Hey, everyone drew Manning here from the fit to fat to fit experience podcast thanks guys for tuning in today for another great episode. And I appreciate you guys tuning in tuning in each and every week. Um, today’s episode is another great one and you guys will definitely, you definitely do not want to miss this episode with a good friend of mine. Uh, dr. Andra Kent patella is her name. She is from Toronto. She lives in Canada, born and raised. Um, she is any, uh, North American naturopathic doctor. She’s a media expert, she’s an educator. Um, she has her Toronto based practice up there. She received her, um, bachelor’s of science and biomedical sciences with a minor in French studies. So she’s fluent in French. And, uh, and from the university of Gulf of Gwelf, I don’t know how to pronounce it. I don’t speak French.

Anybody’s um, very, very smart person. And she does more Thai cup Huerta. She has a background in dancing. So she is a beast in today’s episode. You guys, as we talk about so many great topics, I think you guys are really gonna love this. We talk about balancing hormones. So we talk about bioidentical hormones versus synthetic hormones. We talk about, uh, the man boob problem, which a lot of people have asked me about, especially guys, you know, I would, during my fit, tried to fit experience. I grew some pretty, you know, I would say big man, man, boobs. Uh, but so many people will suffer from this and it’s a hormone imbalance, and we’ll get into the specifics of how to treat that. Uh, we also talk about women and, and thyroid function. We talk about erectile dysfunction and sexual health and both men and women, and how to fix that we talk about.

And just so you guys know for warning, I do open up and talk about my penis in this episode. So I’m just throwing it out there just for warn you guys that open up and I’m pretty vulnerable about it in this episode, but I feel comfortable talking to her, dr. Andy, she’s a doctor, um, a lot of great topics here in this episode, um, with dr. Andra Cappotelli, I call her dr. Andy anyway, so you guys will love it. So it’s just stay tuned, hold tight. It’s going to be a great one. Before we jump into the episode, though, a quick shout out to our show sponsors, uh, Everly, well.com is a company that I’ve been working with for the past few months now. And I love this company. I love what they do, and actually ties into a little bit, um, about what the episode’s about.

We talked about hormones, right? And getting your hormones tested. Uh, what I love about Everly well is they make it so much more convenient to get your hormones tested. Instead of having to go into a doctor’s office, scheduling an appointment, waiting around, drawing a ton of blood and getting the results back that you don’t really understand what the numbers mean. Every we’ll send you the kit that you order online to your house. You do the tests in the convenience of your own. So it’s either a blood or urine sample, usually depending on what test it is. And you, um, you follow the easy to follow instructions that they give you and you put it into the devices that they give you it’s super easy. And you, uh, you mail it off in a prepaid package through ups, or you can schedule a pickup at your own house, even that’s how convenient it is.

But we talked about the importance of, uh, of getting your hormones tested. Well, everybody well.com makes that so much more convenient for you. So you know where your hormones are at. So, you know, what’s optimal for you. So, you know, if you’re suffering from low testosterone or, or your high cortisol levels, uh, or your thyroid, even which so many people have problems with everybody, well.com makes it so much more convenient. So check them out, go to [inaudible] well.com forward slash fit to fat to fit or use my discount code fit to fat, to fit, and you’ll receive 10% off any of your tests that you order through them. Um, so like I said, I couldn’t be happier to be working with Everly well.com. The next sponsor is quest nutrition. Um, you have heard me talk about quest nutrition for years. They’ve been supporters of mine since the very beginning of my fit to fat, to fit journey.

I love what they do. They’re on the forefront of the supplement industry, in my opinion, as far as, um, being this juggernaut, but also being ahead of the game so that they aren’t all, so they’re not, you know, becoming irrelevant, irrelevant, here they are. They’re still on the forefront. In my opinion, everyone knows that for their quest bars, right there, protein, high protein, low carb bars with a lot of fiber and a lot of, um, or a little sugar, sorry, almost set a lot of sugar, a little, very little sugar in their protein bars. Cause most protein bars are just honestly, uh, candy bars with protein in them, right? So, um, I’ve always been a big fan of their protein bars. I don’t do a lot of whey protein nowadays doing keto, which is why I love the fact that they have offered a Kita line of products.

If you go to quest to quito.com, you’ll see a full lineup of delicious tasting food. That’s keto friendly things like chocolate bars and, uh, peanut butter cups and, uh, frozen meals and desserts nachos. I even have even seen, you know, they have chips that are keto friendly crackers that are in my opinion are way better than even Cheez-Its you guys trust me, go try some of their keto crackers. They are delicious. Um, anyways, uh, go check out quest nutrition.com or quest kito.com for their products. We’re a huge fan of theirs and super grateful for their support of this podcast. All right, let’s go and hang out with dr. Andra. Cavatelli Dr. Andy, welcome to the fit to fat, to fit experience podcast. How are you doing today? I’m good. Thanks for having me. Hey, my pleasure, honestly, and you’re coming to us all the way from Canada. See what I did there.

And you, you used it the right way as well, so

I’m sure you never get that from Americans, right.

But it’s always in the wrong spot. That was good though.

Okay. I’m I’m learning.

Great.

So you’re from Toronto.

I’m from Toronto, born and raised in Toronto. Spent most of my time here. Most of my life here, my family is out here. So it’s a, it’s a great city.

Yeah. And, but with the last name can patella, I mean, assuming you’re part I’m Italian, right?

I’m actually, I’m half Italian, so I’m mixed. I’m half Italian, half Jamaican, but born and raised in Toronto.

Oh wow. That’s, that’s an awesome mix. I like that. Have you ever been to Jamaica?

You know what? I have, I’ve been a few, I’ve been a few times when I was younger and then my brother got married there about four years ago. I hope I got that timeframe. Right. Um, so we all went back down for his wedding, which was great.

That’s awesome. So your mom’s from Jamaica, right?

My mom’s from Jamaica and then my dad’s side is the Italian side.

Okay. Cause I don’t, I don’t really hear a lot of the Jamaican accent in there.

No, definitely not Canadian. That’s it? My mom doesn’t have an accent either. So there was no.

Oh, okay. So she didn’t grow up there. She grew up in Canada too.

She was born there, but she moved out of, um, the move to Canada when she was about five or six. And my, my grandparents actually have British accents. Um, cause it was a British colony at the time. So yeah. So I didn’t, I didn’t pick up anything. Mine’s just pure Canadian.

Gotcha. No, that’s super interesting. I love talking about this stuff. We better get to some other important topics cause otherwise people are going to be wondering, is this, are we just listening in on like a date between these two or what? So okay. Health and fitness. Okay. No, anyways, let’s start with your story a little bit, kind of introduce us to who you are, what you did growing up, what your passions were and then what led you to become a doctor? First of all.

So growing up, I was a dancer. So I danced most of my life. I was on ballet was sort of my primary focus. And then as I transitioned at a dancing, I moved a little bit more into the fitness industry. My brother introduced me to that and I got in, I became a personal trainer. Um, I trained all the way through school. So I’ve always sort of had a passion for the health and fitness industry. Um, and growing up, my family was always very healthy. My mum would make really great healthy meals and put them on the table and tell us the nutritional value of everything she put on the table. Um, which was great. That was a great way to, uh, to grow up and to learn. So I’ve always had, I’ve always had a passion for health. Um, and then according to my mother, I’ve wanted to be a doctor since I was about three. So it was just sort of a natural progression to kind of merge, um, merge the two into the profession that I’m in now.

Interesting. So you, and I remember you telling me you went to school for a long time. How many years did you go to school for her?

I did a long time. Eight, eight, long years post secondary. Um, so four years undergrad, four years post grad. Uh, so I’m, I am happy to be done with that. That’s for sure.

Gotcha. Yeah, of course it takes a long, long time to dedicate to going to school.

Exactly.

Yeah. It pays off now and that’s really cool that you grew up with that passion of health and fitness as a base now with your mom kind of feeding you guys healthy meals and, and implementing that. Did that ever cause you at any stage in your life to want to quote unquote rebel or, you know, um, wander outside of that health world? Cause I feel like for me having kids sometimes I’m like, okay, am I overdoing it by teaching them too much about health where they’re just every time they go to their friend’s house, they eat Oreos or, you know, junk food. Cause they’re like, wow, my dad never gives me that. So I’m just curious how it was for you.

You know what? My mother did a good job of getting some great balance in there. So my family we’re really big about family dinners. And so even though she was really healthy, there was always food and wine and things like that. And you know, she had her little treats that she ate every now and then. And so we had no Friday night was pizza night. Um, so she was, she was good at incorporating those things. And you know, we used to get report card treats for good grades and mine was always red licorice and she absolutely bought, so she was good at making sure we were still able to get those things, but 90% of the time we were eating well, um, she made lunches for us that she knew we would love, so she knew would eat them. So she had, she did a great job, I think, of creating a ballot. So I never really felt the need to rebel or to do something completely different.

Yeah. Yeah. Interesting. So I just kind of wanted to give a little bit of a background of how we met, cause I didn’t really talk about that in the beginning. So dr. Andy and I actually met in Tampa at a Quito conference, which we will touch on a little bit of Quito, but that’s not why I wanted to bring her on. Um, I think her specialty is more so in the area of, of hormones and balancing your hormones. And so we will dive into that a little bit of keto, but I just wanted to let everybody know how I met you and how we connected. And I’m grateful we did meet because here you are today, uh, dropping a lot of knowledge on us.

No, and thank you for having me. I love to share. I’m sure as you know, so this is great. I’m happy to, I’m happy to do it.

And this is your first podcast. You said it is. Wow. Welcome to the world of podcasts. It’s super easy. Okay. So, uh, shifting gears here a little bit. So what made you want to dive into hormones specifically? Um, or was that of, um, how did that come about?

Right. So it was an interesting progression into that. Um, I initially started more focusing on sports medicine cause I come from such an active family and an active background. So sports medicine was more what I was moving towards, but just, it just happened naturally based on patients who are coming in men and women. And a lot of the conditions I was treating seemed to STEM from hormonal issues. And I do a lot of, um, metabolic balance, weight loss, detoxification. And I always felt that we kept coming back to hormones. It just seemed that that was sort of the underlying factor for most of my patients. So it was just a natural transition into that. So that seems to be what I, and I, and I love doing that as well. So that, that turned into the primary focus of my practice.

Interesting. And so that’s kind of what you, you focus on nowadays, but you also focus on other things like weight, uh, weight management, um, gastrointestinal and immune health as well. Right.

So I do a lot of digestive problems that probably stems a lot from me growing up. I had a lot of food sensitivities, so I had a bit of a struggle figuring out, you know, getting myself on, on track from a dietary standpoint as well. What worked, what didn’t and I’m sure everybody knows all the crazy misinformation out there. So, um, yeah, so I love, I love helping people really find from a nutrition standpoint, what actually works for them. So solving everyone’s got digestive problems when they come in. Um, yeah. So solving that and that usually the nutrition part usually stems into weight management. So it all kind of rolls into, into each other.

Yeah. Uh, one thing we have in common is that we’re both lactose intolerant. It sounds like you though a little bit more extreme though, to where it kind of cripples you, right. If you have certain kinds of dairy, right. Or is it all dairy?

You know what? I can do a goat milk and sheep milk so that I can do, but any cows milk, not at all that has to be entirely out of my, out of my diet,

Even in different forms of like cheese or creams or ice cream. Of course.

Yeah. No ice cream is ice cream. For sure.

Yeah. I know. I know how that goes. Um, okay. Let’s, let’s dive into hormones then, because I think this is a big thing. And when I tend to think of hormone balance, I mostly think of women tend to struggle with it more. Is that your experience or do you see more or an equal amount of men who either maybe don’t talk about it as much or what, from your experience, what do you see?

I think it’s more, um, the second point that you made is that men don’t talk about it as much. And I think, you know, for men, testosterone starts to decline after 30. So the same way women will lose estrogen and go into menopause. Men, men have that same. They have that same path with the decrease of testosterone, but because we don’t talk about it as much, you know, as men of transition, they don’t bring it up as much. And so a lot of men don’t realize that their mood changes or their inability to lose weight, um, or, you know, inability to build muscle that those might actually be hormonally related and not, uh, not necessarily something else. So it could be that their testosterone or something like that is impacting their ability to meet their health goals. But you’re right. They don’t talk about it quite as much.

Yes. Which is interesting. And I’m definitely a big proponent of this, of getting your hormones tested because here’s the thing is like when your hormones are not in balance, you’re a different person. Like you’re not you. If your testosterone is low, your estrogen is high. Your hormones are out of whack. You’re not who you’re supposed to be. Right. You’re not always a pleasant person to be around. And I kind of referenced this from my fit to fat, to fit journey where, you know, I be gaining senpai pounds in six months was crazy. Yes. And physically, yes, I had man boobs and a love handles, but more so it was interesting how it affected me on a hormonal level. Right. It really did change me. My, my ex wife, Lynn always makes fun of me because she’s like, you turned into a girl, you were always asking if this made you look fat or are you like, I don’t look good in this. I don’t want to go out, um, you know, those kinds of things. She, she joked around, but I really do remember my testosterone was really low, but on top of that, it was, Oh, it was a bunch of things. My sleep was off, obviously eating all those, you know, highly processed foods affected it as well. Um, so when it was, I can relate to that, but let’s talk about what are some of the main things that causes people’s hormones to be off that we can, you know,

That we can fix. Right. So it’s really interesting. Cause a lot of people will come in men and women and they’ll say, I think my hormones are low. Just give me some hormones, but that’s all they want. They just want the hormone testosterone. And that’s it. Um, but you’re right. I mean, as you were mentioning before, there are so many contributing factors to those hormonal changes. So for you, that’s such a perfect example. When you gained that weight, you, you noticed that change in your, in your hormones and then how that affected your health. So, um, I think one of the primary things for sure would be weight gain and poor diet. That’s one of the most common underlying causes of hormonal imbalance in men and in women and men that seems to tank the testosterone, increase the estrogen. And then in women, same thing, they seem to, um, they seem to increase testosterone and increase estrogen. So we end up in this situation where both men and women end up in this estrogen dominant picture, um, and then kind of freak out a little bit cause I do estrogen detoxes in men and they, and it kinda throws them off a little bit.

How does that work? I’m so curious about that. I don’t think I’ve ever heard of that.

No. So what I’m essentially doing is trying to help their body clear and process the excess estrogen. Um, and so I want to make sure that while we’re those lifestyle and dietary changes, I’m helping because if, especially if they’re gaining weight, the fat cells also will contribute to higher estrogen levels in men. Uh, so, you know, people will say they have like the man boobs and things like that, that that’s estrogen. And so you need to, so when you help to clear that estrogen out using specific supplements while we’re doing dietary changes, that kind of helps to, to bring that down as well. And that’s again, both men and women who need to balance out that, um, that estrogen dominant picture. Yeah, go ahead. No, no. I was going to say, and then in women, same thing, that’s where they get a lot of, um, you know, women who will come in with endometriosis, PCLs fibroids, things like that. And they’re told that there’s no solution for that. And really that’s often because of estrogen dominance that they need to, that we need to treat together to, to help manage those conditions.

Oh, it’s so interesting because I have so many guys that reached out to me, um, asking about the man boob thing. Right. You know, how, what exercises can I do? How can I get rid of this? When in reality it’s not about the exercises, you know, you can do as many pushups as you want. Right. Um,

And human, yeah. And even fit healthy. Men can still have those. They can still have that excess tissue because even if you’re, you know, healthy and in shape, you can still have an estrogen dominant picture and low testosterone, which, which is so confusing for them. Cause they think I’m healthy, I’m exercising and eating well, I don’t get it, but there’s a hormonal component that they need to address there.

Interesting. So what are the supplements that cause this estrogen to be depleted or to help clear it out or help clear it up?

Yeah. So there are a few, my three favorites is three C is indole three carbinol. Um, the other one is dim. So just I dim. Um, and then calcium D glucarate. So those are usually my three favorites when I’m trying to clear excess estrogen out of the system. And I’ll use those again in both men and women. And then I also will probably add in a few things from an inflammatory standpoint. Cause most of us are inflamed if people are over-training they’re also, they also might be creating a bit of inflammation. So I do, I manage the inflammatory picture and then try and help the body to clear out that, to clear out some of that excess estrogen.

Now let’s say for example, um, someone’s listening and they want, they Google those three supplements. They just go by them thinking, okay, my man boobs are gonna go away magically. Um, do they need to, I’m assuming you would need to get your hormones tested first to know where your levels are at to see if the supplements would be ideal for you. Correct.

Right. And it’s more than just a blood test cause a blood to blood test will just give you your hormones at that specific period of time. Um, so I tend to do multiple hormone testing. So we’ll do blood work for sure. Just to get that snapshot. Um, and bloodwork is obviously easier to do and easier to track. So we’ll do you know if we want to do follow ups, they’ll do blood work every three to six months. Um, but I tend to do salivary hormones or urinary hormones, uh, depending on what it is I want, I want to see in that situation, I’m probably gonna do a urinary hormone test. Um, it’s a take home test and you take a urine sample at four different points in the day. So we get a really good picture of what your hormones are doing all day. And it also gives us a really good picture of how your body is breaking down and processing your hormones. So we’ll get testosterone and testosterone, metabolites, we’ll get estrogen and estrogen metabolites. And are you pushing along the healthy or the unhealthy pathway? So you get so much more information from that urinary test. We also do cortisol, which is essential when we’re trying to balance hormones as well. So I like the urine testing. So I get a really good overall picture of what the body is actually doing with the hormones once they’re in there. And then from that, we start to make a treatment plan of where we, of what we need to address specifically.

Gotcha. So getting the hormones tested, here’s the thing I think people are like, okay, I need to do that. But they don’t, I don’t know. Maybe most people think it’s inconvenient to make an appointment at a doctor’s office, go through the insurance or you know, how do you go about doing that? What’s the simplest way for people listening to get their hormones tested and which hormones they know how to test, you know, like do they just get all of them tested? Those are questions that I get that I’m passing it to.

It depends on the situation. But if somebody is not sure, then I say just go for it and get most of them done. You want to do your thyroid for sure. Um, and when it comes to thyroid, you want to do the, you know, the actual active, then you want to do your teeth, your teeth three and your T four, you want to do your testosterone, estrogen and progesterone, estradiol and progesterone. I like to get DHA as well. Um, that’s another sort of hormone precursor. So I like to do that. I’d like to do that. So if you were just going to do a baseline, that would be essential. Um, and then I tend to add on from there. So if they’re just going to do blood work, I would do those. But the unfortunate thing is just from bloodwork, is it doesn’t give you as great a picture.

You’re not going to get the cortisol in there so you won’t get a good idea. Cortisol is our stress hormone. So you won’t really get a good idea of what your cortisol is doing if it’s just blood work. Uh, so I usually encourage people to try and, you know, somehow track down that urinary test or that salivary hormone test so they can get a much better picture of what’s actually happening. Uh, and then they can get their cortisol done in there as well. Cause cortisol high cortisol levels will tank testosterone in men, it’ll decrease progesterone in women. Um, so it’s important to get a good look at what your stress hormones are doing to see if that’s impacting.

Gotcha. So let’s, let’s talk a little bit more about women’s hormones and most of the most common ones that are unbalanced and I’m guessing, you know, one of the most popular ones is thyroid people think, well, I can’t lose weight. I’m exercising, I’m eating healthy, especially women. My thyroid must not be functioning. Is that the most common one that you see that has the most issues? And if so, why, but if not, then which ones have the most issues.

So it’s interesting. A lot of women will think, okay, it’s my thyroid. And for sure there is a big thyroid picture there for a lot of patients. Um, I think that the, I think cortisol is actually one of the biggest ones. Um, so cortisol is released from your adrenal glands that sit on the tops of your kidneys and when you’re stressed, your body releases cortisol and that’s supposed to go down when the stress goes down, but most people live in this state of chronic stress. So what ends up happening is they have these unhealthy, elevated cortisol levels and then cortisol encourages the body to store fat specifically around the middle. And when you’re really stressed, cortisol, progesterone can make cortisol. So if your body’s not able to produce enough, cortisol starts stealing progesterone. So it’s taking it away from the hormonal function to create more stress hormones. So now you have, um, more of an estrogen dominant picture, excess estrogen, really high cortisol. And now your body’s just stacking on fat around the middle. So there’s more, so thyroid definitely plays a role, but oftentimes there are other things that are contributing and sort of stalling that weight loss.

Gotcha. Okay. So when, when people have these issues, these hormone imbalances, uh, you’ve already talked a little bit about giving them certain supplements. Let’s talk about nutrition a little bit. What type of nutritional, uh, re uh, regimen, right? That’s right. Yeah. Regimen. You put them on. Is there a one size fits all? What, what do you see works the best for most people or is it customized?

So it’s, it’s odd. It’s always customized, but overall I do try and move people towards low carb, higher healthy fats. And I see a lot of people who come in and they say, you know, I’m, I’m eating chicken and lettuce. I don’t understand not losing weight. And the problem with that is that our hormones are made from fats. A hormone hormone production comes from cholesterol. So when people move on to these diets that have no fat there, you’re not producing, you’re not really giving that source that you need to make your hormones. So you have to have those fats in there. So the, I do always, for most people, I’m pretty much always increasing the fat, unless for some reason there’s some kind of condition that means they can’t, they can’t do that. Um, otherwise most people are moving to a higher, healthy, fat diet.

Um, I don’t always take grains out sometimes I will, depending on how, um, sort of how severe the condition is or how much weight we have to lose or what kind of medical conditions they’re suffering from. Um, and I do tend to take out dairy that I take out that one has always, I get a lot of questions about that, but I do, I do try and get people to take dairy out of their diet as well. Um, yeah. And I remember when I was in school, everybody was, you know, all the natural paths are saying, you know, get off the dairy. And I remember saying, you know, that’s crazy. The whole world shouldn’t be off of dairy. Uh, but then the more that the research came out and the results that I see in practice, I thought, okay, no, we need to take people off of this. So now I have a conver

Interestingly. So what about, like, for example, in the keto world, the it’s big, the whole grassfed movement of, you know, higher quality dairy, is that, does that, is that play into it at all? Or is dairy, no matter how, where it comes from dairies dairy, it’s bad for you.

So I, I, I always hate, I always hate to say overall, this is bad. Forget it. Um, there are some people who don’t want to get rid of the dairy and that’s fine. And so I’ll say for a certain period of time, maybe take it out and then just decrease your consumption of it. But you’re right. Organic, you know, organic dairy sources. Those are better for sure when you know that they aren’t, you know, they don’t have hormones and then, and things like that. So that’s definitely better. Um, my problem with dairy overall though, is that it can cause a lot of inflammation. So, you know, when I see people who get a lot of sinus infections, chest infections, uh, they’re congested a lot, they get a lot of headaches. They had a lot of ear infections as a child. They’re getting acne, all of those, I’m saying, Oh, dairy, it’s all dairy tickets.

Yeah.

Yeah. And then they take it out and they see a big, a big difference. So it’s more from that inflammatory standpoint that I, I like to take it out,

Which is interesting because, um, for example, let’s talk about ketosis for a second. You know, being in ketosis from what I’ve learned is, is an anti inflammatory type of diet, but I’m normally lactose intolerant. But for some reason in doing Quito, I can’t get away with more high-fat cheeses. You know, I do try and pick, you know, higher quality types of dairy, but I don’t have it everyday, but I can get away with more high-fat cheeses or, you know, heavy whipping cream, um, from, you know, organic, uh, organic fed cows that are grass fed those kinds of things, those kinds of higher quality dairy sources I can get away with. Um, but then at the same time, it still might cause inflammation, even though I’m in, I’m in an antiinflammatory type of diet with ketosis.

Right. Um, and although the interesting thing with that is that’s a good point because often when I see people with a lot of food sensitivities, it’s because they have something like leaky gut, they have a lot of gut inflammation. So that might be why you’re able to tolerate more. Is that in a ketogenic diet, you’re actually healing your gut a little bit more. You’re you’re taking out a lot of the foods that actually cause inflammation in the gut. So you’ve decreased a lot of it. So it could be that your, your body is better able to digest it. Um, so that might be why you find that you’re able to have a little bit more for me. I can’t. Um, but for you, that might be why you’re able to digest it a little bit better.

Interesting. No, I was just curious. I had asked that question for myself sometimes a little bit. I’m a little bit selfish on the podcast. Okay. Let’s switch gears here and talk about sex. I totally made everybody uncomfortable. I’m sure. Uh, you do, you do talk a lot about sexual health and you help people a lot. When I attend to hear, you know, this, for example, I tend to think of just men and ed, but for women, is there a lot of, a lot of women that suffer from, you know, um, a lack of sexual health, if you will, as well?

Um, absolutely. And I would probably say that’s one of the prime because I focus a lot on hormones. What ends up happening is that the primary focus of most of our visits turns into a sexual health and it turns into libido, sexual dysfunction. So both men and women in most of my patients, that is something that comes up and that we talk about. And there are, again, a lot of underlying factors there. So I do a lot of, um, you know, sort of counseling in that space as well, to help people figure out how to, how to rediscover their libido essentially, and, and re reclaim their, their sexual health from a hormonal and lifestyle and mental and emotional aspects. So we kind of do all three of them. So I will, I will do hormones for sure if they need them, if there’s a low testosterone picture and men, uh, if there’s an estrogen problem in women, a hundred percent, we’re going to address that. Um, but oftentimes there are other things we can do as well to really help that, that sexual health aspect.

Gotcha. So let’s talk a little bit about that because is it just as easy as okay. Increased testosterone, is that why people tend to suffer from, you know, um, you know, erectile dysfunction or, or women as well.

Right. So we’ll see. So for sure, there’s a hormonal component. So men will see things like, cause it’s true, your testosterone goes down. And so for sure, that will impact that will impact sexual health and sexual function. So men will have erectile dysfunction inability to maintain an erection or a decrease in the firmness. So different things like that, uh, difficulty tubing, orgasm, and then women have the same. They have sort of had those same problems. They’ll have a decrease in libido, uh, you know, dryness, painful intercourse, and all of those are definitely hormonally related. Um, so I will, we’ll do hormones for those things to reestablish that hormonal balance. But oftentimes there are lifestyle factors in there. So as I was mentioning earlier, you know, stress and cortisol actually causes a decrease in testosterone in men. So if we’re giving you testosterone, but you know, say you’re in your twenties or your thirties or forties, and you’re experiencing those symptoms, it might be that we need to look at the stress component, um, in men and in women, they find also that people who overtrain a lot of cyclists marathon, you know, people who run marathons and do extreme athletics, tend to have lower hormone levels because they’re over-training and creating a stress response.

So we’ll give the hormones, but then we also need to find out why the hormones are actually low. So if they’re not actually in menopause or you’re not, you know, your hormone levels shouldn’t be that low, we’ve got to find out why. So we’ll, we’ll give them to you, but then try and get to the root cause of it, to, to address all the sort of symptoms that you came in for in the first place.

Gotcha. So do certain types of diets, do you tend to see certain types of diets cause low testosterone?

So I only find that when people do really extreme diets, so I don’t want to name names of diets, but, um, but you know, there are diets where you’re doing, um, really low cow, you know, caloric intake for an extended period of time. Then you’re getting injections to try and keep you going. And you’re not really giving yourself your body, any of the nutrients that it needs in order to create hormones. So in those instances, yes. Um, I’ll see it in people who, um, you know, are eating again like chicken and lettuce, cause they didn’t ask, what’s going to help them lose weight. And so now they’re gonna throw off their hormones a little bit that way. So I do see that and then obviously unhealthy diets for sure. Um, like weight gain and obesity will, will lower testosterone and estrogen levels in women. So that for sure, but if you’re doing it properly and you’re not doing extended, severe caloric restrictions without giving your body some of the fuel that it needs. So as long as you’re doing some of those fats and you’re, you’re actually fueling your body, I don’t find that that decreases the hormones. I find that that helps to improve hormone levels in men and women.

Gotcha. So how many, how many men, like what’s the percentage of men to women that you work with?

So definitely more women, I would say men. So I would say, you know, 60 to 65% women and maybe at 60% women, 40% men. Okay.

Interesting. Okay. So here’s an interesting topic that we’re going to talk about because I did a very popular post about this, I think maybe two years ago. And it was kind of interesting. It was kind of me being very personal with people and I was scared of it at the post it, but at the same time, someone who will loved it because it opened up their eyes to what could possibly happen. So when I gained my 75 pounds and I’m being very open, I’m like, all right. So here’s how the posts went. We’ll talk about it. Here’s how the posts went. I, there was a picture of me when I was overweight. And I said, when I gained 75 pounds, my penis shrunk two inches. And uh, I had never talked about this until one of my friends talked me into posting about it. I’m like, I’ve totally forgot about that.

Cause here’s the thing. And I had a doctor that I worked with at the time, who out, cause honestly I was freaking out. I’m like, what the hell is going on? Like I know I’m bigger, but it, and it appear to be its normal size. So, uh, what is going on? And he, I think he vaguely explained to me like every 30 pounds you gain, you tend to lose your size. You, you lose inches. Have you, have you ever experienced that? Or was this it was I just totally freaking out now here’s the thing before you answer, I have to let everybody know full disclaimer. It did go back to its normal size. Just so everybody knows this, this episode, isn’t going to go crazy period. Like drew talking about his penis on this episode. That was an important disclaimer. Exactly. I just wanted to throw that in there. Yeah.

Um, you know what, no, you are not alone in that. That is accurate. Um, so people will, yeah. People will say things like that or notice changes when they gain weight. So that is not uncommon. So you are not, you are not alone. And then when you lose weight, they notice that the size increases.

Yes, yes, yes. Okay. I just want to throw that out there. That doctors backing me out. Cause I kind of threw it out there that, you know, this is what happened and I freaked out for a little bit, but I did, you know, it did go back. It did. And that’s what, here’s the interesting thing is people’s response and it was mostly women wives tagging their husbands in this post saying, see what will happen if you lose weight, there’s motivation for you. And people went crazy. Um, and they were like, thank you for sharing this because I’ve been, you know, like there’s some men that don’t just don’t talk about it. Cause they’re like, you know, I don’t know who to talk. Who am I going to talk to about this? But it’s really true.

Yeah. And absolutely. And I find that a lot of, um, men and women as well are really are really nervous to bring things like that up. Or they’re nervous to talk about it. They don’t know how to bring it up or if it’s normal. So I tend to put those things in my intake. So they’ve, they’ve checked a box before we started our visits. So then when we’re in the visit, it’s on the paper and then I bring it up and I find that it’s a really helpful way to get them talking about it. Cause it’s true. Most people are a little bit nervous to talk about it. They don’t want to. So, you know, if I can start that conversation and then once those doors are open, it’s all out. Cause they people have questions they want to know

Exactly. Yeah. Which is super interesting. I think it just, and I’m totally fine talking about it. I know I joke around about it and back then I was super nervous, but you know, I’m okay with talking about those kinds of things. I’m, I’m a little bit different now to where I’m okay with being vulnerable, uh, out in public. And I am, I’m totally fine with that, but I think in general, men struggle with that because they’ll be afraid of being looked at as less than, so I’m kind of getting off topic there. But anyways, I just wanted to bring that out. We’re talking about sex, sexual health or you know exactly. Um, okay. So we’ve discussed, uh, hormones, we’ve discussed sexual health. Um, the top, the, the types of diets that, you know, might be able to help out with people’s hormones. Cause here’s the thing is, and I’m assuming you don’t just give them the supplements. They don’t change their diet and they expect miracle results. Right. You try and get them to change their lifestyle as well.

Right. So I do, um, I do really comprehensive treatment plans and I tell them, you know, we can have a quick phone call after you go through this to try to talk through it. Cause I’ll do everything. I want the lifestyle changes. If there’s a mental, emotional component, we’ll try and dig into that. And then I’ll, you know, if I need to, I’ll refer to a psychotherapist, I’ll do dietary changes and supplement changes. So we’re really trying to hit, it’s a whole lifestyle and not just going to look at hormones and say, okay, you need hormones. It’s a, you know, the first visit is about an hour and we’re looking at absolutely everything happening in your life and then how we can fix it. So yeah. So diet, lifestyle, mental, emotional supplements, all of those things get get into.

Okay. So let’s talk about the difference between synthetic hormones and bioidentical hormones, which is kind of what you specialize in.

Right. Um, so that’s a great question. A lot of people are not familiar with bioidenticals, which is unfortunate cause they’re, uh, they’ve been used for years. They’ve been used in Europe. There’s tons of research supporting them, but you know, North America, we’re a little bit behind when it comes to, you know, natural health or integrative health. So we kind of tend to get on that, you know, get onto those things a little bit later. Um, so bioidentical hormones means that the hormones were given and I usually do them in cream form, but you can do pills as well. There are different ways to take them. Uh, so bioidentical hormones means that the hormone that we’re giving you is identical in structure to the hormones that your body creates themselves. And so the problem with the synthetic hormones that people will take is that they’re not identical in structure.

So when it binds to that receptor, it’s not a perfect fit. So your body will kind of respond to it, but it doesn’t have a perfect response. And that’s where we seem to get a lot of those side effects and you’ll hear, uh, you know, the, the chance of increased risks of cancer and women and things like that. And the interesting thing is that the bioidentical hormones don’t have those same risk factors. Um, when they, when you use them, the studies are showing that they’re actually protective against certain forms of cancer there, you know, for women in menopause, it helps improve bone mass density. So those actual risks and side effects are not as severe with the bioidentical hormones as they are with the more typical conventional hormone replacement therapy.

And are they both roughly the same cost or what’s the cost advantage of one versus the other?

Right. So it depends. So they’re, they’re pretty expensive. Um, they have to be there through prescription. So if you have coverage for that, that’s great. Uh, but the cost is pretty, is pretty similar. The cost is very similar, but not everyone has coverage for the bioidentical hormone. So, um, that makes a difference for some people, but here I’m up in Canada, obviously it’s about, it can be about $400 for three months supply. So I don’t know. And that’s Canadian, so it’s a little bit less us dollars. Um, so for some people that’s absolutely doable for others. That’s a little bit expensive, but

That’s interesting. Yeah. So, um, I don’t think that’s that expensive or that type of, I mean over a hundred dollars a month is what you’re.

Yeah, yeah. And I have a prescription that’s right. You do have to get a prescription for them. I agree with you. I think it’s pretty reasonable, especially given the response and especially for menopausal women. Oh my goodness. They suffer so much when they, um, when they lose their hormones. And I always, I always tell them, you don’t have to suffer, you know, take the bioidentical hormones. It doesn’t have to, it’s worth a hundred dollars a month. It’s worth it to feel as great as you will once you start them.

Yeah. Interesting. So, um, and where can people find out more about bioidentical hormones? So let’s say, I mean, you’re in Canada and that one’s going to travel up there to see you, but where can people go to find out about bioidentical hormones? I’m assuming they just can’t go to their regular doctor. There’s certain types of clinics that do that specialize in this, right.

There are certain practitioners who specialize in bioidenticals. Um, there are certain, I’m not sure if I should give that company, but there’s one, you know, I, I always refer people to the true balance. Um, and I, you know, I did my training in the U S for bioidenticals as well. Uh, and so, but true balance is really great at sort of finding, um, the practitioners who are certified and who can offer those services for people. I mean, for sure, just if they want to read, they can read some information on, on my site. And then, you know, if you just Google practitioners for bioidentical hormones in your area, you’ll be surprised at how many people will come up. Um, so for sure, they’ll, I mean, in most, most places will have practitioners who specialize in that.

Okay. Interesting. Um, really quick before we let you go, I did want to touch on KIDO and your experience with ptosis and, and how you approach it. Cause I know you love your wine and you know, you’re Italian. So, um, what’s your, what’s your opinion on, on the keto diet and maybe exogenous ketones too? What’s your opinion on all of that?

Yeah. I am a big, um, I’m a big fan of the keto diet and, and Isagenix ketones. Now that now that that’s available to us, uh, I have been sort of, I’ve been doing the ketogenic diet with patients and myself for years. Um, and so I, I do like my wine you’re right. So I help people figure out how to balance the things that they love. So I’ve figured out how much sugar is in a specific, you know, in the wine, how much I plan to drink on a certain day and things like that. And I make sure I actually factor that into my caloric intake and my sugar intake. Um, and I’m obviously not drinking a ton of wine all the time. So I tend to be, if when I’m in ketosis, I tend to be able to stay in if I drink wine, but I kind of go in and out of ketosis, but I’m usually always low carb, high fat, and that sort of a, that’s a definite for me. Um, and then I try and move my patients towards that low carb and in taquito if they, if they can. And especially with weight loss as a goal, I’d try and get them. It’s a, it’s a tough diet for some people to follow. So I try, I try and get them to go Quito if they can’t, I D I get them to do low carb high fat, and then I always add an exoticness ketones so that they can supplement with them.

Interesting. Cool. Now I just wanted to touch on that briefly. I’ve I’ve had dr. Dom D’Agostino, who’s talked about the science behind it, and I’ve had a lot of people on talking about ketosis. So I don’t want to overdo it with that, but people know that I’m a big fan of it. Um, and I do it personally more so for the improvement in cognitive function and, and the mental clarity benefits instead of, you know, getting shredded and losing fat, which can be a byproduct for people. Right. If they do it right. Um, how do you see some people doing the keto diet wrong though? Cause I think like with any fad diet, there was a right way and a wrong way to do it. What do you see people do wrong with a keto diet

When you mean when they’re just starting to get in?

Yeah. Like what are some of the mistakes people make?

Right. So often what will happen is I’ll see people start to increase their fat without, uh, a balanced decrease in the carbs. And so then they start to gain weight and they can’t figure out why. Cause they think that they’re moving towards Quito. Um, but they haven’t really balanced it. That macronutrient intake the right way. They forget to consider certain things like a drink they’ve had. So I always get people to track their food for about two weeks. I don’t, I don’t like people to count calories or anything like that, but I need, you want people to be aware of what they’re consuming. So I find that when they’re transitioning in, oftentimes they don’t realize how much sugar they actually eat. Um, so that’s the first thing. And often, even though they’ve cut down the sugar, sometimes they haven’t always cut down the protein enough cause it’s supposed to be a moderate protein diet because protein, obviously it can be broken down to create glucose. So we find, I find that’s a problem as well. So we kind of have to decrease that, um, that protein intake and then make sure that they get that fat intake up.

Gotcha. Yeah. And that’s kind of interesting for me, that’s kind of what I ran into is, I mean, I was used to more of a high protein, high, fat, low carb type of diet, which is more of accurate. Uh, but yeah, really decreasing my protein. I was like, I’m gonna lose all my gains. I’m gonna lose my muscle. You know, I gotta get 500 grams of protein in every day. Uh, but which was kind of scared for me at first, but now I’m like, I tell people, look, I eat probably around a hundred grams of protein a day, which me, I’m running 190 pounds total, you know, about 12% body fat. I can get away with like a hundred, maybe 120 grams at the most, but I don’t need to get in these massive amounts of protein. Like I used to. Um, it’s just kinda nice.

Yeah, it’s great. And I think you, you touched on something in there too, is that’s one of actually the biggest hurdles is getting past those, um, those mental roadblocks. So people who are trying to build muscle and think that to do that, they need ridiculously high amounts of protein, um, or the people who are so used to those low fat diets. So they’re, they’re going, Oh my goodness. I have to eat that now. So it’s that, it’s that mental switch and, and changing what you’ve done most of your life, which is very tough for people to do initially.

Yeah, exactly. Um, okay. Before that you go, I do have to bring this up though. Um, you, here you are, you’re a doctor, uh, very successful and you do things like more tie you do a couple at, uh, which is very unsuspecting of, you know, I don’t know a lot of women, first of all, in general that do that. What got you into martial arts?

So, you know, what got me into it? It was after I finished dancing a lot and I did ballet and most people don’t realize how intense the training is. So I used to dance, Oh, at least four to five hours a day, at least six days a week, sometimes seven, depending on the time of year. So when I stopped dancing, I found that I couldn’t find something as intense that trained me the same way dancing did. And I didn’t want to go back to dancing. Cause I, you know, that was one phase that I’d come out of. So I was looking for something that was equally as intense that gave me that same type of workout. And I was introduced to moist high and I did a class and I thought, this is, this is amazing. And it was just sort of a natural progression from there. And so I did that for a long, long time. Yeah. So it was just, I love those intense workouts and that was it.

That is so cool. And I’m jealous that you do that. I really do wish that I got into martial arts. I did not grow up doing that, but um, okay. Last, uh, let’s talk about your tumor. Yes. Tell us about that. A lot of people might not know about this. Are you okay talking about that?

Absolutely. Yeah. You can ask me. Yeah, no problem. Um, so I discovered, so like we were saying, I, I was, it’s really intense workouts. I used to, I used to end a workout by skipping for 45 minutes. Um, you know, running stairs and crazy things like that. And then I started to get a lot of pain in my knee and I eventually wasn’t able to walk. Um, I couldn’t even go up and down a curb and then I had some testing. Then I found out that I have a tumor in my knee. It’s called a schwannoma. Um, it’s a benign tumor on the nerve that just runs right behind my knee and there’s no treatment for it really. Um, they could do surgery to take it out, but they’re afraid of the risk of nerve damage and things like that. So nobody wants to take it out.

Um, so I’ve just had to deal with, for the past, maybe three or four years with really, um, intense knee pain. When I, you know, even now just walking up and down stairs, it’s still quite a, it still hurts every time I do that. So I’ve had to, um, that was a tough transition. I had to figure out how to, you know, how to change my workouts and my lifestyle and things like that. Cause obviously I can’t skip, I can’t run, I can’t jump, I can’t squat anymore. I can’t do any of the things I used to be able to do. Um, so that was a bit of a mental struggle for that first year before I finally just accepted it and then had to kind of figure out how to be active and healthy in a way that I could without causing pain in my knee.

No, thank you for talking about that because I feel like, um, you know, people have injuries of all types, setbacks sometimes in life. And it’s so easy sometimes just to kind of feel sorry for yourself and kind of wallow in that a little bit, if you will. So what are some things you do to stay positive, stay motivated even though you’re limited now versus, you know, being kind of before.

Hm. Um, that’s a great question and don’t get me wrong. I had my year of being, being pretty upset and depressed about that. Uh, and the, the day, the only thing that actually got me out of the gyms finally was I tried to skip and mind the act just gave out and I just collapsed straight to the floor in the gym, um, and then started crying. So, and I’m not a big crier. So I had to apologize to all the people around me. I was like, I’m having a small mental breakdown right now. Uh, and so I had my year of, um, probably about, well, first six months, I would say of, you know, being really upset about that. And you have to accept a new, normal, a new, um, you know, a different type of, of body essentially as well. I mean, I’m still in shape, but I can’t be the way I was before.

I’m just not able to do those things. So I just, it was more of just an acceptance and I loved being active and I just thought, you know what? I love those things, but that doesn’t mean that I can’t find something else that I love that I’m actually able to do. So I just started searching for other things. I was able to do testing my limits, uh, finding out what I was capable of doing. And that’s what I’ve, I love working out. So that’s what I’ve stuck with and that it’s, and then I sort of got back on track and that has worked for me. I mean, I do still miss the other things I could do before, but

Yeah, no, I can, I can imagine. Um, okay. Before I let you go, where can people get in touch with you? Uh, your social media, your website,

Right. All that. All right. So my website is camp a tele health.com. So you can find all of that information there. And my social media, I’m dr. Andy, Andy, and that’s Andy with an eye. Um, so dr. Andy N D, and that you can find me on Instagram, Twitter, and Facebook

Last couple of rapid fire questions other than why. And what’s your favorite go to, you know, indulgence means,

Oh, my, my favorite treat, uh, it’s not a meal. I would say it’s, I’m a candy person. I’m not into chips or anything like that. So mine are sour jujubes. That’s my

That’s sour juice juice. Is that kind of like sour patch, uh, gummy bears type things.

You know what? No, they’re, they’re not sugar coated. I mean, they’re still full of sugar, so they’re, they’re like jujubes, but just a little, I don’t know. They changed the flavor and make them a little more tart, I guess. Oh gosh. They’re so good.

Interesting. I’ll have to try out to try those out or maybe I should have tried them out. Don’t try it though. He’ll be addicted. Gotcha. So with your knee or at any point in your past, have you ever been overweight?

Um, so I’ve the only time I’ve ever, I wouldn’t say overweight the only time I’ve ever gained weight. Um, actually there were two instances in my twenties. So once I studied in France for a year, um, and my first four months in France, I ate essentially baguettes and the tele and wine and whatever other French food I could get my hands on. Um, so I think I probably gained about 15 pounds at that point that I had to work off. Um, and then another time was in my early twenties, I was put on the birth control pill and I gained 20 pounds from that. So right. And that, and hormonal weight gain is not easy to get off. So those were the two, probably two times in my life where I gained weight. I don’t know if that classifies me as overweight, but I had sort of a, a 20 pound weight gain that I had to get off to get back down to to where I like to be.

Gotcha. So, okay. I’m sorry. One last question about birth control and weight gain, because that’s another topic that, so when people ask me about that or that struggle with what are some better alternatives to birth control. So

Unfortunately nobody likes those answers. Like those answers. Honestly, the only alternative is, um, you know, contrast like condoms, contraceptives like that, spermicide, um, you know, women, there’s a female condom that people can use. Those are the only alternatives. There’s not, some people will use, you know, the timing method and sort of track their cycles, but that’s obviously not as accurate. Um, but I do, I never tell women to come off the pill. That’s also a really big contributor to low libido as well. A lot of women don’t know that, but, um, I never tell them to get off if they don’t want to, but I’ll definitely let women know what they can expect from it. And some of the other options, but they’re not always super happy though, but yeah,

I totally get that. There’s nothing, sometimes the answer isn’t anything sexy. Like people want to hear kind of like, Oh, how do you lose weight? It’s like, well, I wish there was a magic pill.

Exactly. If only there was a magic pill, there is not, there’s not,

Uh, dr. Andy, thank you so much for coming on. I’ll let you go. I’ll let you get back to your, uh, awesome weekend up there and Toronto and off to come visit sometime.

Yes, absolutely. And thanks so much for having me. This was, this was great.

Yeah. And no, we’ll definitely have to have you back on again in the future. Cause I know we’ll get lots of feedback from this one and I’ll have more questions in the future. That’s great. I’d love to. Okay, well, we’ll talk to you soon.

Talk to you soon. Thanks. Bye.

Hey everyone. I really do hope you enjoy today’s episode with dr. Andrew cavatelli. I hope you gained a lot of knowledge from her as I did too. And learn something that is applicable to you and your health. Um, we really do stress the importance of taking care of your own health because, you know, we only have this one body we’ve been given and we are all very blessed to have the technology that we have nowadays and the knowledge as well of, of where we’re at with, with health. And so take advantage of this and really, you know, if you feel like, you know, somebody that is struggling and a kid, uh, benefit from this podcast, please share it with them. Uh, leave us a review on iTunes as well, subscribe to the podcast, uh, help us, you know, forward this movement to other people. Our whole goal is to get, uh, this whole fit to fat, to fit idea.

And then the, the health knowledge that we bring along with the people that we bring on the podcast to the mainstream, uh, to your average person, right to the mainstream or your average person. So, um, thank you guys so much for your support. I definitely appreciate you guys, uh, and girls, all of you who tune in each week and, uh, another way that you can help support us is by following us on social media, all my social media handles our social media handles are at fit to fat to fit just like my book. If you haven’t checked out my book, please do so two New York times bestseller. Um, my website Avenue’s letter, if you can sign up for as well to stay in the know. So, you know, what’s up and coming, uh, in the fit to fat to fit world, like for example, season two of the TV show, which will be airing next spring. So stay tuned with that. And we’ll see you guys back here next week for another great episode on the fit, defective fit experience podcast.

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