by [00:14:50] what they're telling me. And like I said, like I, yes, I check [00:14:55] hormones, but it's not just about the hormones, right? So what if their gut is off? [00:15:00] What if their liver is off? What if their adrenals are off? So it's really [00:15:05] looking deep and- Mm ... and more comprehensive because you can feel like [00:15:10] garbage and maybe it's just your adrenals are off, or you can feel like garbage and maybe it's like your gut [00:15:15] that's off. So, you know, we f- we focus on all of that- Yeah like the [00:15:20] whole, the whole package I guess to help that p- those [00:15:25] perimenopausal symptoms. And like I said, I usually can pull like just from someone coming in and being like, "This is what I'm [00:15:30] going through," I can be like, "Oh, this is probably off this..." And then I get the labs and- Bree Allred: And being like- Yeah ... "Yep, [00:15:35] I was right," or, "That surprised me." Yeah. "Something was different Cassie Milligan: than what I thought." Oh, no, there's always Bree Allred: like little surprises. 'Cause there's people like that in us where [00:15:40] it's like you get the history and you're like this, this, this, and this, and then it's... This is where I'm like we'll [00:15:45] probably do a future episode, but we're always like, "Check, don't guess." Like- Cassie Milligan: Yes. Bree Allred: Oh, yeah ... assess it, [00:15:50] don't guess it. Even though- For sure ... we're usually pretty good at guessing. Cassie Milligan: Yeah. Bree Allred: But there is some value of like, [00:15:55] okay, does the back end actually support what I'm finding- The front end ... on the Cassie Milligan: front end. Yes. [00:16:00] Yeah. And a lot of times it do- like, I mean, yes, a lot of times it does, but sometimes it doesn't. Bree Allred: There are some [00:16:05] wild cards in there where it's like- Yeah ... "Whoa, that surprised me." Yeah. Okay. Cassie Milligan: Where it's like, oh, that lab is actually normal- Bree Allred: [00:16:10] Mm-hmm ... Cassie Milligan: but I usually can pick it up somewhere else. Yeah. Yeah. And so, [00:16:15] yeah, even with perimenopause, you're, you do wanna kind of have a full body approach and doing more [00:16:20] comprehensive lab work. Yeah. Just taking a deeper dive in, into health. Bree Allred: Super cool. Cassie Milligan: Yeah. Bree Allred: [00:16:25] Okay. I'm just gonna check based on your knowledge. I tell people this sometimes [00:16:30] when we're talking about perimenopause, I almost say that it's like the little jets on a rocket [00:16:35] in space- ... where you feel like a psht, psht, psht, psht. Cassie Milligan: Oh, yeah. Bree Allred: Dude, and it's like sometimes it decides to do [00:16:40] like a, "Okay, both engines are on." Cassie Milligan: Mm-hmm. " Bree Allred: Oh, we're just spurting a little bit here and there." Yeah. To where it's like we get [00:16:45] these big fluctuations, and I'm like, I don't know why, but that just sat with me as an analogy or a metaphor [00:16:50] for it. Yeah. 100%. That it's like, it's just these little things like jetting off a little bit, and they're doing it really randomly. [00:16:55] Sometimes they decide to go full bore. Sometimes it's like, oh, one is doing this, and the other one's [00:17:00] misfiring, and it's kind of going this- Cassie Milligan: 100% ... Bree Allred: just up and down and up and down- Yes ... and up and down. That's why- Which is why sometimes you're like, [00:17:05] "Okay, I'm not crazy. I'm feeling great." And then other days you're like, "What happened to me?" What is, yeah, Cassie Milligan: why am Bree Allred: I crazy? Something's going on. Yeah. [00:17:10] Oh, Cassie Milligan: great. Yeah. And I mean, that is really not just [00:17:15] your estrogen, progesterone, testosterone. It can be your estrogen having [00:17:20] these surges. So because it's preparing your body to not have [00:17:25] estrogen anymore. Mm-hmm. So you do get these surges where it's releasing a lot, and you have, like, this really [00:17:30] heavy period one month, and then the next month, like, you have nothing, and for two months you don't [00:17:35] have a cycle, and then, like, one month you have, like, just light spotting, and this is [00:17:40] perimenopause. Yeah. This is what's happening. And, and you can definitely support that with [00:17:45] certain things, right? Mm. Certain hormones to help balance that. Bree Allred: If I am a woman [00:17:50] my age- Mm-hmm I'm 43, for all of your viewers. 43. Okay, [00:17:55] 43-year-old woman, and I'm sitting here being like, "I don't feel like myself anymore." Mm-hmm. [00:18:00] Let's talk about maybe the top five symptoms that somebody, that you're hearing recurring in [00:18:05] your office, and maybe the culprit that you're automatically thinking about it. Cassie Milligan: Okay. The big [00:18:10] one, I don't feel like myself- Mm-hmm ... right? Is, is a huge one that most women come [00:18:15] in with, with that. The other thing is, like, I used to sleep so good, [00:18:20] and now I either have struggle- troubles, like, falling asleep or staying asleep, or [00:18:25] both. I am gaining weight in my abdominal area, and, like, [00:18:30] I've always had a really good metabolism, and I feel like my metabolism isn't as great. A [00:18:35] typical night sweats, hot flashes, right? Even at 43, like you can be like, [00:18:40] "Oh, I had like maybe a hot flash. I don't know if that's what it was, but like I'm [00:18:45] waking up warm every night or I'm waking up in a pool of water." Mm-hmm. You know, like [00:18:50] sweat. That's one. The weird ones, my ears itch. [00:18:55] That's like one. Yeah. Bree Allred: Where you're like trying to get that weird like- ... how do I itch the back of my throat [00:19:00] and scratch my ear? Yeah, Cassie Milligan: my ears itch. Or joint aches. I get a, I get a lot of that. [00:19:05] Bloating. So those are kind of like what are pulling people [00:19:10] in. Just fatigue- Bree Allred: Yeah ... Cassie Milligan: is probably another huge one. I would say sleep and [00:19:15] fatigue, and I think a lot of people think that, "Oh, well I'm not sleeping so I'm tired," but there [00:19:20] can be more. Bree Allred: Yeah. Cassie Milligan: More to it. Bree Allred: Well, and I would say I'm getting seven to eight hours of sleep a night, and I still [00:19:25] wake up and I'm like- Cassie Milligan: Yeah ... " Bree Allred: Okay, here we go." Yeah. Like not fully rested. Do you feel- I have the energy or- Yeah. Do you feel rested? Mm-hmm. Like [00:19:30] Cassie Milligan: are you, you know, tired all day long? Bree Allred: Yeah. Cassie Milligan: Yeah. So when I hear [00:19:35] those symptoms, I mean, yes, I'm gonna pull hormones, I'm gonna pull thyroid, but a lot of it [00:19:40] can be your adrenals. It can be your gut. So just really focusing [00:19:45] on getting the right labs- Mm-hmm ... the comprehensive [00:19:50] labs is something that I'm gonna be looking at. And then once I get those, I [00:19:55] usually can be like, "Yep, this is what's off." A lot of times it's our adrenals. I feel like [00:20:00] we as women, we are kind of just told, "This is your life."[00:20:05] Yep. Like, "Move on. Basically you just have to ride the wave." But I also feel [00:20:10] like we have a lot of stress. We have kids, and we've gotta go home, and, like, take care of [00:20:15] the family, and that's like a lot of pressure. I mean, us as business owners- Yeah ... like- For sure. It's like we work a full-time [00:20:20] job I try to Bree Allred: like plus. Yeah. Plus this. And go on. Yes. Mm-hmm. I Cassie Milligan: just, I feel like we are [00:20:25] almost told that, like, we have to be like this. We have to, like, put on a [00:20:30] smile and pretend like everything's fine, and that really actually can [00:20:35] disrupt not just our gut, but our adrenals. And so you know, making sure that you're, you're [00:20:40] checking those is like- Yep really important. I do adrenal testing in saliva, and the [00:20:45] reason why is because if I was to check your cortisol levels in blood- [00:20:50] The most accurate is getting that cor- that morning [00:20:55] cortisol withi- within 30 minutes of waking up. So I always tell my patients this, like, if you're gonna do a morning [00:21:00] cortisol and you wake up at 5:00, like, what lab is open at 5:30? Like, [00:21:05] none, right? Yeah. And so getting that morning cortisol within that 30 to [00:21:10] 45 minutes of waking up really gives me, like, a bigger picture, a more accurate picture of, like, [00:21:15] what's going on with your adrenals. Mm-hmm. So checking the adrenals. Yes, checking the [00:21:20] hormones, right? Like I said, I do it during certain times of the cycle if needed. If you're [00:21:25] irregular, like, I can't really catch your cycle so I'll just kinda check them. But I'm, [00:21:30] I'm not going off the lab value. I'm going off of your symptoms. How it feels. Bree Allred: Mm-hmm. Cassie Milligan: Yeah. So- Bree Allred: The lab [00:21:35] value is just another thing to help... It's another piece of the puzzle- It is ... to give you some guidance and direction. Yeah, Cassie Milligan: [00:21:40] 100%, Bree Allred: but it's- But it's not the Cassie Milligan: whole picture ... it's not the whole picture. So I, again, I don't treat a lab value, I treat a [00:21:45] patient- Yeah ... and their symptoms. Bree Allred: Yeah. If you have somebody that doesn't know medical stuff, let's [00:21:50] talk about just real basics, like what are the adrenal glands? Cassie Milligan: Yeah. So our [00:21:55] adrenals they release cortisol, which is our fight or flight. Cortisol is actually really important. It helps us, [00:22:00] like, get up and get going in the morning, so it should kinda spike in the morning, and then it should [00:22:05] slowly go down and be at its lowest kind of at the end of the day where melatonin spikes. Sure. It's our sleep hormone, [00:22:10] right? So those adrenals, it's, they, there's two of them. They sit on top of our, our kidneys, [00:22:15] and they do more than just release cortisol. It's actually [00:22:20] post-menopausal. It's gonna release some of our estrogen. Hmm. Interesting. Yeah. So it releases a [00:22:25] hormone called DHEA. So there's a bigger picture of adrenals, but that cortisol [00:22:30] is actually really important to look at. So that is our fight or flight, but it [00:22:35] also is, like, it's, it, it is meant to be our fight or flight, right? It's meant to help us with [00:22:40] kind of stress and- Yeah ... and our threat. And it's a good thing. We need that, right? We need it. We [00:22:45] need it. Yes. And when it keeps going and doesn't calm down is when we have a [00:22:50] problem. Right. And so, like, if you continually are spitting out too much cortisol, [00:22:55] your adrenals are like, "Mm, no more," and that morning cortisol can fall. [00:23:00] And with the symptoms of I'm not sleeping, that can be your cortisol's [00:23:05] high at night instead of low at night. Hmm. Yeah. All the different factors that [00:23:10] play into all that. Bree Allred: All the different factors. There's, there, our body is so [00:23:15] fascinating. Yeah. And it really does try to compensate in places that it needs [00:23:20] to. But a compensation is not meant to be the primary drive either. No. So that's, I think, where [00:23:25] we get into troubles is when the compensatory mechanisms are actually now the primary mechanisms. Cassie Milligan: Yeah. And Bree Allred: like- [00:23:30] And they're not meant to be the primary mechanisms- No ... and they burn out. Cassie Milligan: Burned out. Yeah. [00:23:35] Yeah, so you have to, that's why I say you have to take a full body approach, because if your adrenals are off, it [00:23:40] affects your thyroid, and if your thyroid's off, it affects, like, your hormones, like your sex hormones.[00:23:45] So it is kind of that bigger picture. And the gut, the gut's a huge, a [00:23:50] huge piece. Bree Allred: Yeah. Nutrition, the fuel that you're feeding the back end- Yeah ... as it goes, and [00:23:55] can the digestive system adequately absorb what you're bringing in? If you were to [00:24:00] dumb down hormones for me as best you can. Do you know, I mean, I know they're complex [00:24:05] beings. Yeah. They really are- Yeah ... if we were to give them personalities. But if you had to give them, like, a, [00:24:10] I don't know, think of, like, an inside out version of the- Yeah hormones, what would you say they do? Cassie Milligan: Hormones [00:24:15] basically, like, tell our cells to do something. They, [00:24:20] I mean, like, how do I explain hormones? Yeah. They kind [00:24:25] of, they attach to a receptor site and tell it to do something, kind of like a [00:24:30] peptide. Bree Allred: Mm-hmm. Cassie Milligan: Peptides are a little bit different than hormones, 'cause hormones can actually go, like, into the cell [00:24:35] and, and give instruction. So there's different hormones for [00:24:40] different parts of our body- Mm-hmm and help with regulation. So when, I think a lot of [00:24:45] people, when they hear hormones, they just think sex hormones. Mm-hmm. They're like estrogen, progesterone, testosterone. [00:24:50] But there's more than that. There's thyroid hormones. There's adrenal hormones, [00:24:55] right? There's, I mean, there's a spectrum of these hormones that you're looking at. Vitamin [00:25:00] D is a prohormone. Like, we actually need vitamin D to help with hormone processes. [00:25:05] So you can kind of count it as, like, a hormone. Mm-hmm. So they're gonna go and attach [00:25:10] the cell to, a receptor on a cell to tell it to do something, right? Bree Allred: They walk [00:25:15] across the room and flip on the switch. Yeah. Is that a good example? Yeah. It's like- Yeah ... oh, like, I'm [00:25:20] over here. The brain is being like, "Hey, we need to do this." We need this. Right? And then they're saying, "Okay, [00:25:25] number one- Mm-hmm ... you go tell them, turn on the switch so that they'll do this." Cassie Milligan: Yeah. [00:25:30] Yeah. Does that make sense? Yes, it does. Great. Okay. Yeah. So if you were to give estrogen a [00:25:35] personality, what does estrogen do for us? Estrogen helps our mood. It [00:25:40] actually, like, the personality, it, I mean, estrogen is so beneficial in men [00:25:45] and women, not just women. Men need estrogen. So I see men [00:25:50] too. When they come in and they have zero estrogen- Mm-hmm ... it's very [00:25:55] concerning, 'cause they can have bone issues. Yeah. So, like, yes, estrogen [00:26:00] does help our mood. Like, we need emotions. It's okay to cry, right? You don't wanna cry all [00:26:05] the time. Yes. That's usually, like, an estrogen dominance. But it does help kind of balance [00:26:10] us. Bree Allred: Mm-hmm. Cassie Milligan: It is a, a hormone that helps with cardiovascular support. [00:26:15] It helps with bone support. It helps with gut support. I mean, there's so many receptors- Muscles ... [00:26:20] in our brain. Yes. Like, all the things. Yeah. So it's kind of like the [00:26:25] master, like, I would say, hormone. Okay. Yeah. Bree Allred: That drives things. Okay, if we were to [00:26:30] say progesterone's job or personality. Cassie Milligan: I would say progesterone, so it's kind of [00:26:35] like our, like our calming joy. Yeah. Like, I think of, like- Yeah ... joy on, like, inside out. [00:26:40] That's progesterone. Kind of like... Yeah, just like let's be happy, but it also helps with our [00:26:45] sleep. So it's very adrenal supportive. So it does help us, like, fall [00:26:50] asleep and stay asleep, but it is kind of our, our calming [00:26:55] hormone. It does make us... I would say maybe oxytocin is a more- ... a little more for joy. Bree Allred: [00:27:00] Yes. Cassie Milligan: And progesterone is just kind of that calm. Bree Allred: Nice. Cassie Milligan: It's definitely calming. It's Bree Allred: your [00:27:05] Cassie Milligan: whew. Yes. It's gonna balance that happy estrogen hormone. It is a very balancer. [00:27:10] Bree Allred: Yeah. And estrogen, just like you said, estrogen and progesterone can kinda counteract each other and [00:27:15] help each other along. Yes. When I'm talking about it in a uterus perspective. Cassie Milligan: Yeah. Bree Allred: I would give... I tell people, I'm [00:27:20] like, "Estrogen's the fertilizer. It's growing everything." Cassie Milligan: Mm-hmm. Bree Allred: And you gotta have progesterone to [00:27:25] mow it down. Cassie Milligan: Yeah. Bree Allred: It's like- To balance Cassie Milligan: that ... ' Bree Allred: cause otherwise you're getting overgrowth of everything. Right. Tons of [00:27:30] fertilizer is great till you don't have a mower to mow the grass down. Cassie Milligan: Right. Right. Yeah. And [00:27:35] yes, progesterone is great for our uterus, right? But it's also good [00:27:40] for our brain health and our gut health. So just because someone doesn't have a [00:27:45] uterus doesn't mean they can't have progesterone. I know that that is something that some [00:27:50] patients have been told. Bree Allred: Mm-hmm. Cassie Milligan: And that is not correct. Like, you can have [00:27:55] progesterone if you don't have a uterus. You can't have progestin, which is, you know- No ... birth control- No ... synthetic progesterone. [00:28:00] But absolutely you can have progesterone. It is very brain [00:28:05] supportive, adrenal supportive, gut supportive. Bree Allred: So great. Okay, if we're talking testosterone. [00:28:10] Testosterone's personality. That's our personality. This is our personality, right? It's our [00:28:15] motivation. Mm-hmm. Cassie Milligan: It's their drive. It's our endurance. It's, you know, building that [00:28:20] muscle. It's kind of... Yeah, it's that... I mean, if you have too much, it's our [00:28:25] irritability, it's our aggression, but if you have the right amount, it's our, it's our drive.[00:28:30] Bree Allred: Great. Yeah. Mm-hmm. Okay, those are the main three that I think about. What would you say are some of the other major [00:28:35] players that we should give a personality to? Cassie Milligan: Thyroid. Bree Allred: Okay. Cassie Milligan: Thyroid is our [00:28:40] master, kind of our master gland. Like, it really helps regulate everything. So [00:28:45] I would say maybe the personality is the captain right it's of of the ship.[00:28:50] Bree Allred: Uh-huh. Telling everybody what to do. Cassie Milligan: Yeah. Really helps with e- re- I mean, there's thyroid [00:28:55] receptors on literally every organ in our body- Okay ... to help with regulation. Bree Allred: Nice. What's [00:29:00] another major player? Any? Cassie Milligan: DHEA. Okay. Bree Allred: DHEA- And you said that's in the [00:29:05] adrenals- Cassie Milligan: That is- ... or in an Bree Allred: adrenal Cassie Milligan: hormone? Yeah. There's... I mean, 80, 80% of our DHEA is DHEA [00:29:10] sulfate. That is released from our adrenals. The other 20% is released from our [00:29:15] ovaries. I do check DHEA sulfate, right? But this is... I... What kind of [00:29:20] personality? Like, this is gonna help with, like, conver- conversion from, like, estrogen in [00:29:25] females to testosterone in males, so it's, like, kind of like maybe the bus driver getting your hormones going [00:29:30] down the right pathway- Bree Allred: Okay Cassie Milligan: would be, like, your DHEA, which is really, really important [00:29:35] to look at. The other one is sex hormone binding globulin. Ooh. SHBG. [00:29:40] Bree Allred: I've never heard of that one, so let's talk more. Cassie Milligan: Yes. This is a really important hormone, [00:29:45] actually, because this kinda tells me how your hormones are being processed. Mm-hmm. It helps with kind [00:29:50] of- Put, like helping bind them estrogen and testosterone to be [00:29:55] pushed to the liver to be methylated, and then it helps with the excretion. So it's kind of like [00:30:00] making sure, like another guide to get you through the entire process. If you [00:30:05] don't have enough SHBG or if you have too much H- SHBG, it really does affect the way [00:30:10] that our hormones are processed. Okay. Bree Allred: So Cassie Milligan: that's a huge one. That is one that I always check [00:30:15] with all my hormones is sex hormone binding globulin. Bree Allred: Okay. I love it. Any others that you would [00:30:20] kinda tell, you're like, "Okay, these are..." You're like, "There's so many," but- There's so many. Cassie Milligan: But- You're Bree Allred: like, "How many do you wanna know?" ... you know, we could keep going Cassie Milligan: with Bree Allred: [00:30:25] that. Basically let's say one more major player. Cassie Milligan: I mean cortisol. Bree Allred: Okay. Cassie Milligan: [00:30:30] Cortisol is, is... I mean, I think people think cortisol is bad. It can [00:30:35] be if you have like an overabundance of cortisol, but it's actually really important, and [00:30:40] it's important to kinda keep it level- Yeah ... and where it, like in range where it needs to [00:30:45] be. How would I explain cortisol? I don't know like, kind of like what personality, I don't know like [00:30:50] what specific personality- Probably your ramp-upper, right? Yeah. It's like it keeps everything like elevated and heightened- Yeah ... [00:30:55] and like, "Okay, is a bear gonna get me?" Yeah. It sounds silly, but it's that- It [00:31:00] is that That- Yeah, it's that- ... that elevated, heightened- Mm-hmm ... kind of state. Yeah, and it's gonna help us like [00:31:05] get through that heightened state. It's your get up and go. Yeah. Mm-hmm. It's our fight or flight, right? Yeah. Your get up and goer. [00:31:10] Yep. ​ [00:31:15] [00:31:20] [00:31:25] [00:31:30] [00:31:35]