Ladies, Listen Up!

Women in their 30s and 40s may still look and feel young, but many begin to notice subtle changes in their bodies during these decades. Hosts Kendra and Kerri interview primary care physician Wanda Lowe, MD, for a no-holds-barred discussion about women’s health. They ask: Why can’t I eat a whole pizza without budging my jeans? Do I need a beauty box to keep my skin looking youthful? How can I counteract the inevitable loss of bone and muscle mass as I grow older? Dr. Lowe uses clinical evidence to shed light on simple things women can do to set themselves up for healthy aging. She provides metabolism-boosting tips, explains the mystery of perimenopause, and advises on care for symptoms of anxiety or depression. Lastly, Dr. Lowe offers guidance on vitamin supplements and outlines the preventive screenings women should schedule during these years. Listen up, ladies, for some powerful info you’ll want to share with your girlfriends.

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Today on the HealthTalks NOW podcast, Kerri and Kendra welcome the University of Louisville Medical School graduate, Dr. Wanda Lowe. Today, the ladies unpack what is going on in your bodies specifically in the decades that things start to change from your twenties! This episode speaks about things that are important to women in their thirties and forties.

The episode starts off with Kendra asking Dr. Lowe about her volunteer and medical mission background. Dr. Lowe says that she went on her first medical mission trip when she was thirteen! Her parents led these trips when she was young and this is how she was first exposed to medicine. Later, when she was in Brazil on a mission trip (through her medical school), she lived on a boat and traveled to different villages deep into the Amazon river. She said, “So It challenged me to think of solutions when I don’t have the normal testing opportunities I have – it really sharpened more of my physical demand skills because you can’t do an x-ray, you can’t get lab work…” Dr. Lowe explains how these experiences helped strengthen her confidence and creativity. Even now, during the Pandemic, Dr. Lowe encourages others to be thankful for what we have in the U.S.

Next, Kendra and Kerri start asking Dr. Lowe for some healthcare tips for women. They ask Dr. Lowe to talk about skincare and what women really need to know.

Things to consider for skincare according to Dr. Lowe:

  • Wearing sunscreen
  • Not smoking
  • Washing your skin regularly
  • Hydrating your skin regularly
  • Getting good sleep
  • Hydration
  • Genetics
  • Checking your skin to notice differences and get an annual check with a dermatologist

Dr. Lowe says, “… it matters what we do in our twenties and our teens to our skin…”  She points out that it is a bigger topic like reshaping our culture and what it says about being tan. In general, she recommends wearing SPF 30 on your face, arms, hands and legs every day. She says that most women she sees with new skin cancers are on their legs, and for men – on their arms.

How alcohol consumption can affect a woman’s appearance over time:

  • It depends on how you would define moderate consumption.
  • Splotching on the skin
  • Spiderweb findings on the skin
  • Significant swelling – feet or abdomen
  • Weight

Next, Kendra brings up perimenopause. Dr. Lowe defines perimenopause as the time before menopause where you may be having some lowering levels of the female hormones like estrogen and progesterone. She says that on average this happens for women in their forties but can happen earlier. Another change that can occur during this time is difficulty sleeping.

What to do if you are feeling in a funk? Dr. Lowe encourages you to talk about these things and to consider your lifestyle.

  • Level of exercise
  • Alcohol intake
  • Caffeine intake
  • Sleep pattern
  • Smoking
  • How/what you are eating?
  • Check in with your doctor during a check-up about your mental health.
  • Check in with yourself!
  • Check with your Primary Care Doctor, insurance, therapist, counselor.

What does Dr. Lowe say about your metabolism and potential weight gain in your thirties?

  • Increasing your muscle mass is very important!
  • Exercise
  • Evaluating and calculating how many calories you need
  • Adjusting your diet to match health needs

Dr. Lowe says that the way you should exercise for your heart is also good for your bones. She recommends that you get 150 minutes of exercise a week, alternating that with weight bearing activities. She also recommends variety in exercises. Dr. Lowe gives her recommendations and thoughts on Calcium and Vitamin D intake.

Dr. Lowe recommends making appointments with your Primary Care Doctor, and following up regularly with your GYN. You will hear her favorite Bible verse and other details about Dr. Lowe’s life in the rapid-fire questions at the end.

Key Takeaways:

[1:41] – Kendra and Kerri introduce Dr. Wanda Lowe.

[2:17] – Kendra asks Dr. Lowe to share about her medical mission work in Brazil.

[5:30] – Kerri brings up what it must be like coming back to the infrastructure in the U.S. and how grateful we should be.

[6:40] – Kendra introduces the topic of skin. She asks Dr. Lowe about what women really need to know about skincare.

[8:45] – Kendra asks Dr. Lowe to talk more about sunscreen.

[11:54] – Kerri asks Dr. Lowe about the effects of drinking in moderation with skin and hair.

[14:11] – Kendra brings up perimenopause.

[17:10] –  Kerri brings up mental health.

[24:10] – Kendra asks Dr. Lowe about metabolism.

[26:36] – Kendra asks about bone loss.

[30:10] – What does Dr. Lowe say about vitamins, calcium supplements etc.?

[32:01] – What screenings do Dr. Lowe recommend?

[32:22] – Rapid-fire questions with Dr. Lowe!

View Transcript

Welcome to HealthTalksNOW, bringing you the facts you need to keep you and your family well. We’re happy you’re tuning in today. Baptist Health is committed to providing compassionate, high-quality care that is centered on you. Listen to all of our podcasts to hear from Baptist Health physicians about the latest medical advancements and treatments, and get trusted information on timely health topics from our healthcare professionals. Whether you want to learn more about a specific condition or procedure or find tips for living a healthy lifestyle, Baptist Health is here to help you become a healthier you.

Kerri:

This episode is going to be a favorite, and I can already tell. Kendra and I are both in our 30s, and we’ve been eagerly anticipating having this discussion with someone who can relate to us and to many of our listeners, and who has the clinical knowledge to shed light, tips, insight, and humor.

Kendra:

That’s right. Women in your 30s and 40s, rejoice. Today, we’re asking all the questions you’ve been wondering about these decades and the changes they bring. We have the perfect guest to provide the answers.

Kerri:

We’re joined on the phone today by Dr. Wanda Lowe, a primary care physician with Baptist Health Medical Group, to unpack what’s happening to women’s bodies in the decades when we still feel young, but things aren’t the same as they used to be when we were in our 20s.

Kendra:

That’s the truth. All you ladies listening know exactly what we’re talking about, so you’ll want to listen in to today’s episode and share these tips with your girlfriends.

Kerri:

Let’s get started.

Kendra:

Well, Dr. Lowe, thank you so much for joining us on the phone today. We are really excited to dive into this subject with you.

Dr. Wanda Lowe:

Awesome. Well, thank you, guys, for having me. I’m looking forward to our conversation, and hopefully it’ll be fun and helpful for all of us.

Kendra:

Okay. I’m really excited to catch up with you because you may or may not remember, but I had the pleasure of helping onboard you when you joined Baptist Health. This is a full circle moment for me. I know that you’re a University of Louisville Medical School grad and that you went on to do your family medicine residency there as well, but what really stood out to me, as I remember looking back at your onboarding process, was all of your volunteer and mission work. Tell us about your medical mission trips to Brazil and traveling deep into the Amazon River by boat. How did these opportunities come about, what did you learn personally and professionally, and how did these experiences change you as a doctor and as a woman?

Dr. Wanda Lowe:

Well, thank you. Yeah, I would say probably medical missions has shaped me greatly. My first medical mission trip, I was actually 13.

Kendra:

Wow.

Dr. Wanda Lowe:

My parents would lead medical mission trips when I was young. That’s how I got introduced to medicine to begin with, going back to my birth country of Honduras. When I found other opportunities, I would just jump at them. The Brazil opportunity actually came through the medical school. I went, I think I was maybe a third-year medical student, maybe a fourth-year medical student, with one of our professors at U of L, who is amazing, Dr. Wheeler. It was a two-week trip, and we would travel down essentially every year. Twice a year, we go down and just deliver care, and it’s become regular enough… He and his wife have been going down often enough that a lot of people consider them their primary care doctors…

Kendra:

Wow.

Dr. Wanda Lowe:

… and check in with them regularly. It’s really sweet, just a sweet relationships that they have with a lot of that Brazilian people. But we would live on a boat. It had two floors. The first floor was where we would have our food and…

Kendra:

No kidding.

Dr. Wanda Lowe:

… where a lot of living quarters would be. Then the second floor is where all the hammocks were, so we would sleep on the hammocks and essentially dock in at different villages…

Kendra:

Wow.

Dr. Wanda Lowe:

… just deep into the Amazon River and deliver care in schools and whatever setting we had availability. But yeah, it challenged me a lot. All the trips before that had been more as an interpreter or something along those lines, but it challenged me to think of solutions when I don’t have the normal testing opportunities I have. It really sharpened more of my physical exam skills because you can’t do an x-ray, you can’t get lab work, and just basic things like that. It was, yeah, really shaping. I went again in residency, and it also was just a great opportunity for teaching and giving back to students. I learned a number of my procedures there. I learned how to do some eye surgeries and things that I would…

Kendra:

Wow.

Dr. Wanda Lowe:

… never do here, but it definitely just helps build confidence and, I think, build, “I can do this. Yeah. I can do something,” because there’s so many times as you’re in training and growing and learning you just forget what you know. Those opportunities really challenged me, and they helped me to be creative and to use the resources that I had to find a solution for the person that’s sitting in front of me, even thinking outside of the box for, “Maybe your back pain is because you’re sleeping on the ground. What are solutions that we can come up with with the resources you have to help this? What can we do to bring it relief and help and really….” Yeah, but I helped in those communities. I loved it. I would love to go back there. Yeah. Just sweet, sweet, precious people.

Kendra:

I can imagine how the disparity of coming back to the U.S., and you get back into the infrastructure that we have and the resources and the tools that we have in our-

Kerri:

[crosstalk 00:05:40].

Kendra:

Yeah, in our healthcare industry, and then just realizing how grateful we should be. Yeah.

Kerri:

Blessed. Yeah. [crosstalk 00:05:47].

Kendra:

Yeah.

Dr. Wanda Lowe:

Right. That’s it. I think that’s really key because it’s so easy to forget what we have and the resources that we have. Even during this pandemic time, I’ve been reminding patients of that, and just like, “Yeah, this is hard, and it’s frustrating to wear masks. It’s frustrating to do all these things, but really, we’re so fortunate. We have access to medical care. We have hospitals. We have doctors that do a good job. That’s a privilege. We’re so honored to have that, and there are people across the world that would just love to be in our shoes,” and so just to be thankful for what we have, even if it may not be what it could be or what we’d want it to be. I think it can be helpful just to keep us from becoming bitter or becoming hard.

Kerri:

Ungrateful. Sure. Well, let’s get into it. Skin, peri-menopause, feeling blah, and changes to your body. You ready?

Dr. Wanda Lowe:

Okay. Let’s go.

Kendra:

Let’s talk first about our skin because maybe it’s because it’s such an immediate tell of someone’s age, but there’s a lot of focus in our society on keeping women’s skin from showing a single sign of aging.

Kerri:

It seems like there’s a million things out there, and many of us are suckers for products and promises of anti-aging and immediate results. Kendra and I both have subscriptions to beauty and skincare boxes…

Kendra:

It’s true.

Kerri:

… each month for new products, but what do we really need to know? What recommendations do you have to keep skin hydrated, fresh, and youthful?

Dr. Wanda Lowe:

It’s so hard because the honest answer are just really the simple things, and I think sometimes we try to make it complicated, but it starts out with wearing sunscreen and protecting your skin from excessive sun exposure, from not smoking [inaudible 00:07:29]. Those are probably the two biggest things you can do to keep your skin healthy, to keep it looking healthy, as well as being healthy. Then washing your skin regularly, hydrating it regularly, getting good sleep and hydration, all of those things matter. Then genetics is a big part of it too.

Dr. Wanda Lowe:

It’s definitely multiple factors, but I think sometimes we try to make it more complicated than it is, or we try to cheat our way out of wearing sunscreens and doing the things we know we need to do. But those things are probably honestly the biggest factors. Yeah, it’s fun. I enjoy it. I enjoy thinking about topical vitamin C or [inaudible 00:08:08] collagen or all these kinds of things, but the reality is it’s honestly just the day in and day out. Are you in the sun a long time? What are you doing with your skin? How are you treating your skin from a day-to-day standpoint?

Kendra:

That’s so telling of our society though, right? We often overlook the essential, the foundational things that would really make the biggest impact, and we’re onto the next, “What’s the next quick-fix cure?” instead of just making sure that we’re drinking enough water every single day over our whole lifetime. It’s like, “Well, what can I put on my skin tonight?”

Kerri:

For immediate gratification, [crosstalk 00:08:44] results?

Dr. Wanda Lowe:

Right.

Kendra:

Yeah. Yeah.

Kerri:

Sure.

Kendra:

Well, so you mentioned sunscreen. Let’s dig into that a little bit more. When you’re young, there’s almost an avoidance to wearing sunscreen or using clothing or hats to protect, but as we age, there’s actually more and more emphasis, I see, on products with SPF and making sure that you’re taking precautions when you’re outside. What do you see in your practice as it relates to sun exposure, and how can those early choices impact women later in their life?

Dr. Wanda Lowe:

I agree. As we’re younger, it’s not something that’s on our radar, but even as we approach our early 30s, a lot of us start to get those signs of sunspots or darkening, blemishes on our skin, or different things from a cosmetic standpoint that matter to us. Right?

Female:

Right.

Dr. Wanda Lowe:

I think it goes back to what we view as being healthy and good, but it matters what we do in our 20s and our teens to our skin. I think part of it is even reshaping our culture and reshaping the view of being tan and all those kinds of things, but just embracing your skin and the beauty that it is and enjoying it. In general, so basic rules of sun, so wearing SPF 30 every day is a great idea. [Inaudible 00:09:58] probably wear it on your face, ironically, on your hands and your arms and on your legs. Most women that we see with new skin cancers actually shows skin cancers on their legs…

Kendra:

Interesting.

Dr. Wanda Lowe:

… and then a lot of times on their arms. Those are just telling spots that I think sometimes we overlook when we’re putting on sunscreen because a lot of times if we’re wearing shorts or a dress or something, we’re not getting sunburned, and so we just forget to apply SPF there. But later on in life, in the 50s and 60s timeframe, that’s when we start to see those changes with skin cancers. Then that’s the kind of next thing. From a doctor’s perspective, I think skin cancer would be really big on my radar from a sun exposure standpoint. I do think just looking at your skin, seeing if you have new moles. Are they changing? Are they getting bigger?

Dr. Wanda Lowe:

Do they have multiple colors on the inside? Does it have a regular border, or does it seem to be different than all the rest? If you have something like that, just bring it up to your doctor for your regular physical. They may say, “We need to set you up with a dermatologist,” and start getting annual skin exams. If you know you’ve had a history with a lot of sun exposure or a lot of burns, skin poisoning, or if you have a family history with melanoma especially, but even basal cell or squamous cell cancers, it probably would be good just to set up with a dermatologist and get your annual checks and just be on top of it. Usually, if we catch things early on, it can be much better in terms of prognosis or surgeries or how invasive we need to be if we’re more proactive with getting those things checked.

Kendra:

Gosh, you’re making me think too about the hands. I’ve never seen anyone just slather their hands in sunscreen.

Dr. Wanda Lowe:

I know. But if you think about it, you see a lot of… The skin’s often aging on the hands and [crosstalk 00:00:11:49].

Kendra:

Absolutely.

Kerri:

It’s thinner skin too, and it can tell your age too.

Kendra:

Yeah. That’s such a great tip.

Kerri:

All right. Happy hour. We’ve had a discussion on a prior episode about moderation, so we know the importance of consuming responsibly. But beyond the obvious physical and mental health benefits of drinking in moderation, let’s look specifically at the effects of skin and hair. It’s very easy to identify someone who’s been a long-term smoker by their physical effects, the body, and I think the same goes for someone who’s a heavy drinker, but how does moderate alcohol consumption affect a woman’s appearance over time?

Dr. Wanda Lowe:

That’s a good question. I think it’s multiple factors, and it also depends on how you would define moderate alcohol consumption.

Kendra:

That’s a good point.

Dr. Wanda Lowe:

In general, if you have someone who’s had enough alcohol to impact their liver’s function, then this is honestly a really big and complicated conversation. But the venous system, your body’s ability to make blood clots, and all those things is impaired, and so you start to get splotching of the skin and little spider web kind of [inaudible 00:12:56] on the skin. There’s a lot of irregularity. A lot of my patients who are heavy, heavy alcohol drinkers will get significant swelling. A lot of times, you may not see it as much in the face, but in the feet or in the abdomen are probably the areas where we see those changes the most, and so significant edema. I can think of a couple of patients who are in their 30s, heavy drinkers, and then you just look at them, and their skin really is splotchy.

Dr. Wanda Lowe:

It really is almost shiny because of the amount of swelling. It just doesn’t look healthy. Then with getting involved with AA and going through the appropriate processes to help them come back to a place of sobriety, their skin has actually transformed. It is possible, depending on how far you’ve gone or how far in you are, to get some of that back. But honestly, it’s a really complicated conversation to have. But yeah, it definitely affects their skin. It affects their health. Probably more with weight, I would say. For the average woman who’s not an alcoholic, probably more with abdominal obesity and those kinds of things.

Kerri:

Yeah.

Kendra:

Yeah.

Kerri:

That makes sense. Even just the simple idea of it. You’d probably eat more than you normally would, and it’s full of empty calories in addition.

Dr. Wanda Lowe:

Absolutely.

Kerri:

Okay. Yeah.

Kendra:

Okay. Well, let’s talk now about a topic that doesn’t seem to get a lot of coverage, perimenopause. We hear a lot about the onset of menopause in your 50s, but women in their late 30s to 40s need to listen up. Let’s start by defining it. What exactly is perimenopause, and when does it typically begin?

Dr. Wanda Lowe:

These are great questions. Perimenopause is talking about the time where you are before menopause, so you haven’t gone through the menopausal symptoms yet, but you’re starting to have the lowering of some of the female hormones. Your estrogen and your progesterone are starting to drop. Maybe your periods are becoming more infrequent. Maybe you’re getting hot flashes. Maybe you’re becoming more moody. You might be noticing some of those changes with some of those hormonal changes, and that can vary from patient to patient. I would say on average, it tends to start in the 40s, but there are some women who start to show symptoms in their 30s, but yeah, probably around that timeframe or so.

Kendra:

Okay. It’s caused then, you said, by a drop in the hormonal levels, like estrogen or-

Dr. Wanda Lowe:

Right.

Kendra:

Okay. Gotcha. I think a lot of people associate menopause with mood swings, hot flashes, and the like, what we mentioned. Are there other symptoms of perimenopause that maybe aren’t as common or that people may tend to slough off or dismiss?

Dr. Wanda Lowe:

I think probably the one that I see the most is probably with sleep, changes to the pattern of sleep or having difficulty sleeping, but I would say moodiness and hot flashes are the most common. You will get possible more vaginal dryness. That tends to be more after menopause and perimenopause, but some women will start to have recurring UTIs or different things from just decreased estrogen within the vagina and having more dryness and thinning of the skin there. You can even have painless intercourse and different things like that, but those tend to be more common during the menopausal symptom than perimenopause. It can vary from patient to patient, but if you have questions about it, I would probably talk to your doctor to see what things are looking like, but it can vary from patient to patient.

Kendra:

Do you ever see that patients that are experiencing or heading into that perimenopause or even to the menopause age… Do you find that they have an increase in any anxiety or depression either because of hormonal shifts or maybe because of their lifestyle changing, that that may trigger some depression in people?

Dr. Wanda Lowe:

Yeah. I would say I honestly think we see that at all ages and stages of life. There is a moodiness that can happen with those estrogen levels dropping specifically. We do see more of that, and there’s ways to treat that, that can be really helpful, just to help that irritability period, if you will, during the perimenopausal to menopausal stages. But yeah, it’s definitely something that we see pretty regularly.

Kerri:

Yeah. Well, that’s a good transition. Although we’re beginning to see a breakdown of the stigma and this condition discussed more frequently, we wonder if there’s an awareness problem. Instead of acceptance, do we have an awareness problem? We’ve had discussions in prior episodes with behavioral health clinicians, but let’s talk about these feelings, like if you’re feeling in a funk, lack of motivation, unexplainable withdrawal, or lack of interest, a more mild bread-and-butter-esque depression that one can seek the advice from their primary care.

Kendra:

I think oftentimes, and I can even speak just from my personal experience, the difficulty in recognizing a mild to a moderate depression when you’re not struggling to maybe get out of bed the morning or having self-harming thoughts, but maybe you find yourself saying things like, “Gosh, things feel so heavy lately,” do you see this trend in your practice as well, just a lack of awareness that maybe they’re having these feelings, but not recognizing them as depression because women are taught to push through? Right?

Dr. Wanda Lowe:

Right. Right. I think there’s also a stigma with it. I think there’s this feeling of, “If I acknowledge these feelings, then I’m being weak,” or that this is a sign of something scarier to come. Also, I think there’s a fear of medication. Some of that, I understand. I think it’s good to treat things [inaudible 00:18:28] and seeing, “Okay. If I’m noticing these things, are there things I can change with how I’m living? Do I need to exercise more? How about my sleep pattern? How about my caffeine intake or smoking or alcohol intake or how I’m eating? Am I eating foods that are high in sugar and giving me these drops in blood sugar that are causing my energy to drop?” There’s definitely a lot of things to look into, those symptoms, that can contribute to them, but I think especially…

Dr. Wanda Lowe:

I think it’s helpful to be thoughtful, and even with your routine exam, just seeing, “How am I doing from a mental health standpoint?” I have a train of thought of treating ourselves mind, body, spirit, and treating our whole self. From a mental health standpoint, are you withdrawing? Is this affecting your relationships? Is this affecting how you eat? Are you overeating? Are you under-eating? Is it affecting your interest in doing things that you normally would? Are you just detaching from life?” Those kinds of things are really not healthy. How can we address them? That’s where medications can really help jumpstart the process as you work through the other lifestyle pieces. I think there’s also a fear that once you start a medication for depression or anxiety, that you’re on it for life. That’s also not true. There’s definitely, I think, a lot of the misconceptions about it, which can just be helpful, I think, just to talk about it and bring it up…

Kendra:

Absolutely.

Dr. Wanda Lowe:

… and have someone that you can trust that understands these things and can be helpful.

Kendra:

We’ll be right back. A woman’s body is capable of phenomenal things, but being a woman also comes with unique health challenges. At Baptist Health, we’re dedicated to providing women the services they need to protect their health at every age and stage. From attentive mother and baby care to comprehensive breast health and primary care services, we partner with women to help you attain your very best health throughout your life. To find a provider near you, visit baptisthealth.com/provider.

Kendra:

We’re back with Dr. Wanda Lowe. I love what you said about just checking in with yourself monthly, because as women, we’re told to, “Check your skin often. Make sure you don’t have any changes in your skin. Just do a check of your breasts. Make sure what’s normal for you and what’s not normal for you.” But like you said, a lot of times with stress or with our emotions, we’re like, “Plow through, sis. Keep going to the next thing. You got to be a great mom. You got to do this. You got to do this.” It sounds radical, but it’s so normal. What a great idea…

Kerri:

That’s part of self-care.

Kendra:

… to take a monthly check every month to be like, “How am I feeling?”

Kerri:

Yeah. It would put into perspective of what you’re balancing on your plate that month too to shift of, “There’s a lot going on [crosstalk 00:00:21:20]-“

Kendra:

And, “Is this normal for me?”

Kerri:

Yeah. Absolutely.

Kendra:

Wait, actually, last month when I checked in with myself, I wasn’t this stressed. What changed?

Dr. Wanda Lowe:

Right. Right.

Kerri:

Genius.

Dr. Wanda Lowe:

There’s different kinds of rest too. Maybe someone’s doing a lot of work with teaching their kids right now. They’re doing a lot of mental and emotional work. Then maybe it’s like, “Well, maybe I need to rest in ways that are mental and emotional rest for me. Maybe that’s being outside. Maybe that’s artwork. Maybe that’s different ways to [crosstalk 00:21:50]…”

Kendra:

Such a good distinction.

Dr. Wanda Lowe:

“… with me in these different areas. It does take slowing down. It does take maybe some journaling and thinking through it and maybe seeking a counselor to help them navigate some of that, but that can be incredibly helpful and really lead to a better quality of life.

Kerri:

I love this. If someone’s listening right now, and they’re recognizing these feelings, where do they start? I think it might be a misconception about which doctor to go to, as I don’t think many have a relationship with a behavioral health provider. Is this something a primary care provider can assist with, and what does that visit look like? You mentioned during that examination to express the changes, but how is this tackled?

Dr. Wanda Lowe:

Yeah. That is absolutely within the realm of primary care. Right now, I’m seeing more mental health concerns than I normally would, and I think it’s really important. I would check in with your primary care provider, check in with… If you do have a mental health professional, I think that would be great. If you don’t have a primary care doctor, maybe you’re trying to wait to get established with one, but you’re like, “I need to get the ball rolling,” you can also call your insurance and see, “Okay, who’s on my formulary from a mental health standpoint?” maybe even starting with a counselor or a therapist. There’s lots of options available. Going to friends and talking to friends is great, but there is something different about talking to professionals.

Kendra:

Absolutely.

Dr. Wanda Lowe:

I think it’s just a little bit easier sometimes to be more objective or honest or go through other questions that might be more uncomfortable as a friend. I would recommend that someone talk to someone who is either their primary care doctor, a mental health professional, a counselor, or something along those lines.

Kerri:

Yeah. Because by expressing these symptoms too, you’re also ruling out other possible causes like anemia or low blood sugar, vitamin deficiencies, and other issues.

Dr. Wanda Lowe:

Thyroid.

Kerri:

Okay. Gotcha.

Dr. Wanda Lowe:

Yep. That’s right.

Kendra:

Yeah. Right now, especially this year, telehealth has become so rapidly available across so many specialties. It’s easier now than it ever has been…

Kerri:

It’s so convenient.

Kendra:

… to get help.

Kerri:

Before we wrap up this episode, we want to talk to you about some screenings that we need to be aware of as our body changes in our 30s and 40s.

Kendra:

Before we get to that, we’re going to jump into something that changes the overall body, and that’s our metabolism.

Kerri:

Got it. Let’s do it.

Dr. Wanda Lowe:

Okay.

Kerri:

If you’re seeing weight gain in your 30s, this might be why.

Kendra:

The days of gorging without gaining weight are over, ladies. Back at 21, you may have been able to eat the whole pizza yourself, but now you are going to have to work a little bit harder to keep your body trim and healthy. We understand the metabolism slows generally as we approach 40, but what recommendations do you have for us in regard to changing metabolism?

Dr. Wanda Lowe:

That’s great. I think there’s a couple tools that can be really helpful. With metabolism specifically, the main way that you can increase your metabolism is by increasing the muscle mass. When I think of metabolism, I think of someone who’s laying down or sleeping. How much energy are you spending? The tissue that expends the most energy at rest is your muscle. Ironically, exercising is really critical to maintaining good metabolism. Also, then there’s other factors like if you have maybe a wider waist circumference and have some insulin resistance, and then you’re talking in different kind of [inaudible 00:25:34]. That will change your metabolism in a different way, or if you have hypothyroidism or hyperparathyroidism. It really gets pretty complex, and it’s helpful to go case by case with a patient in front of me.

Dr. Wanda Lowe:

But in general, doing things that build muscle mass, that helps, if you’re noticing that your body is gaining weight, just really evaluating how many calories a day that you’re eating and maybe calculating and figuring out how many calories you need. That changes over time. As we age, our body needs fewer and fewer calories, and so just adjusting our diet to match our health needs. If someone’s in a state of time to lose weight, yeah, probably reducing calories by 500 calories a day. I often see people over-restrict rather than under-restrict, and then just being sensible with water intake and not taking artificial means… I’m not a huge proponent of taking different supplements and things like that to stimulate your metabolism because I think that can lead to other problems.

Kendra:

Yeah. Well, we’d be remiss not to cover the loss of bone, especially with you, in these decades. What we need to know about our bone loss?

Dr. Wanda Lowe:

Yeah, that is great. This is probably one of my soap boxes because I feel like it’s something we don’t talk about often enough, and later on in life, it just matters so much. Bone density is the strength of your bones. Really, the beginning of life is the only time when you can actually build your bone density. Up until you’re 28 or 32 is really the only timeframe in your body where you can build more bone density. After that, when we have reached our 30s or 40s, we’ve probably already peaked in terms of how much bone density that we’re going to get, and that can be discouraging.

Dr. Wanda Lowe:

However, we still have good estrogen levels. We still typically have a pretty good metabolism. It’s still possible to make a really positive impact on your life, and really at any stage of life, even if you’ve been diagnosed with osteoporosis, to still make a very positive impact on your bone density, quality of life, risk for chronic back pain due to osteoporotic fractures due… even falling and breaking your hip, all those kinds of things. There’s a lot of ramifications later on in life that can be impacted. Really, the Osteoporosis Foundation and also even the American Heart Association will talk about different exercise regimens, and they tend to match. It’s really interesting that the way you need to exercise for your heart ironically is also really good for your bones.

Kendra:

Interesting.

Dr. Wanda Lowe:

It makes it easier to give recommendations because they all go together. But typically, I would recommend people try to get 150 minutes of exercise a week and then alternating that with weight-bearing exercises, so having maybe two days where you do some sort of weight bearing activity. Honestly, any form of activity will be good. If it just kills you to do weights, there are other options. Now weights, I personally love doing weights.

Kendra:

Me too.

Dr. Wanda Lowe:

I do CrossFit, so I happen to love lifting weights.

Kendra:

Me too.

Dr. Wanda Lowe:

But there are people who really don’t like that, and that’s okay. There’s other options. Even doing things like handstands or yoga, you can find alternative ways. Walking downhill, you’ll get more impact on your bones that way, and then walking uphill, you’ll get it on your muscles. Walking some hills would be great. Doing Tai Chi, which is more across your bones rather than vertically, can also be really helpful. In general, movement and using your body will be better. Most of us are probably less active than we need to be, and any increase in activity would only benefit our health, not only our bones, but also our hearts. Yeah.

Kendra:

Yeah.

Dr. Wanda Lowe:

I could probably go on and on, but I love…

Kendra:

I love it.

Dr. Wanda Lowe:

… bone density.

Kendra:

The other thing I hear you saying too is having a variety of exercises too because I think a lot of times people get so pigeonholed into one type, like, “I only ride the Peloton bike.” It’s like, “Well, that’s great, but you need to do other things that focus on different areas and different health aspects of your body too.”

Kerri:

Yeah. That helps with burnout. Yeah.

Dr. Wanda Lowe:

Right. Right.

Kendra:

So-

Dr. Wanda Lowe:

I often see-

Kendra:

No, go ahead.

Dr. Wanda Lowe:

I often see in women the three different hinges, the shoulders, the hips, and the knees being affected later on. Those are different functional areas that we need to maintain. Often, when we’re doing one exercise, we’re not going to hit all three joint areas, if you will.

Kerri:

That makes sense.

Dr. Wanda Lowe:

Variety is great.

Kendra:

You mentioned that early in your life you can build that bone density. How does someone do that? There’s been a lot of debate back and forth in recent years, “Take the calcium supplement. Don’t take the calcium supplement. Do the vitamin D. Don’t do the vitamin D.” What is your recommendation as far as vitamins. Do we do the multivitamin? Do we do a calcium? What are some ways that we can help build that if we’ve got listeners who are still in those building years?

Dr. Wanda Lowe:

Even after too, right?

Kendra:

Yeah.

Dr. Wanda Lowe:

Calcium and vitamin D are the two supplements, or mineral and vitamin, that can impact our bone density the most. For your teenagers, they probably need about 1,300 milligrams of calcium a day, and after that bone-building process, probably 1,200 milligrams of calcium a day, and then for Vitamin D, probably around 600 a day, although I deal with mine based off of labs, so that can be a little bit different depending on how much sun exposure someone gets and those kinds of things. But calcium, I’m a huge fan of getting things through nutrition, so ironically, dark, leafy greens and your spinach and kale and broccoli have tons of calcium.

Dr. Wanda Lowe:

I try to veer away from supplements if you’re eating a diet with a lot of vegetables because maybe some of the criticism to calcium supplements is that it might build up plaque in the heart a little further. There can be concerns with that. I do think it’s good to get adequate calcium from a bone health standpoint. If eating dark, leafy greens is not possible, say you’re on a blood thinner or different things that’s not allowing you to do that, a supplement’s okay.

Kerri:

Makes sense.

Dr. Wanda Lowe:

But if you don’t have restrictions [inaudible 00:00:31:56], then I think eating a diet with lots of vegetables is honestly the way to go.

Kerri:

Sure. Okay. Well, let’s conclude with screenings. What appointments should I make?

Dr. Wanda Lowe:

Well, make an appointment with your primary care.

Kerri:

Done.

Dr. Wanda Lowe:

I would recommend just following up with your GYN regularly too. These are things that they would be well-equipped to talk about as well. I think we’re all passionate about keeping you healthy and keeping you strong with a good quality of life as long as we can.

Kerri:

All right. We must, like we should almost insist, that you play a rapid-fire Q&A with us so our listeners can get to know you more. Are you up for it?

Dr. Wanda Lowe:

All right. Let’s go.

Kerri:

Okay. Pumpkin spice everything or apple cider?

Dr. Wanda Lowe:

Pumpkin spice

Kendra:

Yes. What do you do on the weekend or evening to unwind?

Dr. Wanda Lowe:

I love to workout.

Kendra:

Good. What’s a book that everyone needs to read?

Dr. Wanda Lowe:

That’s good. Let me think about that. I mean the honest answer would be the Bible.

Kerri:

Yes.

Kendra:

I love it. That works for me.

Kerri:

Absolutely. Kendra and I do a Bible study together.

Kendra:

We do.

Kerri:

What products are in your purse or tote right now?

Dr. Wanda Lowe:

Let’s see here. I probably have a screwdriver. I am one of those people.

Kendra:

Yes. I’m going to call you if I need something.

Dr. Wanda Lowe:

Some lip balm. Probably some lotion. Definitely my wallet. Who knows? It’s like a Mary Poppins bag of everything.

Kendra:

Well, what’s your morning ritual? How do you start your day?

Dr. Wanda Lowe:

First, some coffee. Wake up, and that’s the first thing I think about. I can already smell it. I make me some coffee and just go from there.

Kendra:

Yes. Love it. What is your favorite Bible verse or quote that you live by?

Dr. Wanda Lowe:

Well, probably one of my favorite Bible verses, and I think part of it is because there’s a tendency to want to feel like you have to do everything perfect, but just saying that it is by grace that you have been saved and not by works. That’s been really impactful to me, just feeling like I have good standing with God just because of my love for him and belief in him and faith in him and not because I’m a good person or do good things. It just helps me to overflow with love rather than trying to earn it.

Kerri:

Dr. Wanda Lowe, we can’t thank you enough for this. We’d love to do it again. For those listening, who I’m sure want to get in touch with you, we’ll put a link in our show notes to your office information.

Dr. Wanda Lowe:

Well, thank you guys so much for having me. It’s been really fun, and hopefully it’s been helpful.

Kendra:

Yeah.

Dr. Wanda Lowe:

Yeah, we should do it again.

Kendra:

Perfect. Well, thanks again for making time for us. We hope you take care.

Dr. Wanda Lowe:

All right. Thank you. Bye-bye.

Kerri:

Wow.

Kendra:

Right?

Kerri:

Apparently I can’t eat a whole pizza anymore. Noted.

Kendra:

That was some seriously good information. If you guys enjoyed this episode, share it with a friend and be sure to hit that subscribe button so you won’t miss the next one.

Kerri:

Thanks for tuning in today. We’ll be back next time right here on HealthTalksNOW, a podcast brought to you by Baptist Health.

Speaker 1:

Thanks for tuning in to HealthTalksNOW. Staying healthy is a lifelong commitment, and Baptist Health can provide the support you need to lower your risks, improve your quality of life, and protect your longterm health. Visit baptisthealth.com to hear our other podcasts, learn about our services, and find more tips to help you stay a step ahead of your health. Baptist Health, be a healthier you.

This podcast is for informational purposes only and should not be relied upon as medical advice. The content in this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. This podcast is not designed to replace a physician’s medical assessment and medical judgment. Always seek the advice of your physician with any questions or concerns you may have related to your personal health or regarding specific medical conditions. To find a Baptist Health provider, please visit baptisthealth.com.

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