
312. Perimenopause Symptoms Can Start in Your Late 30s - Dr. Remina Panjwani
The Ultimate Human with Gary Brecka
- 1h 5m
- Transcript
Summary
Written by a model from the transcript; not yet reviewed.
Gary Brekka hosts internal medicine physician Dr. Ramina Panjwani to discuss the foundational role of the autonomic nervous system, why perimenopause can strike in a woman's late thirties, and how chronic stress and generational trauma sabotage biological health. The conversation exposes major blind spots in modern medicine, arguing that standard blood panels fail to capture true hormone balance and that high performers often push past yellow-light warning signs of burnout until a medical crisis hits. They also examine advanced diagnostic tools like the DUTCH test, the importance of gut-brain healing through fermented foods and breathwork, and why patients must regulate their nervous system before attempting any biohacking interventions.
- Schedule dedicated time to pause every morning because you cannot outperform a dysregulated nervous system that is stuck in fight or flight. 0:50
- Listen to early bodily signals in your thirties such as sleep disruption, brain fog, and unexpected body composition changes as potential signs of early perimenopause. 13:40
- Utilize comprehensive hormone assessments like the DUTCH test rather than standard blood panels to accurately track hormone metabolites, methylation, and vitamin deficiencies. 19:17
- Regulate daily stress and tap into the vagus nerve by practicing simple, portable breathwork techniques like box breathing or the physiological sigh. 44:43
Chapters
- 0:00Episode Introduction and Context
The host sets the stage, explaining the focus on stress, burnout, and the nervous system’s role in health.
- 0:55TED Talk and the “Regulate Before You Stimulate” Concept
Dr. Panjwani explains the motivation behind her TED Talk and how regulating the nervous system is foundational to health.
- 6:09Early Warning Signs of Burnout
The conversation shifts to subtle burnout indicators, emphasizing the importance of recognizing fatigue, sleep issues, and hormonal changes early.
- 9:04Lifestyle Practices for Nervous System Regulation
They discuss practical habits—breathing, journaling, and scheduling—to maintain autonomic balance and prevent dysregulation.
- 13:34Perimenopause Symptoms and Early Detection
The hosts explore how menopause can begin in the late 30s, highlighting symptoms such as brain fog, mood swings, and joint pain.
- 18:10The Dutch Hormone Test vs. Standard Panels
Dr. Panjwani explains why the Dutch test provides a comprehensive hormonal profile that standard blood panels miss.
- 24:32COVID Experience and Systemic Gaps
The discussion turns to the COVID era, revealing how conventional medicine’s limitations highlighted the need for functional approaches.
- 34:24Generational Trauma, Gut-Brain Connection, and Healing
They examine how ancestral stress affects current health, the gut-brain axis, and the tools available to break the cycle.
- 50:44Cortisol’s Impact on Metabolism and Hormones
Explains how elevated cortisol disrupts glucose regulation, sleep, mood, and reproductive hormones, leading to weight gain and other symptoms.
- 52:52Testing Cortisol and Metabolic Health
Describes the Dutch test and other metabolic markers like fasting insulin, glucose, and A1C to assess stress and hormonal imbalance.
- 53:36Gut Health, Inflammation, and Stress
Links chronic stress to gut barrier dysfunction, common food offenders, and the role of inflammation in digestive issues.
- 56:18Practical Gut‑Friendly Foods and Supplements
Outlines fermented foods, fiber sources, and probiotic strategies to restore microbiome balance, especially after antibiotics.
Highlights
- 0:33
Generational Trauma in Biologyinsight
Chronic psychological or physical stress causes cellular changes that alter DNA and get passed down through generations, locking the nervous system into constant protection mode.
- 4:23
Regulate Before You Stimulateinsight
The guest explains the impetus behind her TED Talk, arguing that modern biohackers constantly overstimulate their bodies with advanced tactics while ignoring foundational biological regulation.
- 6:57
Subtle Signs of Burnoutinsight
High performers often miss the yellow lights of burnout, which manifest as subtle fatigue, sleep disruption, brain fog, hormonal shifts, and gut issues long before hitting a wall.
- 8:52
Perimenopause in the Thirtiesstory
The host shares his wife's journey with early perimenopause symptoms starting in her mid-forties, and the guest confirms that modern environmental and lifestyle stressors mean symptoms can begin as early as the late thirties.
- 18:56
Limitations of Standard Blood Panelsdebate
Standard medical blood work offers only a basic snapshot in time, missing full hormone complements, metabolite pathways, and vitamin levels that specialized tests uncover.
- 26:30
Chronic Disease and Healthcare Spendingdata
The United States spends five trillion dollars annually on healthcare while forty-two percent of prepubescent children suffer from at least one chronic disease.
- 56:18
The Gut-Brain Connectionstrategy
The guest explains how chronic stress impairs the gut lining, leading to inflammation and food sensitivities, and why stool tests like GI effects provide superior clinical data.
Quotes
“We live in a world that's constantly stimulating us.”
Unnamed speaker · 0:00 “The Dutch test gives you everything personalized to your body, like the breakdown of the pathway.”
Unnamed speaker · 19:17 “If you're constantly on edge, then your child is going to be on edge.”
Unnamed speaker · 35:25 “If you schedule those simple moments, that's going to regulate you throughout the day.”
Unnamed speaker · 11:00 “You cannot outperform a dysregulated nervous system that's always in fight or flight.”
Unnamed speaker · 0:50 “So if the main one I want to focus on is cortisol.”
Unnamed speaker · 50:54 “You may be hangry, but that's because there's something, you're using your energy, right?”
Unnamed speaker · 51:21 “You want to reset that response, you want to rewire the microbiome and everything and heal that gut so you can get back to, to balance.”
Unnamed speaker · 55:09 “If you regulate that, you're also affecting your other nervous system, your enteric gut nervous system.”
Unnamed speaker · 56:10 “It's not living longer, longer number of life. It's being present. It's showing up for the people you love, for the things you love. It's being functional. It's being creative.”
Unnamed speaker · 1:04:05
Sponsored segments
- Ultimate Brew 17:03–17:21
- H2 Tab 48:14–49:13
About this episode
You might think perimenopause is a 50s problem, but Dr. Remina Panjwani says it can start in your late 30s. She and Gary Brecka go through the early signs, from 3 a.m. wakeups and brain fog to a belly that changes no matter what you eat. They also cover why she prefers the DUTCH test over standard blood work, and how chronic stress and cortisol affect your hormones. Listen to Dr. Remina Panjwani on all your favorite platforms! YouTube: https://bit.ly/4hxX3ov Spotify: https://bit.ly/4j3Lruy Apple Podcasts: https://bit.ly/4hzIKjl Connect with Dr. Remina Panjwani Website: https://bit.ly/4zkxixJ YouTube: https://bit.ly/4zdExrk Instagram: https://bit.ly/475fR8E Facebook: https://bit.ly/4yBCaif TikTok: https://bit.ly/4znvZhR LinkedIn: https://bit.ly/4yBkJyp Thank you to our partners A-GAME: “ULTIMATE15” FOR 15% OFF: http://bit.ly/4kek1ij AION: “ULTIMATE10” FOR 10% OFF: https://bit.ly/4h6KHAD AIRES: “ULTIMATE20” FOR 20% OFF: https://bit.ly/4a3Duze BAJA GOLD: “ULTIMATE10” FOR 10% OFF: https://bit.ly/3WSBqUa BODYHEALTH: “ULTIMATE20” FOR 20% OFF: http://bit.ly/4e5IjsVBREW: THE ULTIMATE COFFEE: https://bit.ly/4elHM82 COLD LIFE: THE ULTIMATE HUMAN PLUNGE: https://bit.ly/4eULUKp CYMBIOTIKA: “BRECKACYM30” FOR 30% OFF: https://bit.ly/4tjyluP GENETIC METHYLATION TEST (UK ONLY): https://bit.ly/48QJJrk GENETIC TEST (USA ONLY): https://bit.ly/3Yg1Uk9 GOPUFF: GET YOUR FAVORITE SNACK!: https://bit.ly/4obIFDC H2TABS: “ULTIMATE10” FOR 10% OFF: https://bit.ly/4hMNdgg HEALF: 10% OFF YOUR ORDER: https://bit.ly/41HJg6S PEPTUAL: “TUH10” FOR 10% OFF: https://bit.ly/4mKxgcn SNOOZE: LET’S GET TO SLEEP!: https://bit.ly/4pt1T6V WHOOP: JOIN & GET 1 FREE MONTH!: https://bit.ly/3VQ0nzW Watch the “Ultimate Human Podcast” every Tuesday & Thursday at 9AM EST: YouTube: https://bit.ly/3RPQYX8 Podcasts: https://bit.ly/3RQftU0 Connect with Gary Brecka Instagram: https://bit.ly/3RPpnFs TikTok: https://bit.ly/4coJ8fo X: https://bit.ly/3Opc8tf Facebook: https://bit.ly/464VA1H LinkedIn: https://bit.ly/4hH7Ri2 Website: https://bit.ly/4eLDbdU Merch: https://bit.ly/4aBpOM1 Newsletter: https://bit.ly/47ejrws Ask Gary: https://bit.ly/3PEAJuG Timestamps 00:00 - Introduction: nervous system, burnout and menopause 04:22 - Regulate Before You Stimulate TED talk 06:09 - Early warning signs of burnout 07:31 - Morning breathing before your phone 11:14 - Menopause journey and frozen shoulder 13:40 - Perimenopause in your late 30s 17:30 - Joint pain and hormone therapy 18:18 - DUTCH test vs standard blood work 20:34 - Internal medicine to functional medicine 28:01 - Odd Girl Out and The Doctor Within 32:53 - How generational trauma gets passed down 38:37 - Spotting generational trauma in seven-year stages 40:21 - Hypnosis and vibroacoustic therapy 42:56 - Breathwork, HRV and heart-brain coherence 47:47 - Stress, cortisol and weight loss resistance 52:40 - Fasting insulin vs A1C and gut inflammation 55:26 - Gut testing, probiotics and fermented foods 58:57 - Why you can't outperform your nervous system 1:02:10 - Peptides for the right person 1:03:27 - What it means to be an Ultimate Human Disclaimer: This podcast is for informational purposes only and does not provide medical advice. It is not intended for diagnosing or treating any health condition. Always consult a licensed healthcare professional before making health or wellness decisions. Gary Brecka is the owner of Ultimate Human, LLC which operates The Ultimate Human podcast and promotes certain third-party products used by Gary Brecka in his personal health and wellness protocols and daily life and for which Ultimate Human LLC and / or Gary Brecka directly or indirectly holds an economic interest or receives compensation. Accordingly, statements made by Gary Brecka and others (including on The Ultimate Human podcast) may be considered promotional in nature. Learn more about your ad choices. Visit megaphone.fm/adchoices
Transcript
11,698 words · 3 speakers
Topics
- Dutch test
- peptides
- fiber
- Regulate Before You Stimulate
- sauerkraut
- FDA
- United States
- The Gut-Brain Connection
- Odd Girl Out
- GI effects
Page updated · transcript and summary are machine-generated