142. Meet Samantha: Your Guide to Thriving In Menopause

The average woman with hot flashes and night sweats suffers for seven to ten years. But what if meaningful relief was possible in weeks — not years? In this episode of Cycle Wisdom, Dr. Monica Minjeur sits down with Radiant Clinic's new menopause specialist, Samantha, to talk about what actually changes when a woman finally gets the right menopause care — and why it is so much more than just getting rid of hot flashes.

Through Jenny's story — a 51-year-old who had been white-knuckling through four years of symptoms before finding real relief — you will hear what becomes possible when lifestyle support, targeted nutrition, and bioidentical hormone replacement therapy work together.

You will learn:

• Why hot flashes, brain fog, weight gain, and mood changes are not things you have to live with — and how quickly they can improve with the right approach
• What the evaluation and treatment process at Radiant Clinic actually looks like from a new patient's first visit
• Why vaginal estrogen may be one of the most life-changing — and life-saving — interventions available to menopausal women

If you have been suffering and wondering whether things can actually get better, this episode is your answer. Learn more or schedule a discovery call with Samantha at radiantclinic.com/menopause

Transcript

Monica 0:01

The average woman with hot flashes and night sweats suffers for seven to 10 years. Seven to 10 years. But what if I told you that with the right treatment, most women can see meaningful improvement in weeks to months, not years. Today I'm sitting down with our new menopause specialist, Samantha, and we're going to be talking all about what actually changes when a woman starts the right menopause care. And I promise you it is so much more than just getting rid of your hot flashes. I am Dr. Monica Minjeur, the host of Cycle Wisdom, where we help women restore hormonal balance and reclaim their wellbeing through personalized healthcare, grounded in clinical excellence. Now, before I bring Samantha on, I want to share a story about a patient that we will call Jenny. Now, Jenny was 51. She was post-menopausal and when she came to us she was having hot flashes eight to 10 times a day, night sweats soaked through her clothes, and she had not slept through the night. In years, she was gaining weight around her abdomen despite having a fairly clean diet, and her brain fog was so thick that she was struggling at work. She felt completely unlike herself, and she had been white knuckling through her symptoms for the past four years. Jenny thought this was just what menopause was. all about after working with our team, we focused specifically on lifestyle changes, nutritional support and bioidentical hormone replacement therapy, and within a couple of weeks her hot flash frequency dropped and she slept through the night for the first time. After the first month, her hot flashes were down to just one to two times per day, and her sleep was consistently better, and within three to four months, her brain fog was lifting, her weight was stabilizing. Vaginal symptoms of dryness had improved, and within six months, she felt like her herself again. Her energy was restored, her mood was stable, and she had back her mental clarity. She said, I didn't realize how much menopause was impacting every single part of my life until it finally started getting better. It wasn't just about the hot flashes, it was about everything. And that is what today is about, and that's exactly why I am so excited to introduce Samantha to you. Samantha, welcome to Cycle Wisdom. Can you start off just with telling us a little bit about your background? What brought you to this space and what really brought you to Radiant Clinic as a whole?

Samantha Nieland 2:36

Absolutely. I'm so glad to be on here. I feel like it makes me official, making my appearance on the podcast. yes, so I have been a nurse. January of 2021. I spent about four and a half years in a cardiac ICU step down unit. I did some additional time in outpatient surgery. So I did some recovery of women's health there. Also in that timeframe went back to school to get my master's in nursing and my family nurse practitioner. So while I was in school, I knew that women's health was obviously an area that I was interested in. I actually came to Dr. Minjeur's Clinic opening and I was like, hello, my name is Sam and I want to come work for you. And so got my foot in the door there and then when I was ready for my clinicals for women's health, I reached out to her and I started training with her. Then, so did a couple rotations with her, and then I also trained with Sarah Norris, who is also a menopause specialist and so did as much of my. Clinicals as I could in this space. Learning about all of the women's health things.

Monica 3:40

And we're so excited to have you here, and I think. Part of what sets you apart from many others who pursue nurse practitioner field is that really this focus and this drive to really help serve women in a way that makes a meaningful difference. So we're so excited to have you on board and excited for our patients to get to work with you. You know as we think about. A woman who has been suffering for years with menopause and oftentimes they think I just have to live with this. This is normal. My friends and sisters are going through this. What are some of the important things that you would want that individual to know first?

Samantha Nieland 4:13

You absolutely do not need to suffer through your menopause symptoms. The message definitely needs to get changed. There's people being told by their providers still that they should wait it out or suffer. I know people that I've seen that are like, it's been 14 years I've been having hot flashes, which is. Absolutely crazy. And unfortunately those providers are just not informed in the most updated research. And so just getting through it is not science supported. It's not an approach that we would want anybody to have to come across. Menopause is also not just about your symptoms, it's about quality of life. And I think that is something that many doctors. Don't understand is that it's not just because they have a couple hot flashes, like they're dealing with this all day and it affects every part of your life and there's so many things that you're gonna improve in your overall health as well to help you to live longer and feel better. So it's just about so much more.

Monica 5:03

And it, and it's interesting, we hear from women all the time when they finally get the treatment that makes the difference how this does impact every area of life. I had a patient recently told me, she said, you saved my marriage. And initially I thought that was very extreme. But she said, look, my irritability was terrible. My hot flashes were terrible. I. Was seriously considering that, maybe it was my husband, maybe it was all his fault. And once I got my hormones under better control it really was about just making sure that she was feeling better and was feeling her best self. And she said, good news. I'm staying with my husband. I still love him. We're in good shape. So it's, It seems extreme in some cases. And for some women it is, right? It is this whole life, whole body, whole quality of life approach. you know, when it comes to treatment I think a lot of people think, oh, it's just about getting put on hormone replacement therapy. At Radiant Clinic, we use a multifaceted approach when it comes to care. For all women's health conditions, but especially for menopausal care. So can you walk our listeners through what that would actually look like for a new patient? If they're coming in brand new, how do we do that evaluation? What would treatment look like and the different facets that we would approach.

Samantha Nieland 6:12

Hormone replacement therapy is just one part of it, but it is very important that you are able to make adjustments in other areas of your life. And so we wanna focus on lifestyle. So sleep hygiene is huge. Obviously if you're not able to sleep and you need hormone. replacement therapy to get you there. Obviously, that's a very big part of it, but you also need to have good hygiene related to your sleep managing stress. If we can get your hormones under better control, this is also easier. So they all connect, of course appropriate movement. Often women are told, oh, just exercise more and move more, and it's all gonna be better. Unfortunately, you're working against your hormones, so that is not true. and then the second area, nutritional and supplemental support. So addressing deficiencies, making sure that we're supporting you where we need to with. Supplements the necessary supplements, we're not overdoing it. We're not putting you on a hundred different supplements because you don't need them. We're just making sure you have the necessary supplement that you need. And then of course, the third area is the bioidentical hormone replacement. So we're using hormones that are to what your body should be producing that your body was producing before menopause. And they're. Dosed in a way that's very personalized to you and your symptoms. So all three of these things are working together to make hormone replacement therapy more effective, and then also making lifestyle changes more sustainable because you have the energy and the drive to continue to do those things.

Monica 7:31

And I just wanna highlight the piece you had mentioned as far as the bioidentical hormone replacement therapy. And I talked about this on last week's episode, how it is so important to distinguish the fact that bioidentical hormones have been found to be safe. And when we look at the long-term data from the Women's Health Initiative back. 20 plus years ago, at this point in time, they were not using bioidentical hormone replacement therapy. And so for many women that's what they heard is that hormones are bad. It's not the same hormones that we're using nowadays. And that really makes a big difference is making sure that they're bioidentical. Let's talk a little bit about. Some of the most common symptoms we see. Most commonly we hear women saying, I've got hot flashes, I've got night sweats. That's one of the most common things that brings women through our door. So what actually is happening in your body when you're having hot flashes or night sweats? And if we go through a treatment protocol, how quickly can women expect to see changes?

Samantha Nieland 8:26

your estrogen decreases as you go through menopause, the body is thermostat, which is in your brain. Your hypothalamus loses its calibration, so it's misreading your body temperature. So any minor change in your body temperature, your. Brain is saying this is an emergency and fires off as an emergency in your brain. You rapidly need to cool down so your blood vessels open up and you get this result of sudden flushing sweating, rapid heart rate, the hot flash. and so it's really just your body's lack of estrogen causing this big reaction in your body. Your body's always had temperature changes and your body's had a good calibration for it. It's just that as you go through menopause, it doesn't have that calibration system anymore with that lack of estrogen. So night sweats, same mechanism occurring during sleep. Most women see hot flashes actually start to improve within just two to four weeks after we start bioidentical hormone replacement therapy, which is. Really incredible. So huge improvement for people who've been dealing with those for so long and can't wear certain materials of clothes, and they have to sleep in certain settings, otherwise they're miserable. So again, just a really big shift in lifestyle there. Severity and duration of those hot flashes also decreases and the sleep improvement starts to cascade healing across all of your other symptoms. So if we can get you sleeping good by decreasing those hot flashes that's a really big deal.

Monica 9:44

Absolutely. And I can imagine if you're sleeping better at night, all the rest of it improves as well. And I think a lot of times women underestimate this. If you're somebody who is dealing with poor sleep, how does that have to do with the cascading of other menopause symptoms and does it make things worse or is it just fairly neutral?

Samantha Nieland 10:04

No, it definitely makes things worse. So when you don't get enough sleep, you're raising your cortisol, so your stress hormone increases, which worsens your hot flashes and increases your abdominal weight gain and disrupts your blood sugar and affects your mood obviously.'cause we all want to sleep better and sleep more. So it really does spiral everything out of control. And so not only is it impacting your health overall, but also. A little bit of your perception of yourself too, because now not only are you not sleeping good, but you've got this extra belly weight and your doctor's telling, you've got higher blood sugars and you should watch that and you need to exercise more and you feel horrible and angry. And so it's really just spiraling everything else out of control. Estrogen and progesterone both are super vital to your sleep structure. So these are both decreasing in menopause and so your quality of sleep is. Decreasing. So if we can support both of these numbers, your sleep is gonna get so much better. So that will help with your mood and your weight gain, and all of that

Monica 10:59

And I think really what we find across the board, whether it's menopausal health, whether it's. Couples dealing with infertility, whether it's the teenager who has irregular cycles, we always talk through how do we get more sleep? That just tends to be one of the cornerstones. It's one of the most challenging pieces to fix oftentimes. But when we look at the fact that a good majority of our hormones are produced overnight while we're sleeping, if we've got somebody who's not sleeping well, it's really crucial that we restore that and. People feel so much better when they can get adequate sleep at night. So it makes a huge difference. Let's shift gears just a little bit and talk about another common symptom we, hear about, which is brain fog. And brain fog or cognition concerns are sometimes one of the most scary things that women experience during menopause. And certainly we have oftentimes women who are very high performers in high demand jobs. And they come in and they say, I'm having brain lapses. Or I get up to give a presentation and I don't remember the words that I'm supposed to say. What's going on there? Is that menopause? Is that stress? And is this something that can actually improve?

Samantha Nieland 12:04

The whole body from the top of your head to the bottom of your toes, it's full of estrogen receptors. So the brain itself is rich with estrogen receptors. Essentially the areas especially needed for memory and focus decision making. As that estrogen declines, you feel the effects of it. So the neurotransmitters, the blood flow to your brain, the memory consolidation, the brain fog is actually real. As you're seeing that decrease in estrogen, it's not just imaginary. It's not that you're just losing your mind and you can't find a word. It's actually due to that decrease in estrogen. Most women see pretty significant improvement in that mental clarity within six to 12 weeks of starting on good hormone replacement therapy. So better sleep also improves cognition, of course. So the two of these are linked together, but can see improvements within a couple months.

Monica 12:56

And certainly for these people who are high functioning individuals, this can make a big difference. And oftentimes we say we wanna fix things as quickly as possible, but we also. Want it to be sustainable. speaking of things that can take a while to fix weight gain is another thing that's a huge frustration for many women. They feel like I'm doing everything right. I'm exercising five days a week. I am eating, cardboard and sticks and like my body is not responding. So what's going on with metabolism and weight gain during this timeframe? And how do we focus on treatment beyond just the hormone replacement?

Samantha Nieland 13:30

We need to stopping telling women that they're, eating incorrectly and not exercising enough because. It's so frustrating. Your husband can stop drinking, pop and lose 20 pounds, but you're going through menopause and you don't have that ability. So it's a very frustrating world for women because that's what they keep being told. So it's not a willpower issue, it is not laziness. It's your hormones and as your estrogen decreases, you would redistribute your fat so it moves to your belly. As most women notice, that is the big complaint that we hear is that they're seeing it move to their belly. Progesterone can also contribute to feeling more bloated and holding onto more fluid as well. disruption amps all of this up. Menopause dries up your cortisol and so you get more belly fat and insulin resistance. rises and thyroid function can be altered and dietary changes. So there's so many things working against you here. It's really not just willpower. gotta come at this from many different directions. So hormone replacement therapy, some strength training to help to decrease that insulin resistance from more of a exercise standpoint. Tracking your macros, but more from the standpoint of being aware of them. So we wanna make sure you're hitting the right amount of carbs and protein, but we're not limiting necessarily. Just being aware and then making adjustments from there poor sleep drives up cortisol, which promotes fat. Storage and disrupts hunger hormones as well. That's another thing that we hear a lot from menopausal women is they're like, I'm hungry all the time. And so that can be caused by that cortisol increase. So hormone replacement therapy in combination with nutritional support and appropriate movement. Not overdoing it, but also figuring out how to stabilize that weight gain. It is usually seeing improvement within about two to three months.

Monica 15:11

And I know one of the things that you've always been really passionate about, even during the time you were doing your training with me is talking about metabolism, insulin resistance. What are some of the things that you see that women do wrong when it comes to trying to lose weight, specifically with insulin resistance?

Samantha Nieland 15:29

A lot of intermittent fasting, which I don't love intermittent fasting. And for some women that's actually not beneficial for them, but a lot of people are told that intermittent fasting is the answer for them. So that's one thing that we say that's maybe not beneficial for them, but actually harmful.

Monica 15:43

One of the other things that we talk a lot about is many women, if even if they're not completely fasting, they're trying to cut out carbs. Completely or minimize carbs. And I think a lot of times women are told carbs are evil. Carbs are the thing that are making you fat. So just stop the carbs. And especially for women that are dealing with insulin resistance, that actually can backfire. Certainly there are cases that we talk about that intermittent fasting is good for certain aspects of health, but from a hormone standpoint and for menopausal women, especially if there's insulin resistance, almost never is it the answer to eat less, cut out more carbs, Not eat at all. And I think that's oftentimes where, it definitely is not a one size fits all approach. And that's where it becomes really important when we do our evaluation to discern, are you somebody who's dealing with insulin resistance? And, being able to understand that piece of it is going to help you be able to figure out from a medical standpoint. What is the appropriate dietary intake that works best for me? And I think that's something for our listeners, that's something that Samantha's really passionate about and she's been really good with helping people to understand it's not just about eat less, move more. That is old news. That is not typically what we find works when it comes from a hormone standpoint.

Samantha Nieland 16:54

Yeah. And a lot of people are told to do the keto diet. I actually just had somebody tell me the other day in menopause that they were told to do the keto diet and We're told it would help their insulin resistance. So it is very interesting that people don't understand that it actually, not eating enough carbs causes your body to produce more sugar. So it's a backward cycle for sure.

Monica 17:13

Absolutely. Let's talk a little bit about emotions during this time. As I had mentioned in the intro, our patient that said, Hey, you saved my marriage, she just felt irritable, anxious, unlike themselves. And many women in menopause just feel like they are a shell of themselves or they explain this Timeframe where they're like looking at themselves from the outside and they're like, that's not me. What is going on? So is this hormonal? Does it resolve? Can emotional imbalance be a part of this process and does it resolve?

Samantha Nieland 17:44

Yes, definitely hormonal estrogen affects how you produce your serotonin, dopamine, gaba, production, all of that So those neurochemicals in your brain that control your emotions and your mood. Irritability, anxiety, low mood. Reactivity, all of that is related to that decline in estrogen. So most women would see that stabilizes within about four to eight weeks of appropriate hormone replacement therapy. So combining that with improved sleep once again and stress management, often that's getting a lot better within a couple months as well.

Monica 18:18

I am hearing sleep come up a lot. This seems like a common theme, right? But again, to your point, if we can improve the symptoms that are pre. Preventing you from sleeping well. Oftentimes that does improve things, and I think women really underestimate the importance of sleep when it comes to how do we heal your body for the long run.

Samantha Nieland 18:34

Yeah.

Monica 18:35

Let's talk about sexual health, genito- urinary symptoms. Leaking urine pain with intercourse. These are things that oftentimes women are too embarrassed to bring up, but definitely things that we talk about in our practice all the time. And so what are some of the most important things that you want women to know about how menopause impacts intimacy, urinary health, urinary tract infections? What do we need to be making sure we're paying attention to in regards to those aspects of menopausal care?

Samantha Nieland 19:04

First of all, more women need to know about this because unfortunately, there's a lot of people out there that are dealing with urgency or frequency, recurrent UTIs just dryness in general. And these are all things that are helped so significantly with the most. Easy intervention of vaginal estrogen. And so it's a little bit frustrating to hear people that are continuing to suffer with these things. So please don't suffer in silence. Estrogen is what keeps all of that tissue elastic and lubricated and thick all over your body, but in that area as well. So when it decreases, your tissue gets thin and it gets more dry. And as that. Tissue thins and gets more dry. You're at higher risk for infections and more pain with intercourse, reduced sensation. All we have to do is a little local vaginal estrogen, so it's highly effective. People who can't have systemic, therapy can have that vaginal estrogen, and so it can just work to strengthen the urethra, help with that urgency and frequency, and then also just bring blood flow to that area and help with lubrication and more comfort. In general and with any intercourse. FDA finally removed the black box warning from vaginal estrogen. So it is very safe. Within about three to six months. Sexual function usually does get better. It does take a little bit longer than some of the other symptoms that we're treating. Libido also tends to return as overall energy and mood and sleep improves. That also takes a little bit of time, but. deserve to, have intimacy be comfortable and enjoyable. That is, once again, another quality of life issue that people should be aware of is fixable and very treatable. Urinary incontinence, I also feel is a very big deal because that is the number one thing that can put people in nursing homes. So I'm like, why are we not talking about this? you don't need to pee every time you sneeze. If we can give you a little vaginal estrogen and that can improve,

Monica 20:55

absolutely.

Samantha Nieland 20:56

everybody should be on it and take it to your grave.

Monica 20:58

Yeah, absolutely. And one of the interesting pieces that we talked about on last week's episode was the number of women that get a urinary tract infection in menopause. 10% of women who are menopausal per year will get a bladder infection, and that seems like a low number. But the other statistic that goes along with that is that once you've had a urinary tract infection in menopause. 55% of women will continue to have recurrent infections. And when we can intervene with that vaginal estrogen, we can significantly decrease the risk of those urinary tract infections, which is still in the top things that are devastatingly deadly to women. They can get sepsis, they can die from a bladder infection. And so if we talk about how do we improve not only the quality of life, but the actual length of your life, by treating and preventing urinary tract infections, we can literally save lives. With vaginal estrogen. Let's talk about the big picture. Let's back up a second here, and as we go beyond just the specific menopausal symptoms, what are the other things that we need to pay attention to when it comes to bone health? Heart health, brain protection. I know you had talked about estrogen impacting all of the cells of our body, but what are the other highlights that we need to make sure we're paying attention to when it comes to some of these other systemic issues that we may not notice? Immediate symptoms of.

Samantha Nieland 22:17

This kind of ties straight back into what we were just talking about lengthening our life, right? So estrogen is very protective to our bones. So broken bones kill people believe it or not. So that is significant if you are losing bone density. Over the first five to 10 years after you start menopause, you're at risk of osteoporosis. And one in three women over the age of 70 will have a fractured bone. So if we can prevent that osteoporosis from the beginning and slow that bone loss with hormone replacement therapy, that's huge. For your heart, women's cardiovascular risk increases after menopause. So hormone replacement therapy has been shown to be cardioprotective for women. Not only that, but it also decreases your risk of diabetes. So decreasing that insulin resistance with early intervention of hormone replacement therapy as well. brain like we talked about earlier, lots of estrogen receptors in your brain, so getting hormone replacement therapy can reduce your risk of dementia and cognitive decline. Treating menopause is preventative medicine, like as a family medicine degree. I think that everybody, should be treating menopause because first of all, half of your population is women, and second of all, it's preventative medicine. So it is about quality and quantity of life.

Monica 23:34

All right, so as we look at all of these things, this sounds great, right? I'm somebody in menopause. I wanna prevent all of these things. I wanna treat all of these things we just talked about. But we know that some women should not pursue hormone replacement therapy, although many women are a good candidate for some type of hormone replacement therapy. So who would be a good candidate for hormone replacement therapy for some sort of intervention, or even just for initial evaluation to see, do I qualify for something?

Samantha Nieland 24:01

Absolutely most women are good candidates. The ideal candidate that I would say is someone who's within that five to 10 year of their last period. So symptomatic, motivated to engage and the key things that we would look for contraindications are gonna be. you've had hormone sensitive cancer, especially breast cancer, you have unexplained vaginal bleeding even though you have gone through menopause and you shouldn't be having bleeding history of blood clots, though there is lots of research coming out about doing transdermal estrogen, having little to no increased clot risk. But that is something that we would wanna talk about. then back to the five to 10 years let's say you're a person that's 12 years out from. through menopause, it does not mean it's a hard stop. It would just be a conversation between the two of us and seeing if you are still a good fit for that. Every evaluation with a woman going through or has gone through menopause is gonna be individualized so we can do a risk benefit analysis. I've had people come in and they're like, I can't do hormone replacement therapy, but I wanna gain information for Younger generations, that's great, but there actually is things that we can still do for you. Vaginal estrogen is obviously one of those. There's no risk with vaginal estrogen, so you can absolutely be on that. And then also at Radiant, we're looking at your thyroid and your blood sugar and insulin and we're looking at more than just your hormones. And so there's still things that we can look at for you.

Monica 25:25

And I think. This is one of those pieces that really sets our care apart is that when it comes to diagnosis, when it comes to treatment, nobody has a one size fits all approach. And so we really focus on that individualized, personalized approach for you. And we say even when it comes to fertility or PCOS care, I don't have. Single patient who is on the exact same therapy across the board. And that same rule applies for menopause is nobody's situation is the exact same. Nobody's lab results are the exact same or their life circumstances. And so we really focus on that individualized therapy and treatment based on not only what your body needs, but also your preferences. Certainly some women come in and they say, I don't wanna be on any hormone replacement therapy, but I would like some additional information on lifestyle changes or supplements or how I could put certain foods into my world that could potentially help. And so I think that becomes really important as we navigate what treatment looks like. And, certainly many women are oftentimes surprised after they start treatment. What do you hear from women as far as. Things that are surprising to them or things that they maybe didn't think would be able to improve and now have seen some change.

Samantha Nieland 26:34

I didn't realize how bad I felt until I started this. I think that's always the thing that most women are the most surprised about is I knew I felt bad, but like now I'm like, wow, I really was not feeling well. And so that's a big one. And then the other one that always gets me is I had no idea that my knee was related to menopause. And you start menopause replacement therapy and you help to cure their joint pain because everything's lubricated by estrogen. So those are always funny ones that we hear.

Monica 26:58

Yes, absolutely. And I think it's one of those, like sometimes you come in with a laundry list and you're like, oh, this couldn't possibly be, but then they go, oh actually this was better.

Samantha Nieland 27:06

Yes.

Monica 27:07

all final question today before we wrap up. So what is one thing that you want every woman listening today to take away from this conversation?

Samantha Nieland 27:15

It is so hard to pick just one thing. I would say science has evolved significantly. So what you heard about hormone replacement therapy 20 years ago is not accurate today. So don't listen to bad research that was done 20 plus years ago on hormone replacement therapy that was using artificial hormones. and this. Today we have so much better research and there's so many things that we can do to support you now. So don't let your doctor tell you that you need to continue to suffer and come and see us. Our care is gonna give you a broader picture of what's going on in your overall health but we'll also take care of your menopause symptoms.

Monica 27:47

Absolutely, and we are so excited to have people start to see Samantha. We are taking appointments already for this, and so we've got her link in the show notes. There will be the ability to do a discovery call with her to make sure that it's the right fit for you. If you're ready to sign up today though, just click on the link in our show notes and we love to start serving you and helping to address your menopause concerns. Imagine if you didn't have to choose between years of suffering and risking your long-term health. Imagine having relief in weeks or months, not years, while also protecting your long-term health of your brain, your heart, your bones. Imagine menopause is a time of restoration and the best days of your life from a health standpoint. This is possible with a personalized evidence-based approach focused on lifestyle, nutrition, and supplement changes and bioidentical hormones working together. Menopause does not have to steal your vitality. It can be the beginning of renewed health to improve your overall health.