Why Your Liver Might Be the Key to Balanced Hormones with Elizabeth Katzman

This is the transcript of an interview hosted on Ruth’s Feel Better. Live Free. podcast.

Ruth Soukup: Okay, let’s be honest. When was the last time you actually thought about your liver? Probably never. But here’s the thing. If your hormones are out of whack, or if you’re struggling with perimenopause symptoms, or if weight loss just feels impossible, your liver might actually be the missing piece. And if you’re on bioidentical hormones, it’s even more important.

Today we’re breaking down exactly why.

For those of you who don’t know me, my name is Ruth Soukup and I’m the founder of Thinlicious and the creator of the Thin Adapted System, as well as the New York Times bestselling author of seven books. And today we are diving into the fascinating world of liver health, hormones and gut health with my guest Elizabeth Katzman.

Elizabeth is a certified perimenopause coach. Functional Diagnos agnostic nutrition practitioner. That’s a mouthful and holistic health expert. She’s also the founder of Strong Choices, a platform dedicated to helping women navigate the challenges of perimenopause through personalized nutrition and lifestyle strategies.

What makes Elizabeth’s approach so unique is her background as a former medical malpractice attorney. So she’s someone who really knows how to dig into the research and separate fact from fiction. And today she’s here to talk about why your liver is so critical to hormonal balance, how it impacts gut health, and what you need to do to support your body during perimenopause.

I cannot wait for you to hear this conversation, so let’s get right to it.

Elizabeth, thank you so much for being here today. I am so excited to talk to you. Thank you, Ruth. Nice to see you. Yeah. So let’s just start with the question that I ask everybody tell us. A little bit about yourself, who you are, what you do, and how you got to be doing what you are now.

Elizabeth Katzman: Sure. My background was as an attorney and I had children, and as I started having children, I noticed some health issues, some frequent ear infections and things like that turning up, and I wasn’t really getting any answers from doctors. So I started researching on my own and figuring out, you know, maybe I should try not giving ’em dairy.

And then they never got another ear infection. And I realized early on that if I wanted to have healthy children, I was gonna have to take more ownership and play a larger role in it. So I went back to school, went to institute for an degree of nutrition than went to FDN as a. Functional diagnostic nutrition practitioner.

That is a mouthful. And it was really just to take some ownership over my family’s health, but it evolved into a business as conversations would just sort of lead into it with other moms on the playground and everyone would have questions. And I started reading people’s labs and slowly evolved into the business.

And now that I am. 50 and my clients are of similar ages. It’s turned into a lot of perimenopause and menopause care. 

Ruth Soukup: I love that. I love that. So you’re not practicing as an attorney anymore? 

Elizabeth Katzman: I’m not. I stopped when, um, I was super sick with my first baby. Oh my gosh. Oh no. And there was no way, and I really always thought I couldn’t wait to get back to work.

And then the second I saw that baby, I was like, I’m never leaving this house. 

Ruth Soukup: I can understand that. Well, I, I don’t ever talk about this, but I. I went to law school for one year and I quickly found like I had planned my whole life to be a lawyer. Like that was all I ever wanted to do growing up. ’cause I like to argue and I thought it would be so fun.

And I was obsessed with legally, legally blonde that I like thought that was what law school was gonna be like. And it is not as you, I’m sure you can attest to. And I was like, what 

Elizabeth Katzman: is this? What have I gotten myself into? So I did not last. The first year is the hardest. The first year is the hardest. If you get through that, you can make it.

Well, I did not, and I have not looked back, but 

Ruth Soukup: more power. I have so much respect for anybody who actually makes it through, because I was like, this is nothing. Now I understand why they had that big musical interlude in the universe. 

Elizabeth Katzman: They’ve skipped over all this. Sucky parts, but I’ll say it was good training for research for sure, like it did.

I bet kinda detective skills. 

Ruth Soukup: Yeah, yeah, for sure. So I am really curious. One of the things that I really wanted to talk to you about, ’cause we talk about gut health quite a bit on this podcast, but you, I wanted to talk specifically about. Liver, liver health and how that affects, because I think you, you talk quite a bit about that and have a lot of expertise in that area.

So can you just tell us a little bit more about the role that your liver plays in your body systems? 

Elizabeth Katzman: Yeah. It shifts throughout the years, but in. Demands in periods of high hormonal demand, there’s more demand put on a liver. So that’s one of the reasons why you’ll see teenage girls with acne, and it’s one of the reasons why perimenopausal women can no longer drink alcohol the way they used to.

To, it’s one of the reasons why your cholesterol goes up for unexplained reasons. When you hit 40, 45, 50 and you think like, I’m not changing anything. I don’t drink a lot of alcohol. I’m not eating. More fatty foods than I used to. I’m still working out and your cholesterol is still rising. We have estrogen receptors in our liver, and so as our estrogen declines with age, our cholesterol at the same time goes up.

And also, you know, there’s such a close link between our gut and our liver health and the way that we metabolize and excrete. Hormones. It’s really crucial at any age. So even though I deal a lot with perimenopausal women, most of my clients have teenagers, whether it’s teenage boys or girls, you’ll find a lot of acne, anxiety, lots of issues that will come back to liver health.

And so all the principles I talk about, regardless of age, is gonna help everybody. 

Ruth Soukup: Yeah, so, 

Elizabeth Katzman: and there’s a lot of great tests you can do. You know, there’s the Dutch test that will show you how you’re metabolizing your hormones. There’s gut tests that will tell you things like beta glucuronidase. I see that being very elevated in teenage years and perimenopause.

So perimenopause is kind of like reverse puberty. So you’re seeing a lot of the same issues at both of those stages of life. And it’s also, I think, a big reason why mothers and daughters, teenage daughters so much moms can like that 

Ruth Soukup: explains so much that being the mom of two teenage girls, 

Elizabeth Katzman: you’re a very similar stages just on the opposite ends.

That’s hilarious. Your hormones are ramping up and yours are winding down, but it’s all a very like rollercoaster for both. 

Ruth Soukup: Yeah, it’s 

Elizabeth Katzman: chaotic. Depending on the day, it could be really high or really low. Mm-hmm. So all the basic principles apply for both age groups, which is really optimizing your liver function so that your excreting circulating estrogens.

’cause that’s even if you are estrogen is low in perimenopause, it can build up. So you can start having feelings of estrogen dominance like you did as a teenager. Even though your estrogen is low, not high, it’s elevated in correlation with your progesterone. 

Ruth Soukup: Interesting. ‘

Elizabeth Katzman: cause your progesterone is declining first.

So that’s where you’re feeling, you know, more anxiety and sleeplessness as a 40, 50-year-old, or even late thirties because your progesterone is getting out of whack with your estrogen. So even though it’s low, you’re feeling breast tenderness. You can get acne again. And so the fundamentals of of liver detox are super important and making sure that your estrogen and progesterone receptors are working properly, and that has to do with keeping your liver clean.

Also, this is a time when your thyroid function is compromised and we need proper liver function to convert inactive T four to active T three. And so that’s all gut livers. That’s why you hear the term tpa. And a lot of time in perimenopause, it can be hard to decipher. Is it perimenopause? Is it ropa?

It’s a lot of times it’s all at once. So you see a lot of Hashimoto’s. When I was sick with mold illness, I had Hashimoto’s for a minute, and that was because my liver was storing mold and I wasn’t excreting it. Oh. And about Oh wow. Yeah, about a quarter of the population has the genetics for that. So your liver doesn’t recognize mold as a toxin, you just store it.

Ruth Soukup: Oh. And how do you find out about that? 

Elizabeth Katzman: You can get a genetic test for HLA SNPs. But I feel like everyone should just live as if they have that because we’re so bombarded with pollution and toxins, and when you fly and when you’re even hiking down the street and you feel like you’re doing something really good, but your lungs are wide open and you’re breathing in the exhaust of the cars that drive by, and we’re just exposed to so much more.

So I usually recommend. People of any age, even kids, like when I pick my kids up from school, I hand ’em a binder, charcoal, zeolite, chlorella, bentonite, clay. Different binders will pick up different toxins. So I like to Interesting. Kind of mix ’em up. 

Ruth Soukup: Okay. Yeah. So let’s talk a little bit more about liver detox specifically.

Like, so what, what would be the steps that you would take? Um, ’cause these are all, these are all new to me. 

Elizabeth Katzman: So there’s different phases of liver detoxification, phase one, two, and three. Three honestly being the most important, which is going to the bathroom, which a lot of people are not doing enough of.

Yeah, and if you’re not going to the bathroom, you are gonna be. Recirculating all of the estrogens that you bundled up so well in phase one and two, and you need proper methylation and sulfation. So all those processes require proper B vitamins, proper sulfation support, which would be your cruciferous vegetables.

Um, and there’s really great, uh, supplements. Sulforaphane supplements that are great for that because sometimes it can be hard for people to get enough cruciferous vegetables. Mm-hmm. And then the methylation part, people talk about the M-T-H-F-R gene SNPs all the time, and I feel like it’s a bit of a misnomer.

I have clients lot saying, but I have M-T-H-F-R and I have two copies and you know, most of us have some sort of snip. The M-T-H-F-R. So again, similar to the mold genetics, I like people to just live as if, yes. So just take methylated B vitamins. Okay. Foic folic acid is synthetic, and so if you have an M-T-H-F-R snip.

It’s going to store in your liver. It’s also for as far as children are concerned, a lot of a DHD children have this issue where they’ll have a cereal that’s fortified with folic acid and it’ll send ’em through the roof because they’re not able to methylate that. 

Ruth Soukup: Oh. 

Elizabeth Katzman: So for women, um. At any age really, you wanna do methylated B vitamins to support liver detox and also enough amino acids.

So we need protein. A lot of women, when they think of liver detox, they wanna do like a juice cleanse, but honestly, it’s more of a carnivore thing. You need enough fat to stimulate bile production. You need enough amino acids. And if someone’s doing a. Green juice cleanse with a lot of oxalates that can add a lot of extra stress onto their liver instead of cleansing.

So I like sauteed, you know, dandelion greens, garlic, onions, olive oil, just things that are already a little bit predigested. By getting rid of some of those oxalates and having enough fat and protein. I think it is the opposite of how a lot of people would think of a liver cleanse. 

Ruth Soukup: Yeah, yeah, for sure. I mean, that is exactly what you think about when you think of like a cleanse, like a juice cleanse or something like that.

So, but you’re saying, so can you get. I mean the meth methylated B12, is that what you said? Yeah. How do you know that the B12 that you’re getting is methylated? Does it say that on the bottle or is this all from food that you should be getting this from, or how does that work? 

Elizabeth Katzman: It’s really difficult now to get enough nutrients from food and the bottle will say if it’s folic acid or if it’s methylated.

Okay. Um, and really most of the really higher quality supplement companies will be methylated. 

Ruth Soukup: Okay. Good to know. So, and then from a food perspective, you should be eating, I would think, red meat, lots of red meat or any kind of protein. 

Elizabeth Katzman: Yes. Red meat, red meat’s, superior to to chicken. Yes. And Turkey and that sort of thing.

You’re definitely gonna have more minerals, more choline. Um, you know, our liver loves choline, so egg yolks. When you scramble your eggs or you do sunny side up, just don’t overcook ’em because you want them. On the more undercooked side, there’s also phosphatidylcholine supplements. Um, recently I have discovered that, so there are a few companies that have phosphatidylcholine supplements, but they’re sunflower lessen based.

So they’re, um. Not animal-based, but what I see in results is that that phospho phosphatidylcholine isn’t getting intercellular and it, so I switched over my clients now to egg yolk animal-based phosphatidylcholine supplements. Dr. Gooden now has a, a great one. He’s a specialist in Alzheimer’s prevention.

Ruth Soukup: Okay. Gosh. I mean, this is like, these are supplements that I’ve never heard of before. I mean, from really, like people talking about it. So you just, so you are, is this something that you recommend for everyone just to, for overall liver health? Just make sure that you’re taking this, these things and getting these right things.

Like what is, like, what’s the consequence? Of not having your liver be super healthy, and how does that relate to that health? Yeah, I mean, I always say it’s easier 

Elizabeth Katzman: to stay healthy than to get healthy. Mm-hmm. And our liver is such a core part of our overall wellness, and most people’s livers are overworked and overstressed.

So I do think that. Being aware and cognizant of your liver health on a daily basis is really important, and depending on the person and the age, you don’t necessarily have to do it every single day For a child, you could give them a methylated B complex every other day. They don’t necessarily need that every day.

And acetylcysteine, NAC is a great one that you could do every other day. For my clients who have endometriosis, then I, that they’re more like three times a day. So it’s really individual. So. But the core tenants really are just to eat as clean as possible. Obviously the ultra processed foods, I mean, if we’re just not eating out of bags and boxes and sticking with fruits, vegetables, meats, we’re solving a lot of problems right there, right?

But most people do need, um. A B complex to support them. Mm-hmm. And women who are having issues excreting their hormones and they’ll know it because they’ll have tender breasts or more painful periods, uh, acne. Then those women would want to also add in some kind of sulforaphane supplement if they’re not doing broccoli sprouts.

You know, broccoli sprouts are a lot more powerful than, than just broccoli. So I love those 

Ruth Soukup: really. I don’t think I’ve ever heard of bro, 

Elizabeth Katzman: bro. 

Ruth Soukup: Broccoli sprouts, bro. Sprouts. Yeah. Where do you get those? Just like a grocery. I get mine at 

Elizabeth Katzman: a, well, I get ’em at a farmer’s market. ’cause I found that the, um, grocery store ones tend to be a little moldy.

They can mold quickly. 

Ruth Soukup: Oh. 

Elizabeth Katzman: So I like to get ’em really fresh. But you can sprout at home too. It’s fun. It’s like, it’s really easy to come up in just a couple days and you cut ’em off. 

Ruth Soukup: I’m gonna have to figure, figure that out. So many, so many new things I’m learning today. I love it. 

Elizabeth Katzman: There’s some good, there’s some good little sprouting kits online.

Um, and the other thing that I love to do that I’ve been doing for so many years, and I also love this for teenage girls, if they’re having PMS, but this is part of my nightly. Wind down routine that I’ve done for like 10 years ever since I had the mold illness issue is I do castor oil packs. Hmm. Our livers love castor oil packs.

You can put it just on your liver or you can do it over your abdomen to cover your intestines also, because it helps with excretion and proper bowel movements and bile flow, and it helps move our lymph and it helps get. Blood to our liver. So as we age and go through perimenopause and menopause, we lose blood flow and circulation to the liver.

So castor oil packs and then actually physically massaging really helps with that. Okay. And I just do a couple drops of essential oil, like frankincense. I really like doing. And 

Ruth Soukup: yeah, it, 

Elizabeth Katzman: with the castor oil, you put a flannel on and then put a towel. And then a heating pad, and I’ll just do that when I’m watching a show with my kids or reading a book before bed.

It’s super relaxing and it really helps keep your liver flowing. 

Ruth Soukup: Oh, I’ve been, I’ve actually been curious about castor oil packs. ’cause I’ve been using castor oil on my face, actually with frankincense for about six months. And it’s amazing as a moisturizer. Yes. Um, super cost effective too, compared to all those expensive moisturizers, but.

I have seen, I’ve seen the, the packs and stuff and so I was curious, do you put it like right on your skin and then put the flannel over top or do you add it to the flannel and then put that on top or how does, I’m like, I don’t know how to do it so Well, there’s lots of complicated, the tutorial 

Elizabeth Katzman: you can, you can make it really complicated.

So I do it the simplest way, which is just putting a bunch of cast oil into my hand, putting a couple drops of oil, and then I massage it. My stomach. My stomach. 

Ruth Soukup: Okay. If you 

Elizabeth Katzman: really wanna focus just on your liver, you can put it on your liver, but I like doing the whole abdomen. 

Ruth Soukup: Okay. And then that’s easy.

Then I put 

Elizabeth Katzman: the flannel right on top. I put a towel so it doesn’t ruin your heating pad and sheets. Okay. And then I put the heating pad on top. About 30 minutes is good. Okay. But for people who are really struggling with PMS or um, or even if you have tender breasts, if you have fibroids or cys, you put the castro ill on your breast and do it over your breast, it really helps.

Wow. That’s, and for people who are sick with mold, you do it a couple times a day and it helps clear the mold so much faster. Okay. It really helps detox the liver. 

Ruth Soukup: Wow. So can how, like, how quickly can you tell a difference when you start doing this? 

Elizabeth Katzman: You ca you have to make sure you’re doing all the fundamentals too, right?

Mm-hmm. It’s one of those things that if you’re not eating clean, it’s not gonna do much. But if you’re eating clean and taking supplements that support detox, you’ll see it quickly and it really helps with people with acne and eczema. It helps clean up skin conditions. ’cause all of that really is liver congestion.

Ruth Soukup: Interesting. 

Elizabeth Katzman: So people will see that quickly. Yeah. 

Ruth Soukup: I was gonna ask like, what are the biggest signs that you, that you notice to know that like there’s a problem with your liver and how, how, I mean, I, I understand that it’s all connected, right? And, and, and we talk about a lot about gut health and we talk about hormones and all of us different stuff, and.

It’s like we wanna put it into a silo, but it’s not, it’s never in a silo because it, everything works together. So, but how do you know specifically that the liver is the issue and not say just leaky gut syndrome or something else that might be going on? You’re, you’re just your thyroid or are you saying it all comes back to the liver?

It’s 

Elizabeth Katzman: usually more than one thing and it’s usually how they’re all communicating with each other. So it is really good to get a complete workup done. Look at your gut. At your, and the interesting thing about the liver is that in order for your, so there’s a ST and a LT, those are your liver markers on a white blood cell count.

But in order for those to be really elevated, there’s gotta be some major issues going on. So your. Liver enzymes can look completely normal, but you’re still having a functional issue. You’re still having liver congestion, so whether you’re having gut issues or thyroid issues, or you’re feeling like you have excess estrogen, it’s all gonna be supported by the liver and keeping it clean regardless of what any test says.

Because if you’re having gut issues, you’re putting extra pressure on your liver. On your liver. 

Ruth Soukup: Yeah. That makes, that makes sense. 

Elizabeth Katzman: So, so it’s hard to put the pieces together by just looking at one thing. So the way that I work with a client is never to address an issue, and clients wanna do that all the time.

They’ll say, well, this says right here that I Hashimoto, so we have to get after those antibodies. And I’m like, yes and no. You know, I don’t like to kind of pin the tail on the one thing. That’s what 

Ruth Soukup: traditional medicine does, 

Elizabeth Katzman: right? You go to this 

Ruth Soukup: specialist for this thing and this specialist for this thing, and this specialist for this thing, and nobody’s talking to each other and they’re all putting you on pharmaceuticals, and it’s all like.

It’s, it’s a mess. It really, it actually, our modern medical system drives me crazy. I don’t need to go on my tangent about it, but it’s like when you really think about it, because you can’t talk about one without realizing that it’s all connected and this like, luckily the solution. For most of it is very similar too, right?

It always comes down to like eat lots of protein, lots of red meat, healthy fats, and I think, and then obviously adding in these other things too, and getting the right nutrients and, and it all comes down to it and you’ll start to see improvement in all these different areas. 

Elizabeth Katzman: Well, that’s why it gets so frustrating when you have a teenage girl that will go to a doctor and they’ll say, well just take the pill.

And she’ll say, well, I’m not sexually active or whatever. Well that’s just, you know, the pill will help your acne. The, the pill will help your pmms and not be but it, but, but why? But why are those things an issue? And doctors also really wanna put perimenopausal women on the pill for the same reasons.

’cause it’s reverse puberty and it helps regulate things. And again, it’s not helping you with your root cause and it is so frustrating. 

Ruth Soukup: Right. Yes. Very frustrating. So one question I wanted to ask, because I think this comes up a lot for my clients, because we advocate for a diet that’s high in protein and high in healthy fats is gallbladder and obviously the gallbladder and liver are very closely connected.

So what happens when you have gallbladder issues? How does that. Or have had your gallbladder removed, how does that tie into all of this liver detox stuff? 

Elizabeth Katzman: Well, again, a castor oil pack is gonna be great for that on a nightly basis. I really like Tudca for that too, to keep it flowing. Um, tcu, what’s that?

TCU is a supplement that helps in a number of ways, is helpful with, it, helps with bile flow, and it also helps with mitochondrial function. So, 

Ruth Soukup: oh. 

Elizabeth Katzman: It helps a lot and I really like it for perimenopausal women. Um, I also really love it for people who are having issues with mold, but it, it really helps with bile and helps the, the liver detox.

Um. What else were we saying? Well, 

Ruth Soukup: gallbladder, I 

Elizabeth Katzman: forgot what the gallbladder. 

Ruth Soukup: Gallbladder, so like is there something different? I mean, adding the castor oil packs, adding the teca. Is there anything else you should be diff, because I, the resistance, I see. Maybe you see this too, is, well, I’ve had my gallbladder remove, my doctor says I’m supposed to not eat red meat and not eat fat, right?

Oh, yes, yes. So then you’re like, well, but actually, so what do you, what do you say? Because you’ve got way more medical credentials than I do. I just, no, I mean, I, well, I always, always say, I got the school of Google behind me. 

Elizabeth Katzman: I always say, listen to your doctor. And if it were me, I would still eat, um, plenty of red meat and fat and protein and take digestive enzymes and HCL especially.

Through perimenopause, menopause when our stomach acid is really going down. Um, then I, I would always recommend sticking with the basics, the fat, the meats, all the good stuff that our body needs for any number of reasons. But I would include digestive enzymes, HCL, and, and I do like Todd cut as well. 

Ruth Soukup: Okay.

Does, and does teca act as a digestive enzyme as well, or just aid in digestion or just 

Elizabeth Katzman: it in keeping Yeah. Bile flowing and, and the mitochondrial function going. Okay. Right. Yeah. 

Ruth Soukup: Because your, your liver is still producing bile if you’ve had your gallbladder removed, correct? Right, 

Elizabeth Katzman: right. Yes. Okay. Yeah. But everything is gonna be a little slowed down and a little more difficult, but it doesn’t mean we can’t still keep things moving.

Right. You know, and fiber, of course. 

Ruth Soukup: Yes. So why, like, why do you think that is? The standard recommendation for, for gallbladder and even for liver function is just avoid, avoid fat and avoid red meat. 

Elizabeth Katzman: I just think it’s really misunderstood and I, and villainized by big food. For their own reasons that we’ve been scared away from what Mother Nature has provided us.

Scared away from butter and eggs and, and meat, what we’ve been intended to eat, that somehow we should be eating a more processed diet that makes food companies a lot more money. And yes, creates, creates a need for us then to take pharmaceuticals to help with the problems that that creates. I just think there’s a lot of machinery behind those messages.

You know, in the same way that we’re told, you know, that we wanna take a statin to lower our cholesterol, well, our cholesterols going higher as we’re aging. ’cause our estrogen’s declining. We don’t need a statin for that. You know, taking some estrogen would help a whole lot. And actually people who live the longest have high, you know, cholesterol above two 20, right?

So the idea that we wanna keep up below 200, so I don’t know if it’s the machinery, it’s what’s taught in medical school, and it’s just a, a misunderstanding of, of how our bodies work and all the things. 

Ruth Soukup: It’s incredibly frustrating. In fact, just this week as we’re recording this. Podcast. Um, I had a episode come out that I recorded, um, called Calories, Fat, and Cholesterol. While you’re worried about the wrong things, and so for those of you listening to this podcast right now, if you haven’t listened to that episode, go back and listen to it. But I went really deep because those are the things that come up with my clients. Over and over and over again, right?

Like, how can you say, I don’t need to worry about calories? How can you say, I don’t need to worry about cholesterol? How can you say, I don’t need to worry about how much fat I’m taking? And then like, this just seems so wrong compared to everything that I’ve been, yes. Told. And so I went through like the whole history and like linking to all the studies of why, why we are being told this.

It goes back to this study in the 1950s that has now been proven to be wrong, but they’re still teaching in medical school, right? Like all the stuff with all of the links to everything. So if, if this is something that you’re worried about and you want to know what the actual research says. Go and listen to that and then go to all the links in there and you can read all of the studies for yourself and see that like it’s not bs.

What we’re saying right now is really true. Like you have been misled, you have been lied to. There is like, there is a better way and this is what we’re talking about today. 

Elizabeth Katzman: When, when you go back to Ansel Keys and the American Heart Association and the whole thing and the push for margarine and the, you know, it’s, it’s really sad and I’m so hopeful for this generation though, because I feel like.

Teens and twenties right now, that group of people are so taking charge of their health in a way that I know I tried to at those ages, but the information wasn’t available. There wasn’t the internet I, I was just reading Self magazine and yes, kinda getting my hands on what I could and everything then was like eating the snack.

Well. Cookies. Eat snack wells. Eat snack wells, have some red wine, do a bunch of cardio. 

Ruth Soukup: Yep. That was, that was the solution. Good old nineties. And I still 

Elizabeth Katzman: see, I still see these teen girls who are, are thinking that way. And I love when I get to talk to ’em and say, you can eat so much food. You don’t have to think about a calorie eat.

You know your protein and your fiber and you’ll feel amazing. You’ll have energy. And build muscle and you can eat whatever, you know, as many calories as you want. It has nothing to do with yes. Body composition’s gonna be amazing. 

Ruth Soukup: Yes, yes. So true. But, so you touched on it for a second there, and I wanna make sure we talk about this since we’re talking about the liver.

Let’s talk about red wine, because I still love my red wine. And are you saying no more? 

Elizabeth Katzman: Well, it depends. Some people can detox better than others. A lot of that has to do with genetics. And there are things you can do. You know, you can take some extra B vitamins, some NAC. Um, you can take some charcoal.

There are things you can do to help it along, but we also develop some more histamine issues as we go through perimenopause. You know, there’s a strong relationship with histamines and estrogens, so women who could drink wine before are noticing that maybe they get a flush when they didn’t used to.

Their eyes get watery, they get more hungover. Um, so we have to sort of separate the alcohol from the histamines. So if if someone feels like that’s them, that they’re having a histamine reaction, then they can try something like a really clean tequila or vodka and see if that works with some lime juice.

Um, and if that’s still not working, then they’re just really having a difficult time with alcohol. I don’t see a lot of women over 45 that do great with. Any kind of alcohol, to be honest, even with doing all of the hacks, it’s just really difficult because our livers are not as, I don’t wanna say they’re, they’re just not as good as they used to be at metabolizing alcohol.

Mm-hmm. So it’s sort of a sad fact. And also if someone’s planning on taking hormone replacement therapy, then it really becomes important that alcohol is limited to not more than. Maybe like a drink a week because we have to, we have to metabolize that HRT through our livers and it’s really important that differently than if we’re making exogenous.

You know, we’re endogenous hormones. If we’re taking them exogenously, that’s a load on our body, on our liver, on our gut. And so we have to make sure we’re really careful about cir proper, properly circulating that out. So, I don’t know. I found that it’s, it’s a process of like mourning. I’m processing this right now.

It’s sort of denial and then anger. Like eventually 

Ruth Soukup: I have to go through all the stages of grief from my wine. So, but I say I cut back, but every once in a while I still wanna indulge what, like what’s my co, what’s my antidote cocktail? 

Elizabeth Katzman: Yeah. Well, I do like, again, I think that wine becomes more and more challenging because the histamines.

Mm-hmm. So I prefer. Uh, you know, I recommend like a clean tequila with some lime. Just keep it very simple. Okay. And then I would take NAC, I’d take a B complex, and then if you are gonna be awake for another hour, I would take a binder, like a charcoal to help get rid of some of the reactive oxygen species.

Okay. Um, ion’s a great one to take. If you feel like you’re gonna go to bed right away, then I would take your charcoal at the beginning when you start drinking. Okay? And then when you get home. You can take, you know, all the methylation support. Ordinarily, I wouldn’t recommend taking a B complex at night because it can be energetic.

Oh. So B vitamins are really for breakfast. But in the case of drinking, um, I would take it at night anyway. ’cause you’re probably, you’re probably not getting a great night’s sleep anyway. No. So that’s another thing that women notice is that. Usually 40, 45, 50. They’re, if they drink, they’re not gonna really sleep it.

You know, you’re sedated, you’re not sleeping, so you’re not, you’re missing out on that deep sleep. You’re probably waking up super early. Yes. It’s, it’s a choice. You kind of choose, like, I know, do I wanna drink or do I wanna sleep? I know 

Ruth Soukup: I need to find, I need to find my, uh, my alternative. I think I haven’t, I haven’t found anything that like really gives me that 

Elizabeth Katzman: I know I’m on the constant look for, well, what about, you know, THC or cv?

But then you’re talking about, well, there’s not as much oxygen to your brain and we have to think about Alzheimer’s. It’s um. Well, I’m allergic to THC. Oh, really? So I get 

Ruth Soukup: violently ill from THC. Yes. I’ve learned that the hard way from some friends who gave me gummies. Oh. Not a good thing. Um, but yeah, so I, I like don’t have that kind of relaxation.

I’ve tried. Um, what is the, what’s the stuff? Stuff? What is it? 

Elizabeth Katzman: Kava. 

Ruth Soukup: Kava. Yeah. And I’ve tried that. It doesn’t do much for me. Doesn’t do much for me either. I don’t really notice and they say it’s like you have to do, like consistently to actually get a result, which seems weird to me. It’s like the opposite, I guess, of alcohol.

You don’t build up an immunity, you build up a reaction to it. But yeah. Yeah, it, 

Elizabeth Katzman: it hasn’t done the trick for me. One nice thing is that when, or if you decide to take HRT at some point. The two weeks of the month that you take progesterone, it is very relaxing. Oh, because that says allopregnanolone and GABA on your brain, so it’s very calming.

Ruth Soukup: Oh, so what about the other 

Elizabeth Katzman: two weeks? Well, you can only use progesterone. Two weeks a month, and it’s okay. I don’t know why this is controversial. It is the way we were designed. We only make progesterone after release an egg during ovulation. The corpus luteum releases progesterone. We only have it for two weeks a month, but first.

Women are told in menopause and perimenopause basically that, you know, dealing with a period is a pain in the butt. Why not just get rid of it? And if you take progesterone all month long, you won’t get a period. But honestly, me personally, I’m gonna be cycling even as an old lady, which may sound gross, but having a menstrual cycle is a longevity sign and it’s your really, your monthly report card to let you know everything’s going well.

And the, the yin and yang of progesterone and estrogen is, you know, it activates tumor suppressor genes and it works with osteoclast and osteoblast for our bone health. There’s a reason that there’s a rhythm to it. Mm-hmm. And so it’s really important to continue that rhythm. And a lot of doctors really don’t agree with that.

They don’t wanna deal with it. They don’t wanna deal with a potential overgrowth of the uterine lining. Fibroid cyst, all the things that happen at us, for us at any age, we’re at risk of those things during, during our whole reproductive years. Right. But we’re just gonna keep that going and you know, if you’re doing all of the lifestyle things, keeping your liver functioning properly, it’s fine.

Ruth Soukup: Interesting, interesting. Yeah. So I haven’t felt like I’ve gotten to the point yet where I need HRT, but I have been curious about, um. What’s the cream? The yam cream? Um, 

Elizabeth Katzman: yeah, there’s, what do you think about 

Ruth Soukup: that’s, 

Elizabeth Katzman: there’s some yam creams or, um, Dr. Um, Anna Quebeca has a cream that people like with pregnenolone and, um, I think it’s good for the perimenopause years and, you know, adaptogens and, and maa flax seeds.

You know, there’s a lot of natural things you can do for those early perimenopause years. 

Ruth Soukup: Mm-hmm. 

Elizabeth Katzman: There’s a few different. Phases of perimenopause. There’s the earlier years where you feel like things are just kind of off, but you’re not ready to take progesterone yet. Yes, and I feel like that’s a great time where you can kinda do, you know, the yams and the Vitex and chase tree, those are all things to help ovarian function and are gonna help help you get a better ovulation to make sure that that robust progesterone is.

Let out in the luteal phase, you can do that early perimenopause and then you’ll notice when you can’t anymore. You’ll just feel it. You’ll feel that it’s not working as well. It may be anxiety, it may be sleep, and then you’ll kind of know like maybe it’s time for, typically the way I do it is I’ll do the progesterone first and I’ll tell a woman, you know, on day 14, 15 or 16, take that until your the day of your first period, and that will do well for.

Mid to late perimenopause, you really don’t, you know, have to add an estrogen until later in the game 

Ruth Soukup: later on, 

Elizabeth Katzman: depending on if you’re choice, depending on the person, but, 

Ruth Soukup: yeah. Yeah, and what’s so interesting to me is that, and maybe it’s just that like now that I’m at this age, right, it’s. Having the conversations, but it, it comes up a lot amongst my friend group, right?

’cause we’re all kind of in this mid forties to mid fifties age range. And yet I don’t feel like it really is like I. Uh, common knowledge, right? Like nobody really knows what’s going on, right? We are all like, yeah, it’s this perimenopause thing, but nobody really know. Like, it’s almost like it’s this secret or ignored by the, the world at large that ev that half the population experiences this at some point in their life.

So why are we not, why are we not like giving more attention to it? 

Elizabeth Katzman: Doctors aren’t trained in it. They don’t teach it in medical schools and only 30% of OB GYN residencies even. That’s so crazy. It’s crazy. So, and a lot of it’s, and a lot of women just assume that their obs gonna be their go-to. 

Ruth Soukup: Yeah.

Elizabeth Katzman: Because that’s their, but those are your reproductive years. Is your OB really? Right. But once you get into perimenopause. And everybody’s like, woo. Dunno what to do with the, yeah. 70% of ’em haven’t even been trained and the 30% that have have been trained poorly, so those are the ones that are gonna be putting you on the pill or on a low dose patch.

They’re the ones that are gonna be saying, oh, you can’t really test because your hormones are so crazy. You can’t even test. We’ll just, you know, see how it goes and, you know, but you can test, you can look at things like FSH if that’s above 25, or even getting close to the twenties. You know that you’re getting ready for some HRT, um, it’s, you, you, you should definitely be testing.

And I love to test girls in their twenties and see, especially if they’re feeling well, to catch ’em at a, a, a, a phase in their life where things are going well, to see what their optimal ranges are, because it does vary. Some women need a whole lot more estrogen and some women need a whole lot less. 

Ruth Soukup: Hmm.

Interesting. Yeah, to be, to start like taking control of it when early before you even get to this phase, seems really smart. As a mom of girls, it’s given me some food for thought conversations that I need to have. It’s good 

Elizabeth Katzman: information to have for them. 

Ruth Soukup: It’s, I mean, what, like my takeaway from this whole conversation is how critically important it is to.

Like, take ownership of this. Like as you’re, if you’re listening to this, right, take ownership of your own health. Don’t trust the, that your doctor that you’ve seen for the last 30 years is gonna know what they’re talking about when it comes to this phase of your life. And there are really good options out there.

I. Might require testing, probably will require some testing and experimenting, but find somebody who can actually help you get the right answers and get the right, get the right treatment. Who knows, who actually knows what they’re talking about? Like don’t just, don’t just sit back and trust that.

Somebody, somebody’s given you the right answer. 

Elizabeth Katzman: No, that it comes down. I love to stay. I feel like it’s so empowering. Yeah. And it, it bums me out when I hear women say, oh, getting older socks, and, oh, this is getting older. And I’m like, ladies, this could, you could feel your best. You could feel your most motivated, have the most energy, have great muscle tone, sleep well.

You can do all of that. Yeah. But we need to really empower ourselves. And I also think it’s nice that we’ve been through enough in life that hopefully we’re in a stage now where we can advocate for ourselves and speak up and say, no, that doesn’t feel right. And yes, you know, I think I’m gonna find a different practitioner now.

I think that this is a stage in my life where it’s time to maybe move on to someone else and or maybe just add to your group of practitioners. I love that. I, I do think it’s a really great time in our life to, to take control of things 

Ruth Soukup: For sure. So I feel like we could talk about this for a long time, but we are out of time, but I wanna make sure that people know how they can find you and work with you if they wanna work with you.

And you have, you have a liver supplement too, right? That you can, that can help with liver detox. So tell us a little bit about that. 

Elizabeth Katzman: I do, I have a Detox Diva with a lot of good herbs and milk thistle and to help your liver flowing. I like to take it before I do a castor oil pack. Oh. So a lot of times what I’ll do is I’ll take a detox liver supplement before castor oil, and then I’ll take a binder after, because you just have pushed a bunch of stuff through and now you can grab it with a binder.

Okay. Especially if it’s right before bed, because again, you wanna take. Binders away from supplements, but that is one of the things I like to do. I do post a lot on Instagram at @strongchoices1, and um, I have a lot of information on my website at strongchoices.com. 

Ruth Soukup: Awesome. And we will make sure that we are linking to all of that in our show notes as well.

So, and actually some of the other supplements that you mentioned, we’ll make sure to link to all of those in the show notes as well so that people can find ’em. ’cause I know we, we talked about a lot of different things, um, and we’ll make sure that we get those all included as well. Elizabeth, thank you so much.

This was a wealth of information and I’m like, I gotta go do a castor oil pack now. Gotta go cleanse my liver!

You can find Elizabeth at strongchoices.com or on Instagram at @strongchoices1

And here are the links to the supplements she mentioned:
Detox Diva
Toxic Tamer
and you can use Discount Code: RUTH10 for 10% off