Episode 13: Beware of Biases, Myths, and Pseudoscience Within Women’s Healthcare with Dr. Jen Gunter

Michelle MacDonald: Welcome to The Wonder Women Podcast, where we discuss a variety of subjects all pertaining to optimizing your physique, building strength, developing a strong mindset, and tools to help you win at life.

I'm Michelle MacDonald and I'm the founder of The Wonder Women Coaching Team. We are a community of results-driven coaches and clients who believe that we can age like never before.

Welcome to The Wonder Women Podcast. I am your host, as always, Michelle MacDonald. Today, I would like to introduce to you a very special guest. I want you to meet Dr. Jen Gunter. She is the fearless OBGYN, pain medicine physician, author, and myth buster extraordinaire, and she's changing the way we talk about women's health.

I have to say, you're a fabulous writer. She's been described as funny, erudite, compassionate, and righteous, and I have to agree. She's the go-to source for everything we thought we knew about women's health, but we're too afraid to ask. With her best-selling books, The Vagina Bible, The Menopause Manifesto, and more recently, Blood, Dr. Gunter has taken the world by storm debunking myths and spreading evidence-based information about women's health that everyone needs to hear.

She's known for her candid and no-nonsense approach. She calls herself Canadian Spice, which I love. She tackles the tough topics from reproductive rights to sexual health and menopause, all with the goal of empowering women with knowledge. Her insights are a breath of fresh air in the often murky waters of medical misinformation.

Let's get started. Dr. Gunter, you've been a vocal critic of pseudoscience and misinformation in women's health. You are known as the lasso of truth, which I love because The Wonder Women. Throughout your career, you've dealt with some controversial topics head-on. Have there been moments or reactions that took you by surprise?

Dr. Jen Gunter: Oh, yeah, sometimes. It's never the things that you think though. You expect whatever, people have political agendas to get upset. But for example, when I have busted the myth about periods syncing, so some people think that if you put women together, their periods will sync up, that's not true, it's been disproven, I actually got quite a lot of hate for that. I was like, “Really? For that one? Who do you think I'm funded by? Like, big non-period syncing?”

But I think it's really because people have beliefs about their bodies and undoing a belief means you have to change the way you've been thinking and everything. Also, sometimes I think it just is a reaction. I don't really know for sure. But that's the one that actually surprised me the most.

Michelle MacDonald: I'm surprised about that. I gotta admit, I'm wrong here. I'm curious what the science says about that because I would have been the one that said, "Yeah, for sure, you sync." So tell me about that. I think what we want to have as a response is, "Oh, that's interesting, tell me more," instead of that knee-jerk emotional response.

We want to stay in our frontal lobes. We want to stay curious and ask questions. I'm asking that question, tell me about that myth.

Dr. Jen Gunter: Yeah, so the myth has probably been around because it's actually misogynistic at its core. It makes women like seasonal breeders as opposed to being in control of your own body. The ancients used to think that women were basically wild animals, and their uterus was like a wild animal inside a wild animal.

This idea that your cycle can be controlled by others is very like wild animal-esque. So that's probably where it comes from. It was tested, I believe, in the early '80s in a paper that supported it existed, but the methodology isn't something we would accept today. So there's that.

Michelle MacDonald: Poor science.

Dr. Jen Gunter: Yeah. Since then, people have attempted to reproduce those findings by several different methods and have not reproduced it. Now we have several different research groups saying it doesn't happen. In addition, the app Clue looked at a whole bunch of their data and they looked at people who lived in the same households who were both tracking and found that there was no correlation.

We have a lot of data, a lot of data that says no, and there's actually no possible way it could happen. There's no biological mechanism. I don't have a substance that I emit that can affect you. There isn't. I think people say, “Well, it's pheromones.”

Michelle MacDonald: I was going to say that's probably what we were saying.

Dr. Jen Gunter: Yeah. This is another thing that rocks people's world is that nobody has ever proven the existence of human pheromones. I know the perfume industry would like you to think otherwise, but they've never actually isolated a human pheromone and to detect pheromones, you have to have a vomeronasal organ and humans don't have a functioning vomeronasal organ.

Dogs do, they got a big one, but we don't. So there isn't a biology that it could happen. There's nothing outside influence like that that could affect the hormones and signal menstruation. So it's completely a myth. I want people to know more about their bodies. That's one of the harms of myths is that they actually make you less informed about your body.

Michelle MacDonald: Then there's the issue of biases. Because I'm sure there are cases, and I know this is happening to me personally, where it seems that, I mean, I'm menopausal now, but when I had a period, it would seem that I would get pulled in to, “Oh, I got my period a couple of days early,” and then my girlfriend would say, “Oh, well, it's my period, so that's why.” But that could be a bias.

I'm remembering this one instance because it's confirming my bias, but in fact, there are probably lots of other instances where I was visiting a friend, and nothing happened to my period and I didn't notice it because it's not fitting my bias.

Dr. Jen Gunter: Exactly. That's exactly what happens. Then it's just math. If you take two randomly occurring events and line them up, they'll at times match, and then they won't and they'll match and you just remember the times they match. We have a great scientific explanation for why you might have noticed that occurrence.

It didn't mean that you were noticing that you synced with your girlfriend three times in the last year was wrong. It's not because you synced. It's just because it was a mathematical occurrence.

Michelle MacDonald: There we go. We've just cleaned up one myth I've been squalled and I love that. I love it when I get to learn something. I feel I should be paying you something, but I won't because then that would influence your very strict policy, I think that you have.

You've got this circle of you're not going to capitalize from spreading, other than writing your books, and this is important for you guys to hear as well, I want to dive in a little bit more about how we can maybe cease for some red flags, but you don't sell supplements, you don't have a special diet out. You really stay away from that space.

I'm sure that you receive a lot of offers to sell some special shoes, a special postural brace, or a special menopause detector. Can we talk a little bit about that?

Dr. Jen Gunter: Yeah, so I have a very strict no-nothing-in-the-space advertising policy. If Tiffany's wants to call me, great, there are no health applications there. I have a shoe with John Fluevog, again, but it's not like a special menopause walking shoe. It's just a cute shoe. I'm open to clothes, that's about it.

Michelle MacDonald: [inaudible] the clothes everybody.

Dr. Jen Gunter: Yeah, clothes and jewelry, not even makeup because that could have skincare applications. The reason for that is we have excellent studies, excellent, excellent data to show us that people become biased when they work with industry.

Even buying a doctor a drug lunch can have an impact on their prescriptions. That's why pharmaceutical companies do it. With a physician in the United States, you can look them up on the Centers for Medicare and see if they've taken money from drug companies for consulting work or for speaking.

But you can't look up a supplement company. You can't look up someone who has a diet. You can't look up any other soft money. You can't look anything else up, and you can't look up someone who's not a doctor.

Unless they're actually saying that they have an ad, which a lot of people skirt around, I see people recommending price saying, "Oh, I love this product and I bought it myself," and you're like, "Really?" so you're using your precious real estate to talk about this one product that doesn't seem like it would be life-changing to you, but what else has that company done for you behind the scenes? I don't know.

Michelle MacDonald: Or they might have an affiliate link or an Amazon store.

Dr. Jen Gunter: Right, exactly. I'm not saying people are wrong for doing that. It's just a choice that I've made not to do it. Because when I first started in the health misinformation space, this was a long time ago, I said, “The only way to do this is to be ethical because it's so hard.”

When I first started in medicine, I thought, “Oh, I could do work for drug companies and I would still stay unbiased,” and you can't. It's pretty clear that you're not. So I follow the evidence and that's just what I do. Sometimes there are consequences like I couldn't get a third season of my podcast funded because the only people who wanted to fund it were supplement companies.

Michelle MacDonald: Wow, really? I wonder if you would do a fundraiser from followers. They would do it probably.

Dr. Jen Gunter: Yeah, I mean, the problem is it was such a highly produced podcast that the amount of money to raise would probably be quite a bit.

Michelle MacDonald: Oh, because it was with TED Talks, right?

Dr. Jen Gunter: It was with TED, yeah. It was very produced. We had a great production company and it was great. I loved it. It married the history of medicine with the actual science to put things in context. I mean, I think that it's a possibility. I'm not definitely discounting it down the road, but it's probably not on my plate for 2024.

Michelle MacDonald: Well, we can see what we can do, we can do about making sure that your account skyrockets because it's just refreshing to have somebody that really walks their talk and maintains their integrity in this space.

You're right, we are biased and we're influenced, especially by money. It's just so important that we have people like you that are in this space sharing a tremendous amount of information.

At the end of the show, I'm going to point people towards more places that they can follow you. I know you've got those three books out as well. They're fabulous books that I mentioned at the beginning.

We've got The Vagina Bible, The Menopause Manifesto, which is an awesome title, and then the newest one about menstruation, everything to do with menstruation, Blood, which is, I'm hearing great reviews about.

Dr. Jen Gunter: Yeah, yeah, it's out. It's out in the US, Canada, UK, Australia, and New Zealand. It was my answer to people saying, “Why does nobody teach us that?” I would get tagged on social media all the time about “Is this true? Is this true? Is this true?”

For me, it's easy to say, “Well no, because I know the science,” but people don't, they don't learn about their bodies in a practical way in school. They probably know more about frog biology when they graduate than about human biology.

I'm sure you can apply that to every field. I'm sure people graduate thinking bizarre things about their muscles and thinking bizarre things about their brains. But the fact of the matter is your brain doesn't bleed once a month and it's a bit of an intrusive body function. I just really wanted people to have this evidence-based resource so they would know.

They could say, “Okay, well, I know this now so I can advocate for myself in the doctor's office. I can block that person on Instagram because they're selling me a scam.”

Michelle MacDonald: Yeah. I think probably, I know I have several clients that are still, we coach everyone from the 20s all the way up to, I think my mother is literally my oldest client, she’d be 78 next month, so that's a lot. I think our youngest client is 20 right now, although we've had 18-year-olds before.

We get everything from the different birth controls and not being able to understand what's going on with their periods. A lot of my clients don't even know what exactly they're taking and what it does to their bodies. It was never really properly explained.

I have gals suddenly going off-birth control cold turkey after 20 years and not understanding that there could be a process for that to make it as pain-free and symptom-free as possible. A lot of PCOS and endometriosis. I have one gal that's just in her perimenopause or the menopause transition, I suppose I should be saying, who is thinking about getting a hysterectomy because she's looking at that as an answer to her sudden, really heavy, really painful bleed. It's a very important space to have open and free discussion about.

Dr. Jen Gunter: Yeah. I mean, there are a lot of treatments for heavy periods in the menopause transition. Certainly, hysterectomy is one of them. But people tend to do also very, very well with hormonal IUD, with hormonal birth control pills.

There's also a medication called tranexamic acid that you take just when you have periods, and that can reduce your bleeding. There's an endometrial ablation, which is burning out the lining of your uterus.

There are some pros and cons. It's one of those either loved it or hated it procedures, and then there's a hysterectomy. I always want to make sure people have the full gamut of options and know the risks and benefits and then they can make an evidence-based choice for them.

Because it's so fascinating in medicine, I can present those same choices to 10 different people and get 10 different, “Wow, I want that.” It's important that one, we try to guide people if you think something's going to be better for them.

For example, if somebody's 38, and they think an endometrial ablation is going to stop their periods, I'm like, “If their goal is to have no bleeding at all, that's unlikely. You'll probably still have some bleeding.” If they're 48 or 49, then that might be a more reasonable goal with that procedure. It just depends on the person, the procedure, and their goals.

Michelle MacDonald: I love that. Again, new book called Blood, and all of these issues, you go into in great detail in this book, correct?

Dr. Jen Gunter: Yeah. I talk about everything. I mean, obviously, the medications are a little bit more detailed because surgery counseling is a bit more one-on-one. Person A's risk with surgeries is different from person B's risk, but there's the general information in there.

Yeah, so people can have this informed choice and go into the doctor's office. When someone comes in and they know about all the different options and they're receptive to hearing about everything, the pros and cons, it's better for them because then they've been more likely to have an informed choice.

One of the analogies I give people is say you went to a restaurant and you only thought there was one meal on the menu, it was roast chicken. You had roast chicken, it was good, you liked it. Then you got home and you found out your friend went to the same restaurant and they were offered five different dinners and they got to choose their own dinner.

They actually had whatever, the rigatoni. They said, “Wow, that was the best rigatoni I've ever had my whole life,” and you're like, “What? I didn't even get offered the rigatoni.” So maybe you're still happy with the chicken, but maybe you would have preferred the rigatoni and you don't know unless you're given that choice.

That's my whole driving thing is you need to have all the information to make an informed choice. There are people who make decisions I wouldn't do all the time, and that's okay, as long as they're informed. That's fine.

Michelle MacDonald: That brings up such a great point, an informed choice, and that means understanding what a person's individual risk factors are because we're quite diverse. Knowing your family history, your own personal risk factors, your age, all of these things combined, knowing what your individual risk factors are, knowing what the options are, like what's on the table, knowing maybe how big of an issue, how much it's impacting your life, that's going to weigh in on your decision-making and also what do you hope what are your outcomes? What do you hope to have happen?

Then the risk factors for each choice. I mean, it's a lot, it's very, very nuanced. I think we probably get into, again, I'm going to use that term, murky waters when we're making emotional choices, when we're looking for that one pill or magic-bullet answer, when we're being influenced by people that we maybe trust, whether it's something a celebrity or an influencer, “Well, she's a doctor and she has a million followers,” or your girlfriends, the Facebook group you're part of where everyone's saying the same thing.

It can be really easy to not take the time to have a more nuanced approach to understanding what your individual risk factors are and what is the best option for you. Do you want to talk a little bit about that?

Dr. Jen Gunter: Yeah, actually, I want to talk a little bit about Facebook groups.

Michelle MacDonald: Uh-oh, we're going deep, girls.

Dr. Jen Gunter: This is obviously not about all Facebook groups, but I know of a couple in the women's health space where all dissenting voices are kicked out. Just be very careful that the spaces that you're in, in these groups that are curated by people, that they may not be as reflective of the general population.

People should be aware of that. I see a lot of misinformation from Facebook groups specifically. Sometimes there are even doctors that get involved in high levels and Facebook groups. Everything gets shunted their way and it's their thing.

I would just be very mindful of closed spaces like that where medical information is being disseminated because you don't know whose voice is being silenced in there. That's just something to be aware of.

I think this gets to a really important point on social media, is you need to fact-check every single thing that you're exposed to, or you need to make sure that the person you're following is somebody you don't feel you need to fact-check.

I don't speak outside of my area of expertise. I hope that people trust me as somebody that they can say, “Okay, well, Dr. Jen Gunter says that she always lists her references,” but that's not always the case. I don't have financial biases, but studies tell us that it's so easy for us to mistake things that aren't true as being true. It can seem true to us. It seems truthy. Why not? That makes sense.

Like period syncing. You heard it before, and you can think, “Oh, maybe there's a mechanism of pheromones.” You can see how easy it is to believe something that doesn't really have any malignancy for you believing that. I mean, yeah, it's got misogynistic connotations, but it's not going to hurt your health today to think that. So yeah, people just need to be really wary.

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All right, so then I want to ask another question. You're known for your very candid approach. I mean, you're very down to earth. You're very factual. I love it. It can be tough in the social media space and I think it must emotionally tug at you sometimes to see some of the emotional responses, championing accounts or myths that aren't true and maybe even harmful or spreading harmful information. What drives you to keep these conversations open and honest?

I subscribed to your Substack. I love it. I can't remember how much I pay, but it's not very much at all, and I recommend that people also subscribe to The Vajenda Substack. But in a world full of misinformation and heightened emotions, it's those emotions, what drives you to keep going and keep being that champion for truth?

Dr. Jen Gunter: Yeah, so I had a very awful medical experience many, many years ago when my kids were born. I was pregnant with triplets and I have twins. I went into labor at 22 and a half weeks and I delivered my first son who died. Then I managed to stay pregnant for three and a half weeks till I was 26 weeks when I got sepsis, a bloodstream infection, and had to have a C-section.

My sons were one pound 11 ounces and one pound 13 ounces. On top of that, my son Oliver has complex heart issues. He's had two heart procedures, actually having open heart surgery in a couple of months. My other son, Victor, was diagnosed with cerebral palsy. So I had to navigate all of that space.

They were in the ICU for several months. They were on oxygen at home for a year. I found that their medical care was excellent, but that there were all these communication gaps that were like, “I didn't know the answer to this and it wasn't really medicine.”

For example, when your kid can't eat and he's throwing up all the time, which happened with my son Victor, due to the way his esophagus was affected from his cerebral palsy, there was no answer. They were just like, “Well, eventually he'll eat,” so I found myself going down rabbit holes.

I ended up changing their formula because I was convinced that maybe that would make a difference and I put them on a soy-based formula, now I wish I hadn't done that, but there was nobody to guide me at that time.

Things like questions like they were both on oxygen and it said, “You can't go into a room with an open flame.” So I'm like, “Well, what do I do? How far do they have to be away when I'm cooking on the gas stove?” They have to be in the next room.

I found all these data voids, which is what happens to people. I fell in them. I saw how easy it was to go down rabbit holes. I would also see other parents, you get familiar with other parents that you all graduate through the NICU at the same time, you see them at follow-up appointments, and I'd see them not understand what the doctors are telling them, the doctor would just walk away and I'd say, “Oh, you need to ask this question next time, or you need to phrase it this way so you get the answer.”

You just realize that there were all these communication gaps, and then I started to think about that in reflection with my own practice. I actually decided to write a book on prematurity to try to help people, and so I did that. Then once my kids were a little bit older and they were doing better, I decided that I would turn my attention to women's health, and that's how I got into it.

I'm very empathetic to people who fall down the rabbit holes. It's not excusable when people haven't had things explained to them. I'm just doing my best to plug those gaps because I know what it's like to be three in the morning and stuck down a rabbit hole Googling something.

Michelle MacDonald: Brilliant. All right. Perfect.

Dr. Jen Gunter: I know it's a bit of a story.

Michelle MacDonald: No. It’s brilliant. I love it because this is important. I mean, you aren't in this for the fame and the fortune. Again, if we look at your social media account, it's not going up hundreds of thousands of followers, you're not trying to ride the algorithm. You're not doing any of those things. You're just Dr. Jen Gunter, lots of truth, gals asking questions to you.

Every now and again, you go in and debunk a myth and you write about it in The Vajenda. You're coming from a place of the real and raw experience. It happened to you. You understand and you work with real patients and you're in there dispensing medications and staying current.

You have colleagues, some of them who I've interviewed already. You guys converse, you're excited about the truth, all of these things are true, and yet for sure, and I know you understand what I mean, you'll have people that are so emotionally attached to their myths, even if the myths are harmful, maybe not for them because of their risk factor, but for other people. That to me is so perplexing, that attachment to the myths, especially when confronted with the science, the conclusive science.

I know you have those anecdotes. You had that one study in 1987 based on 12 people that said inconclusive and must be further studied but never was further studied. Then you've got the meta-analysis that says, "Hey, we looked at all the top research and the conclusion is this," and it's basically debunking that myth. Then people are so attached, especially when people are chasing pharmaceutical interventions, and then they'll say, "But you must be funded by pharma," which is very odd.

I'm sure you get a chuckle. You're chuckling. You're like, "Yeah, it is weird." Or that you behind the science, you're behind the times. Or that you're part of the patriarchy, which is another very odd argument that you're part of the patriarchy that's keeping the truth and the goods from women.

I'd love to hear your thoughts on that, and maybe if you could give some helpful tips for people how to recognize you're in that emotional space or have become a victim of that emotional space, and how to flip it.

Dr. Jen Gunter: Yeah. I'm very empathetic to that situation because most people don't believe inaccurate things about their bodies because they learned that in school with science. They believe it because some predator put that in their brain.

The analogy I always think about is religion. I'm an atheist, so again, I don't mean to offend anybody who's religious, but if I were to go to somebody who truly believed that a communion wafer turned into the body of Christ, and I said, “That's not true,” they would think I was an awful person because that's a belief that they have.

What happens with these medical myths or these false beliefs is they're exactly that, their beliefs and people are mistaking them for science. The problem is they weren't put in their head with science.

So getting them out with science is really hard versus if I see something and I'm like, “Huh, okay, I always thought this, let me go back. Let me look at the literature. Oh, my God, this is a new revelatory study that changes the whole way we think about everything on my board.” So the whole thing about science is you have to be open to change, the greater the claim, the greater the degree of evidence needs to be.

If we're going to completely change the way we think about whatever, Alzheimer's disease, we need pretty good evidence. I get that there can also be confusion because you know what, there are bad studies that are published. We've all heard about studies that are retracted, apparently something like 50 studies about turmeric are all suspect and are going to be pulled.

I don't know if they're going to be pulled, but there's this whole scam or concern about big turmeric, basically. So you have to stay open, always open to the science because we don't know. I mean, when I was a medical student, we thought that in the vagina, the only important bacteria was lactobacillus acidophilus, and that's because it's the only one we could grow, really.

Now we have molecular diagnostics and now we know that there are lots of bacteria in the vagina that's so adapted to that eco-niche, it can't grow in a lab, really. We need molecular technology to identify it. Now that somebody invented new technology, we now know that there are all different kinds of lactobacillus in the vagina, and lactobacillus acidophilus is not an important one.

If I stuck with my fixed false belief, I'd be like a lactobacillus acidophilus truther. I always tell people, “We don't know what cool technologies are going to be invented to tell us something new and completely radically different. That's the path of science. All you can do is the best that you have with the information you have at the time.”

These uncertainties get preyed upon by influencers and people making promises. If somebody wants to tell you they can cure you 100%, or they have the answer that they don't want you to know, they're tying into a conspiracy theory and they're making a false promise. I mean, I always have to be accurate with people and say, “There's no therapy that's going to 100% fix everything. There isn't.”

Michelle MacDonald: Zone therapies are like walkable, like it solves one thing and then something pops up and you go down that rabbit hole of bandaid after bandaid after bandaid.

Dr. Jen Gunter: I mean, sometimes we're doing the best that we can. Sometimes it's a chip shot, like we can take your appendix out. But sometimes it's about mitigation. Then also it can be difficult sometimes for people to do all the therapies.

I mean, I would say, “There's only really one magic therapy, if you want to think about it that way, and that's actually exercise.” Because for every health domain, it pretty much touches everything. But if somebody's sitting in your office with medical condition A, exercising tomorrow is not going to make them. It's not going to fix it. That's a long-term thing.

I think humans are really bad at that. We're bad at sort of, “Well, I'm going to make this change, and over months and months and months, I'm going to see something.” Also, that's just not appropriate. I'm like, “If you're sitting in the office with heavy bleeding, waiting for cycles might not be an option if you're on the verge of needing a blood transfusion.” Versus, “I'm just having some bleeding and my blood count hasn't really dropped yet.” You'll always have to weigh individual risks too.

Michelle MacDonald: I could just keep going down that one with you. I think you explained it really well. It also harkens back to what we were talking originally about biases. I don't know if that was off the recording that we were talking about biases or if it was during the recording. But when we have biases, we have a hard time unpacking what's true and what's not true.

I just want to underline, exactly what you said, if we can remain open-minded, stay curious, ask questions, and be okay with doing a little bit of research, sometimes it's just clicking a link and seeing, “Oh, gosh, that's a really old study,” and “Oh, gosh, that was only 12 people,” then you just skim to the bottom, the conclusion is there's more research.

You don't need to be a PhD to be able to pull from that. Oh, you can’t really extrapolate X from this study. Or you could also follow someone like yourself. This can be hard though, because if you're biased, and you're following and liking things, at least on Instagram, you're more likely to be shown accounts that are going to confirm that bias. That's just the way it goes. So you end up being in this silo of influencers and experts that can be confirming your bias. Then everyone's drinking the same emotional Kool-Aid.

Dr. Jen Gunter: Right, and that's why I'm very big on people curating their Instagram feed. Because not everybody deserves your eyeballs. If you see an account, a big account spreading absolutely verifiable, obviously false information, first of all, what other false information are they sharing? Probably a lot, because misinformation is like a wolf. They always travel in packs. It's never just like one thing, because most misinformation is tied in some way to a conspiracy theory.

Not all, but sometimes it's tied to a financial bias. Then, people should be very, very mindful of giving their attention to people in the medical space, doctors who also are profiting from products that are not tested like supplements or untested medicated face creams and things like that because then there's a bias there.

I mean, if you're personally profiting from a line of supplements, then why then would I not be suspicious that your dietary advice might lead me to need those supplements? I would be suspicious.

If I had a wall of birth control pills behind me and they were like “Dr. Jen Gunter's pills” and I worked for Pharma Company A, and I helped design this birth control pill, you would rightfully be suspicious of anything that I talked about in the contraceptive space or in managing heavy period space because you would think in the back of your mind, “Well, of course, you're going to recommend the pill over something else.”

Even if I'm not intentionally doing it, I'm probably subconsciously doing it, because maybe I make a dollar off of every pack of pills. With supplements, it's a lot of money. It's not a dollar pack. I mean, there was some doctor who came up with a liver shield supplement, which I had reviewed by a bunch of liver experts and they were like, “No, don't take this.” He advertises it basically for women to help them not suffer liver injury from binge drinking. So there's that.

They emailed a friend of mine to be an influencer for them. Basically, in 18 months, they said they're on track to be making seven figures, seven figures, 18 months. Now, I don't know if they're lying about that or not. But you know what I mean, there's a lot of money there, because you don't have any of the headaches of submitting to the FDA and following regulations, and not everybody has time to report these people to the FTC, the Federal Trade Commission, if they're doing soft ads. So how do you tell?

The way I tell people is, “Look, do you want to follow somebody who's selling a product? If you would follow Merck, then it would be fine. That's fine to follow whatever other supplement company, the person who has a supplement.” But if you wouldn't follow a pharmaceutical company, then you need to think of supplements as untested unregulated pharmaceuticals.

Michelle MacDonald: I got to ask, then I want it, but I don't want to get lost on this rabbit hole, but what about creatine? Because I definitely recommend creatine to my clients. It has a lot of research behind it.

Dr. Jen Gunter: Yeah, sure. That's the problem. For example, prenatal vitamins, that's a supplement that has excellent data behind it. I just think that if I was an obstetrician, I had my own brand of prenatal vitamins, that would be like, really? Okay, so how do you trust my advice on that? That's what I'm saying.

There are some supplements that have some specific indications, and that's what makes it really challenging because most of them don't, and they all benefit from that sort of transfer of goodwill, if you will.

I think that one of the issues, and I know this is also true, very true, in the bodybuilding sphere, is that many things are contaminated. So then you have to decide, how do you know that you're going to get something that isn't adulterated with a performance-enhancing substance? Or they recently did a review, and in one of these supplements, they found a product that's never been tested in humans.

Michelle MacDonald: Not surprised actually. My husband and I were at a Mr. Olympia and we had just heard about this successful multi-million dollar, and of course, this happens at big pharma as well, but a multi-million dollar successful lawsuit against a certain company, a big company.

We were thinking, “Oh, they're going to go down, right?” Then they were at the Olympia. The Olympia at that time, this was pre-COVID, was charging an astronomical amount of money to have a key space in the expo and we were a very small company that we were with a Canadian company.

We saw this company with like one of the biggest ad spaces. They had probably a hundred staff. They were giving away tons of stuff for free. The lineup was around the block. So no scandal had occurred. They had been spiking their basically selling fluff as protein, they'd spiked it. That's the world we live in.

Dr. Jen Gunter: Yeah, exactly. I mean, if you buy something for a libido, it could easily have a hormone in it. You want to try to find people who can recommend vetted products the best that you can. That's part of the challenge because yeah, there are some times when supplements can have a benefit, although they're much less than obviously the companies would tell you, but there absolutely are times when supplements can have very specific benefits.

But for example, with creatine, you can probably point to multiple studies that show this advantage for the specific group that's using it for this reason and then hopefully find companies that make vetted products.

There's third-party testing and things like that, but the problem is that we have the same issue like if you've had bariatric surgery, we recommend a multivitamin. How do you know if you're getting one that contains what it claims? The ones that I tell people to be the most about are the ones that are the multi-ingredient supplements.

Michelle MacDonald: The most concerned about.

Dr. Jen Gunter: Yeah, so the ones that say they're like for ovary support or metabolism booster.

Michelle MacDonald: Proprietary blends.

Dr. Jen Gunter: Exactly, oh, proprietary blends, absolutely stay away from that. I would say that the more ingredients in a product, the more skepticism you should have, but of course there are always exceptions. Multivitamins are sometimes needed for people.

You can see how people get, “How do they know?” Because I've just said one multi-ingredient product might be good, but another one could be bad. That's the problem when we don't have regulation.

Michelle MacDonald: We do have some things like consumer reports. I mean, there are various platforms. I guess you have to wonder if they're getting funded themselves. But could we sum things up distinctly for people that are listening to this piece and scratching their heads and going, “Well, my coach said I should be having caffeine before I do my cardio because it helps accelerate fatty acid metabolism.”

Dr. Jen Gunter: I'm not worried about big coffee spiking your drink. So I would just say that people should be able to give you data to back it up. In general, when something's been shown to be really effective, it almost always appears in some kind of guideline.

So you could say, “Oh, look at this in this guideline or that guideline. I don't know the exercise space as well so I can't comment about that.” Then consumer reports often reviews things as does consumer labs. It's hard so you have to find someone that you trust who can say that, “Yeah, caffeine can absolutely have a boost for people. Here are different ways that you can get it. These are products that I've looked at at ConsumerLab or that have been looked at to be independently verified.”

There's also the different labeling that people can see on the packaging to make sure that they're not, I mean, why take something that doesn't have a label if there's a product that it does?

Michelle MacDonald: Yeah, exactly. Certainly, third-party testing, there's also another label, gosh, I don't know, you might know of it for Olympic athletes. So athletes that want to take a protein powder, they have to be very, very, very, very careful, so there's a label for that. It's not just third-party, there's an actual and official stamp. I don't know if it's like WADA approved or something like that. I don't know if you know? No?

Dr. Jen Gunter: No, I don't know, but I know there's a specific sports one for some nutritional supplements as well. It's one thing in medicine. We don't want people to take a supplement because we don't want them to, for one thing, but also it could derail your whole career if you take something that's adulterated and you test positive for a banned substance. It's very much buyer beware. But yeah, those third-party labelings are the best that we have at the moment.

Michelle MacDonald: Then I think in terms of when you're on the social media space, when you see a lot of selling going on, and again, correct me if I'm wrong here, Jen, but if you see people selling a lot of stuff and selling stuff bad, everyone has their ideas about money and all that jazz, but if you couple that with saying something that's proprietary information like “I know something special that nobody else knows and I've cracked the code,” I've seen this a lot around the meno belly and the special diets or the special training that you need to do and that's what's concerning.

I think that's a very easy red flag. Again, it doesn't mean that they're totally wrong, but you should be definitely skeptical and really needing to see concrete evidence, like in very robust high-level research. You gotta be speculating that this one person has discovered something that all the other experts and all the organizing bodies, and I've heard from people the claim that for example, the Menopause Society International, North American, Australasians, that they are behind the times, that they're funded, or they're not current. They don't know what they're talking about.

But my doctor influencer who has a million followers, she has the good detail and she's here. She's my champion.

Dr. Jen Gunter: Right. Well, that's the power of an influencer, that they're able to make people believe that. If there was a stunning new study that should change how everybody should think in menopause, it would be in every magazine and every newspaper, it would be groundbreaking.

If there was a groundbreaking study, you would hear it. You'd be able to Google groundbreaking study. The idea that a single influencer knows more than all of the other menopause societies is just not true. They can't because when you look at the guidelines that are put together, they're trying to get 30 experts to agree on a paper means that there has to be a pretty high level of evidence for all of it.

People have to disclose their biases. Of course, the person with a million followers or whatever on Instagram, where are their financial disclosures? You have to submit your financial disclosures, have all that kind of stuff. If there was true drug company bias, there are people like me on these papers that don't take any money, so the idea that every single person is in the pocket of one drug company is simply just not true.

I would say that I would be very wary of people who say that they know more than the societies, especially when all the societies agree. If you've got the International Menopause Society, the Menopause Society, the British Menopause Society, and you've got the Australasian Menopause Society all basically saying the same thing, it might be some slight different variations, but all basically saying the same thing, and then you have somebody who says they know better, I feel like, “Okay, either you've interpreted the research completely differently, meaning you probably cherry picked what you like and have thrown away, or maybe you don't have the critical ability to evaluate the research, or maybe you don't care.” I don't know what the answer is.

But a single physician doesn't know more than all of these societies. But that's hard for people to know because who's going to actually go and pull up all the different things and look? That's the thing about an influencer. If somebody's got you to believe them, you believe them.

Michelle MacDonald: Yeah. Exactly. I think you went through that experience too when you were debunking the Goop. It was the vaginal egg. I mean, that's what I pulled from that. I'm sure you got a lot of heat from people that were just really attached to their idea of what the truth looks like.

Thanks for tuning in to episode one of a two-part series with Dr. Jen Gunter. She's provided us with a ton of great actionable information around healthcare for women, how to be alert on people's biases, and sharing her own experiences going down that rabbit hole, trying to find answers when the medical system failed her. I'll be sharing more from this conversation next week. We'll be diving deeper into menopause and some options that Dr. Gunter is really excited about. Thanks for tuning in.