Break The Rules #98: The 12 Hormone Types: Which One Are You? with Gynecologist Dr. Shawn Tassone

Special Links & Show Notes

Show Transcript – The 12 Hormone Types: Which One Are You?

Dr. Lauryn: [00:00:00] Well, hello hello hello. Welcome to another edition of the Break the Rules podcast, where we talk about quieting the noise in the health, food, and fitness world. And today super stoked to have Dr. Shawn Tassone in the house. And, Dr. Shawn is a gynecologist and Obstetrician that is board certified in integrative medicine as well. And he is just the hormone guru. So today we’re going to be bringing you to some hot topic, laser focus on hormones. Things that we all would maybe want to ask the gynecologist, like Dr. Shawn… what should I call you?

Dr. Shawn: [00:00:38] You can call me Shawn.

Dr. Lauryn: [00:00:43] Give us a little bit of background about the work you’re doing in the world, and really what got you into this world of women’s hormones as well.

Dr. Shawn: [00:00:52] Real quick. I went into OB-GYN. I think it was initially, you know, you’re 27 when you when I decided that, cause that’s when I ended medical school give or take and you have to make this big lifetime decision about what you’re going to do and what profession you’re going to pick. And I found that that specialty primarily is very nice. It’s very, uh, pleasant. There aren’t a lot of deaths, obviously. There are babies being born. It’s a happy kind of profession. For surgery, obviously on the GYN side, so that’s kind of more my mindset, is if I find a problem, I want to fix it. I just fit that.

And then I looked at the other doctors that were in each of the fields that I liked, and I kind of just fit in better with that kind of specialty. You know, the surgeons were a little more aggressive. The internists were a little bit more, you know, they like to sit around and think all day, all day, which, you know, I’d rather fix it, then think about it. And so I just kind of fit in.

What I found was when I was a second-year resident, my mom was diagnosed with ovarian cancer, which was kind of interesting cause that’s what I was doing for training. And what I found was when she did surgery and chemo, I understood all that. But what I, what I didn’t understand was that all the side effects that she had from the chemo, I couldn’t help her with. I couldn’t, I couldn’t help her outside of medications. I didn’t know what else to do. And I felt with my own mother, I felt here I am a gynecologist and I can’t even help my own mom. And then five years later, she passed away from the disease. And I just kind of said to myself, I’m like, you know, I’m just not, I got to know more because I can’t just let this happen to other women when I couldn’t even help my own mother. I felt kind of lame as a physician.

So a few years later, as you do, when you have a spiritual awakening, you go to Sedona. So I was in Sedona and I was reading the book at the time, which was earth-shattering called 8 Weeks to Optimum Health from Andrew Wild. At the time it was talking about crazy stuff like fish oil and CoQ10. And I mean, back then, that was like a huge, huge deal.

And I just thought it was fascinating and just so happened that his program is in Tucson and I lived in Tucson. So I kinda thought that was a sign. Uh, and I signed up and took the two-year program. In that program, there was an eight-week module on spirituality which also kind of conked me on the head. Cause I was like, I didn’t even think about that. Like spirituality or spiritual practices can change the way that your brain works and stuff.

So I then from 2009 to 2015, Did a PhD in philosophy. And that was kind of just more for my, I think my own journey, but I got the PhD in philosophy and focused that on more mind-body connection. So I learned a lot about the mind and body connection.

And then as I was practicing through all of this, Suzanne Somers came out with her book, The Sexy Years. And that was about her cancer journey and how she was using at the time, these revolutionary bioidentical hormones, it was probably 12 or 13, 14 years ago. And she put me in the back of her book as a reference. I didn’t know this, uh, one day she went on Oprah and the next day I was getting hundreds of phone calls. I was already doing a little bit about identical hormones, but that was back in the day when even my colleagues were thinking I was a weirdo for using these weird hormones. Now everybody kinda does it, but so that’s that kind of launched me into the next stratosphere.

And then I moved to Austin about six years ago and just really kind of honed in on the, you know, being the, the hormone person. And later this year, I have a book coming out with Harper Collins called the Hormone Balance Bible. That’s going to be kind of all-encompassing hormone integrative, my six-step process for fixing imbalances and the 12 most common imbalances that I’ve found over the last 20 years.

Dr. Lauryn: [00:04:52] Wow, thank you for sharing your story. And that’s really no wonder you’re in that field and doing amazing work and really happy to know you too. Hormones are the wild, wild West, and…

Dr. Shawn: [00:05:09] I say that all the time. I literally say that all the time, because there are so many people that are now experts doing them on corners and, you know, plastic surgeon offices. I mean just everywhere in the world. And so it is, it’s like shooting from the hip sometimes.

Dr. Lauryn: [00:05:25] Let’s kind of like break it down a little bit first for the listeners. Like when we say that word hormones, that’s also very overarching. So talk a little bit about some of the basics. Like we think about estrogen, progesterone and testosterone, and maybe cortisol. Um, and thyroid, so that’s a lot of hormones right there.

Dr. Shawn: [00:05:45] Melatonin, vitamin D those would be the big ones.

Dr. Lauryn: [00:05:48] So of those, no one’s really educated. We go through biology class in ninth grade, maybe like talk about hormones, but they’re like, Oh, these are in us. Like, talk a little bit broadly about the role of the different hormones. Let’s start there.

Dr. Shawn: [00:06:04] So hormones themselves, you have to think of them as chemical messengers. So they come from a gland in the body and they take a message to another cell in the body somewhere else. So in the case of say estrogen, which is the quintessential female hormone and women have estrogen receptors basically on every cell of their body, from the liver to the brain, to the heart, to blood vessels and, and skin and all this stuff.

So it has a, it has a specific function. And estrogen deprivation is going, those are women that have say menopause symptoms, like hot flashes, mood swings, irritability, vaginal dryness, hair kind of thinning, just kind of not feeling very good at all. Night sweats,  estrogen excess, or what we call estrogen dominance when there’s too much, it can be kind of the exempt, you know, breast tenderness, heavy irregular painful periods, headaches, weight, gain, insulin resistance, you know, so the thing about hormones and this would be for all the hormones, it’s more about moderation rather than not enough or too much, you know? And that’s, and then kind of estrogen, you want to balance that one out with progesterone because they play off of each other. Where if you think of estrogen as being kind of stimulatory, progesterone is kind of calming.

So, women that have too much estrogen, not enough progesterone, I call that jokingly, the “choke-a-bitch syndrome”, where you feel like you just want to choke someone out. And I also say sometimes people need to be choked out, but if they don’t need to be choked out and you still feel like you want to choke them, then there’s probably something going on there.

And progesterone is good for sleep. So women that don’t have enough will have a lot of insomnia problems, which is rampant obviously. And then if you don’t sleep, your cortisol goes up. You know thyroid well, first of all, the number one testosterone, the number one hormone that I see in balanced and women is testosterone. Overreaching far and away in most of the age groups, testosterone deficiency is number one for women, and that’s going to be most common, you feel tired, especially in the afternoons three or four o’clock in the afternoons. Testosterone is the hormone of desire. So if you don’t want to have sex. If you don’t want to do the things that you used to like to do, you know, your hobbies, you know, exercise, whatever you just feel, kind of “meh” what I say. That’s probably more of a testosterone issue.

And then the thyroid is obviously metabolic. So your thyroid is kind of your furnace. Too much and you get anxious and you lose tons of weight, even though you don’t want to. Too little and you’re cold all the time, your hair is thinning, your weight gain, your periods can be thrown off.

And then cortisol is one that we don’t talk about a ton, and it comes from the adrenal glands. Cortisol is a stress response hormone. It’s metabolic in a sense, but along with thyroid, you have cortisol and thyroid to survive. Those you need to live. The other hormones, you don’t need them to live at all. You can live without them. You might not feel very good living without them, but you can survive. Whereas cortisol in thyroid, you have to have those to survive. And cortisol can cause, if it’s too much, cause you’re super stressed all the time, that can cause weight gain. It basically can cause you to kind of destroy your own tissues. Like you just start to catabolize it’s a catabolic hormone. Whereas testosterone is anabolic, it’s muscle-building cortisol is the other way and it breaks things down. So if you have too much, it’s not good. So that’s kind of those hormones.

Dr. Lauryn: [00:09:35] Yeah, thank you for explaining that better than our ninth-grade biology teacher. Tell us a little bit about hormone imbalance then. And you mentioned testosterone being something that’s super low on women, something that may not even be super talked about. We hear a lot about estrogen as women. A lot about estrogen excess and maybe like, is it, disconcordant with, um, estrogen, testosterone? Do they yin yang or is it primarily cortisol that’s driving the testosterone?

Dr. Shawn: [00:10:09] So hormones in and of themselves, start with the brain talking to either the ovaries or the adrenal glands or the thyroid. So you have a little gland in the base of your skull called the pituitary that makes hormones like luteinizing hormones, follicular stimulating hormone, thyroid-stimulating hormone, corticotropin-releasing hormone. It makes all of these hormones that then go to those glands and then tell those glands what to do. Then some of the hormones, as you just said, are interrelated in the sense that – so let’s take estrogen for instance. If estrogen is high, estrogen will raise two proteins in the blood called thyroid hormone-binding globulin and sex hormone-binding globulin. What those two globulins do, those proteins do, is they grab on to extra thyroid and extra testosterone in the bloodstream and they inactivate it. So if estrogen is super high, active thyroid can be low and active testosterone can be low because of the effects of the estrogen. So that’s why women that are on birth control pills, which is a super high level of estrogen, can have thyroid dysfunction and can have low testosterone. And we’ve seen that in young girls that take a testosterone therapy, they have, they have low testosterone, low free testosterone, and they actually have decreased libido and things like that because of it.

Other hormones that interact with each other, estrogen is the main one that can interact with other things. Cortisol and DHEA can kind of interact with each other because they come from the adrenal gland, but DHEA is kind of a parent hormone of estrogen and testosterone.

So DHEA breaks down into either estrogen or testosterone. So if you have high DHEA, but you’re super stressed, that can raise your other two hormones. As opposed to, if it’s super low, then obviously it could lower those other two hormones because there isn’t enough of it around. And finally, the last thing is, if testosterone is high, testosterone can, there’s a process it’s called romantization, which is a process that happens in your fat cells. And your fat cells can take testosterone and turn it into estrogen.

So women that have higher testosterone levels, either they’re taking too much testosterone and men for that matter, can aromatase into more estrogen. So you have to be careful with women that say have an estrogen receptive breast cancer. If you give them say testosterone because it can turn into some estrogen. So that’s kinda how those can interact sometimes.

Dr. Lauryn: [00:12:40] Thank you for explaining that and talk a little bit about the drivers then of hormone imbalances and what would be behind those. And is estrogen the one that the domino that sets it off?

Dr. Shawn: [00:12:53] Estrogen dominance is probably the second most common hormone imbalance that I see. And I think it’s because, and this is the main driver, in my opinion, in society right now is obesity. I think obesity and poor diet are probably the two biggest drivers of hormone imbalance, and at least in this country. And that’s because fat just can make what can make us excess estrogen as I just discussed, fats can also make you insulin resistant, which then affects your cortisol levels, which then makes your sugar levels go up. And it just kind of feeds on itself. When your estrogen is high, because you’re obese your thyroid is low, so your metabolism goes down. So for sure, diets and obesity are the two, the two big drivers of forming imbalance.

I think stress is another main driver of imbalance because stress again, and this isn’t just like stress that’s, you know, physical stress it could be emotion or psychological stress as well that your body doesn’t really know the difference. So it could be financial with all the stuff that’s going on. Right now. We were just talking about this, how I’m sure my cortisol is up because I’m just worried about keeping my doors open and my employees and my bills and things like that.

Another main driver is insomnia. Insomnia will wreck your hormones. And that’s very common in women that are probably in their forties and fifties. Insomnia is rampant. And the problem is if you, if you use a sleeping pill, one, you’re probably not getting a great night’s sleep. You’re sleeping, but it’s probably not the same as if you were naturally sleeping. And second, you’re not really getting to the problem. You’re not finding out where that insomnia is coming from. Where’s the stress? You know, if you’re not removing the stressor for the insomnia or whatever it’s coming from, then you’re not really fixing, you’re just covering it up with another medication, even if it’s a hormone. So those would be probably the big ones that I would think of.

Dr. Lauryn: [00:14:55] Yeah. And a lot of those, like, even thinking like obesity and insomnia, like you got at, but there is a root cause behind those. It’s not just a person’s obese, um, or like falls within that spectrum. However, I would say a lot in my practice, I see the other end of the spectrum, where not obese at all and perhaps doing all the things like eating really healthy diet and working out a lot and an estrogen imbalance or cortisone imbalance is obviously be present and talk a little bit about, and that may go back to the stress as well.

Dr. Shawn: [00:15:28] So probably the people that you see are the, are your, you know, your, your storyline as well with eating, eating disorders, but not just eating disorders, which are stressful, but some people overdo, right? Some people that are very thin, they’re just addicted to say exercise or they’re addicted to being physically fit.

And like I said, your body doesn’t know the difference between a good stress, which could be exercise or a bad stress, you know, it’s stressful. if like a person like you has like no body fat, it’s hard for you to keep your hormones balanced because your body pulls from fat and cholesterol to make hormones.

So if you’re eating good fats, that’s great. And then you’ll probably be okay. But for people that aren’t eating a good diet and are eating high saturated fats or whatever, not eating good fats, or they’re not eating well because they’re fasting too much because they’re worried about how they look or whatever, that’s going to wreck their hormones because your body has to have cholesterol to make hormones. So I think on the other end of the spectrum, yeah, you, you could have someone who like, I, I had a lady this week, for instance, who my recommendation to her was not to exercise because she’s a good wage. She was like 140 pounds and 5’5″. So she, she was fine. But what we saw with her Dutch test, which is a urine test is that her cortisol was so low that it was barely registering. So here you have a woman who is tired already. Her hormones were low. Her thyroid was on the low side or testosterone was on the low side, her cortisol was on the low side. Those three hormones are all about energy right there. And she’s going to work out 45 minutes a day in this high-intensity interval training, you know. So she’s not only burning the candle at both ends, she’s burning it with a blow torch. Right? And there’s nothing left. So the body’s trying to compensate her DHEA was through the roof because the body’s trying to do something to compensate. So when I told her not to work out, or if she did work out to walk, instead of do high-intensity stuff, she liked freaked out. She’s like, well, I have to work out. And I’m like, no, you actually don’t. Because I think the reason that your, your body is your rundown.

And the 12 hormone imbalances that I have, that I found over the years from women telling me their stories, I’ve collected into what I call 12 archetypes. So the woman with low cortisol like that, I call them saboteurs. And saboteurs, meaning that they’re sabotaging their own health, they’re taking care of everyone else, their job, their employees, their employees, their work, their family, their kids, their husband, whatever they’re taking care of everyone else at their own expense.

And their cortisol’s low, now this is the end stage, the saboteurs, the end-stage of the other end cortisol excess, which I call the workaholic. So workaholics, just they’re running on the hamster wheel and they feel great and they’re doing it on everything. And then eventually they, they crash. And so, so every, like the estrogen dominance, I call that queen the testosterone deficiency, I called the nun. And each of these has a storyline.

And when I talk to patients like this lady, I started telling the story of the saboteurs. Like I kind of just was hinting at with you and they’re like nodding their heads. Yep. Yep. That’s me. And you can tell them these stories and it’s funny because they think I’m so smart, but the reality is I have just listened to this 40,000 times over the past 20 years, and I’ve just collected all these stories. And that’s why I’m writing the book because the book is all about these 12 imbalances.

Dr. Lauryn: [00:19:01] Definitely going to have to connect folks to that. And yeah, your book, when are you planning to launch?

Dr. Shawn: [00:19:07] You can find out what type you are. I have a quiz online right now. It’s at my, my website is tassonemd.com/quiz. And it will, based on how you answer the questions, it’s not the same as drawing blood obviously, but it might give you a little insight into what’s going on.

And it’s funny, cause I’ve had women I’ve had about 18,000 women take it and I’ve had some women go out of their way to challenge me. I had a lady a couple of weeks ago. She was like, I just want you to know your quiz is wrong. And I said, okay, well it’s a quiz. It’s not labs. And she said cause it says that I’m a hyperthyroid, but I’m actually hypothyroid. And I said, okay, well, when was the last time you had labs drawn? And she said, Oh, it was like six months ago. So she emailed me back like yesterday and said, Oh, I want you to know your quiz was right. I drew my labs and I was taking too much thyroid.

So it’s pretty accurate. I’m always amazed. And it’s just because of the way that I asked the questions and how you answer them. And if you answer them honestly, it will give you a pretty good idea of what’s going on.

And I just did that for some edification, but also to get women just started. You know, nothing’s going to suffice for blood or urine to test hormones, but it does give you a starting place that’s free and we don’t have to, you know, then you can kind of start asking the right questions and it will also give you a printout of the storyline for that particular architect.

Dr. Lauryn: [00:20:28] Very cool. I’ll definitely put a link to that in the show notes. What is the website?

Dr. Shawn: [00:20:33] It’s my last name. It’s Tassone.

Dr. Lauryn: [00:20:39] Cool. One question for you as we kind of wrap up too, it’s like beyond just like natural hormone imbalances of the life we live in, what about hormone imbalances caused by like actual, like, Hormone, not necessarily even therapy. I’m thinking like copper IUD is an example. Like one on women comes off of that.

It may not even be hormone imbalances, body imbalances, or coming off of birth control after being on it for either sex reasons or for like acne that they had. So those are hormone imbalances that can occur. What do you see in practice and how does a woman come back to like balance.

Dr. Shawn: [00:21:17] Well, theoretically the copper IUD shouldn’t cause a full level hormone imbalance because it doesn’t have hormones in it. It’s copper. And I guess you could say that if there’s a hormone imbalance when you have the copper IUD, it’s probably coming from something else. Some of the other IUD’s Mirena, have levonorgestrel, which is a progestin.

So theoretically they can get into the bloodstream obviously and can tend to shut down the ovaries a tiny bit. A lot of women do still ovulate though when they have the IUD, but some don’t.

The birth control pills are, are really bad for turning the ovaries off. They just shut the ovaries down. So when you go off of them, it could take a while for your ovaries to wake back up. It could be months where you’re not doing a whole lot, and that could feel kind of crappy because you’re going from the super high level of hormone down to a very low level of hormone.

And the reason that it works for things like acne and stuff like that is because it’s shutting everything off. So everything goes away, but you’re not fixing the problem. You’re covering it up. Right. So as soon as you, as soon as you take those birth control pills away, the acne is probably going to come back because you never really fixed the problems to begin with.

And that’s part of the problem. And that’s why women stay on them because they had horrible periods. The doctor threw them on PCOS or acne doctor threw them on birth control pills, and then they got better. And then they come off of them because they don’t like them. They’re having headaches or whatever, and then the symptoms come back because it never got fixed in the first place. So they go back on them.

It’s kind of a, you know, it’s a self-fulfilling prophecy of sorts. Um, and there’s a lot of things, medications that are like that, um, you know, Excedrin or whatever you take cause you have a headache you can rebound and well the other way.

I always joke with my kids cause they drink Gatorade and it’s like, yeah, they put citric acid in the Gatorade, which dries out your tongue, which then makes you want to drink more. So it’s the same kind of process.

Now birth control pills are fine for a girl that needs them for birth control. I’m not trying to dissuade people from using birth control pills, but a lot of women that are on them, I would say probably more than half are using them for a problem that never got fixed. Bleeding, pain, uh, endometriosis, fibroids, and they’re not fixing the problem or they’re not getting at the root cause. They’re just sort of covering it up. Those are the ones. I mean, I can’t tell you how many times I see a 52 year old woman on birth control cause it’s ridiculous.

Dr. Lauryn: [00:23:51] Yeah, it is. It’s crazy. And I see a lot of it in my practice as well. And I would say kind of back to the IUD, what I don’t see necessarily is the hormone imbalance, but it’s like the gut, the liver imbalances a lot of histamine reaction if it’s not working for them, maybe from the copper, I’ve seen that before with breakouts. It’s all connected.

But John, you’re just a wealth of information and I’m really excited for folks to get to take your quiz. I’m even more excited to read your book when it comes out.

Dr. Shawn: [00:24:23] I will get you an advanced copy. Um, didn’t we meet at Halcyon that one day?

Dr. Lauryn: [00:24:30] Yeah.

Dr. Shawn: [00:24:31] You were thinking about going to medical school.

Dr. Lauryn: [00:24:34] I was thinking about medical school and then I decided I just love what I’m doing now. And to spend eight more years in school just feels like it would be…

Dr. Shawn: [00:24:44] I’ll tell you what, it’s a road. My son just applied and didn’t get in this year and I’m talking to him and I’m like, you know, You should go to nursing school or be a nurse practitioner or physician assistant. If you become a nurse practitioner, you could be a nurse anesthetist and there’s all kinds of things you can do and not have to… I mean, it is a long road and I don’t know, it’s I just, I see what’s going now with all the coronavirus stuff and how people are having to take care of people with no PPEs. And it’s just, it’s just horrible. How you know we’re treated, but I think, you know, at the same time, it’s a great profession.

Until recently I thought there was job security. I found out that nothing is secure anymore. Everybody’s going to can be affected by this. And this is really gonna throw people’s hormones off. I mean, realistically the stress from all this is going to mess up a lot of people with sleep patterns and, you know, even yesterday, my 15 year old, took him outside. And he went over, his friends wanted to go for a walk and they hadn’t been out in probably two weeks. And he came home and he’s like three hours later, when he came home, he was like, I have this horrible headache. And he goes, I think it’s the sun. And I’m like, yeah, you’re probably right cause you haven’t been out for weeks. And it’s like, it’s just kind of weird. It’s just, I think that this is really going to change how we live our lives in the future. Just like kind of 9/11 did for travel.

Dr. Lauryn: [00:26:10] Yeah, I think it will as well. And I think your practice will definitely be rebounding with the hormonal imbalances. You’re right on that. And so just thanks for sharing some time for us today.