Nayan Patel: 
Hello everyone, this is Dr. Nayan Patel, Chief Significant Officer for Thrive Lab. And with me today, we have a nurse practitioner, our very first nurse practitioner at Thrive Lab, Katie Jo Dixon, and we'd like to welcome her as well. Briefly, I am the Chief Significant Officer for Thrive Lab. I work with a very well-known team over here of providers that have the single mission life to help patients achieve the best outcomes. And with that, I want to introduce you to Katie Jo Dixon. 

Katie Jo Dixon: 
Dr. Patel, it's so great to join you today and to share our mission and values for our people that we get to serve with Thrive Lab every single day. Like you said, I got to join Thrive Lab at the starting point over two and a half years ago. I am a nurse practitioner, as you said. I'm based out of Austin, Texas, in the heart of Texas. I've been a nurse since 2012, and for the last two and a half years, I've gotten trained in medicine and in hormone replacement therapy.

Nayan Patel: 
Well, thank you for the introduction. I appreciate that part. And again, thank you for being with us since day one. It has been two and a half years, which is a lot more than I can tell because I've been with Thrivelab for close to a year now. And I've told you my story, but it's like when Joshua came to me and asked me, said, hey, we have this mission in life to make healthcare, hormone health affordable for everybody. And I know that you have some protocols and strewn his whole process, can you please join the company? And I said, no, I have a lot of other things to do in my life, but he was persistent and he made sure that I was very clear with the goals in his life. And after a while I said, you know what? This goal absolutely aligns with me. So I was able to join the company and I'm here today. I'm so blessed to be here. We worked with such an astounding team of providers that really cared about their patients. medicine, we always talk about treating the patients, not the numbers, right? So tell me how important it is for you to get hormone levels checked?

Katie Jo Dixon: 
That's a great question, Dr. Patel. So when we assess our patients through their lab work, we know that the way labs operate is that they take a measurement, an average of all the patients that visit the lab during a certain time period, and they create a protocol based on that. Well, the individuals visiting the lab, there's a percentage that are healthy, there's a large percentage that are unhealthy, unfortunately, and there's a very small percentage that are optimal. So when we look at the labs, we're assessing for optimization. I use a much narrower window for lab values to determine if you're optimal or not. So labs are important, but they're not the selling guide for our practice. Our practice is focusing on you as a person and not treating a number on a page. Going back to the experience you shared with you and Josh, having Josh be resilient and asking you for your services, They went to their primary care provider. They were told no for hormones. They went to their OB-GYN. They were told no for hormones. They went to their endocrinologist and they were told no for hormones. So by the time a client comes to my door, unfortunately, they are crawling their way into my office after being told no, no, and no, using these parameters that are not based on optimizing your hormones.

Nayan Patel: So by the way, we'll make sure Josh is our CEO of Thrivelab. So we want to make sure that people know who he is and not just some random person off the street, of course! Is there a particular age that we check the hormones for for women is like the younger versus older, is there a difference in how we check the hormone levels?

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Katie Jo Dixon: 
There are differences based on your age. We are noticing, unfortunately, women younger and younger showing signs of hormone dysregulation. I often attribute it to neuroendocrine disruptors in our environment. Many of our younger patients may have what's called PCOS, polycystic ovarian syndrome. So their hormones are up and down. And then when a woman enters perimenopause, so most people know about menopause, the average age of menopause in the United States right now is 51 years old. Well, your perimenopause can begin a decade before true menopause happens. So peri means around, menopause is when you've no longer had your cycle, your menses, your period, for at least 12 months. So you could go 11 months, 10 days, 52 seconds, and if you have a bleed, you're not in true menopause yet. So many of my female clients will tell me, I went to my doctor and they told me not to check my labs and they patted me on the head and said, you're in perimenopause, grin and bear it. So we are addressing the perimenopause epidemic that's happening in our country right now.

Nayan Patel: 
Absolutely, and this is something that I've noticed for so many years. I've been practicing hormone replacement therapy for well over two and a half, three decades now. And in my tenure, I've seen so many things that have happened. And we are right. We don't treat numbers. I mean, if you don't get treated by numbers, you can go to any healthcare provider in a very limited time setting. Then they're going to get those numbers checked. And then how come they're pretty good? And so I'm assuming that it takes a lot more time to address the patient's needs by looking at the symptoms, looking at what's wrong with them, and analyzing how we can approach them better, rather than just look at a number and try to fix the numbers for them.

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Katie Jo Dixon: 
You are absolutely right, Dr. Patel. So many of my clients that come to me tell me, I checked my thyroid and I was told that it was normal. I said, I understand that. We are going to dig deeper. We are going to be the detectives for you. And if you're having symptoms of low thyroid, if you're having fatigue, if you're experiencing constipation, if you're losing your hair, if it's becoming brittle, if your nails have changed and they're breaking off, those are some clear signs of thyroid dysregulation. So with our panel, deeper and we look past the preliminary test that is the screening for pathology, we're looking for optimization. Like I said earlier, and for example, I had a client that we checked her thyroid, her TSH, thyroid stimulating hormone, that's the brain speaking to the thyroid to tell it, to give it more hormone, was completely normal. Then we checked her markers for autoimmune thyroid and they skyrocketed. So we knew we needed to intervene for her quality of life.

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Nayan Patel:
Absolutely. So you just nailed a couple of few things, which are the symptoms, right? So you mentioned a few symptoms that are what the most common reason people come to go see a doctor's office to get them help. What are some of the other symptoms that you have not mentioned like sleep disturbances, which is probably the number one issue, fatigue, what else?

Katie Jo Dixon: 
Sleep is huge. There are studies that indicate that many people who experience chronic pain syndromes experience decades or several years of sleep issues before the chronic pain develops. So sleep is huge, especially for a woman in that perimenopausal state, they may have issues falling asleep. That can be related to high cortisol. They may have issues where they're waking up in the middle of the night. That could be related to hot flashes. cater for most women that there's changes in your estrogen and or your testosterone levels because the brain is waking you up, surging, seeking these hormones that are now becoming deficient. And it's like a roller coaster ride where you may be high one day, low the next day as the body tries to adjust. So the sleep is huge, hot flashes during the day and at night. The hair changes I mentioned earlier, not only thyroid, but our hair follicles with hormones such as testosterone for some women and estrogen for others. So we see many changes that overlap. The hormones are like a symphony in the body. If you went to view a symphony and there was a violin that was out of tune, it would clearly stand out. So we look at the whole hormone panel to see how we can make a symphony in tune again. And that is the best way to improve this woman's quality of life.

Nayan Patel: 
You put it so eloquently, right? Symphony, that's what we do, right? We listen to patients' complaints. We're listening, is any complaint out of tune, right? Is everything within the normal range? Or is it something, is there a particular symptom that is out of tune? And maybe it's the drums or the violin or in the patient. Is it the weight gain issues, is it the sleep disorder, is it the heart fractures, is it reducing libido or sex drive or whatever, right? Something is not aligned properly and when you hear that, something is not aligned properly, there's no blood test that's going to tell you exactly what's wrong with them. Right? Symptoms are telling you a whole lot of things.

Katie Jo Dixon: 
I like that you brought in the libido because that is a huge indicator for many women. And often women discount this symptom. They think maybe it's because I am a full-time mother now, or maybe it's because I'm working, or maybe it's because I'm stressed out. And they put that part on the back burner of their health. I say the spark in the bedroom also mirrors the spark in your life. So we want to optimize the libido. And we know that libido is often associated with low testosterone levels. And so women who are experiencing low libido, I had one client tell me the other day, she said, I have a gorgeous husband, he's blonde, he likes to surf, he has a six pack. And I have no interest whatsoever in being intimate with my husband. And once we were able to correct poor testosterone hormones, she had a renewed spark with her marriage. Some of my female clients will come to me and say, Katie Jo, I am on the verge of divorce. My husband and I are fighting, we don't have intimacy anymore. huge part of our relationship, please help me. And listening to our patients, we will be able to listen and hear that. However, if we only focus on the testosterone in a lab, that's normal, then the woman would not be treated.

Nayan Patel: 
Thanks for sharing that. I mean, there's so many different ways, so many different reasons why people come to Thrive Lab to optimize their hormones. And I'm so thankful for sharing some stories like those. I'm sure you have one more story that is even better than what you just shared so far with us. Tell me one more story, something about patient outcomes. Ha ha ha. So, I'm going to go ahead and start with a question that I've been getting.

Katie Jo Dixon: 
So circling back around to listen to our patients, I've had multiple patients tell me, I finally feel heard, Katie Jo. I feel as if I'm being heard and I'm being listened to. And that's huge because in our patient appointments, we allow for a longer length of time to listen to our patients. And then I'm able to hear the patient's stories and be able to connect those dots for them. I had a patient today and she said, during the second half of my cycle, I become so moody. She said, I am enraged. I'm a business owner. I own my own business. I can't go to work and flip my top with my employees because I'm not going to keep them. And we were able to identify that it was a progesterone deficiency, that her moodiness, her irritability during the luteal phase of her cycle from when she ovulates until when she menstruates again, that she was experiencing a severe hormone deficiency. gave her the confidence that as we correct this, that her mood would be improved and she would be the wonderful boss that she knows that she is inside.

Nayan Patel: 
So there's one symptom that we didn't talk about, because it is by far catching up with the whole of America for decades, and that is weight loss, weight gain. We are seeing an astounding number of patients who are actually having weight gain issues, and the pandemic did not do any justice to us; for years we have seen weight gain just spiraling upwards. And I mean, you've been in the block. I've been in the block. And we've seen all the different diets and the pills and the shots have come across the last 20, 30 years on how weight loss has been addressed. And I want to talk to you about a peptide called semaglutide. And the reason is because for the very first time, there's a slimmer hope that we will actually be able to help these patients. Can you elaborate on how we are doing this today? How are we doing this today?

Katie Jo Dixon: 
Semaglutide is an amazing peptide therapy. And many of us know common peptide insulin is a hormone and a peptide at the same time. Many of my female clients when they come to me, they come in a painful state. They tell me, Katie Jo, I look in the mirror and I don't recognize who I am anymore.
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Katie Jo Dixon: 
I have a patient I met with today. She revealed to me that she was a former candidate for a statewide pageant. where they choose Miss America. And she said, Katie Jo, in the past, I could eat whatever I wanted. I would drink sodas. I was in this pageant. And she said, now I don't recognize who I am in the mirror. I have what I call a midlife middle where you start to notice the abdominal section gaining weight. And we know that when you gain weight around your abdomen, that can be fat around your visceral organs. That would be the organs deep inside your abdomen. And that type of fat leads to poor health outcomes, to diabetes, to high blood pressure. And so using a medication, a peptide like semaglutide, we can reverse this epidemic in America by helping others maintain a healthy weight, decrease the abdominal fat, and also improve their self-esteem and self-confidence.
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Nayan Patel: Absolutely. You put it so nicely about semi-glutide as being a peptide that is actually helping the root cause of the problem, which is the insulin, which is another peptide. Right? And over the years, we have seen HCG diet, the fiber calorie diets that you can inject HCG and the fiber calorie diets. Yes, it works, but it's not life-sustaining. It's not sustainable for a long period of time. Everybody in America was using these products and later we found out that it was really toxic to your heart. So the FDA has approved semaglutide already for diabetes and while it's helping with diabetes, it's also helping with weight loss, which is what most people need more than anything else. So, again, thank you for explaining patients on how to use it correctly. So what methods of HRT do we offer right now and why?

Katie Jo Dixon: 
Yes, I will call in you as my backup here. So there's several different hormones and peptides that we offer as well. So my favorite hormone is thyroid. I am a proactive thyroid fanatic because I know if we can increase your metabolism, our thyroid is our master metabolizer, then we can increase your body's ability and then we also can increase your energy. So thyroid is one of my favorites. In our formulation, we use two different types of thyroid. We have a bioidentical thyroid called biothyroid, and then we also include porcine-based thyroid as well. And this is where, when we dig deeper as detectives for our patients, we determine which thyroid medication would be the most beneficial. Then we also use estrogen. We use a specific type called bi estrogen. Bi for two, like the word bicycle. So our estrogen has both E2 and E3. These types of estrogens are known to be protective for women. There is a doctor I've trained with, Dr. Pamela Smith, and she told us in a lesson that when she goes to the airport, she looks at women to see who's using hormone replacement therapy. 

She said, if you're using progesterone, it'll increase the circulation to your skin and you'll have that youthful glow. it will help to maintain your pores in a tight closed position, so you're not having the sagging aging skin. And if you're using testosterone, testosterone helps erections in the skin as well. It helps to maintain your muscle mass and your muscle skin erect and hold their shape in your face. So estrogen is one of my favorite hormones for this very reason, because we know if it's affecting the skin on the outside, it's also affecting internally as well. So I want to keep your blood vessel lining soft and supple with the use of estrogen and decrease the hot flashes at the same time. And then testosterone is also one of my favorite hormones. I mentioned erections, keeping the muscles erect. So not just erections in what we would think of men's health, but in women's health, also using that for the low libido, which we spoke about earlier. In our formulation with the estrogen, the bi estrogen and the testosterone for women, I prefer the labial application. And we go into detail with my female clients about why the labia is such a great application site. And one of the reasons is because there are so many blood vessel endings and nerve endings in the labia that you can use a very small amount of medication and have a therapeutic effect with a very small dose. And I've noticed since we've used the labial application of testosterone and estrogen that my female clients have quicker responses. their symptoms are relieved for a longer length of time.
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Nayan Patel: 
No, thank you. I've used labial application for over 16, 17 years right now. And initially I was a little hesitant to switch my patients over from topical application to label application. But once I do that part, it is nothing but just a blessing to my patients' life, right? They never change the site again. They seem up at the same spot all the time for 15, 17 years and they get the same response every single time. So it's very, very nice to see. that part. One thing we do not do, and I'm glad you paid about the erection in your skin, you know, I would have put it a little bit differently. I would have probably said that, hey, it causes skin thickness would be a better way to put it up than the erection of your skin, because I don't compare that properly, correctly. But anyways, that's a nice way of putting this
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Katie Jo Dixon: 
I'll give another example for you, Dr. Patel. So if you see someone who's not using hormone replacement therapy and you notice their skin, they often have these saggy wrinkles. For some  individuals, they'll start to notice the area of the eye being shallow and sunken and the skin pulling away from their face. The testosterone is helping to lift those muscles. On the opposite end, if you are a female client and you're noticing lots of edema underneath your eyes or you wake up in the morning and you're puffy, you're swollen. That could be hormone related. It could be related to progesterone or it could be related to thyroid. 

For myself, I am not only a mentor, but I'm also a member, so I use bioidentical hormones myself. When I started to use bioidentical thyroid, in the morning when I wake up, the puffiness under my eyes is almost completely gone.

Nayan Patel:
Thanks for sharing that, but I did not know that part. Hey, you always learn something new every single day, right? One thing you do not do is pellets. Now, I have my own theory, which I will mention to you, but I would like to hear your theory first, then I'll tell you why I think we don't do pellets.

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Katie Jo Dixon:
All right, well, we'll compare notes. So in my practice, I tend to receive pellet rejects. I had a client who had an infection from where she was cut. I've also had clients that have experienced what we call supraphysiological. So the levels of the hormone rise above what your body would ever naturally be able to produce. Specifically with testosterone, it can cause hair loss in women. It can cause roid rage, where you are raging internally, and you want to argue with every single person you encounter, it can cause facial hair growth. So you are optimizing your hormones and now you're growing a beard. Or it can cause acne where you have cystic-like acne on your face. So with the pellets, I see those possible side effects. And to me, it's not worth it when we have an alternative like the labial testosterone, that we can have the good impacts of testosterone, we can prevent your muscles from wasting, can increase your energy without having to risk the side effects of having the supraphysiological dose. And I say that because many practitioners have great success with pellets.

Part of our mission is making hormone healthcare accessible. So we're using the platform of our technology to reach patients that might not be able to see healthcare providers. Pellets do require an in-person visit while our visits are via telephone calls or video conferences. versus an office where I wouldn't be able to serve my patient who lives in rural Montana to insert a pellet.

Nayan Patel:
And how about those post-surgical scars that they get after the small insertions they make? Maybe once or twice is okay, but every three months if they get inserted, every three months, after a while you run out of the spaces where you're gonna put it up there, right? How about scar tissues, do you have scar tissue under the skin? 

Katie Jo Dixon: 
Yes exactly. One of my patients said, “I want to use hormones through the longevity of my aging.” And she said, “I can't see myself being 70 years old and going into a doctor's office to have them scar me and put that in.” She said, I know that hormones are gonna protect my health long-term. I know that it'll protect my brain, my bones, and my heart. But if I'm having to go in every three months and for years after that, my backside will not look pretty. And other clients have told me it is a vanity. They don't want to have scar tissue. So their partner, their husband would see that. So they want to prevent that from not happening.

Nayan Patel:
Especially if you had the body to wear a bikini, you won't be able to do that anymore because of the scar tissues that can develop over there. I'll tell you another reason why we don't do pallets all the time because at Thrive Lab we want to mimic human physiology. Us humans, we don't produce hormones every single day, 24-7, 365 days a year. We produce hormones in a sporadic manner. and then it goes down and then we don't do anything. And then the next day again, it goes up and goes down. Or maybe sometimes it goes up and down twice during the daytime. When you do pellets, it's the same hormones every single day, the same levels. And what we do know is that a continuous, continuous treatment of any hormone therapy is actually a body that doesn't have a chance to clear it out, to get rid of it. So the hormones, instead of helping you, the excess hormone actually being harmful or hurtful in that case, I mean we see a lot of side effects but that's just the tip of the iceberg, just the side effects, but eventually the side effects can become towards much worse, eventually can lead up to major diseases. That's another reason why we don't do too many injections either. We do have injections available, because injection has a shorter life, so you do shots maybe once a week, once every two weeks, so it's okay a little bit. But pellets, it's long term. There's a huge high and a huge low, which is very hard to maintain for a lot of our patients. That's the reason why we don't do them.
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Katie Jo Dixon:
What's interesting, is that you mentioned the other diseases that could happen from having your hormones elevated to the super physiological state for a long period of time. And one of my personal and professional missions is to help individuals' lives, my own personal experience and my own health. I've had malaria, I've had hepatitis A, I traveled a lot. So my liver is a place that I'm especially sensitive to after having some of my own health challenges. So protecting the liver is essential for my patients. key recycler in our body. It helps to take out the trash and if we're overstressing our livers with very high hormones it is on overdrive and that long-term can lead to fatty liver disease or other issues. So it's important when you're seeking out a health care provider for your hormones that they're taking all of this into consideration.

Nayan Patel:
Thanks for bringing it up because with that, I do have to let you know that, thank God, we do have a product called Glutathione that is available to clean the liver out for us all the time. And it's something that I've been passionate about. We have patents on it. It's available through the Thrivelab platform at a discount price for all over patients. And it's the single most important butter molecule in the human body to keep your body clean at all times. The liver is by far the most important organ that we need to be clean at all times. Having those levels optimized and making sure that all our patients have access to it to make sure their liver is always clean has been a game changer in HRT or what we call BHRT, the Bioidentical Hormone Replacement Therapy. So anyways, this was a great conversation. If somebody is out there looking to get help, what would the next step for that person be?

Katie Jo Dixon:
Well, the next step I would say is not to wait to get help because every day you wait, your hormones are not going to replace themselves on their own. So you may try different diets, which Dr. Patel, you mentioned, all the different diets. If hormone deficiency was a dietary deficiency, then we wouldn't be in the place where we are right now. So don't wait. Reach out to us at ThriveLab, our website, ThriveLab.com, and on there, there is a self-assessment that you can take. a few minutes because I'm a patient, I've completed it myself, and it will enlighten you of your symptoms that you may think are hormone related, and it will confirm that. And then from there, we'll have our team member reach out to you to have an appointment with a provider so we can go over in detail your symptoms, your struggles, and then develop a plan that would be a way to optimize your hormones.

Nayan Patel:
That's so well said that if it was a deficiency that you don't want to – you think it's a food and I mean you see all the time people go, oh I've tried soy and yams and all these different products. I take some over-the-counter supplements to help me with my hormones. Hormones are hormones. They're internal chemicals that you can get from plants. If plants have hormones, they'd be human beings, right? They are not human beings. We are human beings so we have the actual, real hormones that make us tick. And one more thing I wanted to mention is that not a lot of people know that both men and women, both of them, the highest number of hormones they have in the body is testosterone and is not estrogen in women. The only time the estrogen rises in women is guess what, when they're ready to have a pregnancy and to have a baby. That's when the levels rise and then it'll drop right back to low levels and the testosterone level is always high. So testosterone level is, testosterone is always highest in both men and women, but yet in women it's this much and in men it's way, way, way higher. But when women say that, oh I don't need testosterone, I said, hello, your body makes too much testosterone. To begin with and not replace testosterone is actually not beneficial for good health. And so it's good to let people know, but at the same time when you see people having the aha moments, that they learned something new. That brings so much joy into our life because our mission is to help every woman possible and to thrive. We want to make sure that we help everybody and make it accessible. We want to do a good job, but at the same time we understand the cost of it as well and we want to make it accessible. Before I go any further, I just want to make sure, do you have anything further to share for us? The closing remarks.

Katie Jo Dixon:
I wanted to share that health is wealth. No amount of money, if you have a disease that's debilitating, if you have diabetes or high blood pressure that could lead to situations such as strokes or heart attacks, no amount of money can fix that if you experience a life-changing health crisis. We know that using hormone therapy can optimize your health, prevent you from going down the pathway to chronic illness. And we also know that it can improve of life. So I, as a member of hormone therapy, I want to give one last example for a story for you.

Katie Jo Dixon:
So last night I went swimming at a pool party with some girlfriends and I was able to wear my bikini and all my girlfriends are about 10 years older than me. But what I noticed is they all had the midlife crisis. They all had joint aches and they were moving slower. And I thought if you had started hormones a decade ago, you probably would not be able to be in the condition that you are now. So that's another cry to prevent yourself from going down that rabbit hole of pain and joint aches. If you took the word aging and you replaced it with deficient hormones, you'd be having a very different conversation in our healthcare. We wouldn't be saying this is because of aging. We would be saying this is because of hormone deficiency and we know that can be corrected.

Nayan Patel:
You put it so nicely, healthy as wealthy. And in my tenure of doing hormone therapy, what I've noticed is hormones to me are considered the angel of life, angel of death. Too many hormones is not good for you because it can give you a lot of problems. That's why we need a platform like ThriveLab to help address those hormone needs in the correct manner. But too little, it can't function. So you're gonna have the right amount. So that's why we call it the angel of life and angel of death. 

With that, I wanna make sure that everybody gets to experience hormone replacement therapy. I want everybody to at least give it a shot for yourself. You don't have to suffer. You don't have to go through these life changes on your own. There are people out there like us, they can help you. They can give back control to your life. And with that, you can enjoy the second half of your life.

And it's so important for us to make sure that we all want to live that 30, 40 years post menopause as enjoyable as we did the first 40 years. So thank you. Thank you very much for joining us today. I appreciate your time today and thanks for educating all of our patients and letting everybody know that we are here to help them. questions, please reach out to us at thrivelab.com.