Nigma Talib, N.D.: The Beauty of Aging
“The key is to really believe it when you see something that you're doing every day in your diet that is making your hormones off, or your skin off, a lot of women know what's happening to their bodies. We're more intuitive in that way than men are. So I think it sounds really cheesy and we've heard it over and over again, but please listen to your body because it's telling you something. It’s important to listen and make a note of things that make us feel terrible and things that make us feel good.” So says Dr. Nigma Talib, a Los Angeles based naturopathic doctor and the author of the best selling book, Younger Skin Starts in the Gut. A pioneer in the naturopathic medical profession, Dr. Nigma has been asked to speak all over the world, bringing light to the root causes of illness and how the application of cutting edge dietary, supplemental and functional laboratory testing guidance can correct health issues and enable optimal well-being.
Dr. Nigma joins me today to talk about all things wellness, from Vitamin D deficiency and sleep hygiene, to stool tests and hormones. We discuss the nutritional supplements to take to ensure you look like a grape, not a raisin; the importance of the 80/20 rule; and how to establish your personal hormonal baseline through testing. Our hormones are messengers, she tells us, but when they are out of whack wires can get crossed, leading to fatigue, joint pain, premature aging and depression—making it all the more important that we listen to our bodies and get curious, putting together the pieces of our health in a way that allows us to live optimally and feel our best.
EPISODE HIGHLIGHTS:
Grapes, not raisins…
Exploring the 80/20 rule…
The essential supplement checklist…
Exercise, done right…
MORE FROM NIGMA TALIB, N.D.:
Reverse the Signs of Ageing: The Revolutionary Inside-Out Plan to Glowing, Youthful Skin
Visit Dr. Nigma Talib’s Website
Follow Dr. Nigma on Twitter and Instagram
DIG DEEPER:
Exercised: Why Something We Never Evolved to Do Is Healthy and Rewarding
Hate Working Out? Blame Evolution - NYT, January 2021
TRANSCRIPT:
(Edited slightly for clarity.)
ELISE LOEHNEN:
Maybe that's a good place to start: The importance of Vitamin D people. So Vitamin D obviously bone. We'll just start there since that seems to be a problem for me, but it's function as functions as a hormone, right?
NIGMA TALIB:
Exactly. It's basically a vitamin, but it's also pro-hormone. It's involved in so many anti-inflammatory pathways in your body. And as we get older, Elise, we can't absorb vitamin D as well from our foods and from the sun. A lot of people think, oh, I'll just go out in sun, bathe and I'll get my vitamin D fix. Well, to get your vitamin D fix, you actually have to have 20 minutes a day, full body exposure. I'm not talking like, just have your bikini on for at least 20 minutes a day. And either your neighbors will appreciate it, or I'm not sure how you're gonna take that time to do that. And then you get sun exposure and premature aging. So it's like taking a Vitamin D supplement is something that I highly recommend. 90% of us are low in Vitamin D and the older we are, the darker your skin tone, the less likely you are to absorb vitamin D.
ELISE:
And I know you said it's an anti-inflammatory, but it obviously it has significant implications for osteoporosis and bone health. But is it bigger than that?
NIGMA:
Yeah, no, it's definitely important for building bone, uh, density, obviously. Um, but you know, it, that's not, its only that's what it's known for. And at least it's known for something huge, but it's good for so many different, hormones. A lot of people, you know, we look at Vitamin D a fat soluble vitamin, which means that you can only absorb it if you're eating it with foods that have fats in it. So that's another thing people will take their vitamin D don't often take it with food, so they're not gonna absorb it as well. Um, but it is an important vitamin and it's something that most of us are deficient in.
ELISE:
What would you say? And I know that you see women well, you're one of those detectives, so I know that people often come to you when they're sick. I don't know how many people you see who are legitimately healthy across every specter, but what do you primary, like what are the easy to fix things that you see in your practice besides Vitamin D?
NIGMA:
And, and the funny thing is, is like every time I run a labif this patient hasn't seen me before, nine out of 10 times, they're low inVitamin D and they're sitting in front of me saying Dr. Nigma, I have achy joints. When I put my feet off the bed, first thing in the morning, my feet hurt. It's hard to get started. And I'm like, mm-hmm, but either vitamin D is low, you know, just among other things. People come to see me after… I get those patients that have seen so many doctors, they've seen to so many specialists, they've been to different complimentary practitioners and they're really suffering. And they're saying no one's been able to fix what I have going on. So I'll run a bunch of lab tests. Um, I always run a stool test, um, on most of my patients, cause I wanna know what's happening in the gut microbiome.
I'll be able to see, even if they say to me, Dr. Nigma, my digestion's perfect. I'm like, okay. And I'll get their stool tests back and they'll have all sorts of overgrowth, dysfunction with pancreatic function, which then is upsetting their blood sugar, causing them to gain weight. So I'll do like a plethora of, and I will come out with, at the end of the day, here's what we're gonna do. Here's how we're going to eat. Here's what supplements we're gonna take. And this is what we're going to, we're gonna do for four weeks and then we're gonna follow up and see how things are going.
ELISE:
Because some people can't absorb certain micronutrient, right. I think I struggle to absorb Vitamin B for example. But is that typical? And that's what you see?
NIGMA:
That's a really good question. As we get older, the stomach acid actually becomes…we don't have enough stomach acid contrary to popular belief. We always think, oh, there's too much acidity. Our stomach needs to be acidic in order to break down our proteins, convert them into amino acids. We also need that stomach acid for intrinsic factor to absorb B12. So we notice as people get older, they have something called hypochlorhydria, which is low stomach acid. And then you get that mal-absorption of vitamin B12, which is super important. B12 deficiency is you, you lose your hair, you feel tired. It's a horrible feeling. And as we get older, that's what tends to happen. So again, mal-nutrition, mal-absorption of these nutrients occur as we get older, due to changes in the pH in our stomach and also our ability to digest and absorb.
ELISE:
Well, you’re goals to me, I feel like whatever, I always want what you're having Nigma. Because you look amazing and luscious, always. I feel like you one, you're not an ascetic person, which I appreciate, like you are not punishing towards yourself ever. And do you feel like that also happens, like there are too many of us that are sort of aging and we are too, we we've been too depriving of ourselves throughout life. And then we sort of like really hit a wall or is that not so much a problem? I worry about that where I'm like, I don't wanna be desiccated. I wanna be juicy as the wrong word, but let's just go with it.
NIGMA:
You want to be a grape, not a raisin.
ELISE:
I wanna be a grape, not a raisin. Thank you.
NIGMA:
And you know, as we get older, I mean I think if wait, I'm gonna be 50 this year. So it's like fifties in new 40. I mean, we are aging much better. We have more access to taking nutritional supplements, which are a must, no matter what anyone says, there's no way you're getting all your nutrients from your food. We're more educated than ever before women we're all living longer and women are now taking bio-identical hormones. They're, you know, taking precaution into making sure that they're increasing their vegetable intake, because we know that prevents cancers and premature aging and it helps mitochondrial function. So we are educated. Like my patients are some of the most educated women on the planet and I learn so much from them. And I think it's super important to constantly educate yourself on what you can do to live and feel more optimal.
And I think, you know, it's not a, not aging because aging is beautiful. There's the fine lines and wrinkles. These are sexy. They're kind of, you know, you know, we're okay with Richard Gere having wrinkles and all that gray hair, but we need to accept that more for us women and not have that, you know, compare ourselves to supermodels or 20-year-old. You know what I mean? Because there's something really sexy about being 50 and you know, having some wrinkles and having, you know, but what's not sexy is having this uneven skin tone and darkness under the eyes and you know, discoloration of the eyes. Because we know that the body's the livers not healthy or whatever that isn't sexy and that can be changed that can be transformed easily with diet and lifestyle. And I see it all the time with patients and they look younger after I promise.
ELISE:
Well obviously, I personally adore you and you’re a dear friend, but I also sort of love watching you in the wild because you practice life in a way that I really appreciate, like you've never made me feel in any way, like I need to be like cutting, you know, like you're not, I don't know how to say this, but you don't you're not too strict. You're not strict. I feel like it's always additive and it's not. We talk a lot about you talk about wine face and dairy face and gluten face, which we'll talk about, but you watched me drink wine without too much scolding.
NIGMA:
And I've done it too. Like when in Rome you do what you need to do. And it's all about the 80/20 rule. Like you've gotta live life, but it's about, you know, in moderation. It's like, what do I want during the weekdays during the school nights, I'm going to practice wellness and eating what I know my body loves. And then if I go to a birthday party or if I go out somewhere, I'm gonna have that glass of wine, you know what I mean? Yeah. Or I'm gonna have that drink or if you don't feel like it don't do it. Like just, you know, I guess the key is not to feel ashamed of what you're doing and sort of embrace kind of what makes you feel good. And if that class of what makes you feel good then have it.
ELISE:
No, I really appreciate that about you. You're not shaming. I think that's the word I was reaching for.
NIGMA:
Except, except except when I talk about your cat, that's the only time!
ELISE:
Well we started off talking about my vitamin D levels because I asked you to run of blood work, um, because I feel so tired, but I also feel like there's probably nothing really acutely wrong with me besides my vitamin D. And are you just seeing just general exhaustion? Just like COVID level everyone is is in. Is that just the new status quo?
NIGMA:
Yeah, I think, I think people there's a few things going on. Number one, most people have by now had COVID and are not entirely sure what they're feeling. Are they feeling the long-COVID side effects or are they feeling the exhaustion of COVID and are burnt-out as a result. Which is it? So I'm working with a lot of new patients that have had long COVID and it's really devastating. It's really hard. They're not the same again, they're not able to climb stairs or exercise or, you know, without feeling immense fatigue. Then you've got the burnt out population, which, you know, they've had to deal with their kids to, you know, kids have taken it really bad. The COVID has really affected anxiety levels in teenagers and younger. And kids in general, I think there's a certain threshold when they're young enough, it didn't really affect them. But if they're like in that past eight or nine, it seems that that group seems to be highly affected. So I think we're just all trying to come down from this post COVID, you know, cause it's affected us in so many ways physiologically, mentally, physically. Post COVID, you know, it's it's, you know, and people are still getting COVID I'm still getting messages from my patients saying, oh my God, I finally got COVID. Um, I feel horrible. What do I do?
ELISE:
But the long COVID seems quite extreme. Like if you have long COVID symptoms, it is obvious. Right. And then, you know, I've had COVID twice, which I very, very mild. COVID been vaccinate, vaccinated and boosted as well, but I don't think I have that. I think I just have, the general I'm in my mid-forties and I'm slowing down…
NIGMA:
So what are you feeling like what, what are you feeling right now? Like what are your, if you don't mind sharing?
ELISE:
I can't quite go like I used to, and I really have always prioritized sleep, you know, post-college I realize I'm someone who really needs sleep and I never really get less than seven hours, but I try to get eight or nine and even so I'm just wiped by the afternoon. I feel like I need a nap. So that's what I'm noticing. Just like that feeling of, oh, I need a bed day. Like I need to spend a whole day in bed. But I feel like maybe that's normal…
NIGMA:
I've definitely seen a few things that I'm gonna talk to you after about, um, one them being your vitamin D and that can cause major fatigue in it, of itself. You know, the fact that you're not waking up feeling exhausted. And again, correcting these deficiencies makes the whole think about it. It's like a domino effect when you have whole vitamin D it then penetrates to every single part of the, the body, the musculoskeletal, the gastrointestinal, like it's all connected, you know, that it always ma used to make me question medicine when I was younger. Like why do we have a gastroenterologist, an endocrinologist? You know, the body's like one we're, we're all connected. Everything is connected. The gastrointestinal is connected to the brain function, you know, like it's all connected.
So I think in some ways when you're feeling that just need to, we just need to assess, okay, what are we deficient in? What do we need to increase? What do we need to decrease? And also sleep hygiene is also something that you need to get more strict about the older you get, because it is harder. Our Melatonin levels are more depleted, the older we get. So there's, we have to be a little bit it more strict about, you know, sleeping in the dark, certain temperature, not being on your phone, first thing at night, you know, all of those different things that contribute to poor sleeping.
ELISE:
Yeah. For people who maybe don't have access to a functional doctor or naturopath or it feels like there are just some basics that everyone benefits from and Vitamin D is one of those vitamins. And I feel like there's been a whole, probably almost mythology about vitamin D point. Like you can take too much vitamin D and I think even if you do the side effects are quite minimal, but it's very hard to actually even achieve that level. People seem to be scared of it, or averse to taking it, but vitamin D, vitamin B, like what are the things that you're just like, just take it, take it every day. You'll never overdose. You might not absorb it all, but what's your checklist?
NIGMA:
That's a really good question. Because a lot of people ask me that and what I see constantly is, okay, I'm gonna talk about vitamin D again. Yes. Vitamin D deficiency is huge. B vitamins. Are you actually, I don't know if you knew this Elise that they did a study on vitamin D and the people that kept getting COVID over and over again, and then suffered long COVID were those low vitamin D levels. So it's, you know, interesting. Right. And then the other vitamins, like B vitamins, B one diamond, riboflavin, pantothenic acid Perine, all of those vitamins actually are important in hormonal metabolism. So women, we go through changes in our cycle. Like we start with our periods, we get menstruation, like PMs issues. Then we go to per menopause and then menopause. I mean, there's one common to a nominator in all of those. And it's men, they're the problem.
But it's cause it's like PMS, right? Um, PMS is like, we have all these issues, right? Like it's like from teenage all the way to our fifties and sixties, forties, fifties, and sixties, it's like nonstop. So the vitamins that you need to take are the B-complex vitamins, because those are what help with your hormone metabolism. They help with the bloating and the symptoms of PMS. Important for so many functions in the body, including blood sugar metabolism, cognitive function, energy. The list is so long, you know, so B vitamins are super important. Vitamin D is super important. And then magnesium, which I have to report yours was perfect. I was very surprised. Cause a lot of people have low magnesium levels. Magnesium is basically found in every cell in our body it's used for energy metabolism it's it helps with sleep. Um, you know, I would marry magnesium if he was a man, because he's perfect, you know, everything, it helps you, you sleep, it helps you calm down. It helps gives you energy. And that's one of the most deficient minerals founded people and I was surprised in your case, you must be taking magnesium.
ELISE:
Well I do take some magnesium and I try and give it to my son to help with his sleep and his restless leg syndrom. I'm not perfect about it, but I have, I do take it. Um, and then there's two kinds, right? Like the kind for sleep. And then the kind that makes you go to the bathroom. I sometimes take that too.
NIGMA:
Yeah. And, and exactly. And if it helps go to the toilet, go for it. It’swhat people talk about in their forties and fifties, right? Like to the toilet…
ELISE:
It's critical, but it's, that's been a lifelong. My mom used to feed me Metamucil as a child. I don't know that that helped me, but it's been a lifelong, a lifelong experience. Um, okay. So magnesium. And is there anything else that you feel like it's super critical?
NIGMA:
Well, yes. Okay. So we talked about Vitamin D B complex and then the, the typical vitamin A, the, the antioxidants, right? The a C E Zinc Selenium. They, I call them the ASIS. These are strong, very important antioxidants, vitamin A is never talked about. I have no idea why. Now vitamin A taken in large doses can cause issues and is not, is contraindicated in pregnant women. To a detriment because women that are trying to get pregnant or pregnant tend to have low vitamin A levels. So that needs to be discussed with your practitioner. And I always put my patients that are pregnant on vitamin a, but a proper dose. Um, you know, that that's necessary. Um, AC E Inc, selenium selenium is helpful for the thyroid. Okay. Um, thyroid, what happens is we get older, our thyroid, see it's a very, very vulnerable gland.
It's very sensitive to the radiation from our phone from travel. It's a very cute gland that sits right here. And it's very sensitive. A lot of women pass the age of 30 these days. I'm seeing with underactive thyroid or Hashimotos, I'm seeing those very commonly. And again, selenium deficiency. Our soils are deficient in selenium. And then I'm seeing a lot of other deficient of nutrients, like iodine deficiency. Um, and that is indicative if you have a lot of breast pain, if you have issues with your thyroid, underactive thyroid. So these are some of the values that I also test for on lab work.
ELISE:
Let's talk about hormones. And then maybe we talk about a little bit about heart health, but, um, yeah. So hormones I've obviously had those looked at throughout my life. Do you feel like most women should be doing baseline sort of Dutch Test and looking at hormones? Or is it something that's not necessarily indicated unless you really think something's amiss or is there, is there a version of establishing a baseline? That's always something that I wanted. And then I realized I'd be cementing myself in time and obviously my body is changing. So there is probably no version of maintaining your hormones exactly how they were throughout your life. I see you shaking your head. Um, so how do you, how do you advise people to think about that?
NIGMA:
Yeah, well, you said it exactly right. Our hormones are constantly changing. So I don't think that you're gonna ever be able to have a baseline per se. However, we can look at a healthy baseline for you. Say for example, when you were younger, you had P C O S polycystic ovarian syndrome, say you had endometriosis and that was measured. Then, then that would be getting a baseline of when you were in your state where things were diseased or you were ill, perhaps mm-hmm, <affirmative> a better word. Um, so I, when a woman is going through the changes, if she's experiencing irregular cycles, um, hot flash, um, irritability, mood swings, uh, changes, and even changes in your skin can be the first sign of hormonal dysfunction or, you know, um, where your hormones are not in balance. There's so many things, constipation, diarrhea, like it can affect your gut.
So I always recommend that a woman do a blood hormone test and also a Dutch Test, because then I can actually see exactly what's going on. I can see how your hormones are metabolizing. I can see the reference ranges with regards to estrogen, to progesterone ratios. I can see your cortisol, which is a hormone secreted by your adrenal blinds. I can see how you're dealing with stress. And I can see how your hormones are basically metabolizing. I can see if they're converting into more toxic compounds or rather getting more dirty, the hormones, getting more dirty over time, where they're not in a useful function, hormones are messengers. You know, they send messages to various parts of your body and when your hormones are deficient or in excess, you can send the wrong messages and you can start to get things like fatigue, joint pain, pre mature aging. Um, the fatigue is real and depression as well. Elise is a huge one.
ELISE:
That makes sense. And is it, are our hormonal signatures unique to us or are they more specific to a certain time in life? Like, is it helpful to be like, here's my best to us from five years ago and from three years ago and from now, or is that like, I'm just wondering if we're working our way towards an understanding of health. That's so highly individual where my Dutch Test might look very different from another 42 year old woman, but we're both balanced or whether it's more of a collective ideal.
NIGMA:
Tt's almost like an art being a, a doctor sometimes because you're actually, you're looking at the whole picture and you're sort of, you're looking at their symptom picture, but you're also looking at their diagnostics and you're looking at everything as a whole. So it's like kind of a painting that I've been given like of canvas and, you know, I need to put together all the pieces and make sure that it's flowing properly and, you know, looking beautiful for that patient at the time. Everybody's so individual, so as a 42 year old Elise, you'll be different than another 42 year old, you know, depends on like your adrenal glands, right? Like how much stress are you under? How much stress is that other person under that's gonna be the most important is that assessing adrenal function and making sure that those adrenal glands are working optimal. And there are reference ranges for where we want cortisol to be in the morning, afternoon, later afternoon and evening, that is gonna be the template for getting your hormones to work more optimally. Cause that's gonna determine if your hormones are going up or down. Does that make sense?
ELISE:
No, it makes sense. I just think, you know, we're treated and I get it. This is how this is, you know, we don't have highly specific medicine. I mean, in some ways we do. And in many ways we don't right, as you mentioned, there's sort of a template or there's an idea of how big we should be and how much we should weigh and what the of our body should look like and how they should be operating. And yet we find clearly that we're so different, in how we contact the world and metabolize the world. So it'll be interesting to see as the science develops, whether we'll ever be somewhere where we're like, oh, I really have an idea of what's happening in my body today. And we'll have early alerts because you mentioned symptoms. I also think people are, um, some of us are very sensitive, right.
And might immediately know when something is wrong. Whereas other people have potentially been disconnected from their bodies, but they entire lives. And they have no idea that, oh, I just thought this was normal. Right? Like our idea of what's normal can often be, um, things that we accept, but that are definitely not normal. Um, like you'll, you know, when I first met my husband, I love telling the story. But um, he had had so much, he had such terrible gas, like so much abdominal distortion and distress and early on in our relationship, he was like trying to hide it for me, which is making him even more ill. Finally. I was like, what what's happening? And he's like, I just always, this is just how I am. And I was like, this isn't normal, just so you know. And of course he has gluten intolerance. Maybe he, he has never been tested for celiac, but major gluten intolerance. But in his mind, when I met him, you know, he was 35 years old, he never functioned differently. And so the things that we accept as who we are, can be sometimes a symptom that's not addressed as a symptom. Does that make sense?
NIGMA:
Totally.
ELISE:
Good. Old Robby, Bob.
NIGMA:
And it's debilitating because the first, this is when women tend to wake up is, I mean, having a issue with what your husband went through, that's quite debilitating. And I see a lot of men going through the same issues and it's always their wives bringing them in. They don't know where to turn. They don't know if this is normal. But for women, when, when we start complaining is when we gain weight that that's, that's, that's only like they're exhausted, they're
ELISE:
Sad and so true.
NIGMA:
Like they don't care about how like the fatigue levels, they like, they ignore all of that. It's when they start to gain weight is when they start to go, is
ELISE:
Is weight gain just sort of a natural side effect of aging. Like we, maybe it fat is protective and we need to be a little bit juicier.
NIGMA:
I like the juicy, I like that. I don't think, think so. I don't think that, I think that, you know, if we were, we're sitting in our cars, we're not moving as much as we used to. I mean, LA is a different world. Everybody wakes up at five in the morning here to work out.
ELISE:
It's not me, but yes.
NIGMA:
Not that way yet. But yeah, I think the culture of exercise and, you know, you see like 80 year olds running marathons now, like, you know, it's, there's, there's no age in which, and, and again, the more muscle you build, the more fat you burn and the more muscle you build, the more, uh, longevity there's studies that are linked to that, that the more muscle mass increases your longevity and your health and wellness. So I don't think fat really plays a role. I'm talking like excess fat. We all need fat. I mean, our brain is mainly fat. So, you know, if I called you fat head, that's actually a compliment because fat is actually important. It's like intelligence, the marker of intelligence. Um, but you know, I think generally speaking, we're, you know, when we get that belly and that, you know, um, that excess adipose tissue, um, there's increased risks for diabetes, right. Heart disease stroke.
ELISE:
Yeah. And that's a really important distinction, right? Because surface fat is typically maybe benevolent or it doesn't affect us. I mean, you see, you see this a lot actually in people who present as thin, but they have a lot of fat around their organs and that's deadly. Right?
NIGMA:
Absolutely. And we see, um, fatty liver, I see, you know, fatty liver in 30 year olds that, you know, shouldn't be there. Um, you know, and you know, we always see people with high cholesterol now, high cholesterol doesn't mean that 50% of people that have a heart attack, abnormal cholesterol. So it is nothing to do with cholesterol to do with things like homocystine and oxidative stress on the blood vessels. Um, also again, carrying too much at adipose tissue, like fat in the abdominal area can be linked to insulin resistance. So all of those things are super important and that's why exercise is so important because it helps with maintaining insulin sensitivity. It helps with increasing muscle mass. It's good for your stress levels. So exercise when done, right. Um, is an absolutely incredible, and I personally like you have to choose what you love. Like I love Pilates, so if I love it, I'm gonna do it more. Mm-hmm <affirmative>, you know,
ELISE:
You just said when exercise went done, right. So what does that, what does that mean?
NIGMA:
Um, I have seen patients that really overdo it on the exercise and they're already burnt out. They've got three kids, they're running a company and they're got their personal trainer pushing them. And they're exhausted. That is exercise done wrong. If you are burnt out, the last thing you should be doing is exercising heavily because that basically further depletes your adrenal glass. So you need to be doing restorative exercises like stretching. I know people, if I tell them to stretch, especially adrenal and junkie is gonna look at me and go, oh, there's no way I'm gonna do that. I've had to force some patients to do that and say, give it a try for three weeks, just listen to me for three weeks. And then that do what you want. And they'll literally feel so much better. They're like, I did not realize that this exercise was adding to me feeling burnt out. And one of the ways to look at this, Elise is if you feel more tired after exercise, you're not, you shouldn't be doing it. If you feel invigorated and you feel great for the rest of the day, that means you're right. You have to kind of make sure that, you know, sometimes it can be good for people that are stressed out cause you're letting off steam, but there has to be a limit, you know? Right. Um, cause your body needs to heal.
ELISE:
Yeah. No, that makes a lot of sense. I think as someone who, like I can get pretty high on exercise and then I find, and I use it sometimes as like a, a excuse or I use it to sort of try and balance eating whatever I want and um, which I recognize. But as my dad, you know, my, as a doctor and he's always like you can't, it's all diet. Like if you, if that's your goal diet, it's diet, like you can do a treadmill and you're not gonna burn the equivalent of a Snicker's bar. So exercise in of itself. I mean, my parents are very, very active. 75 year olds is great. But using it as sort of like a way to balance your diet is maybe not good. I don't know. I don't know, be, hear conflicting advice all the time. I'm not a doctor guys.
NIGMA:
You you've, you you've said something so incredible. And I think a lot of people do that. Right. A lot of people go, okay, I'm now gonna work out like extra hard to more cause I had that Snickers bar. Right. So, you know, we all do that. It's totally normal. But to realize that yes, what your dad said is absolutely right. Diet is the foundation. So if you're then exercising excessively, because you're burnt out and you ate your Snickers bar yesterday, because you are burnt out. Because it's the only thing that gave you energy, then you're kind of doing it the wrong way.
ELISE:
Right? No. And I think that that's, that's the cycle that I definitely recognize where I'm so tired. I mean yesterday at Legoland, um, you know, you have to exit out of the gift store, Nigma. You've probably never been to Legoland, but I bought a bunch of gummy, like those peach rings, apple rings. Cause I was like, I'm so tired. I'm not gonna be able to like make it back to LA unless I'm on a major sugar high. And I recognize in that moment that that's not good.
NIGMA:
You made it back from Lego land that's for sure.
ELISE:
I was just working on survival. But that's a very familial familiar cycle. I think to many of us, I do it with caffeine as well. I mean we all do right. Which is where you're sort of flogging yourself to get through it and then you'll figure you'll pay for it later somehow. And I, I definitely have done that in the past where I'm like, oh, I'll pay for it with like a run. I'm just trying to walk. I'm just trying to move my body these days.
NIGMA:
Yeah. I think that's super important is that, you know, sitting down and being sedentary, like we're in front of our computers all day doing zoom zooms, we have to get exercise out. Um, we have to go outside and we live in the most, the weather here is beautiful all day long. So there's no excuse to not sort of go for a walk on the block.
ELISE:
No it's really actually is that I interviewed, this professor at Harvard, Daniel Lieberstein I think his name is, and he wrote this book called Exercised and it it's an evaluation of sort of all of the biology of exercise across time and going back to our ancestors. And he talks about two things that I think are very reassuring. One. We are engineered to conserve energy. That's historically biologically how we're built. So if people feel an aversion to exercise, that's very normal and natural and does not mean that you're quote unquote lazy. That's something that we sort of have to override. But also our ancestors and their food sources were very different clearly. And they had a lot less access to energy and a lot less access to calories than we do. And they had to earn their calories, but they spent a lot of their days in a very sedentary state preserving calories.
So to actually meet the PAL is what is called of our ancestors. Isn't that hard. It doesn't actually require much from us. It's not, it's not a dramatic difference. They're not, they weren't like triathlete every day in the way that I think that we've been sold. That story of like our ancestors were CrossFiting maniacs, like at it all day. No. So we can bridge that gap. We often in some ways move against our biology, but I thought that was a fascinating book and, and profoundly reassuring, um, both in, I think it's 150 minutes a week, moderate intensity exercise and then maybe some walks, some stretching.
NIGMA:
Like 20 minutes a day.
ELISE:
Yeah, exactly.
NIGMA:
And that makes sense. That makes yeah, and I think when you're trying to work to a goal, that's impossible. You're just not gonna do it.
ELISE:
Right. Exactly. And we're engineered to try to survive, you know, and I think that that's where it's funny when we distort our body, which of course modern life does. We're always trying to get back to that place of balance, but piling it on isn't always, always the right thing either. So you mentioned heart, heart disease and cholesterol. Like, do you worry? I mean, obviously there's an epidemic of heart disease in women and we're not, our symptoms are different. Do you worry about that with your patients?
NIGMA:
I do. I do. You know, it's a silent killer. We hear the up so many times and there's usually no symptoms. Fatigue is just one of the symptoms and how many illnesses could that be related to? So it is so I'm constantly measuring markers like homocystine, C protein, cholesterol does play a role, um, you know, in the, the risk for stroke. But I'm, I'm looking at blood sugar levels as well, because that is one of the most important like hemoglobin A1C. I'm seeing, you know, upwards in the area of 30 to 35% of my patients have abnormal love levels of this. And this is high blood sugar, high glucose in the blood for over a period of, um, 12 to 14 weeks. So it's a good indicator that that person is prediabetic. Um, that person is mono metabolizing, their blood sugar. The insulin is insensitive and that plays a huge role with, you know, risk factors for cardiovascular disease, not just diabetes, but you know, all the cardiovascular.
ELISE:
Yeah, no, you mentioned cholesterol. And as you saw, I've had hereditary high cholesterol since I was a tiny slip of a child. So I have never had a cholesterol level below 200, even. When I was a child, my parents put me on a very restrictive diet. Cause at that point, cholesterol was everything. It was like an emerging holy grail of medicine. And even though they were like, this doesn't make any sense, my brother and I, and my dad all have very high cholesterol. So they, I think maybe got my cholesterol down to 180 by putting in a depriving diet as a nine year old. But I've always had it. So do you discard, I've sort of always discarded it, but do you, is it when that suddenly emerges as a factor that it becomes problematic or is it not, do we just not really understand it at this point?
NIGMA:
That that is such a great way of that you asked that there are two aspects of that, the fact that you have it a genetic propensity towards high cholesterol, we need to look at you as, okay. Your baseline is it's probably safe, you know? But what I would wanna do with you is I would wanna increase your cardiovascular exercise. So we know that more endurance, cardiovascular increases HDL cholesterol, which is protective. So I would want to get you on a few botanicals and herbs that would help with your liver and getting rid of any kind of excess cholesterol that's dirty and could clog arteries down the road and all of that. So I'd wanna work on that and I would wanna work on your elimination, which means I would wanna make sure, sure that you're going to the toilet every day, because that's the way your body eliminates the cholesterol.
A lot of people forget that, you know, the only way to get rid of it is by pulling it out basically. So we gotta make sure that we're optimizing bowel function. Um, we're also optimizing your diet rich and things like flax seeds and chia seeds that are gonna actually help facilitate bowel movements and empty the intestine. You wanna be able to be constantly emptying and getting rid of that excess cholesterol. We don't wanna build more on top of whatever. Is there genetically for whatever reason, your body producing more cholesterol, actually cholesterol is not a bad thing. It's like the mother to all the sex hormones. So a lot of people that actually are on statin drugs or actually have low cholesterol, are those individuals that tend to have poor hormone function. So interesting cholesterols, actually not a bad thing. Again, remember I said to you, 50% of people who have have a heart attack have normal cholesterol. So I would look at other factors in your bloods, like homocystine C reactive protein lipoprotein, a, these are some markers that would increase your risk for, um, heart attack and illnesses. So I would make sure that I, I look at all of those factors, get a baseline and again, improve your overall elimination of any excess cholesterol.
ELISE:
I know we're almost out of time, but do you feel like there's anything else that you're seeing that, like, if you could speak to women everywhere that you would want them to pay attention to?
NIGMA:
I think the key is really believe it when you see something that you're doing every day in your diet that is making your hormones off or your skin off it, a lot of women know what's happening to their bodies. We're more intuitive in that way than, than men are. So I think it sounds really cheesy and we've heard it over and over again, but please listen to your body because it's telling you something. And so I think that, I think that it's just important to listen and make a note of things that make us feel terrible and things that make us feel good. Like I know for me, I know those chia puddings that, you know, I make, they make me feel amazing. Like I actually feel energized. I feel great. And so I try to incorporate more of that throughout the week. I know that dairy may makes me feel awful. I get congested. I get, you know, I don't normally am a person that gets pimples or acne, but if I do, I will get lo and behold a spot here or one here. And it's just like, you know, we know what foods and what things are making us feel worse. So, you know, just make a mental, okay. These are the foods that don't make me feel good. These are the foods that make me feel good and follow that because that will go a long way.
ELISE:
Yeah. In terms of arriving at that. Cause obviously we all have sort of messy walls. Right. Um, and it's hard to actually know with any force like or any of sure. Oh, it was that. Do you, um, and food sensitivity tests can be sort of all over the place, right. Based on your current diet, do you just recommend everyone sort of try and do an elimination diet for a certain amount of time and then introduce things one at a time? Or how do you, how do you look at that?
NIGMA:
Yeah. It, it is, it is of work. So if a food intolerance test is great because, you know, even though it's not a hundred percent and it is gonna be based on your current diet, it's still important. And there's some things that you would probably never guess that would be an issue for you without doing it. So that's one way, if you can't do that elimination diet's always been the gold standard. So look at what you do every day. So if you're eating eggs, you're doing dairy and you're eating one of the food groups like gluten sugar, dairy and wine follow the four week plan in my book, because it does really give you a nice guide while keeping you eating really nice and healthy. So I find that people that do the four week plan and eliminate all those food, most of them have an amazing outcome.
Listen to your body. It's saying no. And the thing is, at least there're alternatives to these. I know. And that's the beauty of it. And I think it's just, it's not shaming yourself. It's not making yourself feel bad. It's just like, this is what my body life. And I'm gonna try it and not feel bad about, you know, having it, if you have it, you'll feel it.
ELISE:
If you can’t tell, I love Nigma. She always comes from a place fo deep support and not scolding or shaming or restricting. And she is entirely reasonable and is intervened many times in my health to keep me on track. She has a book that’s full of information, and she really focuses, she also does incredibly facials, and she’s very focused on the skin, and how it often telegraphs what happens deeper in our bodies. So for those of us who use that as a tentpole, she is your guide.