211. Emma Heming Willis and Dr. Nicole Beurkens: Why Women Face a Higher Alzheimer's Risk—Menopause, Brain Fog & Prevention

What if the brain fog, forgetfulness, poor sleep, and mood changes so many women experience in midlife aren't just signs of getting older—but signals that their brains need more support? Women account for nearly two-thirds of Alzheimer's cases, yet women's brain health has historically been overlooked in medical research and conversations about prevention. And as estrogen levels begin to change during perimenopause and menopause, those changes can affect everything from memory and mental clarity to metabolism, sleep, and emotional well-being. In this episode, I'm joined by Emma Heming Willis, co-founder of Make Time Wellness, and Dr. Nicole Beurkens a clinical psychologist with a background in nutrition science, for an important conversation about women's brain health, hormonal changes, and what we can do today to support cognitive health as we age. Emma shares her personal experience with brain fog, feeling dismissed by her doctor, and the lifestyle changes that inspired her mission to make brain health a priority for women. Together, we explore the science behind cognitive aging and the everyday habits that can make a meaningful difference. In this episode, you'll learn: Why women face a higher risk of Alzheimer's disease and dementia How declining estrogen during perimenopause and menopause can affect memory, focus, and brain energy Why brain fog, forgetfulness, and sleep disturbances deserve attention How chronic stress, trauma, and the demands of caregiving can affect brain health The connection between chronic inflammation, metabolic health, and cognitive function Why nutrition, protein, fiber, and reducing ultra-processed foods matter for brain health How sleep supports memory, cognitive performance, and long-term brain health What to know about brain health supplements, including rhodiola, curcumin, and other nutrients What the emerging research suggests about hormone replacement therapy and women's cognitive health We also discuss practical ways to prioritize self-care, manage stress, improve sleep habits, and build sustainable routines without adding another overwhelming responsibility to an already busy life. The biggest takeaway? Brain health shouldn't become a priority only when memory problems begin. Protecting your brain is part of protecting your future. And the choices we make around sleep, nutrition, movement, stress, and hormonal health can help us take a more proactive approach to aging. Because longevity isn't simply about living longer. It's about maintaining the clarity, independence, and quality of life that allow us to enjoy those extra years. Learn more about Dr. Shah: Website: drshah.com https://drshah.com Clinic: next-health.com https://www.next-health.com/ Instagram: @darshanshahmd and @extend_podcast Learn more about Emma Heming Willis and Dr. Nicole Beurkens Website: drbeurkens.com https://drbeurkens.com and emmahemingwillis.com https://emmahemingwillis.com Instagram: @emmahemingwillis, @drnicolebeurkens and @maketimewellness Try Make Time Wellness at maketimewellness.com https://maketimewellness.com/, use code EXTEND20 at checkout for 20% off as a gift to our listeners! Also available at Target, Amazon, Ulta, The Vitamin Shoppe and Meijer. Thank You to Our Sponsor! Momentous: Head to livemomentous.com and use my code DRSHAH at checkout for up to 35% off.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:03Dr. Darshan Shah?

  Welcome to Extend with me, Dr. Darshan Shah, a podcast dedicated to cutting-edge science, research, tools, and protocols designed to help you extend your health span. Having become one of the youngest doctors in the country at the age of 21, and trained and board certified at the Mayo Clinic, I've accumulated three decades of practice as a board-certified surgeon and longevity expert. Over that time, I've discovered that a mere 20% of health knowledge yields 80% of the results when it comes to your health span. We're living in a new era where we are creating a new healthcare system, no longer focused on disease management, but achieving optimal health and vitality. Join me as I interview world-renowned experts, offering you a step-by-step guide to proactively avoid disease, and most importantly, extend your health span.

• 0:48Dr. Darshan Shah?

  Today, I'm joined by two guests who are changing how we talk about women's brain health, Emma Heming-Willis and Dr. Nicole Birkins. Dr. Birkins is a clinical psychologist who has treated both children and adults. She went back to school for a degree in nutrition science so that she could combine brain health with nutrition and functional medicine. In her clinic, she kept meeting mothers in midlife who said they felt foggy, weren't sleeping, and couldn't hold it all together anymore. That led her to focus her practice on what happens to women's brains as they age. Emma Heming-Willis is a co-founder of Make Time Wellness. She started it after a doctor brushed off her own brain fog as mommy brain. She's also been a caregiver, so she knows that side of brain health personally.

• 1:31Dr. Darshan Shah?

  Today, we're going to be talking about why most brain research has been done on men, and how perimenopause and menopause raise a woman's risk of dementia and Alzheimer's. We'll also cover what caregiving costs the caregiver, and practical things that you can do now, like sleep, nutrition, stress management, and supplements to protect your brain for the long term. Let's dive in with Emma and Dr. Nicole.

• 1:59Dr. Darshan Shah?

  Dr. Nicole and Emma, thank you so much for coming on the podcast today. The Extend Podcast is an incredible honor to have both of you. You and I have talked a lot in the past, and now finally, we have you on as well, Emma. So, thanks for joining us.

• 2:11Speaker 01

  Thank you for having us. We're so excited to be here and talk all about women's brain health.

• 2:15Dr. Darshan Shah?

  Yes, yes, I'm very excited about this conversation because we've had a lot of podcasts on just brain health in general. And I think a lot of the research on brain health has been mainly done on men, right? And I think this is kind of a huge blind spot we have in the care we provide, in how we think about brain health as a category. And one of the biggest problems that I see is that the people suffering the most, the women, are often the ones that are not given the care when it's the right, when they need it, right? And I think also, there's a huge conversation that we're going to have today around prevention as well. And you know, brain health, we talk about it so scientifically a lot in our conversations on this podcast.

• 2:58Dr. Darshan Shah?

  And I'm really excited to bring in more of the human element to this, where this is an emotional journey, especially when there are diagnoses that we have to deal with, right? And so, I think obviously, there's prevention, there's care, and we can get into all of it today. That's good with both of you.

• 3:13Speaker 01

  Sounds great.

• 3:13Speaker 02

  Absolutely.

• 3:14Speaker 01

  Let's do it.

• 3:15Dr. Darshan Shah?

  Well, before we do this, you know, Dr. Birkins, you and Dr. Nicole, you and I, we've talked in the past. I would just love for you to tell the audience a little bit about your history and your career, and why this became a focus. And then, Emma, you as well, like, why are you so passionate about women's brain health and how you guys came together? I think there's so much value in that story because your company that you've joined forces with is a mission-led company. And I love companies that are mission-led. So, please, maybe you can start off, and then we can give it to Emma.

• 3:44Speaker 02

  Sure, absolutely. You know, my background is as a clinical psychologist, and I trained in both pediatric and adult care, and spent a good portion of my career early on working with children and teenagers. And the interesting thing when you work with kids is that you also get a lot of experience working with the adults who come along with them. And so, as I got further into practice and really expanded and started treating then, a lot of the parents, moms especially, of the kids that we were seeing at our clinic. And that got me, I mean, obviously, I've always been interested in brain health. It's why I became a clinical psychologist. It's been my focus area. Got really interested in the nutrition and sort of functional medicine side of that,

• 4:29Speaker 02

  which is why I went back and got a degree in nutrition science, to be able to weave those things together. And it just was a natural evolution of looking at what's happening with women in particular. Alongside them, I was also raising kids, and then getting older and going through, you know, all the changes that happen in your life as you age. And so, it was a natural progression then of becoming really interested in, boy, this is a tough life phase for women as we get further into middle age. And we've still got kids, we've got careers, we've got partners, we've got parents who are aging. And it really gave me sort of a bird's eye view into what was happening for women in this stage,

• 5:12Speaker 02

  and the changes that they were experiencing, particularly on the brain health side. You know, moms coming into the clinic going, "I've always had it together before. I've been able to keep 1,000 tabs open in my brain. I've got the kids and everything, and I feel like I'm not holding it together that well anymore. I feel like I'm foggy. I feel like I'm not sleeping well. I feel like I'm snapping at everybody." And so, that really got me interested at that point in my career of saying, hmm, what's happening with the brain in women as we age, both personally for myself as well as for patients? And so, that was a natural connection then, when, you know, Emma and her team came to me and said, "Let's do something around this."

• 5:55Dr. Darshan Shah?

  Yeah, yeah. And so, from your like 10,000-foot view, do you feel that as women are going through life, and they go from childhood to adulthood, and then through the perimenopause and menopause stage, does their risk just gradually build up? Or is there a kind of like an exponential increase in risk after perimenopause or menopause?

• 6:17Speaker 02

  It's interesting, you know, and one of the things that you mentioned earlier is how little research is done on women's brain health. I would say on women's health in general. You know, one of the reasons women historically have not been included in a lot of clinical trials and research that has gone on is because we do have a more complicated hormone system. And so, you just kind of noted that, that progression of, we go through puberty, then many of us go through that phase of hormone change with pregnancy and breastfeeding. And then, we get maybe this little period of time where things even out, and then we head into the perimenopause/ menopause transition. So, women, you know, there is an increased risk factor over time

• 7:01Speaker 02

  just from the standpoint of, we go through so many major hormonal shifts and sort of metabolic reorganizations throughout our life. But where we really see that risk increase is in that shift towards perimenopause and menopause, when that estrogen is just dramatically dropping. So, I would say, you know, the evidence points to the risk is there and is more for women than men over time, but certainly, that perimenopause transition accelerates it.

• 7:31Dr. Darshan Shah?

  Yeah, that's kind of what I have seen as far as, you know, when I have, we have so many patients here at Next Health, 50% of them actually women. So, you know, I get to see a real variety of different types of patients with all different backgrounds. But I really love it that I see half women patient, half men patient. And I made a promise to myself, this podcast would be half female guests and half male guests because it's just like, that's my, half my audience. Like, why do we ignore that half in all the things that we talk about, right? And so, another reason I appreciate you guys being here. And Emma, like, your journey and your life has brought you to this place as well. And I'd love to hear from your own words, like, what that journey consisted of, and why you're so passionate about women's health.

• 8:15Speaker 01

  Yeah, I mean, a few years ago, I was experiencing my own brain fog and went to my doctor and said, you know, "I'm not feeling sharp. I don't know what's going on. I'm walking into rooms. I don't know why I'm walking into this room. Like, I just don't understand what is happening." And he dismissed me. He said, "You know what? You're not getting enough sleep. You have mommy brain. You're stressed. Don't worry, you're going to be fine." And I walked out of that office thinking, "Oh, thank God. Thank God, he thinks I'm going to be okay." But, you know, time passed, and I wasn't getting any better. And I sought after a brain health doctor who introduced me to this lifestyle change and this shift.

• 9:00Speaker 01

  And brain health wasn't something that I knew about. I didn't know, you know, I knew about heart health, breast health, you know, gut health, but really not brain health. I didn't even know that was a thing. So, I, you know, started to change my lifestyle, taking fistfuls of my, you know, vitamins multiple times a day, trying to, you know, remember to get rest and the right nutrition and movement. And all of these things, I really started to see a shift and really started to feel like my brain fog, you know, was starting to lift. The issue was, taking the handful of vitamins multiple times a day just was not sustainable for me, for my life.

• 9:44Speaker 01

  You know, it's hard to choke down pills.

• 9:47Dr. Darshan Shah?

  Sure.

• 9:47Speaker 01

  And my co-founder Helen, who was a friend of mine, I said, "You know, I'm seeing such a dramatic shift in how I'm feeling, and I would love to be able to put all of these vitamins into like a drink suppo- Or like a gummy, something that's just easy to take, something all in one. And Helen was like, this is so in my wheelhouse. We can absolutely do it. So, you know, we started this brand Make Time Wellness. But as we started to go down the rabbit hole of women's brain health, you know, we started to realize just how at risk women are, you know, this one in five women, you know, will develop Alzheimer's in their lives. Two thirds of, you know, the world's Alzheimer's patients are women.

• 10:29Speaker 01

  And that was really, you know, shocking to me. But what I loved and felt so encouraged about is that there are things that we can do today that supports our brain in the long term.

• 10:41Dr. Darshan Shah?

  Yeah, absolutely. And, you know, we're going to talk a lot about the science today about, you know, estrogen and nutrients. But before we do that, I think it's important to highlight the emotional, psychological aspects of this. And I think both of you have some unique perspective to share there because that's also something that doesn't get talked about a lot on podcasts, right? We love talking about the science and the mechanisms and the drugs. But there's definitely, in my opinion, a psychological, I would say, not just a lifestyle, like as far as your lifestyle habits goes, but what's going on in your life that affects your risk of Alzheimer's as well, right? Can you guys speak about that a little bit? The psychological implications of going through perimenopause and just even, you know, we were talking a little bit earlier about being caregivers, right? In life, how does that affect

• 11:25Dr. Darshan Shah?

  your risk? And how does that affect how you think about this?

• 11:28Speaker 01

  I mean, especially as a caregiver, I'm a caregiver myself.

• 11:33Speaker 01

  You know, we put ourselves last on the list, and not even just caregivers, women.

• 11:38Speaker 02

  Women.

• 11:38Speaker 01

  Women in general, right? Like, we are always the last on that list. We are, you know, managing our children and our older parents and, you know, spouses. And we're, you know, we're doing all these things that are helping them and benefiting them. But we, you know, aren't valuing ourself or just not thinking about ourselves in that way. And then when you get into the caregiver aspect of it, you know, a lot of caregivers are doing this with zero support, right? So they can't leave their person at home to be able to go get their yearly, you know, go to the dentist, get their mammogram, you know, that there's a statistic that, you know,

• 12:21Speaker 01

  some caregivers die before the person that they're caring for. Because they just aren't able to put their health first. And, you know, brain, your brain health is something that will suffer too because of that. So, yeah, so.

• 12:37Dr. Darshan Shah?

  It's a lot of stress. It's a lot of, like you said, neglect of self-care. So is there a mindset shift that you would like the women and the men listening to this podcast to potentially think about having to put more self-care into their lives if they're a caregiver?

• 12:54Speaker 01

  Yeah, I mean, I think that you cannot sustain the journey of caregiving if you are not putting yourself first and thinking about yourself. It's really impossible to be able to do that. And I think as women, mothers, you know, we are putting everything together so thoughtfully. But there just comes a point that that whole bottom will fall out if the person who is leading the charge is not well. And I think that was my wake-up call was my husband's neurologist. He, you know, said, you are burning the candles at both ends. And it's time for you to start thinking about yourself and start valuing yourself.

• 13:35Speaker 01

  And I think that that was important for me. I needed someone to give me permission and to really sort of wake me up that you need help and you need care.

• 13:46Dr. Darshan Shah?

  Yeah. And I think you show up better for the people that you're caring for when you take care of yourself as well.

• 13:52Speaker 01

  Of course.

• 13:52Dr. Darshan Shah?

  Because you're doing it with more, I would say, I think there's a little piece here of resentment almost sometimes too, sometimes, right? Like, if you're spending 120% of your energy to take care of other people, it does psychologically create a feeling that, why am I doing this? What am I doing this for at the end of the day sometimes? And that must be one of the emotions that can occur. And I know, you know, there's other emotions that tie into this as well. And there's a lot of, there's a lot of talk or I would say, research around even like postpartum depression, increasing the risk of neurodegenerative disease in the future. What do you think about your kind of like emotional state and how that leads to your eventual risk of neurodegenerative disease?

• 14:36Speaker 02

  You know, it's interesting because in Western medicine, at least, we've historically separated the brain from the body, right? As if everything that happens from here down is completely separate from what happens in our brain and our mind. And I think that's really done a disservice in general. You know, the fact that we talk about mental health versus physical health, when it's all just health. Everything that's going on in our brain, which includes our mind, our emotions, our lived experience, impacts what's going on in the physiology and the health of our body and vice versa. So this idea of thinking about us as whole humans, I think is really important. And we know, you know, as you mentioned, there's been so much research, especially in recent

• 15:18Speaker 02

  years, around the connection between things like trauma, for example, which we think of as something that happens in the mind, in the brain, and how that impacts things like our inflammation levels, our metabolic health. So we're getting a lot more data on what we've known clinically for a really long time, which is that these things are completely connected. So if you understand that, then it makes sense for women living in the world that we live in with the lion's share of the caregiving burden throughout our lives. Now, that's a stereotype, but it's a stereotype for a reason.

• 15:58Speaker 02

  You know, that we would have more of that burden on an inflammation level, on a brain level throughout our life. And then, again, you throw in all of those life changes, like you mentioned, postpartum depression, which absolutely, if you have a risk, if you have had postpartum depression, postpartum anxiety, postpartum psychosis, you are more at risk. If you've had any diagnosed mental health kind of condition, including things like complex trauma, PTSD, those kinds of things, it does make you more vulnerable to neurodegenerative kinds of issues, not just Alzheimer's, but more broadly, all the different forms of dementia and other kinds of neurodegenerative things. So, and I don't say that to scare people, to

• 16:43Speaker 02

  make women or men think, oh, my gosh, I've had a history of that, you know, I'm going to get Alzheimer's. No. But it is an important thing to be aware of. And I think it's empowering for us to understand that we need to be thinking about our brain as we age. We spend so much time, as Emma said, you know, thinking about our cardiovascular health and our risk of breast cancer and all these things that are much more commonly talked about. And yet, our risk of Alzheimer's is greater than our risk of breast cancer. And, and no one's talking to women about protecting their brain and about supporting their brain. And there's

• 17:26Speaker 02

  a million reasons to do that. So that's why I think this message is so important. And, and women are at greater risk. We don't yet understand all of the reasons why women, for example, are two thirds of the population of people who get Alzheimer's. We have theories about that. There's more research going into that. We need far more research. But when we look at all these parts and pieces that we're talking about, you begin to bring that into focus and say, yeah, it makes sense that brains and emotional systems and physiological systems that are taxed more over time are going to be at greater risk.

• 18:03Dr. Darshan Shah?

  Yeah, absolutely.

• 18:04Speaker 01

  It's funny when I think about, you know, this Make Time Wellness and the product and when people have come up to me like, oh, you know, it's so great. I love, I love what you're doing. I need to get this for my mother. And I'm like, no, we need to get it for yourself. You need to start today. And, you know, that's, and at Make Time, like, we're, we're not using scare tactics. You know, our, our brand is, is empowering. And, you know, we're giving women practical ways to care for their, for their brain. But yeah, I think the scare tactic, it's, that's not what it's about. But it is empowering to have that information and to know.

• 18:41Dr. Darshan Shah?

  Yeah, absolutely. You know, I think about trauma, for example, you mentioned trauma. Many of us have had traumas in our lives as a child, even as an adult, right? And I think that we know that there's a connection between trauma and what, how you deal with those traumas later in life that impacts your risk of getting neurodegenerative disease. What should a person, male or female, do if they know that there's traumas that occurred in their life? Is, is it worth it for them to find a therapist, a psychologist, or undergo even, you know, bring this up now, to undergo any sort of even plant medicine treatments to work through

• 19:22Dr. Darshan Shah?

  those traumas? How does that impact their risk of neurodegenerative disease in the future?

• 19:27Speaker 02

  Yeah, I mean, look, if you're a human living in the world, you don't get to adulthood without experiencing some degree of what we might call a trauma, right? And some of those are really what people think of in terms of the big, you know, horrible events and things that happen. But even smaller things can be traumatic because the experience of trauma is in the person, not in the event. It's how our brain and our mind integrates it, makes sense of it, which is why the same experience can happen to 10 different people. And they may have 10 different reactions to that, ways of moving through that.

• 20:07Speaker 02

  Some people are significantly impacted by that decades later, whereas others have moved on. And that speaks to our individuality, too, in terms of how our brains function, how we're able to make sense of things. So my stance on treatment for that is that any time anyone, child, adult, whatever, is experiencing something that is having a negative impact on their well-being, on their ability to function, on their emotional state, on their relationships, they should seek help for that, just as they would for something physiological that's going on. Sometimes that absolutely should involve psychotherapy of some sort. Sometimes that can involve group support kinds of things.

• 20:52Speaker 02

  Sometimes it involves, you know, reconnecting with important people in our lives, family members, developing community around ourselves. Sometimes that involves psychiatric medication. Sometimes it can involve supplements and diet changes. It can involve plant medicine or other kinds of, you know, approaches like that. So I think the important thing is that people recognize that there are resources and things available. Now, we can have a whole conversation about how accessible those things are, you know, to the broader population. But to be aware that that is not a weakness if you're struggling with those things, even if you say, well, that's something that happened to me 30 years ago. You know, it shouldn't be bothering me now, or I need to be, you know, tough and get through it. If something is still creating issues for you,

• 21:36Speaker 02

  it's not too late to get the help for that and to get the support that you need. Psychotherapy can be amazingly impactful for people, as can, you know, all of these other kinds of approaches. So I think, again, it's the awareness of we do have things that we can do to support people. You can change your brain. You can change the way that you process these things, and that's just going to help you feel and function better.

• 22:01Speaker 01

  I also think even going a step down from trauma is just like everyday stress.

• 22:06Dr. Darshan Shah?

  I was just gonna mention.

• 22:07Speaker 01

  Stress in general. In general, you know, how that builds in our body. And that's, you know, like, one of the pillars is like, you know, mindfulness. And, you know, for me, I schedule brain breaks in my calendar. Everything else is scheduled. It's sometimes just really important for me to have a little alarm that goes off saying, you know what, stand up, get outside, get some fresh air. You know, I think that meditation is important. And for me, my meditation isn't about sitting and being in that for 20 minutes. It's, for me, it's like getting out for a walk, going for, you know, getting into nature, going for a hike, gardening. Like, that's my form of meditation that really just sort of connects me back into myself,

• 22:50Speaker 01

  which I also know is really important for my brain health.

• 22:53Dr. Darshan Shah?

  Yeah, yeah. I like, my morning walk is my time for meditation as well. So I think it's a good point that you don't need to be sitting there in like a, you know, cross-legged pose to do a meditation. There's many ways of doing this. And to our earlier point about self-care, those moments of finding time for your brain to rest is self-care as well. So everybody, everybody, male and female, should be trying to build those into their life. As far as stress goes, you know, there's this whole category of supplements called adaptogens, right? How do you feel about adaptogens? Is that part of your product line? And which ones do you think are very effective?

• 23:29Speaker 02

  Yeah, I mean, so in our product line, Rhodiola is one that we lean on. It's got great research behind it. It's been used, you know, safely for a long time. We particularly know, again, for women with stress levels, it can be very helpful for calming and relaxation. But also, not that sort of foggy, sleepy calming and relaxation, but that my brain is alert, I can still think and do things, but I'm just more relaxed. You know, ashwagandha can be a great option, you know, for many people. I think, again, just building awareness that these things are out there and available that can be helpful. Obviously, you know, women need to be speaking with their healthcare practitioners

• 24:11Speaker 02

  based on, you know, what's right for them if they are taking medications and other kinds of things. But these kinds of adaptogens can be great supports.

• 24:20Speaker 01

  Yeah, I love, I love Rhodiola because it, you know, like, increases your energy, but also lowers your cortisol. And, you know, I think that's really helpful.

• 24:27Dr. Darshan Shah?

  Was that one of the supplements that you used? You said when you were taking handfuls of supplements?

• 24:31Speaker 01

  It was, you know, curcumin. That was one of our main ingredients in there. Yeah, everything that I was taking, except for there's one that I wasn't, which was Cognizin, which I don't think was available when I was, you know, discovering all these different supplements. Cognizin I love because it's a really well-studied ingredient for women. And that really helps with focus, mental clarity, so that we've included in our products, too.

• 24:56Dr. Darshan Shah?

  What is Cognizin for the listeners?

• 24:59Speaker 01

  Didn't I just say it?

• 25:01Speaker 02

  So Cognizin is acetylcholine.

• 25:03Dr. Darshan Shah?

  Acetylcholine.

• 25:04Speaker 02

  Yeah, so acetylcholine is an important nutrient that really, the way that I explain it to people is it allows your brain cells to communicate better with one another. It helps with, if you think back to your biology, you know, class at some point that we all took, cells have membranes, right? And those membranes need to be nice and healthy. And they allow our neurotransmitters, which really is what allows our brain to communicate with itself. They allow those to work better. And so Cognizin is, is just a specific type that has been well researched, particularly in women, which is why we liked it. Because there's more and more research out there on nutrients and the impact on brain health and, and body health, but not a lot that's been done specifically on women.

• 25:46Speaker 02

  So when we saw the data on that, and, okay, you do see improvement in things like focus, attention, working memory, those kinds of things, particularly in women, particularly in that middle age and older phase of life, that was really compelling. And then, obviously, you know, formulating that and taking the supplement and seeing the difference with it. So we really try to formulate these in a way that are, you know, particularly useful for the things that women are having complaints about and dealing with and struggling with in this phase of life, because we know that we need to keep it easy, too. I mean, look, you and I can have all, two-hour-long conversation about diet changes

• 26:26Speaker 02

  and, you know, get the sleep and do, and those things, they're, they're all really important. And yet, Emma and I know from just being this age in life and having friends and, you know, seeing what everybody's going through, when you give women in this stage of life a huge laundry list of, here's the 400 things you need to do. Oh, and you need to eat a totally anti-inflammatory, organic diet with no, you know, processed things in it. And you're thinking, okay, but I'm still trying to feed my kids at home and I have a job and all. It, it becomes even more stressful for a lot of women, right? And thinking, well, now this is a second job I've taken on in just trying to eat in a way that's healthy.

• 27:09Speaker 02

  So I'm not suggesting that we shouldn't look at good ways to shift the food that we're consuming. But what we've been really intentional about with Make Time is giving women something that is simple and easy to build into their routines that they know, even if nothing else, they're covering some of the gaps and they're helping support their brain and body function, even if they can't get to the rest of it.

• 27:33Dr. Darshan Shah?

  Right.

• 27:34Speaker 01

  Yeah, because I feel like even for myself, I'm not hitting, you know, the, the pillars of great brain health seven days a week. You know, I'm just sometimes not able to. But I know that if I'm at least covering my bases with a supplement and movement or making sure that I, you know, had a good night's sleep, it's really just about how to incorporate and how, and to know about the pillars. And I actually really enjoy them because, you know, it's, you know, we're talking about nutrition and rest and sleep and connection. What else, what else are we?

• 28:10Speaker 02

  Stress reduction.

• 28:10Speaker 01

  Stress reduction. You know, these are things that we can apply in our everyday life that's really obtainable.

• 28:17Dr. Darshan Shah?

  Yeah, absolutely.

• 28:23Dr. Darshan Shah?

  Creatine isn't just the most researched supplement. It's actually proven to deliver results. So whether you want stronger muscles or you want a sharper mind, creatine is the energy source you're going to need to get there. Momentus just introduced Signature Spec Creatine. It's their highest quality creatine to date. It has 10 times fewer impurities and two to five times stricter heavy metal limits than even other premium creatines. And it's all backed by six stages of testing and certification. Not to mention, the ultrafine micronized powder makes it so easy to mix into your favorite drink or smoothie. Try it yourself at livemomentous.com/DrShaw

• 29:06Dr. Darshan Shah?

  and you'll get up to 35% off your first order using the code DrShaw.

• 29:14Dr. Darshan Shah?

  So you know, we've mentioned inflammation a few times here, and I'd love to get your perspective on why do women get inflamed? What can they do about it? And you know, some of the things that you mentioned like curcumin is incredibly valuable for lowering inflammation as well. Can we talk about inflammation a little bit?

• 29:32Speaker 02

  Yeah, absolutely. I mean, you know, inflammation is an issue for men and women. I mean, again, if you're a human living in the world today, hard to not have some degree of inflammation. Just we have added so much to the environment that we live in that, you know, can make us more inflamed. Certainly, the foods that we tend to be exposed to and eat today as compared to decades ago, we know are more pro-inflammatory. We're more stressed, we're not sleeping as well. All of those things lead to greater amounts of inflammation in the body. People say, well, you know, inflammation, why is that a bad thing? I mean, people think of like, oh, I cut my finger and it gets red and hot and inflamed.

• 30:16Speaker 02

  That's acute inflammation, but we have this chronic inflammation. I know you talk about this a lot on the show, so I'm sure your audience has a good understanding of that. But it's sort of like this slow building fire in our bodies that as we get older, all of those inflammatory impacts can increase and can start creating challenges for us with our health. Where people often notice it first or where we tend to talk about it more is metabolic health, right? Weight gain, heart issues, high blood pressure, you know, those kinds of things. But inflammation is just as important to think about for brain health. Because when you have these higher levels of chronic inflammation,

• 31:00Speaker 02

  sort of this simmering fire that sometimes can become raging, especially as we get into the hormone shifts, that does have a significant impact on how our brain functions. And so we want to be thinking about those inflammation levels. In fact, there's some, you know, studies now showing that if women are more inflamed heading into the hormone transition of perimenopause and into menopause, it can make for a more difficult transition. So sort of the higher level of baseline inflammation we have, the more likely we are to struggle during those massive hormone shifts. Things can even out on the other side of it. But you know, we talk about perimenopause feeling like that roller coaster.

• 31:43Speaker 02

  And that can be a decade, you know, of our lives. The more inflamed we are heading into that, the more challenging that transition can be. So again, just that awareness of even at younger ages, thinking about what can I do to support lower levels of inflammation? I'll just feel better in general, but especially for women as we head into our 40s and 50s and those hormone changes, the work that we do upfront with that to keep our inflammation levels down can really help.

• 32:12Dr. Darshan Shah?

  So what are some of the things that we can do to keep our inflammation levels down upfront?

• 32:16Speaker 01

  I mean, for me, I think about nutrition. You know, that's one of the things that I really sort of think about when I think about inflammation. You know, I make sure that I'm having my supplements. And like you said, the turmeric is something that's so important. You know, I was going to ask you, what do you, what do you think about for younger children? I've actually never really thought about that.

• 32:35Speaker 02

  Yeah, I mean, I think food is such a powerful lever to pull here because we know that highly processed foods, ultra-processed foods do tend to lead to higher levels of inflammation. So the more that we can eat what we call whole foods, things that are nutrient dense, right? Fruits, vegetables, animal proteins, whole grains, healthy fats. Those are things that really are sort of the powerhouses of keeping our inflammation levels low. We're going to have stress. We're going to have, you know, sleep issues at various points in our life. We're going to have lots of things that can let that inflammation creep up. But by and large, when we are eating a diet

• 33:20Speaker 02

  that is lower in, you know, those kinds of ultra-processed things, and that goes for kids. I mean, the data on that is really good for kids as well. When we think about the number of children that are developing brain-based kinds of issues, we know that higher levels of ultra-processed food, higher levels of inflammation can be connected to that. So that's the great thing is when we're talking to women about brain health, about eating for brain health, eating to lower inflammation. The great news is you don't need to be doing a diet that is different than what your kids or your partner or whoever. This is a good nutrient dense way for everyone to eat. And I think it's important for us to think about it that way.

• 34:04Speaker 01

  I also know that there's some really great cookbooks out there that are really, you know, like brain health focused. There's one from Annie Fenn. I can't remember the, the name of that book, but she wrote this really great, like really yummy recipes. And, you know, I always just make sure that I have some of those ready to go meals in my refrigerator because it's so easy just to just grab something when you're really hungry. But yeah, so I was just thinking.

• 34:30Dr. Darshan Shah?

  Yeah, that's a really good piece of advice because I think a lot of people think that when they're really hungry and you grab something really fast, the first place it goes is their pantry. Then they find, you know, the wrapped snacks, like chips and cookies and stuff. And having something prepared in the fridge that's healthy for you can be a game changer. Because I think that's where we really get ourselves, to your point, inflamed with ultra-processed food is the fast, quick, processed food that's in packaging, right? And so we've kind of eliminated all of that from our house and we just focus on what can we put that's quick, but also still high in fiber, high in nutrients as well, right? And so I think that's, that's critical.

• 35:11Speaker 02

  And I think times have changed. I mean, when I think back over 30 years of seeing patients in the clinic, back when we were talking about these, I mean, there weren't a lot of us, especially not in mental health, talking about this 25 years ago. But you know, it was a much different conversation than today where we do have so many more options. There are more convenience kinds of options now that are still healthier for us than there used to be, right? So, you know, thinking about little packs of nuts or, you know, even fruit or meat sticks, things that now are available that, that weren't, that can make it more doable, especially for those of us

• 35:54Speaker 02

  who are still in the trenches of raising school age kids and, you know, running around and, and doing all that kind of stuff. You know, don't, don't be afraid of using things that are quicker and easier and still really nutrient dense, right?

• 36:08Dr. Darshan Shah?

  Absolutely. And I think, you know, when you eat that way, it also helps your metabolic health, right?

• 36:13Speaker 02

  Absolutely.

• 36:13Dr. Darshan Shah?

  So I think, you know, I see a lot of women in the perimenopausal, menopausal age, and we do a lot of blood testing on all of our patients and they get to that age and out of nowhere, their hemoglobin A1C goes to 5.8, 5.9. Like, what is happening? And I think a lot of it has to do with nutrition, right? Nutrient absorption, gut health as well. And you know, what's your feeling about that? And I think, you know, one of the things that we always talk about with women that are going through this change in their metabolic health is focusing away from starchy carbohydrates, ultra-processed foods, snacks, and being more protein forward and more fiber forward. Do you agree with that?

• 36:55Speaker 02

  Yeah, I mean, look, as estrogen drops in perimenopause and heading into, you know, the postmenopausal years, it has a huge impact on every organ system, our brain, our gut, our heart, our blood vessels. And so you see this whole cascade of changes. The metabolic ones, I think, are some of the earliest ones. You know, I'm a great example of that, had great labs my whole life. And then a few years ago, all of a sudden, I'm getting my yearly labs done. And it's like, what is this, right?

• 37:29Dr. Darshan Shah?

  That's exactly what I see all the time.

• 37:31Speaker 02

  That's exactly. And so it's, it's the estrogen and the hormone shifts that drive it. And I think what happens, and it feels like just so unfair, but the things that we were maybe able to get away with early in our lives, before estrogen started to like disappear.

• 37:48Dr. Darshan Shah?

  Right.

• 37:49Speaker 02

  That disappearance of estrogen, suddenly it unmask the whole thing. And it's like, yeah, you can't get away with that anymore. But, but it is actually changing the physiology of how we metabolize things. I mean, when we think about the brain, the brain is a very glucose dependent, energy dependent organism. So for, you know, the, most of our lives, up until estrogen starts to decline, our brain, you know, is an organ that uses sugar, it uses glucose for fuel. When estrogen starts to drop, the brain has to go through this whole reorganization process of using fuel differently, because suddenly it does not become as efficient at using glucose anymore.

• 38:31Speaker 02

  And so a lot of the symptoms that we start to see, the fogginess, the, the sleep issues, the, the memory issues.

• 38:39Speaker 01

  The lack of energy.

• 38:40Speaker 02

  The lack of energy, all of that is part of this reorganization process that our brain is going through of how it needs to now get energy, use energy. The good news is that balances out once we go through menopause. But in those years where it's having to reorganize, it's a tricky thing. And it's the same for our, our metabolism in our body as well. And so that's why you see these shifts. It's this hormonal, you know, change that's leading to this cascade of events that really our brain and our body have to reorganize around a new normal. And it feels really unfair, right? Like, well, wait, now I have to also change the way I eat.

• 39:21Speaker 02

  Like, these things that were working for me okay before are not working now. But I look at that again, you know, in my better moments as an empowering, okay, this is a good call to action, right? This is a call to action because ultimately, you know, whether it's for my brain or my heart, or, you know, any other part of me, I want to be eating and moving and living in a way that helps me not just add years to my life, but add quality of years to my life. And so I think it's just a call to action of saying, okay, time to pay attention to some of these things more now.

• 39:57Dr. Darshan Shah?

  Yeah, that's a really nice empowering way to think about it. It's like, you know, you're not, it feels unfair, obviously. And it does feel like, why? If you look at it as a call to action, which is the same analogy in men. Men go through andropause. You can't just put on muscle and keep the fat off anymore just by walking around. You have to go to the gym, right? And so it's, it's the same for even men that are aging as women, that these are called to actions. And to that point, like, what are some of the signs women should watch out for that are occurring in their life as they're kind of going through this transition to maybe push them into that call to action mentality? What are they looking out for? You mentioned a few of them, brain fog, lack of energy, right?

• 40:42Dr. Darshan Shah?

  Did we miss any in these conversations?

• 40:44Speaker 02

  Sleep. I want to touch on that because sleep is such a critically important thing for brain function. And I know women listening are like, oh, one more person telling me that I need to sleep. But I have to say, like, often when we do, you know, interviews like this, people say, what's the number one thing? And I always say, sleep. Because sleep is so restorative for our brain. Sleep is when our brain kind of takes out the trash. Literally, it gets rid of plaques and, and substances that are problematic. And again, it's one of the big risk factors as we look at what predisposes somebody to developing neurodegenerative kinds of issues.

• 41:26Speaker 02

  Poor sleep is one of them, especially people who have been chronic poor sleepers. So we really want women to be thinking about, you know, if you're starting to notice that you're not sleeping as well, or not sleeping at all, which happens to some women, you know, in perimenopause, that in and of itself is a big red flag to, okay, I need to get some support because I need to look at what I can do for this. Because just getting at least a decent number of hours of quality sleep at night is so protective and healing for the brain.

• 42:01Dr. Darshan Shah?

  Yeah.

• 42:01Speaker 01

  Yeah, that was like one of the first things that I did when I was implementing, you know, this lifestyle change, was really looking at my sleep and just realizing how, what a terrible sleeper I had become, especially after you have children. And then, you know, the, the slightest bit of noise will wake you up and startle you awake. You know, so, yeah, I mean, I've been very mindful about trying my hardest to, you know, get seven hours, six, I mean, really, I'm kind of like six to seven. And I feel like it's good quality sleep. And by the way, you just feel so much better when you do. Because when you are getting adequate sleep, you know, you feel like you can function better. You want to get into the gym and, and move your body and go for the walk.

• 42:44Speaker 01

  I mean, I think that sleep is really the top pillar for me.

• 42:49Dr. Darshan Shah?

  Yeah, and I think also the sleep increases your resilience to all the stuff that you're fighting against all day, whether it's yelling kids in the house, or, you know. Because when you have poor sleep, you're just not going to be as resilient and you wear down a lot faster. In your kind of like caretaker mode, I think that there's also sometimes almost like a guilty feeling about getting enough sleep too, right? Um, I know, like in our household, when the kids get up, like, you have to be up, right? And you have to be up there dealing with them. How do you talk to women about, how do you build this into your life? How do you get better sleep when you have a busy schedule?

• 43:25Speaker 01

  I mean, it's just about prioritizing it and understanding how important sleep is. I mean, I didn't really understand it until, you know, there was always this idea of like, oh, I'll sleep when I'm dead. I'm just gonna work myself to the bone and, oh, who needs sleep? You're a wimp if you need sleep. No, it's like, it's actually so important. I think, you know, as, as caregivers, that's also really hard. If you are someone, the only person in your house that is a caregiver and caring for someone with a disease of some sort, it's, it's stressful. It's hard, it's hard to shut your mind off. I mean, I think you're constantly in this fight or flight. But it, it, it's important to try and bring in help, family, friends.

• 44:08Speaker 01

  So at least a caregiver, you know, you can't, again, like, seven days a week is probably hard. But if you could have someone come in for a night or two, that would be so beneficial to help support a caregiver so that they can get adequate amount of sleep.

• 44:24Dr. Darshan Shah?

  Yeah, absolutely.

• 44:25Speaker 02

  But you know what I say to women too, especially if you've got young kids who are not sleeping well, sleep is equally as important for children. You know, one of the first things I would ask about when parents would bring their kids into the clinic is, tell me about their sleep. If kids aren't sleeping well, parents aren't sleeping well. And so it's important for the whole family to get a plan in place where everybody is going to bed and everybody is sleeping. And that's especially important as women get older. And, you know, many women are having children later in life now. And if you've got a toddler or preschooler thrashing around in your bed all night, and you're not sleeping, and now you're heading into these hormone changes, it is like the perfect storm.

• 45:09Speaker 02

  And so not for women to feel guilty about, oh, I need to get my kids to sleep. Your kids need to learn how to sleep well, because that's important for them and their brains too. So important for everybody, everybody to sleep. And I think the thing, you know, that we do have more control over than maybe we want to think about is our habits around sleep, right?

• 45:32Dr. Darshan Shah?

  Right.

• 45:32Speaker 02

  So routines for sleep are things that, you know, as I said, we have control over that we sometimes don't want to think about, right? But the winding down before bed, sort of getting into a routine where your brain senses, okay, it's time to head to sleep. Now it's time to settle down. Our body and our brain uses something called melatonin, which is a hormone that it produces that helps us wind down when we're sitting and staring at our tablet or our phone, exposed to blue light, or even just, you know, big overhead lights on and very active brain late into the evening, that doesn't allow our melatonin levels to rise. And then we don't feel as sleepy. So we want to support our brain and our body in winding down for sleep.

• 46:16Speaker 02

  And that can look like, you know, we each have our different routines for that. But that can look like, you know, at least 30 to 60 minutes before you want to go to bed, starting to get into that wind down routine. That is a simple thing that we can do that has a really powerful effect on our sleep.

• 46:31Speaker 01

  You have to like romance yourself to sleep.

• 46:33Speaker 02

  There you go.

• 46:34Dr. Darshan Shah?

  That's a good way to put it.

• 46:36Speaker 01

  I mean, it's interesting because I do have like this wind down, you know, routine. Last night, my daughter had, um, she was playing sports and it went really late. So by the time we got home, it was like, you know, we slammed into bed and I had like the worst nights sleep last night. But when I take that extra time, you know, to really like dim the lights, I like to read a book, that really helps me sort of, you know, wind down something not to, you know, something that's not stimulating my, my brain too much. That kind of maybe bores me a little bit, then I'll fall right to sleep. So I think it's, I think that's important.

• 47:10Dr. Darshan Shah?

  All good points, about the things you do and don't do. Like to your other point, like, having your phone next to you in your bed is just ruins your sleep too, so. And then, you know, I want to talk about, we talked a lot about routines and habits. I think, you know, we got it really well into like awareness, one in five. You know, that can be a scary statistic for people. But I do believe that it's one in five because we are not focused on routines and habits. And we haven't done the things that we should have been doing for the last few decades that has led to this kind of massive uptrend in women's Alzheimer's. And one of them is hormone replacement therapy, right? I mean, for many years, hormone replacement therapy was not offered to women.

• 47:49Dr. Darshan Shah?

  And I think that also is part, was part of the problem, why we are, why we are here now, right? So what is your? Feeling on hormone replacement therapy? And I think there's, I mean, there's a direct link between estrogen levels and Alzheimer's risk, right? So we should talk about this.

• 48:06Speaker 02

  Well, I think my, my first thing that's important to cover with this question is that it's really frustrating and unfortunate that we don't have clear research on this for women, right? Like, the fact that this is still an outstanding question and a theory at this point in 2026, knowing the stats that we know about how much more likely women are to experience Alzheimer's and dementia, it's pretty frustrating that we don't have concrete answers to this. Certainly, there are hypotheses around this. Certainly, we do have research-based reasons to believe that declining hormone levels, estrogen in particular during the perimenopause, menopause, and beyond transition, is a factor

• 48:51Speaker 02

  in the development of Alzheimer's, but we don't know that for sure yet. It's very exciting research happening in Dr. Moscone's lab and others right now that will hopefully give us more concrete answers to that in the coming years. But I think in the meantime, you know, it's important for women to understand that shifting hormone levels, again, we've been talking about this whole phase of midlife to later, you know, stages of life, that hormone changes do play a role in how our brain functions, period, right? Plays a role in whether we're sleeping well, which is connected to the development of

• 49:30Speaker 02

  cognitive symptoms and dementia, plays a role in our mood, plays a role in our processing. So, you know, that's enough reason to be looking at how we can support ourselves with that hormone piece. And I think that's why, you know, many women find that estrogen replacement therapy, specifically hormone replacement therapy more broadly, can be a really important part of their overall plan for navigating this phase of life and protecting all different organ systems, the brain included, as we continue to age.

• 50:06Dr. Darshan Shah?

  Yeah, I totally agree. Emma, do you use hormone replacement therapy? And do you feel like it's valuable? And I'm curious, you know, I think a lot of the women that I see, and we put on hormone replacement therapy, they feel cognitively clear as well the minute they get on it as well. So I'm just wondering, what's your opinion, Emma?

• 50:25Speaker 01

  Yeah, I mean, surprisingly, at 50, I am not there yet. I, I, it's wild. I don't know. I feel like I'm one of a kind, maybe. I'm not, I don't care what's happening. But, you know, recently, I have, I've been, you know, having my hormones tracked because I'm like, I'm feeling like it's knocking at my door. But I'm not there yet, but I am so grateful for the education that is out there now, which, you know, now has sort of empowered me to, you know, keep that in the back of my head and to understand that if I am all of a sudden experiencing a little more brain fog or not feeling like myself, this might have something to do with perimenopause.

• 51:09Speaker 01

  And, you know, if, if having a hormone replacement was right for me, if my doctor suggested that, it is absolutely something that I would consider.

• 51:19Dr. Darshan Shah?

  Yeah, I think it speaks volumes that you're open to it, and you've heard about it, and you know it's part of the potential solutions if you were to get symptomatic. You know, it wasn't like that even five to 10 years ago at all. Like, it was not even on the table. And it's just so great that both of you have pretty, such incredible education out there. People just need to know, they need to know this is, this is part of the solution. It could be a potential huge part of the solution just for the now and brain fog, but also for the long-term cognitive impairment and Alzheimer's disease.

• 51:52Speaker 02

  Well, and I think something that's really important for women to be aware of, you know, still, the narrative is very much around menopause equals hot flashes, menopause equals rage, menopause equals, you know, maybe more physiological kinds of things like sleep. And I think it's really critical for women to know that for many of us, brain-based symptoms are one of the first things that we experience, or that you can have brain-based cognitive kinds of symptoms without even experiencing some of those more common things like hot flashes. I was a great example of that. I've never had a hot flash.

• 52:33Speaker 02

  I am very much at the tail end of perimenopause and brain-level symptoms, particularly brain fog, mood changes, just knowing that something was not right with how, you know, I was feeling and how I was functioning. For me, that was, that was a big initial indicator. And so I think just for women to be aware that brain types of changes can, that's enough of an indication, you know, that, that it's worth having a conversation with your healthcare provider about what might be going on with hormone changes.

• 53:07Dr. Darshan Shah?

  Yeah, for sure. You know, you mentioned something briefly there, sleep. We should dive into sleep because I think one of the biggest symptoms that I see that gets really under-recognized because it gets kind of blamed on everything else is sleep disturbances. And, you know, people are like, oh, my life is just more stressful, I'm having hot flashes, I'm not sleeping well. But I feel like there's more of a direct relationship with sleep as well. And so, yeah, what are your feelings on sleep and how that ties into the whole story?

• 53:40Speaker 02

  I mean, we know sleep is critically important throughout the lifespan, right? Lack of enough good quality sleep has a negative impact on our brain function, whether we are a toddler or 99 years old, right? The human brain requires enough good quality sleep to function well. And where that particularly becomes a challenge for women during this phase of life, particularly that menopause transition, is that there are, it's like what already may be a challenge for many women, to your point, like stress, taking care of everybody, not getting enough sleep anyway, now gets compounded by the fact that hormone shifts are making it even more difficult to sleep.

• 54:25Speaker 02

  And, you know, that's one of the things that we need the research to tease out further is how much of the cognitive challenges and the brain dysfunction and the dementia risk that we see in women is related to the hormones themselves versus related to the downstream effects of not getting enough restorative sleep, which when we aren't getting enough of those deep sleep cycles, you know, we don't be sleeping cycles throughout the night, not getting enough of those, not going into deep sleep, over time, when you are chronically deprived of those quality periods of sleep, it has really, really detrimental impacts on the brain. Everything from just feeling like you need more coffee and not having enough energy

• 55:08Speaker 02

  and feeling irritable, to really struggling with memory, with processing, with emotional regulation. And so that's why, to me, it doesn't matter the age of the patient I'm seeing, I'm always asking about sleep. And if sleep is, is an issue for this person, we are delving into it and we are looking at what the plan needs to be to get them sleeping better.

• 55:32Dr. Darshan Shah?

  Yeah, all great points. Emma, what are your, some of your sleep hacks or sleep tips for people?

• 55:39Speaker 01

  Yeah, I mean, you know, that was, that's one of the pillars, I think, that I lead with is sleep, because after I had my children, I became a terrible sleeper. You know, the slightest little noise would wake, wake me up. And, you know, as life has progressed for me, you know, it's not something, sleep is, is not really what I excel in, but I realize how important it is for my brain health. So for myself now, you know, I have a couple of tips where I try to disconnect from social media, the television, about an hour before I go to bed.

• 56:20Speaker 01

  You know, I kind of have to like romance myself to sleep because I think, you know, slamming into bed to try and get some sleep, that's just too stressful for me. So it's really about just winding down, you know, making sure that the lights are a little dimmer in the home. Reading is something that I know really relaxes me before bed. And, yeah, I mean, you know, it's just these little, little things that I've put into place because I know that when I get a good night's sleep, I'm going to wake up feeling so much better, so much more refreshed, obviously. And like I said, it's, it's an important pillar for our brains.

• 57:03Dr. Darshan Shah?

  Absolutely. Are there any supplements that you think help with sleep?

• 57:07Speaker 01

  Well, Make Time Wellness has one. We have our, we, yes, we do. We, we have one. It has some melatonin in there. It's got some lavender extract as well as chamomile. And it's just a really beautiful supplement that I really like, that helps ease me into sleep. So I take it about 30 minutes before. And, and that, that is, that has really been a game changer for me with just making sure that I get off to sleep with ease and hopefully stay asleep.

• 57:41Dr. Darshan Shah?

  Yeah, Nicole, you know, there's some controversy around melatonin at night sometimes. And I'm just wondering, how do you think about that? How do you talk about that?

• 57:50Speaker 02

  Yeah, you know, I've always been a proponent of melatonin when it's appropriately dosed and and used. I think that the research, there's an abundant amount of research on melatonin. It is safe, it is effective. I think in the U.S. at least with over the counter products that are available, people tend to take more melatonin than maybe they actually need. You know, you go to the drugstore or your big box store, whatever, and you find the 10 milligram, you know, bottle of that. And that really is overkill for the vast majority of people.

• 58:27Speaker 02

  But to me, any concerns, you know, that that may surface around the use of melatonin pale in comparison to the concerns for somebody not getting good sleep chronically. Melatonin is also a powerful antioxidant. It serves a lot of purposes. What I will say, though, is when I'm using melatonin in a treatment plan, or like as Emma said, Make Time Wellness has a great sleep supplement that includes melatonin, that in and of itself is not the solution to sleep issues, right? That can be helpful. But to Emma's point, we want to still be working on what we call those sleep hygiene strategies. And we want to have a sleep environment that's conducive to sleep.

• 59:12Speaker 02

  We want to be, you know, doing all the things that help regulate our circadian rhythms, help us be able to fall asleep and stay asleep. But certainly supplementation can be a part of that, whether that's melatonin. Magnesium is another big one to look at there. I will also say something that many people aren't aware of is that iron status is really important for good sleep. And so even if you don't have, you know, a diagnosis of like frank anemia or something like that, if you have suboptimal iron levels, particularly suboptimal stores of iron that would be measured like with a serum ferritin, that can really interfere with sleep. And I see that both in pediatric and adult populations.

• 59:55Speaker 02

  So all the more reason to just be working with your healthcare provider on, you know, testing and looking at what specifically might be preventing you from sleeping or, or, you know, might be causing struggles in other areas. And supplementation, when done appropriately, can be very, very helpful for that.

• 1:00:13Dr. Darshan Shah?

  Yeah, that's so true. I'm so glad you mentioned iron, because one of the therapies that we do at our clinics is ID iron infusions, actually. And we get a lot of referrals from sleep doctors that, you know, the, the good ones do some blood work and they check. And it's, it's a, it's a chronic problem in men and women.

• 1:00:32Speaker 02

  Correct.

• 1:00:32Dr. Darshan Shah?

  Right? It's not correlated. And I, I don't know if some of that is having to do with our gut health and also just as we age, we just don't break down the nutrients as well. But I do see this kind of accelerate as you age, iron deficiency.

• 1:00:48Speaker 02

  Absolutely. And, you know, I think it's a combination of a lot of things. But again, it's such a simple thing to test for. You don't even need to have a functional medicine, like your, your basic primary care or whoever you see can run, you know, an iron panel and a serum ferritin and see. And especially for people who are having really restless sleep, you know, iron is one of the first things that we want to consider there. So, you know, I think there are several roles that supplementation can play for sleep along with the good sleep hygiene kinds of things. And of course, you know, you mentioned sleep medicine practitioners, you know, again,

• 1:01:28Speaker 02

  another indication, particularly as we're talking about as we age, perimenopause, menopause beyond, making sure that if we're having sleep problems, that we've been screened for sleep apnea and that we're, you know, getting a sleep study if need. Again, this is a low hanging fruit that people, you know, I have patients who have gone decades not sleeping well and racking up all kinds of problems as a result of that. And it turns out, they really should have had a sleep study 20 years ago and would have benefited from, you know, some therapy for that. So I think we have a tendency, especially in our culture, to just accept that poor sleep or not getting enough sleep is normal.

• 1:02:11Dr. Darshan Shah?

  Yeah.

• 1:02:12Speaker 02

  And I think that's really problematic because people end up just tolerating that and thinking, well, this is just the way it is. You know, I'm a busy human, living in America, doing all the things. And, and I really want people to get the message that if you are having anywhere from mild to significant sleep issues, it is worth having a conversation with your provider. It's worth looking at, you know, what can be done to help that.

• 1:02:37Dr. Darshan Shah?

  Absolutely. And I'm so glad you mentioned serum ferritin, because I think a lot of people go to their doctor and they're like, is my iron okay? But what they're looking at then is a CBC and they're just looking at the hemoglobin. And you're, you're going to be iron deficient way before your hemoglobin is low. So the ferritin is definitely a marker that, that people should be checking.

• 1:02:56Speaker 02

  Yeah. And I'm really glad we have some new guidelines that just came out in the last few weeks around levels, both for serum ferritin, as well as the standard things we run on an iron panel. And really, I think will allow many more people to get appropriate treatment now because those guidelines have shifted. No longer are we, you know, as practitioners, waiting until they are really so deficient. And so again, I see that as, you know, an area where medicine is, is shifting to be more aware of the impacts that these kinds of deficiencies, iron in particular in this case, can have.

• 1:03:34Dr. Darshan Shah?

  Yeah. Do the guidelines give like a, a new optimal range for ferritin?

• 1:03:38Speaker 02

  They, they did. And a new, a new, you know, bottom range as well as an upper ceiling range. But the, the range for being low now, it has gone up, that number has gone up. So people will now be diagnosed with suboptimal iron with a, a higher iron score than what we were waiting for prior. And I think that's really going to be valuable to many people.

• 1:04:01Dr. Darshan Shah?

  Got it, got it. Well, I'm going to look up the study and post the information on, on the show notes as well.

• 1:04:06Speaker 02

  Absolutely.

• 1:04:07Dr. Darshan Shah?

  Do you remember when that study was published or anything?

• 1:04:08Speaker 02

  Yeah, I'll send it to, it's actually the guidelines from, I think it might be, is it the American Hematological Association? I, I'll look up it. It was one of the medical associations that, that produces the, the guidelines for that. And it's the first real change in those guidelines in, in many years. And, you know, I think, you know, Dr. Shaw, you and I and practitioners like us have been using a different sort of cutoff for what we consider appropriate for a patient. But I'm glad to see in mainstream medicine now, those guidelines are getting adjusted. And again, it's just, it's an evidence-based recognition that suboptimal iron is, is a

• 1:04:49Speaker 02

  problem for people and that people actually would benefit from iron repletion well before they, they, they have been referred for that in the past. So.

• 1:04:59Dr. Darshan Shah?

  Yeah, that's fantastic. Well, this, this is such great information that both of you guys provided us. And I really appreciate both of you joining us. You know, I know we talked about several supplements, melatonin, rhodiola, ashaganda, we did more curcumin, even the Cognizin supplement. And, you know, what I really love is that you guys have done your research on these products and these ingredients and put them together for people. And I'd just love for you to just maybe give us a overview of the different products that you have and where people can find them. Emma, maybe you want to take this one?

• 1:05:30Speaker 01

  Yeah, sure. So we have a drink powder. That's probably our, you know, best selling product that we have. It's the drink powder for brain, body and beauty. Cognizin is in there, curcumin, L-carnitine, there's a multi and then a biotin. This powder is really great for, you know, mental clarity and focus. And obviously the curcumin helps with inflammation. The L-carnitine, it boosts your cellular energy, enhances your brain function and supports your nerve health, I want to say. And, you know, that is just like one scoop into eight ounces. I like it on really ice cold water.

• 1:06:11Speaker 01

  I know that Dr. Nicole likes to stack that in her, you know, large bottle of water. And it's really pleasant. We say that it tastes like, you know, the good for you version of Tang. So I really enjoy that. I think we talked about the, the menopause supplement that we have. Again, that's got, I think, wild yam in there, which supports, you know, balance during menopause and brings you some comfort. There's, you know, we also have Cognizin in there because, you know, that was one thing that we felt was missing in these menopause supplements was, you know, bringing in that

• 1:06:51Speaker 01

  brain health ingredient like Cognizin, which, you know, we really need when we're going through menopause, when we're not feeling so, you know, sharp. We have the NAD rhodiola, which I have right here, which is, you know, about time for me to take it because around two, three o'clock, when I really want to go for a coffee, I take one of these and it really helps just boost my energy so I don't crash. And so I've really been enjoying that. And then we talked about the, the beauty sleep. And everything is available on our website at maketimewellness.com. We're also available in Target.

• 1:07:33Dr. Darshan Shah?

  Wow, amazing. Well, this has been an incredible episode. I, I just really want to thank both of you sincerely for making this happen. And, you know, I just can't wait to buy some of your supplements, give them to all of my favorite women in my life. Maybe even sneak some in myself.

• 1:07:51Speaker 02

  Absolutely. You know, we get, we get requests from that. We have, you know, the, the, I've had several people say, can my husband take this? And I'm like, yes, if they don't mind, you know, the, the female oriented branding on the outside of the bottle, absolutely. It is, it is, that's right. It's great for all of us. And I think, Dr. Shaw, that we have a special code for your listeners as well. I think EXTEND20 if they want to go ahead and, you know, try, try some of the products that we've talked to about.

• 1:08:22Dr. Darshan Shah?

  Awesome. Thank you so much for that code. And where can people learn more from you guys? Is there a place on the internet or social media?

• 1:08:30Speaker 01

  Yeah, I mean, maketimewellness.com is a really great place to learn more about the brand and what we're doing over there. You can follow us on social media. We're at Make Time Wellness over there. And, you know, that content is really for women just to understand and, and get some practical tips on caring for our brain, where, where to start. So those are two places where you can find us.

• 1:08:55Dr. Darshan Shah?

  Thank you. I know, Nicole, you're on social media giving great advice all the time.

• 1:08:58Speaker 02

  Yeah, Instagram's the main place that I hang out on there, but I, I'm on all the, all the things, but it's Dr. Nicole Birkins.

• 1:09:05Dr. Darshan Shah?

  Well, thank you both so much.

• 1:09:07Speaker 02

  Thank you.

• 1:09:08Speaker 01

  Thanks for having us. Thank you.

• 1:09:12Dr. Darshan Shah?

  Thank you so much for listening to the podcast today. Please remember to subscribe if you liked this episode and give us a good review and share a link with your friends. It really helps to support all of our efforts. I also want to remind you that the information shared on this podcast is for educational purposes only and is not intended to replace professional medical advice, diagnosis or treatment. Please consult with your healthcare provider or physician before making any decisions or taking any action based on what you hear today, especially if you have any underlying health conditions or on any medications. Your doctor knows your personal health situation the best and it's always important to seek their guidance.