The Flipping 50 Show

From homes to health care, you and I need to advocate for yourself. You have choices and you have power. You can take action and you do have choices. 

My Guest:

Karen Mulroy is an attorney who retired at age 62 without regret to spend quality time with her parents until their death at the ages of 97 and 98. They passed away within 4 months of each other, followed by the death of her former husband, with whom she maintained a close relationship. She has navigated the challenges, rewards and emotional aftermath of caring for loved ones through their final moments.

Questions We Answer in This Episode:

• [00:06:13] What is your background and life experience?
• [00:08:52] What were your challenges and rewards of caring for aging loved ones?
• [00:18:55] What is your advocacy for aging loved ones?
• [00:39:00] Do you have any tips to redefine and reclaim life after loss?
• [00:35:04] Any other tips for midlife and older women about how to advocate for yourself?

Practical Advice for Non-Lawyers: Steps for dealing with home or health issues:

• Make a record
• Take pictures/videos
• Get expert opinions
• Escalate reasonably

You don’t need to “lawyer up” immediately—just document and ask respectfully.

It’s important to ask questions, trust your gut, and speak up—especially when others can’t.

Key Takeaways

• Being an advocate starts with asking questions. You don’t have to be a lawyer to advocate effectively. Documentation, curiosity, and assertiveness help.
• Even intelligent, experienced people can fall into denial. Advocacy requires persistence and compassion.
• End-of-life care should align with the patient’s values. Knowing and honoring their wishes is crucial.
• You have more power than you think—use it wisely. Especially with institutions like healthcare or builders.
• Support systems matter. Having another person to back your advocacy—like a nurse practitioner in the family—can amplify your voice.

You Have More Power Than You Think — Advocate for Yourself

Connect with Karen:

• Instagram - @earthdogs3
• Questions and Consultation - mlsmulroy@icloud.com 

Other Episodes You Might Like:

• Previous Episode - How Mold Toxicity Affects Hormonal Balance During Menopause And Effective Detox Strategies
• Next Episode - Take Up Space: A Perimenopause BodyBuilder on Her Strength Journey
• More Like This - Workplace Menopause Rights: What Women (and Employers) Need to Know

Resources:

• Join the Hot, Not Bothered! Challenge to learn why timing matters and why what works for others is not working for you.
• Short & Easy Exercise videos in this 5 Day Flip Challenge.
• Don’t know where to start? Book your Discovery Call with Debra.

Exposure to mold toxicity affects hormonal balance.

You may not have been exposed to mold or you may not know that you’ve been exposed to mold. That mold doesn’t always look like asthma or you getting sick, but it may look like a simple symptom that might be mistaken for menopause.

Stay tuned to this episode and learn what mold exposure can do, what it might feel like and why you might simply mistaken your menopause symptoms when they could be so much more!

My Guest:

Dr. Jaban Moore is a Doctor of Chiropractic located in Kansas City who works virtually with clients through functional medicine to assist them in overcoming chronic health conditions. He went from being an award-winning college athlete to not being able to get out of bed. He sought out countless doctors looking for answers, but doctors only gave him “band-aid” solutions.

He was later diagnosed with Lyme disease. After overcoming this complex infection, he helped clients discover the causes of their symptoms. Dr. Moore specializes in Lyme disease, PANS/PANDAS, autism, parasitic infections, and environmental toxicities.

Questions We Answer in This Episode:

• [00:13:44] How does mold toxicity specifically impact hormonal balance during menopause?
• [00:18:45] What are the common symptoms women might experience if mold toxicity is impacting their hormones?
• [00:22:46] How can women identify if mold exposure is a hidden factor in their menopausal symptoms?
• [00:30:53] What detox strategies do you recommend for safely eliminating mold toxins from the body?
• [00:37:08] Are there specific biohacking tools or supplements you like that can support hormones during this detox process?
• [00:40:03] How long does it typically take to see improvements once mold toxicity is addressed?

Why Mold Toxicity Affects Hormonal Balance More Than You Think

What Mold Exposure Can Do?

• Fungus that grows on walls, food, flooring, etc.
• Beauty products, Botox, and lifestyle toxins contribute to a decreased immune system.
• Disrupts mitochondria, elevates cortisol, blocks melatonin.
• May cause exercise intolerance due to “backpack of toxins”.

Symptoms of Mold Toxicity

• Chronic fatigue, weight gain, anxiety, GI issues, hormone imbalances
• Can trigger inflammation, autoimmune responses
• Mold symptoms are often mistaken for menopause

Dr. Moore’s Detox Roadmap

1. Replenish nutrients (glutathione, potassium, sodium, B12)
2. Open drainage (lymph, liver, bowels)
   • Safe place - remove environmental toxins (air, food, water, hygiene products, dental and implants)
   • Nervous system - address stress and trauma (therapy)
3. Start detox using antimicrobials + binders (e.g., carboxy, pectasol)

How long will it take?

• • Mold detox alone: typically 3–4 months
  • More complex cases: can take years
  • Depends on sensitivity and co-infections

Biohacking Tools That Work

• Infrared Sauna (160°F+)
• Red Light Therapy
• Lymphatic Drainage
• Castor Oil packs, dry brushing
• More advanced: Ozone Blood Filtering (EBOO), Pulsed Electromagnetic Field therapy (PEMF), Neural Therapy 
• Most aren't required, but they speed up recovery

Connect with Dr. Jaban:

• Website of Dr. Jaban Moore
• Facebook - Dr. Jaban Moore
• Facebook Group - True Healing Strategies with Dr. Jaban
• Instagram - Dr. Jaban Moore
• Instagram - @redefiningwellnesscenter_
• Tiktok - @drjabanmoore_

Other Episodes You Might Like:

• Previous Episode - What Is Sarcopenia and How to Avoid Sarcopenia In Menopause
• Next Episode - Retired Lawyer Shares How to Advocate for Yourself & Loved Ones
• More Like This - How to Use Stress as a Tool for Hormone Balance

Resources:

• Don’t know where to start? Book your Discovery Call with Debra.
• Join the Hot, Not Bothered! Challenge to learn why timing matters and why what works for others is not working for you.
• Go to ewg.org to look up the water database for your local municipality

What is sarcopenia and why is this such an important topic for every woman over 40? 

That is the topic of conversation today. 

What is Sarcopoenia?

• Sarcopenia is to muscle what osteoporosis is to bone. 
• Significant loss of skeletal muscle mass and or muscle strength.
• Sarcopenia is tied to anabolic resistance in midlife women, making it harder to gain lean muscle growth or maintenance after 40.
  
  Older adults - both men and women - have to work harder to gain lean muscle mass. 
  • Women have less overall body mass and muscle to begin with and more dramatic reductions in estrogen at menopause, than men experience loss of testosterone. 
  • The key stimulus for muscle protein synthesis, will suffer more from loss of strength and mass if they aren’t carefully offsetting it with planned and progressive resistance training. 
  • For women, estrogen protects muscle and bone. We need and use testosterone which is the most abundant hormone in the female body - but it’s the decline in estrogen that makes the difference in muscle preservation.

What Contributes to Sarcopenia? 

• Malnutrition.
  • Combined with sarcopenia, it’s a predictor of all-cause mortality than sarcopenia alone. 
  • The United States is one of the most overfed and undernourished countries in the world. We’re not eating well enough to sustain health. 

Sarcopenia is 100% avoidable. 

How Do You Measure Sarcopenia?

• Strength
• Fat free mass and height
• Online calculators 
• There are physical tests or measures that include grip strength or calf circumference. 
• Women didn’t measure or track their skeletal muscle mass decades ago to know where it was at peak. It's harder to say how much mass or strength you’ve lost. 

The Surprising Statistics on What is Sarcopenia

• On average, muscle loss occurs 3-8% each decade starting at 30.
  That CAN accelerate during menopause transition.
• It isn’t associated with loss of estrogen driving skeletal muscle protein synthesis down. It’s the side effects of the decline of estrogen. 
  • Not sleeping.
  • Struggle exercising as hard or as long 
  • Less support for your muscle from testosterone and growth hormone 
  • Have cortisol, ghrelin and leptin hormone dysregulation that interferes with muscle and fat.

We do have the ability to regain lean muscle. 

It’s proven (and shared in prior episodes) that 85+ individuals can gain both mass and strength. 

Available Sarcopenia Assessments:

• SARC-F 

  • A simple questionnaire that is a good point of reference but an easy assessment if you’re active. 
  • How it works:
    • Includes 5 components with scale scores range from 0 to 10:
    • Strength: How much difficulty do you have in lifting and carrying 10 pounds?
    • Assistance in walking: How much difficulty do you have walking across a room, whether you use aids or need help to do this?
    • Rise from a chair: How much difficulty do you have transferring from a chair or bed, whether you use aids or need help to do this?
    • Climb stairs: How much difficulty do you have climbing a flight of 10 stairs?
    • Falls: How many times have you fallen in the past year?

• Flipping 50 Fitness Scorecard 

  • Helps not only measure strength and muscle mass but to see how you rank according to others in your age group. 
  • Most important is progress, comparing you to you. Start where you are by benchmarking it and learn how to improve it.

How is Sarcopenia Diagnosed?

• Fat-Free Mass Index: FFMI ≤ 15 kg/m2
  Visit this URL to calculate (turn on metric to see result): https://ffmicalculator.org/
• A strength test.

What is Sarcopenia: The New Glossary

• Osteosarcopenia - low bone mass and low muscle mass
• Sarcobesity - low muscle mass and high fat mass
• Osteosarcobesity - low bone mass, low muscle mass and high fat mass 
• Osteobesity - low bone mass and high fat mass 

The biggest risk of sarcopenia is falling due to instability and inability to “right” yourself when slips and falls occur.

I promised we’d visit what’s possible so here that is:
A 1.9-3.3% increase in global muscle mass in humans is associated with a 4.1% to 5.8% lower fat mass and reduced A1c and fasting glucose in studies lasting 2 weeks to 3 years.

How to Avoid Sarcopenia?

• Resistance train 2x per week minimum, for some that’s maximum.
  Know your recovery needs.
• Consume high protein foods and micronutrient dense foods at each meal.

Wouldn’t it be wonderful if in 30 or 40 years, “What is sarcopenia?” is a question like “What is scurvy or rickets?” now which is never heard of.

That starts with us. 

References: 

• Nutrients. 2023, PMID: 38201856.
• Sports Medicine, 2025, PMID: 40576707.
• Advances in Nutrition 2025, PMID: 40222723.
• Scientific Reports, 2025, PMID: 39833326.
• Front Med (Lausanne), 2025, PMID: 40636391.

Other Episodes You Might Like:

• Previous Episode - Stronger Muscles, Longer Life: The Untold Value of this Accessible to All Anatomy
• Next Episode - How Mold Toxicity Affects Hormonal Balance During Menopause And Effective Detox Strategies
• More Like This:
  • 5 Reasons You’re Not Losing Weight or Gaining Muscle After 50
  • Protein for Menopause Hormone Support
  • Where Protein Recommendations for Women Come From?

Resources: 

• Don’t know where to start? Book your Discovery Call with Debra.
• Use Flipping 50 Scorecard & Guide to measure what matters with easy at-home self-assessment test you can do in minutes.
• Opening in August!! Join the Hot, Not Bothered! Challenge to learn why timing matters and why what works for others is not working for you.

It’s no secret in 2025 that stronger muscles lead to longer life.

If you’re a woman in perimenopause, postmenopause or anything in between, this is no surprise to you. I think we are very aware of it, but let’s unpack how weight lifting treats and prevents chronic diseases.

Women, at any age, need stronger muscles for a longer life. Not just for aesthetics, but for functionality and independence.

My Guest:

A longtime Vanity Fair contributing editor, Michael Joseph Gross has published investigative reporting, essays, and books about culture, technology, politics, religion, and business. He was raised in rural Illinois and lives in New York City.

Questions We Answer in This Episode:

• [00:04:31] How did this become a topic of interest to you personally? 
• [00:07:54] Let’s connect strength training to prevention and treatment of illnesses often associated - even accepted - with aging?
• [00:20:17] Weight training has been shown to decrease anxiety and to have positive effects on risk of Alzheimer’s or type 3 diabetes, can you explain for the listeners? 
• [00:26:31] How has the work of Dr. Maria Fiatarone Singh showed that weight training may reduce the risk of Alzheimer's?
• [00:33:13] Why is lifting heavy important? Do you worry that leading with “lift heavy” intimidates women? What did you uncover as evidence that it is never too late to start progressive strength training?

Why Strength Training?

• Strength training changes more than just your body—it's internal too.
• It’s not about looking stronger—it’s about being stronger.
• Adolescence and menopause are both times when women feel their bodies are changing without their consent. Strength training gives back a sense of control, capability, and power.

Stronger Muscles Longer Life At Any Age

Strong Youth:

• Peak bone mass forms in youth—strength training in adolescence builds lifelong health.
• A 10% increase in bone mass reduces future fracture risk by more than 50%.

Strong in Midlife:

• Dr. Maria Fiatarone Singh, geriatrician and professor in Sydney, Australia, found that even 90+ year-olds can gain muscle mass with high-intensity training.
• Weight training can treat and prevent nearly all chronic diseases.

Stronger Muscles Through Weight Lifting Treats and Prevents These Diseases:

• Type 2 Diabetes
• Heart Disease
• Osteoporosis
• Depression and Anxiety
• Insomnia
• Osteoarthritis
• Frailty
• Dementia & Alzheimer’s
• Blood Pressure and Cholesterol
• Fall Risk

Periodization & Smart Strength Training:

• Periodization: Cycles of high effort, deloading, and rest.
• Women (especially Type A) tend to push too hard—leading to burnout or injury.
• Strength training should energize you, not exhaust you.
• Part of lifting heavy is lifting light.
• The goal: Live better, not just lift more.

Ancient Greek Lesson: The Right Time to Train

• Greek word kairos = the “opportune moment” for action.
• Good training is about doing the right thing at the right time.
• Don't blindly follow a plan. Train for your body today.

Connect with Michael:

• Michael’s Website
• Twitter - DuttonBooks

Other Episodes You Might Like:

• Previous Episode - 5 Things I Would Do If I Were Tired All the Time 
• More Like This - What’s Best Total Body or Split Routine in Menopause

Resources:

• Tune in to the upcoming Flipping 50 Masterclass.
• Don’t know where to start? Book your Discovery Call with Debra.

So many women say they’re tired all the time in menopause. 

Even those who do exercise to improve health, which would include energy levels, will often say, “I’m tired all the time.”

Let me share what I would do, and actually did at the end of 2019 when I found myself recovering from a big year of mental and physical stressors.

80% of the population don’t exercise, specifically 80% of women don’t lift weights the minimum times per week needed for optimal metabolic health. If you are one of those 20% you should be the most energetic people in the room wherever you go!

If you exercise consistently and you’re tired all the time, something isn’t right. It may be about the exercise you’re doing, the fuel you’re consuming or absorbing, the way you’re handling the stressors on your plate, or a combination. There may be something more going on, but often when you have this “check engine” light going on, addressing some changes will help.

This is the best place to start to address why you’re tired all the time in menopause.

1. Stop Exercising “As Usual” 

The mentality “This is the workout I always do. If I don’t, I will lose my fitness” makes it worse!

Even though metabolism changes are documented, pushing exercise to the brink of exhaustion is not the first line of defense in fixing it. 

Science states, “The basal metabolism of the female body decreases significantly, which can mean a decrease in the basal metabolic rate (BMR) of up to 250–300 kcal per day.” This inspires a diet mentality that is of the eat less, exercise more, you’re not going to benefit from this. 

2. Move And Eat In Small Snacks 

Small movements (exercise snacks) like walking 10 minutes 3 times a day, instead of a long walk, will be better for overall fatigue. This helps sustain blood sugar levels.

If you are suffering from adrenal fatigue, you may have blood sugar dysregulation and you may not have an appetite in the morning. Eating in small snacks throughout the day can stabilize blood sugar levels too.

Tired All the Time Isn’t “Normal” 

3. Track Food To Check On Macro And Micro Nutrient Intake 

Cited in studies, key preventive nutrients in menopause are: 

• • Vitamin D
  • Calcium
  • Vitamin C
  • B Vitamins
  • Protein
    

I would also add:

• • Magnesium
  • Omega-3

We need protein and micronutrients to gain lean muscle and strength.

4. Consider Lab Testing For Micronutrient Sufficiency and Cortisol Levels (saliva vs blood, dried or wet urine) 

Lab testing will tell if you are sufficient in levels of micronutrients.

You can take a look at, are you in norms or are you optimal?

5. Support With Adaptogens To Help The Body Help Itself 

Maca, Ashwaghanda, and Rhodiola

I found the most benefit personally from Maca. I felt better within a week just taking a morning dose.

These are all steps you want to take whether you are or aren’t on HRT. If you’re progesterone is low and that’s interfering with sleep, it can make a big difference. These things just cover the basics and relate to your exercise and fitness routine. 

Additional steps you want to take:

• Check thyroid levels with a functional doctor.
• Get a stool test if your digestion isn’t what it should be. That will tell you the status of your good and bad gut bacteria and let you know how to feed with the right probiotics so you feed the good ones and starve the bad. 
• Utilize a health coach who understands optimal levels vs norms of micronutrients.
• A doctor is necessary to help you interpret many things like thyroid and hormones as well as getting the right tests to begin with. 
• Seek support from a functional doctor who can recommend specific tests that differ from your traditional physician and help you sort out any of these. 

References to Why You’re Feeling Tired All the Time in Menopause: 

• PLoS One, 2024, PMID: 38421977.
• Nutrients, 2023, PMID: 38201856.

Other Episodes You Might Like:

• Previous Episode - You’re Not Really Bloated!
• Next Episode - Stronger Muscles, Longer Life: The Untold Value of this Accessible to All Anatomy
• More Like This - Why It May Be Your Thoughts Keeping You Fat, Tired or Injured in Menopause
• More Like This - How to Make Progress without Tired All the Time Results

Resources: 

• Don’t know where to start? Book your Discovery Call with Debra.
• Opening in August!! Join the Hot, Not Bothered! Challenge to learn why timing matters and why what works for others is not working for you.
• Balance hormones in menopause with Femmenessence® MacaPause®.
• Get your micronutrients tested with YourLabWork.

We’ve had it wrong! You’re not really bloated!!  

My guest explains what ‘bloated’ is … and isn’t… How your hormones and gut interface happen and why adding protein might NOT be the thing you need to do right now if you’re not really bloated.

My Guest: 

Shefaly Ravula, PA-C, IFMCP is the visionary founder of Precision Gut Health, a virtual telehealth practice on a mission to unlock the secrets of gut health, nutrition and longevity. At the heart of her practice lies a powerful fusion of functional medicine, culinary nutrition, and a profound commitment to digestive and metabolic health optimization. Using a deeply individualized approach, she is dedicated to guiding patients towards a future where gut health and longevity are intricately entwined—and where vibrant health is not just a destination but a lifelong journey.

Questions We Answer in This Episode:

• [00:06:57] What is the difference between bloating and distention?
• [00:20:10] Why stomach acid matters but also why it makes me nervous, as a practitioner?
• [00:14:44] What is the purpose of an elimination diet and when is it misused or misunderstood? 
• [00:28:03] In terms of hormones, how important is gut health? 
• [00:27:40] Chicken or Egg type of question: Do hormones changing influence gut health or does gut health changing influence hormones?
• [00:30:17] In terms of gut health and hormones, how important is protein? 

Bloating vs. Distention?

• Bloating is a sensation, often tied to hormonal changes, water retention, or constipation.

• Distension is visible abdominal swelling, often worsening throughout the day.

What is Gut Health?

• Optimal functioning of your entire digestive system, which includes not just your intestines but your stomach acid, enzymes, gallbladder, and liver

Fix Your Gut Health, Maybe You’re Not Really Bloated

Stomach Acid:

• Essential to digestion.
• Without enough acid, food isn't properly broken down, which can lead to bloating, distension, and other digestive problems.

Hormones:

• Hormonal changes during perimenopause and menopause can slow down digestion.
• Estrogen, progesterone, cortisol, and DHEA affect gut motility, inflammation, and the body’s ability to detoxify through the digestive tract

Protein:

• With ongoing gut issues, trying to hit high protein goals can add stress to an already compromised digestive system.
• Timing is key — healing the gut first, then optimizing protein intake for metabolic and hormonal benefits.

What is the Elimination Diet?

• Helps identify food sensitivities or reduce inflammation. 
• Designed to be short-term and therapeutic — not permanent.
• Elimination diets are often misused.
  Done wrong, they lead to excessive restriction and fear of reintroduction.

Connect with Shefaly:

• Website - Precision Gut Health
• Facebook - Precision Gut Health
• Instagram - @precisionguthealth
• TikTok - @precisionguthealth

Other Episodes You Might Like:

• Previous Episode - 5 Reasons You’re Not Losing Weight or Gaining Muscle After 50
• Next Episode - 5 Things I Would Do If I Were Tired All the Time 
• More Like This – Why Am I Bloated? Is Your Protein Causing Midlife Gut Issues?

Resources:

• Join the Flipping50 Membership for evidence-based workout programs.
• Understand how sleep relates to your hormones, muscle mass and weight loss with Flipping 50 Sleep Yourself Strong.

If you are exercising but not losing weight or gaining muscle after 50, there are some easy and yet not-so-obvious reasons why. 

This is for all of you exercising but not getting results. 

Whether you or women you work with are interested in gaining muscle after 50, you may like this: 

How to Design Strength Programs that Work PRE, peri and post-menopause is a new workshop I'm offering complimentary to our members and existing Menopause Fitness Specialists. If you’re interested as a non-member, add your name here to the notifications list. 

5 Reasons You May Struggle Losing Fat or Gaining Muscle After 50

1. Not Working To Muscular Fatigue 

• • Starting out: 5-6 reps to fatigue
  • Experienced - 2 reps from reserve

Workouts to gain muscle strength:

• • Light - in between 6-30 reps
  • Moderate - +/- 15 reps
  • Heavy - 10 or fewer reps

2. Too Little Recovery

3 things that have to recover: Muscle, Connective tissues, Adrenals

• • Muscle

48 hours of recovery is not enough for a lot of people. As we age, we need more recovery time.

If you take too little recovery time, you will feed more tired than better and not gain lean muscle mass.

• • Connective tissues (ligaments & joints)

Recovery may be slower and healing from an injury or a strain.

Take time with warm ups and cool downs. Work on mobility around key joints like ankles, hips and shoulders regularly. 

• • Adrenals

Prolonged elevated cortisol after a workout is problematic if already chronic elevation of cortisol exists.

Estrogen regulates the HPA-axis (cortisol/adrenal signaling) function. Less estrogen reduces the ability to regulate stressors.

Decreasing exercise, reducing inflammation and taxing of the adrenals, improving sleep, nutrition sufficiency, and identifying ways to reduce negative effects of cortisol with tools that work for you.

More Reasons Why You're Not Gaining Muscle After 50

3. Too Few Calories Or Protein 

May limit muscle protein synthesis.

If you’re in a caloric deficit:

• • a moderate deficit (<500 calories below maintenance) 
  • resistance training 
  • high protein intake
    Can help preserve muscle during fat loss.

BUT for muscle growth, a calorie surplus is usually necessary.

An 8-week study on heavy resistance training performed in a split routine (with young adults) suggested a much higher protein intake successfully improved fat loss with resistance training in active adults. That was 3.4g protein / kg body weight. For me doing that math at 130lbs would mean an intake of 200g of protein.

A recent study pointed out that for muscle strength older adults need adequate protein, and for mass, adequate micronutrient density.

4. Too Little Sleep

Inadequate sleep can lead to a decrease in muscle strength in the post-night session .

Sleep, post-exercise recovery and athletic performance seem to be significantly related and it appears that vigorous exercise can intensify the negative relationship between sleep deprivation and recovery.

5. Not Enough Quality Volume 

POST menopause requires more volume than PRE menopause for adequate stimulus.

Post-menopause recommendations are 6-8 sets of exercise for any one muscle group per week.

PRE menopause: 

• • Per day: 3 to 4 sets per 8 major muscle group 
  • Per week: 48 to 64 sets total, spread out in 2 (or 3) workouts.
    These work before estrogen and other hormonal declines have occurred.

POST menopause:

• • Per day: 6 to 8 sets per 8 major muscle group
  • Per week: 77 to 144 sets total, spread out in 2 (or 3) workouts.

That is a wide range but researchers suggested more is needed. More research is needed to determine if this is really true. More importantly, you should test it to see if it’s true for you. 

References for Gaining Muscle After 50: 

• Sports Medicine, 2024, PMID: 38970765.
• Seattle Midlife Women's Health Study. Menopause, 2009, PMID: 19322116.
• The Journal of Clinical Endocrinology and Metabolism, 2017, PMID: 29106594.
• International Journal of Sport Nutrition and Exercise Metabolism, 2022, PMID: 34697259.
• Journal of the International Society of Sports Nutrition, 2015, PMID: 26500462.
• Biology of Sport, 2021, PMID: 33795917.
• BMC Women’s Health, 2023, PMID: 37803287.

Other Episodes You Might Like:

• Previous Episode - What to Do When Joints Hurt, Ache or Need Replaced? A Doctor Viewpoint
• Next Episode - You’re Not Really Bloated!
• More Like This - Extended Cardio and Low Protein Equal Short Term Weight Loss

Resources: 

• Don’t know where to start? Book your Discovery Call with Debra.
• Understand how sleep relates to your hormones, muscle mass and weight loss with Flipping 50 Sleep Yourself Strong.
• Learn how to Design Strength Programs that work pre, peri and post-menopause.

What do you do when your joints hurt?

Do you think this is only temporary because I did too much of something?

What can you do when joints hurt, or at least ache? Are you thinking or told about knee replacement?

If this is you, this is your episode!

My Guest: 

Dr. Joshua Schacter, DO, FAAOS, America’s Holistic Orthopedic Surgeon, is redefining joint care with a commitment to providing actual solutions for his patients.

Spending a decade as the Chief of Orthopedic Surgery and Director of the Advanced Orthopedic Center of Excellence, he saw the need for non-invasive, innovative solutions that address the root causes of pain and dysfunction rather than masking symptoms.

When his wife was diagnosed with the “breast cancer gene”, the Schacter’s became obsessed with wellness, health and how to accomplish true healing. Dr. Schacter dreamed of a more effective and patient-centered approach, the Pinnacle Method.

Questions We Answer in This Episode:

• [00:05:25] How did your personal experience cause you to shift your focus from traditional orthopedic care to a more holistic and integrative approach? 
• [00:21:18] What is orthobiologics? 
• [00:20:20] How does The Pinnacle Method address not just the symptoms but the root causes of joint pain? How does the Pinnacle Method help patients achieve long-term wellness?
• [00:21:30] How do the treatments you offer support the natural healing process?
• [00:37:00] Can you define PRP? The efficacy and timeline, cost and success rate? 
• [00:37:35] What do you find to be true today on surgery and non-surgical treatments? What evidence or success stories would you share to illustrate the effectiveness of the Pinnacle Method?
• [00:39:30] Your approach is optimizing overall health and longevity. How do you incorporate wellness and prevention into your care for patients?

Know What You Can Do When Joints Hurt

What is orthobiologics?

• Use of the body’s own healing capacity.
• Includes PRP (platelet-rich plasma), stem cells from fat or bone marrow, cord blood.

What is PRP?

• Platelet-rich plasma: Draw blood → concentrate platelets → inject into affected joint
• Cost: $2,000–$6,000 per dose

What is The Pinnacle Method?

• Combines PRP, functional medicine, and BHRT
• Addresses the whole patient, not just symptoms

Key Takeaways

• Orthobiologics like PRP and stem cells are effective alternatives to surgery, especially when used early.
• Steroid injections can accelerate joint degeneration and should be used cautiously.
• The Pinnacle Method is a patient-centered approach combining regenerative orthopedics, functional medicine, and hormone therapy.
• Menopause-related hormonal changes significantly affect joint health, making hormone balance crucial.

Connect with Dr. Joshua:

• Website - Pinnacle Sports Medicine
• Facebook - Dr. Joshua Schachter
• Instagram - @drjoshuaschacter
• Instagram - @pinnacleintegrativeorthopedics
• YouTube - @drknighthawk

Other Episodes You Might Like:

• Previous Episode - Extended Cardio and Low Protein Equal Short Term Weight Loss
• Next Episode - 5 Reasons You’re Not Losing Weight or Gaining Muscle After 50
• More Like This - Do You Have a Dominant Side? Joint Pain Solutions I’m Using Right Now
• More Like This - A Trek Up Mt Kilimanjaro with 3 Artificial Joints at 70

Resources:

• Join the Flipping50 Membership for evidence-based workout programs.
• Short & Easy Exercise videos in this 5 Day Flip Challenge.

Short term weight loss sounds great BUT it’s not all fat – it’s muscle!

Muscle will be much harder to regain as we age because of anabolic resistance.. 

Clothes might feel loose and you get weight loss compliments. But short term weight loss is just giving a “false positive” honeymoon period. This might mean you divorced muscle, the love of your life.

1. Muscle Mass Loss (Sarcopenia)

• Protein Deficiency

• • Protein is essential for building and maintaining muscle tissue.
  • Insufficient protein intake exacerbates muscle atrophy and increases the risk of falls and injuries.

• Excessive Cardio

  • Prolonged cardio can lead to a breakdown of muscle tissue for energy, particularly if glycogen stores are depleted.
  • This can worsen age-related muscle loss and counteract maintaining strength and function.
    
    

2. Bone Health (Osteoporosis)

• Protein Deficiency

• • Protein is needed for bone health and bone density.
  • Inadequate protein intake, especially after menopause, increases the risk of osteoporosis and fractures.

• Osteoporosis Risks

  • After menopause, risk of osteoporosis increases due to declining estrogen levels and can weaken bones prone to fracture.

• Sarcopenia and Osteoporosis Link

  • Having both increases the risk of falls and fractures.
  • Poor nutrition leads to sarcopenic obesity and increases the risk of osteoporosis.
    
    

3. Other Negative Effects

• Reduced Physical Function

  • Since inadequate protein leads to muscle loss, this reduces strength, impaired balance, and decreased ability to perform daily activities.

• Slow-Healing Injuries

  • Protein repairs tissues. Deficiency can slow wound healing and recovery from injuries.

• Weakened Immune Function

  • Amino acids from protein build antibodies and maintain a healthy immune system. Low protein intake can lead to frequent illnesses and infections.

• Potential Cardiac Issues (Excessive Cardio)

  • Associated with potential adverse cardiac effects, such as myocardial fibrosis and an increased risk of atrial fibrillation, in some individuals.

• Musculoskeletal Injuries (Excessive Cardio)

  • Increases the risk of musculoskeletal issues like osteoarthritis and stress fractures.

What Can You Do Instead of A Short Term Weight Loss

Recommendations:

• Prioritize protein intake with 30 grams each meal.
• Balance cardio and strength training to build and maintain muscle mass.
• Listen to your body and avoid pushing yourself too hard or engaging in prolonged, strenuous exercise if it causes excessive fatigue or pain.

References: 

• Chucherd O, Vallibhakara O, Vallibhakara SA, Sophonsritsuk A, Chattrakulchai K, Anantaburarana M. Association of Sarcopenic Obesity and Osteoporosis in Postmenopausal Women: Risk Factors and Protective Effects of Hormonal Therapy and Nutritional Status. Arch Osteoporos. 2025 Jun 26;20(1):83. doi: 10.1007/s11657-025-01573-w. PMID: 40569474; PMCID: PMC12202630.

• Filip Vuletić, Berte Bøe, Considerations in the Aging Female Athlete, Operative Techniques in Sports Medicine, Volume 32, Issue 2, 2024, 151091, ISSN 1060-1872, https://doi.org/10.1016/j.otsm.2024.151091.

Other Episodes You Might Like:

• Previous Episode - Simple Ways to Know if You’re Following Protein Rules in Menopause
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• More Like This - Protein for Menopause Hormone Support

Resources: 

• Join the Flipping50 Membership for evidence-based workout programs.
• Short & Easy Exercise videos in this 5 Day Flip Challenge.
• Get the Flipping 50 Protein & Fiber supplements for women over 50 to support muscle health, enhance recovery, and meet daily nutritional needs.