What Comes After Ozempic and Everything In Between With Dr. Cory Rice - Episode 291

Important links:

Get in touch with Dr. Cory Rice & his team here:  https://mymodernmedicine.com/meet-our-team/dr-cory-rice/?srsltid=AfmBOop9IaJVgYBnqGUvjhb0UjRNM8nxMSAJMaaZLt-ark8JH5cwU7jk

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Dr. Cory Rice graduated from Baylor University with a bachelor’s degree in forensic science and then completed medical school at the Arizona College of Osteopathic Medicine in Glendale, Arizona. He attended Methodist Medical Center of Dallas for his internship and residency in Internal Medicine.  Dr. Rice’s professional interests include nutrition-based chronic disease management, thyroid management, longevity/precision medicine, and bioidentical hormone replacement therapy. His main focus in his practice is on wellness and prevention, nutrition, therapeutic lifestyle change and appropriate hormone balancing for men and women. Dr. Rice also currently serves as the Chief Clinical Advisor for BioTE Medical, the nation’s leading provider of natural hormone replacement therapy using subcutaneous pellets.  

Are you considering Ozempic or another GLP-1 medication for weight loss? Before you jump on the bandwagon, this eye-opening conversation with Dr. Corey Rice reveals what your doctor might not be telling you about these popular drugs.

Dr. Rice breaks down the science behind GLP-1 medications with crystal clarity, explaining how they work in the body and who should consider using them. Unlike many providers who prescribe medications without adequate monitoring, Dr. Rice advocates for a comprehensive approach that examines gut health, hormone balance, and nutritional status before initiating these powerful medications.

For women in menopause, Dr. Rice offers particularly valuable insights about how hormone balance affects weight management and whether bioidentical hormone replacement might be a better first step than Ozempic. He also delves into fascinating emerging applications of GLP-1s at micro-doses for inflammatory conditions like Alzheimer's and Parkinson's, revealing the broader potential of these medications beyond weight loss.

This conversation offers practical wisdom that you can apply to make more informed health decisions. Share this e

Chapters

• 0:00 Introduction to GLP-1 Discussion
• 4:59 Dr. Corey Rice's Background in Medicine
• 10:41 Understanding GLP-1 Medications and Mechanisms
• 18:01 Ozempic Face and Muscle Wasting
• 27:36 Gut Health and Akkermansia Connection
• 36:07 Bioidentical Hormones and Weight Management
• 43:02 Peptides and Comprehensive Treatment Approach
• 55:20 Microdosing GLP-1s for Inflammation
• 1:03:05 Final Thoughts and Contact Information

Transcript

Sandy Kruse: 0:02

Hi everyone, it's me, sandy Kruse of Sandy K Nutrition, health and Lifestyle Queen. For years now, I've been bringing to you conversations about wellness from incredible guests from all over the world. Discover a fresh take on healthy living for midlife and beyond, one that embraces balance and reason, without letting only science dictate every aspect of our wellness. Join me and my guests as we explore ways that we can age gracefully, with in-depth conversations about the thyroid, about hormones and other alternative wellness options for you and your family. True wellness nurtures a healthy body, mind, spirit and soul, and we cover all of these essential aspects to help you live a balanced, joyful life. Be sure to follow my show, rate it, review it and share it. Always remember my friends balanced living works. Remember my friends, balanced living works. Hi everyone, welcome to Sandy K Nutrition, health and Lifestyle Queen.

Sandy Kruse: 1:40

Today with me I have Dr Corey Rice and he's a weight management specialist and he's very, very well versed in GLP-1s. Yes, we are talking about Ozempic and Wegovy and any of the GLP-1s. We get into so much detail in this podcast recording. We basically talk about what comes after GLP-1s as well, because the facts are, you know, this is actually a diabetic drug, so we even get into some other stuff, like you know, 50 plus women who just want to be skinny again, and what are the implications of this and what is it even doing to society on what is beautiful, what is not. I mean, this is such a big conversation.

Sandy Kruse: 2:38

I have talked at great length about weight, about what is health. The reason I did that, or do that, I should say, is because I don't have a thyroid gland and I'm going through, or have gone through, menopause without a thyroid gland and most of you who are listening know that the thyroid is like. The Thyroid is like the thermostat for your body's metabolism. It controls everything, and having my entire gland removed definitely changed my life forever. And weight is something that you know. For me, I'm always thinking about it, guys, and this is the truth, and a lot of women obsess of you know that 30 something body they used to have. These are definitely my truths. I'm not that. You know I'm only five foot two barely, and you know I can't chase that 110 pound body anymore. I can't. And as much as I'd love to be thinner, I also know the implications of being too thin as we age and that is one of frailty. So we get into a lot of this.

Sandy Kruse: 4:04

This is such a massive conversation. I'm going to ask you to please, please, share this. Share this with a friend, share this on social media. Be sure to tag Sandy K Nutrition. It's kind of the way that we get the word out, because I don't do any advertising for my podcast. It's going to be six years in February since I started this and I would just really appreciate that, and I would also appreciate it if you can go ahead and review my podcast with a few kind words on Spotify or on Apple. Those are the best ways to do it. And, yeah, follow me on Instagram. I'm quite active there and, yes, I thank you. Thank you, thank you so much for being here each and every week.

Sandy Kruse: 4:54

And now I'll cut on through to the interview with Dr Cory Rice. Hi everyone, welcome to Sandy K Nutrition, Health and Lifestyle Queen. Today, I have a special guest with me. His name is Dr Cory Rice, and Dr Rice graduated from Baylor University. I've heard great things about Baylor, by the way. It's cool, it's cool, great things. And he graduated with a bachelor's degree in forensic science and then completed medical school at the Arizona College of Osteopathic Medicine in Glendale, arizona. He attended Methodist Medical Center of Dallas for his internship and residency in internal medicine. Dr Rice's professional interests include nutrition-based chronic disease management, thyroid management hey, did you know I don't have a thyroid gland? Maybe you didn't even know that. Maybe we can talk about that.

Sandy Kruse: 5:51

We could talk about that definitely. Longevity, precision medicine and bioidentical hormone replacement therapy all my favorite topics. His main focus in his practice is on wellness and prevention, nutrition, therapeutic lifestyle change and appropriate lifestyle medicine. Dr Rice also currently serves as the chief clinical advisor for BioT Medical, the nation's leading provider of natural hormone replacement therapy using subcutaneous pellets, and today I'm so excited about this. I have been wanting to do a show on GLP-1s for a long time and I've kind of waited for the right person. And here you are now to talk to us all about GLP-1s and everything in between, like what comes after, who are candidates. So I am so excited to welcome you, dr Rice, to the podcast. Thank you for coming.

Dr. Cory Rice: 6:59

Yeah, thanks, sandy, I appreciate it. This is a hot topic really for anybody, whether you're a clinician or just a consumer, layman, patient. What have you so? Anytime I can spread information and not misinformation, happy to do it.

Sandy Kruse: 7:12

Yeah, and now I think that you have a very busy clinic there. Maybe tell us a little bit about your background.

Dr. Cory Rice: 7:19

Yeah, love to. So I think it's important to understand I started out not necessarily knowing or wanting to go into health care. As you mentioned, I actually was the first graduate from Baylor with a forensic science degree. So I actually worked in law enforcement for two or three years on the forensic side of things and dealing with death honestly, and what that taught me was how to put puzzles together. And what that taught me was how to put puzzles together. Essentially, what studying death taught me was how to put people back together and tell their story. And the irony is I've kind of come full circle in what I do now.

Dr. Cory Rice: 7:54

So I conventionally went into internal medicine, not knowing what I wanted to do when I went into healthcare, and ultimately that gave me a ton of options. So I worked in inpatient medicine, outpatient medicine, really dealing with the sickest of the sick, and this was roughly 13, 14 years ago, two years of doing that. I was pretty disenfranchised with medicine and the medical machine, as I like to call it in the country, up an outpatient practice and grew that really into what it is now, which is truly more of a functional medicine, slash lifestyle medicine type emphasis. Internal medicine really gave me the skills and the tools to understand the breakdown of glands as they become chronically diseased, but it didn't really help me understand how to fix people or put them back together, and so I started off in death and now I work in life putting people back together. Um, because every human being, whether you have weight challenges, whether you have Hashimoto's, whether you have cancer, whatever you have, there's a reason, um, and if you can figure that, puzzle out and reconstruct something, um, and restore function back to dysfunction, oh my God. It's like it's literally not even a, it's like a hobby for me to give people back their health, essentially.

Dr. Cory Rice: 9:11

And so that's, in a nutshell, what I do. I have two offices in the Dallas area that are busy. I've got a team of people. It takes a village. It's not about Dr Rice, it's about the people that support me and I support, and we have tens of thousands of patients that we interface with on a daily basis, from all over the country, and we treat a myriad of things. Whether you're a professional athlete, I've got actors, I've got actresses, I've got people that are sick, I've got people that have a year to live, you name it, everything in between. So that's really what I do day in and day out.

Sandy Kruse: 9:42

Yeah, I love the way that you explain that about putting people back together and, you know, because I believe that we all have the chance to make changes that can really have an impact and I love that you kind of look at it holistically. You look at a person's health holistically. You don't discount nutrition, you don't just. You just kind of, like you said, you piece them together. And one of the big things that we're seeing right now and you know this in your practice you see this all the time. I'm sure People think GLP-1s are a quick fix. Right, let's just lose a few pounds here and there, Dr Rice, let's just get it done without making the changes. There's a lot of confusion on social media because you have so many different people talking about it in different ways, so maybe let's begin with what are GLP-1s? That's a good place to start.

Dr. Cory Rice: 10:51

Yeah. So you know mechanistically. What's really important, I think, for your audience to understand is you and I, as humans we all as humans make GLP-1s in our body. So a GLP-1 is something we're producing inside of our gut. So that'll come back later when we get into the gut. But ultimately, if you have poor gut health, you're not making a lot of GLP-1. So why I mention this is if you go on to GLP-1 appropriately, you should do okay on it if you have appropriate gut function period.

Dr. Cory Rice: 11:21

If you have a dysfunctional gut and a dysfunctional diet, you're not going to respond well to a GLP-1 because you're not even able to make your own GLP-1. So, to answer your question, what do they do? Essentially, they increase the secretion of insulin. So insulin, as your audience may know and tongue-in-cheek I like to say, we are the United States of diabetes and we are the United States of hyperinsulinemia, or high insulin. It is what it is. We have a lot of people Upwards of 40% of the human population in this country has high insulin or insulin resistance. So GLP-1 specifically helped to force the body to secrete insulin, which helps to bring blood sugar down. So in a way, it's helping to sensitize the cells within the pancreas that make insulin. When someone develops diabetes, they lose those cells in the pancreas to make insulin, so if you're not making insulin, your blood sugar stays way high and you get diagnosed at some point with diabetes. So that's number one.

Dr. Cory Rice: 12:18

The other thing it does is it suppresses what's called glucagon. Glucagon is a hormone that essentially just raises blood sugar, and so it suppresses the excretion of glucagon or the production of glucagon, so, in a way, that's a positive thing. The other thing it does is it promotes the term satiety or fullness. So, essentially, you inject this compound and you just feel full, and so those are the mechanisms of action of what they're actually doing. I think the devil's in the details, though, of is that appropriate for everyone, and is it not? There are certain people you have to be careful with on these things. I have used these compounds, and I would say, for certain patients they're miracles, but these are not, in certain and most cases, to be forever in perpetuity compounds. You have to be able to come off of them at some point, for whatever reason, and if that's the case, you want to keep the weight off, you want to keep the fat off, right, and so, mechanistically, that's essentially what these GLP-1s are doing, and so mechanistically.

Sandy Kruse: 13:26

that's essentially what these GLP-1s are doing. Okay, I have a question about that, because a big piece of this is it used to be used only in diabetics. Is that right?

Dr. Cory Rice: 13:35

Yes, yes.

Sandy Kruse: 13:37

That's what it was kind of created for. So let's say we're talking about who it's for. Let's say I'm 55 years old, I'm in menopause, I have some. You know it's not that easy for me to keep weight off. I have a good lifestyle. I move my body every day, I eat whole real foods, that kind of thing. My HbA1c and I know you're probably going to get into what that is is decent. I just had it done. It was 5.5. You know, I know you'd probably say 5.2 is better, but HbA1c is okay. My fasting glucose is okay. My fasting insulin is okay. Could I even think about going on it? Like, who's a candidate for it?

Dr. Cory Rice: 14:26

Okay, so to your point on label, yes, diabetics and potentially weight loss patients, people that have a BMI above a certain cutoff where they are clinically obese or overweight. But I will also tell you, as a functional medicine person who essentially all that means is you're finding the root cause of someone's illness, you're not trying to just cover it up with a bunch of pharmacologic agents. So that's my whole deal is look, there are lots of things we're uncovering about these compounds, and the two pillars of treatment are for the diabetics and for people that need to lose some of the visceral fat or some of the inflammatory fat around their body. The real answer here is and a lot of this has not been parsed out completely in the literature this is more of anecdotal or observational because of a lot of us that do this. But I will use small dosages of this in inflammatory degenerative illnesses, and so you name it. I've used it in multiple sclerosis, I've used it in Alzheimer's, dementia, parkinson's, as a very, very tiny dose. This is not for people to lose weight. This is a compound that appears to be sweeping the body of inflammation. So we do know that it lowers the amount of beta amyloid overload, which can be one of the mechanisms leading to degenerative illnesses, whether that's Alzheimer's, whether that's Parkinson's, whether that's you know, you name it multiple sclerosis.

Dr. Cory Rice: 15:52

And so I think there's a way and there's a place to use this. These aren't going to be FDA approved, on-label uses. These are going to be off-label uses, which I mean 70 to 75% of medicines used in America are off-label anyways. So you know, that's just essentially what we do, and so I think, yes, if there's someone that's needing to lose weight, it's a consideration. However, I'll just give you my opinion on the use of these.

Dr. Cory Rice: 16:22

In the initiation of them, I don't think anyone should use a GLP-1 or consider a GLP-1, whether this is an injection or oral administration, until you've objectified what is their menu plan and nutritional profile and their day-to-day habitual eating schedule? What do they normally do as far as their diet on a normal basis? And two objectify whether their gut function is even appropriate to handle the weight they're about to lose. So if you don't digest protein, carbs, fats, if you don't break them down, if you don't absorb them, if you've got overgrowth, undergrowth, parasite, pathogen, I mean, if you have things happening within your gut and you're not looking at that and you put someone on a weight loss agent, you are setting yourself up for a disastrous outcome, and I see this time and time again.

Sandy Kruse: 17:11

Yeah, there's a lot of symptoms that I've heard about with GLP-1s in some people and then some people are fine. So what are some of the symptoms that some might experience if those things are not in order that you mentioned?

Dr. Cory Rice: 17:27

Yeah, Two most common side effects, bar none, are nausea and having reflux or heartburn. You know, I think done appropriately, you don't have many of those side effects. You don't have many of those side effects. Again, I'm biased to myself because I see what I see every day, but I just don't see people, Sandy, with side effects very often, and if they do, it's going to be mild nausea or mild reflux.

Dr. Cory Rice: 17:57

There's some literature out there about it delaying gastric emptying or delaying the food clearance through the stomach and then ultimately leading to a paralyzed sort of stomach where things aren't mobile. And I mean, I have never seen that. And I guess, listen, you give the wrong agent to the wrong patient. If the wrong doctor gives the wrong agent to the wrong patient, you're going to get the wrong outcome. So I guess in the realm of reality, sure, those things can happen. But I think, done appropriately and this is one big problem, I think in my profession there's no real certification, there's no real licensing, there's no. If you have a medical license, you have a medical license and you can sort of like do what you want and what you feel is appropriate for your patient. You don't need to go through GLP-1 training and unfortunately we don't have that. I think it'd be nice because there's best practices out there where patients just do not get the side effects and they achieve the results they want and they keep the weight off. That's ultimately what I think anybody wants.

Sandy Kruse: 18:55

That goes on to this so, because you obviously have a ton of experience with GLP-1s and not everybody who's listening is going to come to you your doors are probably already pretty busy. So what would a patient want to ask of their practitioner? You know what questions are important for a patient to ask or even know about. Like, what do you need to know of this practitioner before they put you on it? Because I'm going to tell you, dr Rice, like I'm not going to name names, but I know of doctors who are just sending emails saying, hey, have you thought about going on one? And I'm like, okay, well, what's your process? How do you know if I'm a candidate? Yeah, well, I'm going to lead it off. Simply, you should ask them what's your process.

Dr. Cory Rice: 19:44

How do you know if I'm a candidate? Yeah Well, I'm going to lead it off. Simply, you should ask them do you have a process? A lot of them do not, so a lot of my colleagues. It's literally a prescriptive relationship If you want it, you get it, and when you don't want it, just tell me you don't want it. There's no, you just call the office and we'll fill it for you and that's it. I mean, there's no supervision, there's no oversight. So the first question is do you have a process? And if so, what is it? I know my process, but I'm just saying you need to have a process because, ultimately, losing weight is not healthy. If you're losing healthy weight, so you're trying to drive unhealthy weight. You're trying to drive the unhealthy weight that you're trying to lose correct.

Dr. Cory Rice: 20:21

You're trying to sensitize the insulin. So this is another very important part of insulin. Again, this compound induces the secretion of insulin so you can keep blood sugars lower. Well, insulin is a growth hormone. So what I would tell your listeners is one simple, ineffective, inexpensive test have your provider check your fasting insulin. What is your insulin? If someone has an elevated insulin level, they have an elevated growth hormone. So the more insulin you have, that you're producing, you're going to grow. Your belly is going to grow. Other things in your body, like tumors and cysts and skin tags and polyps in the colon, they grow when you have high insulin. So insulin is an independent risk factor for cancer. So I would say always check your insulin level if you can. If they don't, no problem. But back to okay, let's determine. You put me on this. What does this look like?

Dr. Cory Rice: 21:14

Well, the most important thing, when you go on to a weight loss agent like a GLP-1, can you retain muscle? In my opinion, muscle is the currency of life. If you don't have muscle or lean, dense mass, you don't live as long, you don't live as healthy period, you become disabled more. So you need to retain muscle. And as we age, you hit on the hormonal thing and I can hit on that later. But we all lose hormones. As we age, we lose hormones. So when you lose hormones, things happen right you lose muscle, your blood sugar goes up, your blood pressure goes up, your cholesterol goes up. Everything happens as you lose hormones. And so that's a critical piece as well. But I would want to know how do you ensure that I'm losing the weight you want me to lose, ie the fat, and I'm retaining my muscle. How do you monitor my protein consumption? Right, protein to help synthesize muscle protein synthesis. I mean, if you don't eat enough protein, because this agent, as I said, is inducing fullness, it's reducing your appetite. So if you're not wanting to eat, you have to make sure that when you do eat, you're eating protein period, otherwise you will lose your weight and that's going to just.

Dr. Cory Rice: 22:22

I hope we get into this because I want to talk to you about these individuals out there that are on GLP-1s. They've been on them forever and they're now a malnourished human and they like what I call the cry box. The cry box is the square on the ground. You step on it and it gives you a number and it makes you cry. Well, that cry box may be getting better.

Dr. Cory Rice: 22:43

What I'm referring to is clearly a scale. The scale number may be getting better, but you feel awful. So is it worth it for that number to make you happy, but to feel completely awful? And there's real reasons why they feel awful that you know. If you want me to get into, I can, but these are things that I'm seeing now People that are on these, but on them way too long, and when you ask them the question, what is your goal and what is your treating provider's goal Like? What are we trying to do here? They all say the same thing Well, I wanted to lose weight. They didn't really tell me what their goal was. It was just do you want it or do you not? And that's a lot of the majority of the relationships out there between provider and patient.

Sandy Kruse: 23:21

I think you raised such an important point just right there. I have actually written about this because I am a person who has, since I had a total thyroidectomy. I'm not the same as I once was. I don't care that every doctor says, well, it should be, because you're on this mix and your thyroid panel looks perfect. I'm like I don't care. It's not my actual thyroid organ, it's never going to be the same and I'm also in menopause at 55. So I've got a lot of things going on. So for me, health is the most important thing. But guess what I see. Health is the most important thing, but guess what I see. Every TV station you turn on, you see these celebrities, the real housewives, all of them. You know they talk about ozempic face muscle wasting. They look frail. To me, these are women that are my age and I'm like if this is the example that a lot of menopausal women are looking at, it's very unhealthy In my mind. As a holistic nutritionist, I'm also a certified metabolic balance coach I'm like this is not healthy for everyone.

Dr. Cory Rice: 24:35

Demonstratively true, yes.

Sandy Kruse: 24:37

And, honestly, there's a lot of stuff that goes on in a woman's brain around menopause and it can really mess with what you think is beautiful, what you think is healthy. So it's a lot bigger of you know a subject and you know I would love for you to get into some of this. Get into some of the muscle wasting aspect that we see. The ozempic phase, like how does one safely who's a candidate? Like am I a candidate? If I'm, and I and, by the way, I have one of those body composition scales because I want to see what's going on with my bone, I want to see what's going on with my muscle, I want to see what's going on with my entire physiology, everything. So who's a candidate?

Dr. Cory Rice: 25:30

Yeah. So listen, as before, diabetics and insulin resistant patients, people with high insulin they're candidates. They're candidates to consider the compound. You still have to find someone who is going to do it safely, appropriately, I think. Anyone who is having massive problems losing weight you know these people. I've tried everything, everything, literally everything, and I can't lose weight. Those are considerations to try this.

Dr. Cory Rice: 25:56

I still would strongly recommend you understand how to eat prior to this, how to even follow these things, how to follow nutrient-dense platforms prior to doing a GLP-1, because I'm going to get into what you call the ozempic phase and sort of the other side of it. But you need to know these things beforehand. I still want to know, in some capacity, what is your gut function, basically speaking? Do you take the trash out every day? If you do not take the trash out every day, you're going to feel like trash when you go on GLP-1s. It's just that simple. So if you're not having adequate bowel function going into a GLP-1, you need to get adequate bowel function before you go on to a GLP-1. These are very basic things but they're not looked at in medicine, which is very, very unfortunate. So then you get to the other side of this and the people that go on to this and you know, are just raving about their weight loss and things like this.

Dr. Cory Rice: 26:58

What I would tell you is a lot of these people, what they're not telling you and this is a very, very I'm going to keep this as basic as I possibly can Cellular death within the body exhibits very concrete symptoms, right? So I started off in death. Now I'm working in life and I can tell you, when someone's dying, they're, they will experience everything from hair loss to brain fog. They can't remember yesterday, they can't remember this morning, their energy goes to the toilet, they don't feel good, they get anxious, they get panic attacks, they're very depressed, they're not motivated. Their nails are starting to break. Their skin is very, very dry. Motivated their nails are starting to break. Their skin is very, very dry. That is the sign of someone who is, little by little by little, dying on the inside. So this is what I see.

Dr. Cory Rice: 27:53

These are people that come in that are like tired and brain foggy. They're happy with their weight because their weights come down, but they're now on three to four different medications to treat energy, to treat anxiety, to treat sleep. None of these things work. None of these bodily functions work when you're not feeding it. So what I tell them is you are nutritionally deplete. You have no basic raw material to make your machinery run. It's literally like we plopped you on an island with no food. And we come back and check on you in four weeks and you're sitting there and you're like oh my God, I'm skinnier, but you can't remember yesterday. You're so tired and you feel awful. This is the sign of someone who, on the inside, needs nutrition.

Dr. Cory Rice: 28:44

So these people, what I tell them is I have to deconstruct you before we can reconstruct you. You haven't earned the right to be on GLP-1. And they all say the same thing. Well, if I stop this compound I've been on it for a year and a half If I stop it, I'm going to gain weight. I'm like I don't care, you're dying. I mean, we need to feed you appropriately and then, if you start storing visceral fat, we can consider earning a GLP-1 again. But my goodness, we've got to like save you right.

Dr. Cory Rice: 29:14

And that's what we're seeing is people that are now being medicated on a GLP-1 for symptoms caused by the GLP-1. And I'm not saying this is one or 10 people caused by the GLP-1. And I'm not saying this is one or 10 people. This is like an army of people out there that think it's normal because they get around other patients that are like oh yeah, girl, I feel the same way, but I like how I can fit into my shirt and I'm like what, do you understand what I'm saying? It's very, very backwards. So I think you can have the best of both worlds. I think you can learn how to eat food appropriately, I think you can absolutely get adequate gut function and I think you can qualify to go on a GLP-1. And I think you can lose the fat and I think you can retain muscle and I think you can get off the GLP-1. I think those are the types of things I keep coming back to. Is what I'm saying I unfortunately feel like is in the minority.

Sandy Kruse: 30:04

That just isn't how practices are run when they're using GLP-1s and it's very unfortunate. Yeah, you know I actually like right here I'm looking at it I have a vitamin and mineral reference guide that shows all the nutrients and the symptoms of depletion and the foods that you need to actually restore the bodily functions. So I love what you're saying, because not enough people are saying it. So it's not about the weight loss, it's about really making your body more efficient and healthier. And really, for middle-aged well, I guess technically I'm past middle age, unless I live to 110, which it's always possible, right? But for people around 40, 45, when they start to see changes in their body, if they're not educated enough in how to support their body before they go on it, then that's when you see all those symptoms. So I love that you brought that up. Now here's a question for you, and I don't think I've ever read anything about this. You know, if somebody loses weight too quickly, is it possible that they can do damage to the gallbladder?

Dr. Cory Rice: 31:27

You know, I think if you lose weight too quickly, that is induced. Or if it's, you know, unfortunately in healthcare when someone loses weight unintentionally it's cancer until proven otherwise. It's cancer until proven otherwise. And so, yeah, if it's from that, if it's from a malignancy that you don't know you have, then certainly it can lead to all sorts of organ dysfunction and organ problems.

Dr. Cory Rice: 31:51

If you're inducing, if you're doing a caloric restriction and you're giving a signaling agent that's telling the brain stop eating, if every gland is not getting the raw material it needs, if it's not getting the nutrition it needs to actually operate and like just basic things like protein transcription and translation and just simple. You know the Krebs cycle and ATP and all that. If you're not, I mean it stands to reason that whether it's the gallbladder or whether it's the kidney or whether it's the liver, the brain is always the first to be preserved. So you know the body will do everything it can to protect the brain, and basically at the detriment of everything else. But if you're not getting anything else to the other organs, then it stands to reason that sure you can have issues there. Because if you're not feeding the body, the gallbladder isn't being used, it's not secreting the bile acids to help with digestion, because there's nothing to digest. So yes, I think that's possible, for sure.

Sandy Kruse: 32:48

Now, another thing that I know a lot of people have heard about, and I'm sure you're going to know. The answer to this is that, oh, just take this Ackermansia probiotic and it's just like a GLP-1. What are your thoughts on that one?

Dr. Cory Rice: 33:06

Yeah. So this is a great question. So, to your listeners, acromantia is a microorganism that essentially to keep it basic it helps to just feed and create and restore the biofilm. So, just as you may know, the intestinal wall is surrounded by this mucosal layer. It's this sort of slimy layer. Well, that slimy layer is what houses all of what's called the commensal bacteria. It's all the bacteria that supports the immune system and fights off everything from cancer to COVID, to viruses, to funguses. What have you?

Dr. Cory Rice: 33:40

Ackermansia, historically, has actually been very difficult to fix without your diet, without doing prebiotics and fiber and eating correctly, and all of that. There's particular companies now that have invested lots of money in the ingenuity into actually getting acromantia isolated so that you can supplement with acromantia to essentially facilitate the creation of the biofilm, so that your intestinal wall, ie your immune system, which is where about 70% to 80% of it resides, is now intact. So things like Hashimoto's or things like autoimmune disease or what have you start getting better. I mean, truly that's how that works is you're repairing the immune system. So acromantia is a great tool to use to seal the gut if there's problems. And you've objectified that the acromantia counts are low.

Dr. Cory Rice: 34:31

I think the biggest thing about acromantia and you're exactly right it's now being tied off into glucose response and GLP-1s, and I'll get to there. But what I want to tie off is acromantia is not an in perpetuity organism. You can't keep taking this forever. It is meant to cycle on, cycle off. So 90 days, tops maybe even less, is enough. If you keep taking acromancia, you're going to get overgrowth and that's going to lead toia definitely has a role in inducing the gut to make its own GLP-1. Therefore it does stand to reason that there could be some. There is adult literature that acromantia can help regulate with glucose utilization and the glycemic response, so I think it's something to it, but it still doesn't change the fact that you can't be on acromantia in perpetuity period.

Dr. Cory Rice: 35:28

So I hope that answers your question.

Sandy Kruse: 35:31

Yeah, yeah, you did, because it's also misleading. When you see it and if you're not in the industry you may not understand You'll be like, oh yeah, all I got to do is take some acromantia and it is like a GLP-1. So you've made it very clear, dr Rice, that it will help your body to make GLP-1s itself, but you cannot stay on it. I know I went on a little acromantia protocol last year. I only did two months of it, so you know, but and I haven't touched it since and I guess I guess it could be something that some might try. Here's another question, though I don't want to lose this one because it's if you know you're talking about stabilizing somebody's wellness before they're, you know, ready for a GLP-1, making sure that all things are in order with bioidentical hormones Is bioidentical. Are bioidentical hormones a piece of that puzzle that might actually help to stabilize even weight?

Sandy Kruse: 36:53

Even like let's just say I'm a menopausal woman. Who knows, maybe if I get on the right mix of hormones I'm not gonna. The weight will come off anyway, like what are your thoughts on that?

Dr. Cory Rice: 37:03

Exactly, exactly correct. So the term hormonal imbalance is real. It isn't woo-woo, it isn't conjecture. The women make three hormones. To keep it simple, as I keep saying testosterone, progesterone and estrogen.

Dr. Cory Rice: 37:20

If those are out of balance, your weight is out of balance. It's that simple. If one is too much, you gain too much weight. If one is too little, you can't lose weight. It's this sort of like.

Dr. Cory Rice: 37:29

You have to walk this balance and I guess the reality maybe it's unfortunate, maybe it's not this whole thing we're talking about is what I call idiosyncratic. It is very individual to the person. It is not a wide. What works for your friend or your sister or your mother or your audience doesn't always work for you. Everyone needs an individual, personalized assessment to determine what ratios they need and how much they need of what Same thing on the male side Very, very synonymous. And so, to your point, I would put this in the category of so hormones, eating appropriately, peptides, supplements, any of that stuff. If you don't optimize those things prior to trying a GLP-1, you will not get to the most efficient, effective and healthy response on a GLP-1 than someone who doesn't do those things. So since we're on the topic of hormones, people do not respond to a lot of things as favorably on the weight loss side if their hormones are not balanced appropriate.

Dr. Cory Rice: 38:30

You use the term bioidentical. That term is fine. I like the term isomolecular. It's essentially a molecule that is identical in your case to the ovarian hormones you've been producing, since your ovaries have been producing hormones, and the same idea on the male male side. So I'm just very simple. Why would I put something in my body or recommend for my patient's body something that is not identifiable from what I've been producing my entire natural life or what this patient has been producing? I don't think putting a synthetic hormone makes a lot of like sense just at the receptor level, because the receptor isn't understanding what you're trying to get it to receive. And so, yes, I am a fan of hormones that are indistinguishable, essentially, from what a human has been producing their entire natural life, since they've been producing hormones.

Dr. Cory Rice: 39:21

But balancing these hormones appropriately are critical if you're considering going on a GLP-1. So put that back on the checklist when your audience is looking for providers. I would say do you check my hormones Period, do you at least start with the labs, and then it leads to a conversation and you hit the nail on the head. That conversation may lead to other service lines and other modalities that dissuade you from ever even wanting a GLP-1. Like once, you get like the ability to lose weight and gain muscle, and you know this the more muscle you have, the better your metabolism. If you don't have much muscle, you don't have a great metabolism, so you need hormones to build muscle. So if you build muscle, you have better metabolism. Better metabolism, you lose weight. You lose weight. You may not need a GLP-1. I mean, it's all this sort of thing, right? So I hope that's what you're asking.

Sandy Kruse: 40:08

That's exactly what I was asking. So I haven't started testosterone yet or DHEA. Those levels have been pretty good and I started with progesterone and estrogen, but you know that's not to say things aren't going to change. And then I'm going to want to bring that in because I know testosterone can be very helpful for a lot of women to help the building of the muscles, so especially at my age. So you mentioned peptides Like what kind of peptides do you like in somebody who's midlife let's use a woman's body who's midlife, in menopause trying to lose a bit of weight, maintain muscle. How do peptides come into play here?

Dr. Cory Rice: 41:01

Yeah. So great question I would start off with I don't initiate peptides until hormones are assessed and balanced, because then, once you get those in the ranges where the literature supports them being so that you do get optimization on the symptom side of hormones, whatever's left over that isn't getting better, whether that's body composition, maybe it's sleep, maybe it's energy, maybe it's cognitive problems, I don't know. Hormones usually hit most of that, but there's still people that are going to be like okay, libido's better, sleeping better, I just can't lose this weight, I can't build this fat, I can't. That's where I feel like peptides, assuming everything equal, their diet's fine and all of that. That's where I feel like peptides can help. So, whether it's the body composition so there's different groups and classes of peptides which you and your audience may know and maybe they don't. But back to my same, before I go further with this, peptides are just groups of amino acids that are grouped together and essentially the way I think about it is these exist in our bodies naturally. These have been compounded in a way that delivers something a little more concentrated and more therapeutic therapeutic, so you can get there quicker than waiting for your body to produce it on its own timeline.

Dr. Cory Rice: 42:29

So, whether it's the body composition ones, there are ones that help with hair loss. Let's say that you have hormone postmenopausal hair loss or hormone-induced hair loss. There's wonderful peptides that you can use as foams, gels and injections to help fix that and kick that back into place. There's great peptides for cognition, cellular energy, which means body energy, cellular health and recovery and things like that. So the body composition ones help with recovery. There are great ones for sleep. So even if progesterone and estrogen and the combination of testosterone in a woman is not helping you sleep, there's great peptides to help you sleep.

Dr. Cory Rice: 43:12

And the great thing about peptides is, again, they're not pharmacologic agents in the sense of synthetic pharmaceuticals. They are tolerated very, very well. There's very little downside to doing them. I think the one thing I would caution about peptides, depending on the ones you use, is those are similar to acromantia. You cycle on some of them, you cycle off, because you will build up your receptors, will build up a tolerance, and the peptide won't work on you as it once did if you're not careful there. So you know, honestly, the devil's in the details. It depends on the type of what you're looking to do, but there's usually a peptide for most of these things on the enhancement, regenerative side of things.

Sandy Kruse: 44:02

So there's actually a lot of things to consider before you, you know, decide okay, I'm a candidate for a GLP-1. So I think yeah, I mean honestly, you know this a lot of times people just want the quick fix. But if you want a fix, you can't just not do the work, like you got to do the investigation and then you got to see what's out of balance and what is. You know what are the causative factors for it? Sometimes it just might be age, sometimes it might be genetics. Like there's many, so many avenues to look through. There really is, there really is to me. And then you know work with your practitioner to say, okay, let's tweak this a little bit, maybe this is what you need, let's do some tests. So it's just, you gotta everyone's individual and I love that you speak about that. But I know people who are on GLP-1s and they're going to say, okay, well, I'm scared to get off of them now because I'm going to gain the weight. So could you get into that with us a little bit?

Dr. Cory Rice: 45:31

Sure, and what I would tell you before I get to that is you are so correct. The best patients I see are the ones that know their bodies so well that, quite frankly, what they really pay me for is to be their pattern recognition specialist, because they know I see a lot of other patients and they really draw upon my expertise to help them in their constellation of presenting symptoms. That is not like every other females or every other males, and so I love people that are so in tune with their body that, because they make my job much easier than going on this wild goose hunt looking for things that I don't know that are there. I would say that my colleagues may not feel that way. Sometimes they may be scared of these people that come in and they're so I need this is what I feel on these days, and I'm like heck. No, you're your own doctor. I'm literally just here trying. You are the captain of your ship. I am just trying to steer it in a way that's going to get you to your health goals but, honestly, keep you off out of the medical machine. I mean, that's what I'm trying to do, and so you're just so right. I wanted to. I wanted to say that. So to the people that are nervous or scared about coming off of GOP ones, um, I would just tell you this they're not going anywhere. So if you just were nervous, understand, if you come off of it, I'm sure you could go back on it, um, if you had to, but at some point assuming you don't have a degenerative illness um, that I feel like maybe might be part of your treatment regimen on the long haul in microdosing.

Dr. Cory Rice: 47:09

Now, microdosing isn't a formalized, recognized term, but microdosing is below the dosing that has been approved by the FDA for diabetes and weight loss, and so a very, very small dose can help sweep the body. As I said, not lose weight, but sweep the body of that inflammation. So there is somewhat of an argument on that side to discuss it. But let's not talk about those people. These are just people straight on GLP-1s, had good success, are nervous to come off of them. What I would say is always strive to get on the lowest dose you possibly can. That give you the results, because eventually what you're going to find is you may not need to be on this like you think, because the body has a way of adapting. So if you go on a GLP-1 and you get up to one of the higher dosages and you lose the 30, 40, 50 pounds and then you back off to 2.5 or the 5, whatever it is, whatever compound we're talking about.

Dr. Cory Rice: 47:57

On the lower end of the dose, if you've removed, you've essentially had a surgical resection of all that fat. Hopefully You've essentially had a surgical resection of all that fat. Hopefully, if you've removed all of that fat, you've essentially had an organ resection, because fat is an endocrine organ, right, it's activating all sorts of inflammation and all sorts of badness you don't want. When you remove all that inflammation, you help clean off the receptor sites. So you're making your receptors not hide anymore. They're coming up and they're receptive now to receive anything Vitamin D, they're receptive to receive hormones and thyroid and when your receptors become receptive, you feel so much better.

Dr. Cory Rice: 48:32

When you feel so much better, you have more motivation. When you have more motivation, you exercise. Yeah, I didn't exercise in 15 years. Well, now you do because you care and you want to and you want to look like that person or you want to feel like that person. So you start doing things you didn't do before, because now your body has been completely transformed. So I feel like it's only natural that someone that adapts that lifestyle and when you adapt that lifestyle, typically you don't want to eat the inflammatory foods, right, foods that traditionally cause inflammation.

Dr. Cory Rice: 49:01

If you remove the inflammatory foods and you add nutrient-dense foods back in, it's creating a human that is now repleted so that you work and you feel great and you sleep and you have all these emotions and all these feelings, whereas before you lived a very numb life because you were so… you were so inflamed from the excess weight. And so when you fix this person, I like to remind people what they used to feel like like in the rears, like what do you remember? When you came to me? You had migraines every other day. Now you don't. You had eczema all over your body, now you don't.

Dr. Cory Rice: 49:39

So I don't feel like it's a difficult conversation if you can get people to adopt those. Now I'm talking about the way we do it. I get it. I'm the minority. The majority are not going to go through this like all that time with patients to explain what they should be doing and all that I mean.

Dr. Cory Rice: 49:54

A lot of times they don't do that, and so I would be nervous if I was the patient that wasn't being supervised or wasn't having their muscle looked at or wasn't having someone tell them how much protein to eat or what protein to eat, or, you know, asking about bowel function and asking about hydration and how much water are you getting?

Dr. Cory Rice: 50:10

Not just fluid, but actual water, like these are things that are just basic to a weight loss program that if someone's not following it, I would agree they should be a little nervous in coming off of that compound. So what I've had patients do they start on one clinic, they're on a GLP-1, they'll switch to us because they've just heard, I guess, that we do a little more monitoring or any monitoring, and they want to be a part of that. So I would say stay on the GLP-1,. Try to find a clinic that knows how to design the program in a way that gets you off of it, in a way where you don't gain the weight back I mean that's really the idea in a way where you don't gain the weight back. I mean that's really the idea.

Sandy Kruse: 50:45

I like it. Here's a question. You mentioned receptor sites. We talked about producing our own GLP-1. If you're on a GLP-1 for a very long time, you said that those receptor sites, if you lose the weight they actually wake up, so they don't weaken as a result of being.

Dr. Cory Rice: 51:08

Yeah, if you're eating protein, yeah.

Sandy Kruse: 51:10

Oh, okay, if you're eating protein.

Dr. Cory Rice: 51:13

If you're malnourished? If you're malnourished, those receptors hate you. They hate you. That's why you lose hair and you can't sleep and you're anxious and panicky and, you know, depressed because they hate you. But if you're retaining muscle, eating enough protein, drinking enough fluid, having regular bowel movements, your receptors are going to be like it's like fertilizing your lawn. I mean, they're going to love you and now you can give whatever you can get, like now when you give vitamin D, it actually will absorb her. Now, when you put her on estrogen or testosterone, oh my God, now I feel it. It's because before you were so blunted, everything was so blunted because of the inflammation in your body.

Sandy Kruse: 51:54

Okay, and then if you are on a GLP-1 for a really long time, it also doesn't affect your own production of GLP-1s once you get off of it.

Dr. Cory Rice: 52:07

Shouldn't Nope? Assuming back to the same kind of pillar of what I mentioned earlier of gut function If you go into a GLP-1 with poor gut function, you more than likely are going to come out with poor gut function to some degree. You may not be producing GLP-1 as efficiently as you would like, but assuming all things equal regular bowel movements, no bloating, you know, no reflux prior to initiation of GLP-1, if you start the GLP-1 and you come off of the GLP-1, if you have great gut function, then you should be able to produce GLP-1. There's no reason you shouldn't just because you were on an injectable or an exogenous form of it yeah, because you know, like you know I'm.

Sandy Kruse: 52:49

I'm asking just because you know how, if met, if a man starts testosterone midlife, you know eventually he's the. The pituitary will no longer. What is it? It won't signal to the testes to make testosterone, so you kind of have to stay on it.

Dr. Cory Rice: 53:09

Isn't that right? No, that depends on the form of testosterone. There are forms out there, synthetic forms, that will basically necessitate that you stay on it to some degree. And I'm only telling you this because I have men of fertility age that tell me they don't want to have children. And then they meet Ms Wright later in life and realize, ok, I guess I do want kids, and we have to figure out how to induce spermatogenesis.

Dr. Cory Rice: 53:38

Spermatogenesis is testosterone making sperm. Testosterone makes sperm, but that's his testosterone, not the testosterone he's been injecting or taking in his body. So there's ways to get him back to doing that. And there are forms of testosterone on the market that when you give them tea, their levels will come back to their pre-treatment levels, like virtually every single time if they come off of the testosterone. There's other forms out there that if you keep giving it oh my God, if they start off at 300, they're never going to get back to that. If you stop the therapy it comes back to 100 or 150 or way low, and so I mean I can tell you what those are, but ultimately it isn't like a permanent.

Dr. Cory Rice: 54:25

It is possible that TRT can induce permanent infertility, but if you know what you're doing. There are ways to actually repair that. Assuming your pre-treatment sperm counts were intact, right, if you weren't making them prior to TRT. We can't make you make them by giving you testosterone. But assuming all things equal, things were okay prior to initiation, absolutely, you don't have to stay on it lifelong. Now most men do because they like the benefits of it, but there are certain modalities and ways of administering it that are just not, as they're not as permanent as some of the other ones.

Sandy Kruse: 55:01

This is really insightful. Now I have to get into the micro dosing of GLP-1s for inflammation, because I have read that some will take it if they have heart issues. Is that right, dr Rice?

Dr. Cory Rice: 55:23

So lots of things, yeah, so microdosing. First off, there's no established protocol for what that actually means. There's the formal dosing schedule relative to diabetes and weight loss. That's very, very formal. Anything below the lowest dose of the formal recommended lowest dose of whatever compound we're discussing that's considered microdosing. It has to be compounded, so you use a compounding pharmacy but you essentially use it.

Dr. Cory Rice: 55:55

I'll give you an example. If you have someone who is thin, great muscle, they don't have any. Their insulin is like three, they don't have any excess insulin. They don't have any excess adipose, basically very little fat on their body, but they have dementia or they have one of these degenerative problems, I will use a lower microdose than someone who has excess insulin, needs to lose weight but also has a degenerative illness like dementia or something like that. So microdosing is really a very individualized way of fixing an inflammatory response that's leading to some endpoint diagnosis like degenerative neurologic illnesses and things like this. So I can't tell you there's a standard dose or a protocol or anything like that. It's just lower than the lowest dose on the weight loss schedule and it really comes down to do you want this person to not lose weight? Do you want them to lose weight, in combination with the inflammatory reduction mechanism of action that it does.

Sandy Kruse: 57:09

Yeah, I find it really fascinating that more and more research is coming out about that. Do you know who Dr Tina is?

Sandy Kruse: 57:17

Dr, it's Tina T-Y-N-A. Dr Tina, dr Tina, she was the first one I heard talk about using a microdose, a GLP-1. This was like a while ago, about a year and a half ago, and she noticed that in menopause, despite the fact that she works out, she takes bioidentical or what did you call it? Again, you said so molecular, yes, um, and she does all the right things, but she noticed that it's like her body's still like. I do think that, as a woman, we go through an inflammatory process, despite all the work we might be doing. No, question.

Sandy Kruse: 58:09

Things are not working. The same doctor.

Dr. Cory Rice: 58:10

Yeah, not a question, women have a very hard fight. Men, the way it is, it's just men are more machine-like in being able to take on toxins, pollution and what have you, and get rid of it. Women store things. They store things. You touch it, you drink it, you breathe it, you eat it. It is on you, in you, and sometimes it takes a while to get it out of you, unless you are doing well. There's a lot you can do to get it out of you, but that's a whole nother discussion.

Sandy Kruse: 58:44

But yeah, women, you need to be a little sensitive, if you're not a woman, to what they're going through, our bodies and our uniqueness, in order to have a good practitioner to work with to help us navigate some of the things Like for me, for example, not having a thyroid gland and understanding that these hormones don't work in isolation, and so if my estrogen drops, it's going to affect my medications for my thyroid and the whole thing can be complicated. If my estrogen drops, it's going to affect my medications for my thyroid, and you know the whole thing can be complicated, and so I just want to mention that. So I love that you talk about GLP-1s for people in a very bio-individual way. So one last question, because we certainly covered a lot in this hour, but have you ever worked with a patient where it is strictly for inflammation and that's it?

Dr. Cory Rice: 1:00:01

100%. I see that on the weekly, I feel like sometimes on the daily. So when people establish with us, the very the most important thing is not what their lab show or their gut microbiome. It's what they want, period. And what a lot of people will tell me is I feel inflamed. Now that may mean their sex drive's gone or they don't sleep, but they're focused on. My body feels like it's inflamed. I'm swollen. I just don't feel healthy. Help me feel healthy again. Great, once we know that we start to go to work and we start to look at all the data and we start to just analyze the data, we do a data reveal party and we ultimately start fixing that. I mean that's it so. So, yeah, yeah, that's that's. That's pretty critical.

Sandy Kruse: 1:00:54

I love that. Do you? Do you only work with American patients?

Dr. Cory Rice: 1:00:59

You know I work with patients almost in every state. I have a Texas license and I don't know, honestly, don't know how that works internationally, because I have patients that are in the states and then they go live somewhere overseas or wherever, but they're still my patient because they established with me in my state lines. So I can only speak for Texas and Texas really requires that at least one time you're within the borders of where I'm licensed to practice. You can even just I've had this happen. I've had doctors from California who are my patients will go to the border, fly and then fly home. They don't come all the way to Dallas and see me in person. So I can do Zoom with patients as long as they're somewhere in Texas.

Dr. Cory Rice: 1:01:45

Once, everything. After that we can do virtual Everything Unless this is why I do such a comprehensive initial visit If you get a new symptom that you didn't talk to me about on the first visit, technically by law you have to fly to the state, to my state border, and tell me okay, now I have headaches, can you help me? It's silly but it's true. But at least in Texas that's the rules.

Sandy Kruse: 1:02:17

Okay, that's good to know. I mean because I'm sure a lot of people are going to listen to this and want to know how they can see you or your team. Well, you're very sweet and I they can see you or your team.

Dr. Cory Rice: 1:02:26

So Well, you're very sweet and I mean this sincerely when I say this. This is not about me. I would love to see my providers, we would love to help anybody in your audience, but one of my biggest callings in the world is to train my colleagues. So I do so much teaching Sandy that it just that's like my passion, because I learned long ago. It is not about my abilities in front of a human, it is my abilities in front of my colleagues to change the way they look at pathologic disease and how can they fix it, how do they put the genie back in the bottle without having a patient leave on 10 prescription pills. And I absolutely love doing that and I'm so blessed to be able to do it. But, that said, I still love practicing medicine because what makes me really good at one makes me really good at the other when you're training your providers or teaching your colleagues. If you're not doing this in the trenches, you lose the legitimacy of the experience. So, but yes, we would be happy to help anybody.

Sandy Kruse: 1:03:26

Can I send my husband to Dallas? I'm just kidding. I'm just kidding. Yes, yeah, sure I mean he doesn't listen to my podcast, so don't tell him. I said that Somebody might tell him. He knows I always slam him all the time. You know he doesn't listen to me.

Dr. Cory Rice: 1:03:41

But he might listen to you. Selective hearing. All spouses have it. You can't judge it.

Sandy Kruse: 1:03:47

Exactly All right. So what is your website? Where can people find out more?

Dr. Cory Rice: 1:03:52

Yeah, so website is mymodernmedicinecom, so mymodernmedicinecom, that's it.

Sandy Kruse: 1:04:00

Okay, that's perfect. Thank you so much. Really is such a blessing for you to share your wisdom with us on GLP-1s. We got through a lot and I will have a transcription for anybody who wants to see the transcription, and everything else will be in the show notes. Thank you so much, dr Rice. Thank you, sandy.

Dr. Cory Rice: 1:04:21

Very, very much. I really enjoyed this Me too. Thank you, sandy, very, very much. I really enjoyed this Me too.

Sandy Kruse: 1:04:27

I hope you enjoyed this episode. Be sure to share it with someone you know might benefit, and always remember when you rate, review, subscribe, you help to support my content and help me to keep going and bringing these conversations to you each and every week. Join me next week for a new topic, new guest, new exciting conversations to help you live your best life.