Dr. Sara Gottfried has serious medical street credits with her Harvard MD and Kaiser background but she is anything but a traditional OB-GYN. Instead, Dr. Gottfried is more medicine wise woman than cold clinician who spends no more than 15 minutes a visit per patient. Founder of The Gottfried Center, yoga teacher, bestselling author, women’s health advocate, and mother, Dr. Gottfried found time to share her organic gynecologist philosophy. To learn more about Dr. Gottfried go to www.SaraGottfriedMD.com
1. What is an organic OB-GYN?
I help women who’ve lost their groove feel attractive, ripe and delicious again with natural hormone balancing. I’m much more likely to prescribe leafy greens, a cleanse or special meditation than a synthetic pill, and that’s what I consider to be organic gynecology. My wellness coaching is pesticide-free, additive-free and contains no fake sugar. It’s natural, not synthetic. I find the root cause, not just treat or mask the symptoms, and form a highly participatory partnership with women. I got the idea of “organic gynecology” when I took a pledge to wear only organic clothes for one year. All of those features fall under my personal definition of organic.
2. How different are you from a traditional OB-GYN in terms of what you offer patients?
I find that old-school or traditional medicine fails women. It dismisses their concerns about weight gain, low energy and hair loss with a pat on the hand, and “You’re getting older.” I find that totally unacceptable. Women want to know what’s happening to them, what’s causing their symptoms, and an offer of an anti-depressant misses the mark. I was taught in my training to treat hormone imbalances with birth control pills. I’ve trained the same way as other Ob-GYNs in that I graduated from HarvardMedicalSchool, served my residency at UCSF and am board-certified. But I’m also a yoga teacher and seeker of the deeper truths for women. I’ve struggled with PMS, weight gain, and diminished libido, and found that “evidence-based integration” of cutting-edge science blended with proven ancient wisdom provided the best results for me, and by extension, my patients.
I consider myself in the transformation business. Because once I’ve helped a woman, she is changed forever. Once the path is cleared for this new road, she ecstatically takes it. In addition to following faithfully the customized protocols I’ve designed, she appears at my integrative medicine/yoga workshops. She tosses her meds and bolsters her stress resilience with herbs and meditation instead. She eagerly joins my online cleanse and renounces harmful foods like sugar, caffeine and gluten. Sure, my street cred, MD from Harvard and obsession with epidemiology, gets her in the door. But what keeps her coming back is the profound physical and emotional transformation she experiences.
3. How come you don’t take insurance?
If I took insurance, I couldn’t spend 50 minutes with each patient. If I took insurance, I would need to employ someone full time just to negotiate and haggle 8 hours a day with insurance companies. Our insurance system is broken and I decline to participate in a broken model that doesn’t value my contribution.
4. Did you always have this type of practice in mind?
Yes. I grew up with a great-grandmother who was a Whole Foodist and serious yogini. I realized her wisdom when I hit medical school and felt toxic from the long hours, stress and lousy food. Her connection to innate intelligence about the body made sense to me. I sought avant garde clinicians such as Deepak Chopra, Andy Weil and Chris Northrup as my mentors, and never looked back. Harvard taught me to be a physician-scientist but also to question authority and to think for myself. I realized early on in my medical education the promise and hope of integrative medicine. Conventional medicine always felt like the bathing suit that never quite fit right.
5. What was your personal and professional evolution like that led you to create theGottfriedCenter?
Authenticity breeds superpowers. I’m not different than any other woman who seeks authenticity. I tried to work within the conventional system for 10 years after residency. I worked at Kaiser as an OB/GYN. I saw 30 patients per day. I felt the vitality slowly drain out of me, and I felt I was unable to deliver the superb care I was trained to give in such short appointment times. I then worked as an academic researcher, studying breast cancer. I missed the contact with women, and discovered that searching for the Truth alone in a lab wasn’t for me either. When I left Kaiser and founded the GottfriedCenter, it was like coming home. I love spending 50 minutes with new patients. I have time to know what troubles them, and to understand what they most want to change. I have time to formulate and tweak customized, evidence-based protocols with botanicals and bioidentical hormones. The results are nothing short of miraculous. Lately, I’ve had the urge to share my message more broadly, and I’ve landed a contract for my first book, The Hormone Cure (Scribner/Simon and Schuster). I love writing, but the common thread of what most energizes me is time with women, hearing their stories, and determining in partnership with them how I can most be of service of their vitality.
6. Perimenopause and Menopause are natural. Why the drive for bio-identical HRT? Women were not designed to give birth after the age of 35.
I don’t feel it’s my position to say when women are designed to give birth. There are plenty of women who conceive naturally well into their late forties. They don’t make headlines, but it is perfectly natural. I agree that perimenopause and menopause are totally natural, and I do not want to medicalize them. However, many women suffer through the symptoms of perimenopause, from night sweats and disrupted sleep to intrusive hot flashes and brain fog. Mood may dramatically worsen or anxiety may surface. PMS may become an order of magnitude more intense. Rather than presenting the view that hormones are bad, the black/white or polarized thinking that dominates the media and traditional medicine, I prefer to present women with options. Do you want to try Chastetree Vitex, an herb for PMS proven in several randomized trials or something else?
7. What is your project “Dear Thyroid” all about?
DearThyroid (http://dearthyroid.org/) is a wonderful resource for people who have thyroid troubles, such as the top 3 – weight gain and unforgiving metabolism, fatigue and constipation. It’s based on a simple idea of writing a letter to your thyroid, which is an empowering experience for its members. In our mission statement, our goal is stated as this: “Rebrand thyroid diseases and thyroid cancers, for ourselves. Change the public’s perception of how thyroid diseases and thyroid cancers affect patients and families, financially, emotionally and physically. Misconceptions about thyroid diseases and thyroid cancers are rampant. We come together to give this disease a voice and a face, in our own words. By doing so, we hope to find healing, raise awareness and eventually a cure.”
Membership is free. I post weekly as a writer on DearThyroid to try to offer unusual or oblique ways to get your thyroid hummin’. I love sites such as DearThyroid that help people, mostly women, learn how to get their hormones working for them, not against them.
8. Why do women have thyroid problems in much higher numbers than men?
We don’t understand why women are more likely to have thyroid problems. We presume it has something to do with estrogen, progesterone and testosterone. Our ovaries distinguish us from men, and thereby our relatively high amounts of estrogen and progesterone, and lesser amount of testosterone. This may explain some of the difference, but we really don’t understand the mechanism. One example is that testosterone helps your body make more active thyroid hormone (T3) out of inactive thyroid hormone (T4). Perhaps men are better at making T3 because their testosterone is 20- to 40-times higher than in women. I believe women also have more issues with stress and stress hormones, namely cortisol, compared to men, particularly working moms. We burn ourselves out by overgiving until we drop, and burning through our adrenal glands, where cortisol is produced. Our bodies are not designed to be in overdrive perpetually, which is how many of us now live. Burn out is the result, and that applies to several endocrine glands, including the adrenals, ovaries and thyroid.
9. In your personal opinion, what is the debate over Armour Thyroid versus synthetic? Why is it hard to get a prescription for Armour?
Most people with underactive thyroid get started on a synthetic thyroid medication, such as Synthroid or Levo-Thyroxine. They stay on the same dose for decades without any personalization or tailoring to their particular situation. I treat the person, not the disease. I consider choosing thyroid medication to be similar to shoe shopping – it can take a while to find just the right fit. And the numbers, your TSHand free T3 and T4, may not tell the whole story. Your symptoms are every bit as important. I use both Armour and synthetics, depending on the patient. Vegetarians prefer synthetics since Armour is dried pig thyroid. Yet the majority of my patients feel better on dessicated (dried) thyroid compared to synthetics. Armour is bioidentical to human thyroid hormone, and contains all of the thyroid hormones, including T1, T2, T3 and T4, and that suits a lot of people more than simply taking T4, which is what Synthroid contains. Armour and its more hypoallergenic cousins, Naturethroid and Westhroid, have been used safely for many decades and are similarly regulated by the FDA. You can even get Armour at Kaiser Permanente, but many patients are only offered the synthetic option. Armour is hard to get mostly because of the bias that traditional doctors have against it. I didn’t even learn about it in medical school, and didn’t hear of it until a patient asked me to refill a prescription she had. Then I learned I had hypothyroidism, tried Synthroid and had an increase in my hair loss. I tried Armour and found it was a much better fit.
10. Is there less hair loss on Armour than synthetics? How can bioidentical HRThelp with the breakdown signs of aging such as hair loss and other physical impairments?
I haven’t seen rigorous data, such as randomized trials, proving that Armour causes less hair loss than Synthroid, but my anecdotal experience is that it does. Low thyroid causes decreased mental acuity, fatigue, and constipation. Long-term low levels are associated with delayed reflexes and greater risk of Alzheimer’s Disease in women. I believe that optimizing your hormone function, not just with bioidentical hormones but also with proven botanicals, helps all of us age with a greater quality of life and vigor.