Episode 444: The GLP-1 Triple Threat: Maximizing Benefits with Hormones, Strength Training, and Proper Dosing

Hi guys, it's Tony Robbins. You're listening to Habits and Hustle.
Crush it.

Hey friends, you're listening to Fitness Friday on the Habits and Hustle podcast,

where myself and my friends share quick and very actionable advice

for you becoming your healthiest self.

So stay tuned and let me know how you leveled up. Are there hidden benefits to GLP-1s that the FDA just isn't talking about? In this Fitness Friday episode of Habits and Hustle, I sit down with Dr.
Tina Moore to break down the truth about GLP-1 medications and the hype surrounding them. Dr.
Tina is an expert in holistic regenerative medicine. She shares why these drugs are more than just weight loss tools and how the conversation around them has become very polarizing.
This is a short clip from our full interview where you can find the full episode linked in the show notes below. Please listen and comment with anything you'd like.
Enjoy the episode. Yeah, I mean, the other thing is like, how do you maximize the benefits, right? Like, can you if you're just doing all the lifestyle things that we spoke about, like strength training, eating the amount of protein you should be eating daily, micro dosing it or taking a dose that just kind of like helps you, like don't overdose.
Right. The appropriate dose for the patient.
The appropriate dose for the patient. How, what other ways are we able to maximize the benefits so we see the returns long-term? Strength train, Build muscle.
Focus on muscle. In fact, I just told my husband the other day, you're just wasting all these peptides I'm spending money on because you're not in the gym.
Don't waste the opportunity. Strength train.
Build the muscle. Eat the good food.
Like I said, there is a potential. Well, not a potential.
They have piles of studies on this. There is a neuroplasticity that occurs on the GLP-1s, meaning your brain is wiring new pathways and learning new behaviors and hardwiring it in.
So why not take that opportunity while you're having a little bit of appetite suppression? There's also this onus of responsibility. People get back in the driver's seat.
A lot of people describe it as like, oh, I feel in control again. And I'm not just in control of my eating.
They're in control of their alcohol. They're in control of their smoking.
They're in control of all these vices. Those are some other big industries that maybe turned off my Instagram.
Yeah, yeah, yeah. Honestly, it could be anybody at this point.
It could be Anne over here who turned off your Instagram. They're studying it for alcohol cessation, alcohol abuse syndrome.
It shuts off the noise in your brain. That's what I've heard.
The hedonic noise. It shuts off the noise.
So all these things that are your vices or your addictions, because food can be a massive addiction, right? Just how alcohol or drugs. And if it's shutting, it quiets your brain.
Actually, it can really save somebody's mental health in that way in itself. My only thing I'm curious about is, can your body become acclimated? Because I've also seen friends of mine who, it was great.
And then after now six months of using it, they're eating again how they used to eat. Yeah.
Not because they're necessary. It's habitual.
Because eventually you go back to your habits of what you used to do, right? You can chew through it, as I call it. You can definitely override.
Yeah. And if you take those higher and higher doses and that's that cellular receptor I was talking about, and you get acclimated at those higher doses, then where do you go from there? I'm really concerned about the people that are on the super high doses, especially if they're not strength training, especially if they're not using that opportunity to change all their lifestyle habits because taking the peptide away, they're just going to crash and burn, and then they are going to have muscle loss.
There is real muscle loss happening. I'm not saying it's not happening, and there is real side effects happening.
I not negating that. I just think it's a dosing and management issue.
It's a dosing and management. Yeah, I think so.
Then let's talk about, you were saying middle age, right? Like you're saying, like, how can we use the GLP-1s to really maximize what's happening in perimetopause or even menopause for people who are going through that? I know we said, we kind of mentioned with Dr. Mary, the whole, that study.
Are there any other tips and tricks or things that we can do, in your opinion, to really make, kind of make, get us the biggest bang for our buck? Well, I think HRT is critical and I've been using it in my patients for decades and when that Women's Health Initiative study came out decades ago saying estrogen was dangerous, those of us who actually read the study, again, people aren't reading studies before they start vilifying everything. That study showed estrogen and progestins.
Progestins are fake progesterone, and they will sit on the cell and they will not have the same impact as progesterone. And that's really dangerous.
So we use progesterone, natural, real bioidentical progesterone, to offset any issues with estrogen. So I don't like using unmitigated estrogen alone.
I like having a progesterone on board. So anyway, those of us who read the study 20 years ago were like, we're going to keep using it.
And we've been prescribing it ever since. And our patients are very happy on their hormone replacement therapy.
I feel terrible because there's a whole generation of women who got severely screwed over. And this is why as we go into those years and our estrogen starts to wane, not even talking about progesterone, which is a neurohormone and we need it.
But as our estrogen starts to wane, a couple of things happen that are really, really bad. Number one, we start to become more insulin resistant and we start to become more metabolically compromised, period.
It's going to happen to all of us as our estrogen wanes. Number two, our fat cells start to act differently.
Our stem cells start preferentially turning into adipose tissue, which is fat tissue, and our fat tissue starts to redistribute itself into weird places. That's why we all turn into the sort of, they call it the gynoid shape, which is that belly with the skinny legs and arms, whereas we used to have the butts and hips.
We start to get more of a male figure, which is that middle section, the middle-aged middle, and the skinnier arms and legs. And estrogen also helps with, to some degree, there's a mechanism where it helps with muscle protein synthesis.
So we start to lose muscle, even with our best efforts. Our tendons and ligaments, that was my world, was regenerative orthopedics.
Our tendons and ligaments start to become brittle and friable. And I started getting, that's how I really knew I needed to double down on the estrogen.
I just kept getting injured and injured and injured in all of my workouts. And I was like, what the hell is going on here? So this is a disaster.
And I've always told my patients, stay on this side of the curve, meaning start the hormones, test the hormones and start the hormones way before you think you need them. Because once you're on the other side of it, it's looking like from the studies that I've been reading, I've been really diving into the musculoskeletal component because like, again, that's my world.
The pain component, there's a whole arsenal of impacts that estrogen has on our pain that they're just discovering and putting together, which is so cool. Because I've known this for decades with patients and I just didn't have the data to put my finger on it.
I just had patient outcomes to prove it. Estrogen on the other side, especially after all the adipose tissue has laid itself down, because women will become, as I said, more insulin resistant, more metabolically compromised, and usually more obese.
It just adds up, right? Like 60 some percent of post-menopausal women are obese. So in this country, I don't know where that stat came from, but I heard somebody say it who's an obesity doctor and I looked it up and there is some version of that.
I found like close percentages on either side, but it's a pretty significant number. Anyway, on the other side of that, estrogen over here, estrogen is protective.
It's got protective benefits to our cardiovascular system. It's got protective benefits to our joints even.
Over here, it might actually harm. Once people are over that hump, especially if they've laid down a lot of fat and they're metabolically pretty severely compromised.
And I've seen this in patients. Estrogen just can go rogue.
So it actually over here, it causes vasodilation and it helps your vessels stay open and patent. Over here, it can cause vasoconstriction.
Just by waiting too long to start taking it. Yes.
Dementia over here, it's protective against dementia. Over here, it might actually cause dementia to get worse.
Over here, it's protective to your knee joints. Over here, it might make your knees worse.
So this whole generation of women who got bamboozled by this stupid women's health initiative study 20 years ago have completely been screwed over. Whereas I've been taking estrogen since I've been taking progesterone since I was in my 30s.
I've been taking estrogen since I was in my mid-40s. I'm not messing around.
I know what my mentors have all taught me that have all been doing hormone replacement forever and ever in practice. And I've seen this clinically, you get too far on the other side and I would put those women on hormone replacement therapy and it just, all bets are off how it's going to go.
It really sucks. Over here, if you started gaining belly fat, estrogen can really help with that because that's, again, that's where the fat wants to redistribute when you start losing estrogen.
Over here, you might have a real problem. This is why I think GLP-1s are such a wonderful tool in this tool belt because these women need help over here.
And I think the adipose tissue and the metabolic dysfunction is what's driving the potential deleterious effects of estrogen. And we need to clean it up.
And what's going to clean it up? Yes, lifestyle, of course. But also, can we bring something in that might actually really help reset that metabolic health and really get them dialed in and get that inflammatory adipose tissue off of their bodies so we can apply the hormones they need? This is where I think GLP-1s are like a godsend, potentially.
So it's kind of this like middle A, it's like this triad of GLP-1s, HRT, and strength training that I think are just, at least the HRT and the strength training, in my opinion, are non-negotiable. The GLP-1 is up for discussion, but in my world, I think as long as the patient doesn't have any outstanding contraindications, I am probably going to suggest it.
And then it's a risk tolerance thing. And then we dose appropriately so we don't induce any side effects.
So it's not a miserable existence on it. There's no need to be miserable on your ozempic.
Wow. So what about when people are starting to play around, like they take the testosterone, but not the estrogen? Testosterone is awesome.
It's really awesome. I've done a whole series of like educational content around testosterone, but, and it's great for pain too, so is estrogen, but some people are going to aromatate.
Like you have this aromatase enzyme that lives in your belly fat specifically, and I am one of those people. If I take too much testosterone, it aromatases into estrogen.
And in the fat, that aromatase enzyme causes testosterone to convert into estrone, not estradiol. And in the brain, it converts into estradiol from what I understand.
And so depending on how your aromatase enzyme is behaving, and some people just have a lot of it, then it's going to potentially turn it into estrone. Estrone is the estrogen that's highest in menopausal women.
And I don't have any great data on this, but something, this is what I have been like engrossed in the past three months is trying to figure out, I think estrone is what is potentially causing a lot of these, you know, your menopausal issues. I don't think estrone's the most favorable type of estrogen, but I don't have any data to support that yet.
But what I have found when I'm looking at estrogen and adipocytes, those are your fat cells, how it behaves in your fat, estrone maybe isn't the best. So I used to rely on testosterone to convert into estrogen for women.
And a lot of doctors believe that, and I believed that, but I'm starting to wonder, depending on their belly fat situation, that might not be the best answer. Now, if you don't have any belly fat, it's probably not as problematic.
But for me, when I first went on testosterone, I got really lean in the midsection and my abs looked great. And I was like, and then over time I started turning into a little apple shape and my pain started roaring and I was like, something is wrong.
And my estrone was super high. So.
And you think it was converted from the testosterone. So how do people find out if that's happening to them? You test, you can test and there's different tests that are, there's blood tests.
That's the standard of care. I know a lot of people poo poo on the Dutch test, but the Dutch test shows pathways, which I think is cool and that's helpful.
So it just depends, but relying solely on testosterone, I think, I don't think is it. I think testosterone, I think estrogen is wonderful.
I think testosterone is wonderful. And I think progesterone is wonderful.
And I think all of, I think of all of these as like a symphony and we need all the instruments, right? And I think of peptides the same way. We don't just use GLP-1s at super high doses as a monotherapy and hope for the best.
I think we use the symphony. But you know what I'm getting from this podcast from you is that it can be very complicated and overwhelming.
And it's really important to have somebody who you trust, who knows what the hell they're talking about, who you work with. Because I think there's so much information and that's like really, it's like information overload.
It's a lot. Right? Because I'll talk to you and I'll get some, and I'm like, okay, this sounds great.
And then left to my own devices, I'm confused. And then I'll go to my doctor who's like, let's say a regular gynecologist.
And she's like, what are you talking about? Your testosterone is fine or your estrogen is fine. And then they won't be able to properly balance me.
Then I'll to find someone like you and more often than not and you can be honest you won't take me like maybe you'll take me as a patient but like the ones who seem to know the most are not taking patients I'm not taking patients anymore you're not taking patients because you're too busy writing books and doing the media tours and going on the podcast and then like all the people who have all the knowledge who are really good are like too, they're now like media personalities. They're not taking patients.
I know. It's like a shitty situation that it leaves people in.
Like what are people supposed to do? We're left with like these mediocre doctors who don't know what the hell they're doing because people like you are too busy doing media. Well, it's not even that.
It's just, I mean, I got out of practice in 2018 because I was burned out. I still take patients here and there by referral, but I don't have, I don't have like an open door.
Yeah. If I begged you, would you take me on? Of course.
Okay, please. No, I'm serious.
I have a course. So I made a course that, because I really wanted to get my brain down into the internet in case anything ever happened to me, because this de-platforming by Instagram.
You're very upset about it. Well, it wasn't the first.
I mean, I've been getting targeted since 2020. And so I was like, I'm going to put my brain down.
Like, how do I go about patient care from a comprehensive point of view? And so I made a course for clinicians that I let the general public into. So if people are interested, they can find it on my website.
And I have a free

four-part video series that takes people through a lot of the information that we're kind of just

touching on and leads them into that if they're interested in buying the course. And for now,

the course is open to the public.