About Our Guest- Esther Blum- Changing Your Diet To Live a Happy Life

Esther Blum is an Integrative Dietitian and High Performance Coach. She has helped thousands of women permanently lose weight, eliminate the need for medication, lose stubborn belly fat, and reverse chronic illness. Esther teaches her clients how to get clear and decisive about what to eat while healing their relationship with food and their bodies.

Esther is the bestselling author of Cavewomen Don’t Get FatEat, Drink and Be GorgeousSecrets of Gorgeous, and The Eat, Drink, and Be Gorgeous Project. She currently maintains a busy virtual practice where she provides 360 degrees of healing with physical, psychological, emotional and spiritual support. Esther believes that diet and supplements are the foundation to healing, but treating the whole person is paramount.

Widely respected as an industry expert, Esther was voted Best Nutritionist by Manhattan Magazine. She has appeared on Dr. Oz, the Today Show, A Healthy You with Carol Alt, the ISAAC show, ABC-TV, FOX- 5’s Good Day NY, and Fox News Live. Esther is an in-demand authority frequently quoted in E!Online, In Touch, Time Magazine, The New York Post, The Los Angeles Times, In Style, Bazaar, Self, Fitness, Marie Claire, and Cosmo.

Esther received a Bachelor of Science in Clinical Nutrition from Simmons College in Boston and is a graduate of New York University, where she received her Master of Science in Clinical Nutrition. Esther is credentialed as a registered dietitian, a certified dietitian-nutritionist and a Certified Nutrition Specialist (CNS), the certification from the Board for Certification of Nutrition Specialists (BCNS). She is also a member of the American Dietetic Association, Dietitians in Functional Medicine, Nutritionists in Complementary Care, and the Connecticut Dietetic Association.

Esther lives in CT with her family where she can be seen cooking up a storm, going for long hikes, and blasting 80’s music by the fire pit.

Full Podcast Transcription

Esther Blum 00:01
I have a client who just absolutely refuses to give up booze but he has it twice a week. And he’s still losing weight. And the minute he started having it three, four days a week, he stopped losing weight. He discovered this on his own. He was able to connect the dots, so I really educate and empower my people to say I can make these choices, but I’m also gonna have these consequences. So they’re able to take ownership of it and that often ensures longevity.

Diva Nagula 02:02

Hello everyone and welcome to another episode of From Doctor to Patient. Today, I’m joined with Esther Blum, she’s an integrative dietitian and high performance coach. She’s helped thousands of women permanently lose weight, eliminate the need for medication, lose stubborn belly fat, and reverse chronic illness. Esther teaches her clients how to get clear and decisive about what to eat while healing their relationship with food and their bodies. She’s the best selling author of Cave Women Don’t Get Fat, Eat, Drink and Be Gorgeous, Secret of Gorgeous, and the Eat, Drink and Be Gorgeous Project. She currently maintains a busy virtual practice where she provides 360 degrees of healing with physical, psychological, emotional, and spiritual support. She believes that diet and supplements are the foundation to healing but treating the whole person is paramount. Widely respected as an industry expert, Esther was voted best nutritionist by Manhattan Magazine. She’s appeared on Dr. Oz, The Today Show, A Healthy You with Carol Alt, the Isaac Show, ABC TV Fox Five, Good Day New York, and Fox News Live. She’s an in- demand authority frequently quoted in E-Online, In-Touch, Time Magazine, The New York Post, The LA Times, Instyle, Bizarre, Self, Fitness, Marie-Claire, and Cosmo. She received a Bachelors of Science Clinical Nutrition from Simmons College in Boston, and is a graduate of New York University where she received her Master of Science in Clinical Nutrition. She is credentialed as a registered dietician, a certified dietitian-nutritionist, and a certified nutrition specialist. The certificate from the Board of Certification of Nutrition Specialists, she’s also a member of the American Dietetic Association, Dietitians in Functional Medicine, Nutritionists in Complementary Care, and the Connecticut Dietetic Association. She lives in Connecticut with her family where she can be seen cooking up a storm, going for long hikes, and blasting 80s music by the fire pit. Well, I’m so pleased to have you here on the show today. And just reading your bio is just fascinating. And I’m so excited for the show. And it’s interesting, a lot of people who come on the show, to talk about these healing modalities that they basically have chosen as their profession to help other people have a unique story about themselves. And so I’d love for you to take some time and just really talk about your story and how you got here.

Esther Blum 04:51
Yeah, so there’s a couple of paths that brought me here. One was conscious and one was sort of subconscious. The conscious one was I grew up in a family of healers – my father and grandfather were both amazing physicians, the kind of physicians that did house calls and had an answering service that would you know, often call on the weekends, and my grandfather was an ears, nose, and throat doctor. He was Harry Blum, the tonsil king of Brooklyn. He was one of the first graduating classes of NYU medical school. When I was about six, he took my tonsils out – I had chronic tonsillitis, I was sick all the time. I had ear infections every month -my mom joked it was like getting my period every month only with antibiotics, like just antibiotics and antibiotics. Now, they did not know about diet. So of course, I grew up eating tons of wheat and dairy and we were kosher, so there was no butter, only margarine and all this real pro-inflammatory food. But long before I knew that I knew I was very interested in medicine, but I didn’t want to go to medical school. I had a career counselor kind of quiz me and nutritionist came up as one of the fields of study because it’s a pre-med degree, but you don’t have the residency, you don’t have the – I had a hospital internship and board exams, but it’s nowhere near the length of time required as a physician. So my dad was like, great, if you don’t want to be a doctor, don’t do it. That’s cool. My grandfather was like, you’re gonna be a dietician? Like, what’s wrong with you? Why wouldn’t you be a doctor, you’re never going to be a success. You’re never going to make money. It’s like, Oh, yeah, watch me. Watch me. So you know, so that was

one reason why, is I just was fascinated by the science. You know, my mom was a nurse, my grandmother was a dietician, who my grandfather trained to put the ether mask over my face when he took my tonsils out. So pretty crazy, right. But then the other piece of
the story is my middle brother – he was always really sick and had a ton of GI issues. He was born with a mild case of Spina Bifida. To this day, he’s in a wheelchair and struggles with his digestion and gut function. So I was, you know, subconsciously, I think I was never able to help him when I was younger. And now of course, I treat him, I’m treating him now for gut issues as well. So that feels really good to be able to heal people and pass along to other people. You know, my parents didn’t have the tools to manage it. There wasn’t the same information on the gut microbiome as there is now and, you know, special diets and all the foods. I mean, I remember, I don’t know about you….but growing up, I had friends who were Celiac, right? And they would just eat corn and rice. And I was like, what do you mean, you can’t eat bread? Now, of course, you can get you know, cassava flour tortillas and almond flour muffins. And there’s so many variations….you could get paleo waffles. But back then there was none of that. And so we’ve come such a long way.

Diva Nagula 08:03

Yeah, it’s really fantastic. And it’s, I mean, now, the role of a nutritionist dietician is so imperative in aiding in issues with chronic health. Back in the day when I was working in the hospital, you know, it was like, we never really looked at the nutritionist notes in the chart, it was like, okay, it’s just filler for the charts. And now I’m like, wow, I mean, this, the role of what you guys do is so important, especially a person who plays a role and the integrative nutritionist, a functional nutritionist, this is like, stuff that’s imperative, and really, dissecting all of the stuff that’s going on in the world with toxicity with poor nutrition, GMOs, and then also abiding by their individual patients, individuals’ food sensitivities and intolerances. And so it’s really important and it’s like, for us physicians who went to school, we didn’t learn any of this nutrition. And you know, I’ve had to take courses and I’ve had to go into integrative medicine to understand nutrition and I know that’s the foundation of everything and if you don’t have that dialed in, good luck. I mean, it’s a foundation to build on for improvement in health and wellness.

Esther Blum 09:18
So can I ask you a question? Because yes, I was a hospital dietitian for five years and nobody read a darn note of mine. So let me ask you a question. You have crossed over – you have gone rogue in modern medicine, which is beautiful. So why don’t you think….what’s your opinion on why doctors don’t take nutrition into consideration? Especially gastroenterologists?

Diva Nagula 09:45

So this is funny – my father’s gastroenterologist and my brother’s a gastroenterologist, so, my dad’s very old school. He’s not practicing anymore, but it wasn’t until I had my own health issue did he realize the importance of diet. When I had got diagnosed with cancer, and I was reading all this information about how nutrition plays a role and how, you know, I was inundated with toxicities from eating so much of conventional foods, which were laden in pesticides. And when I started to mention all this and started to wake him up, because it hit home for him, obviously. And then I have my brother who’s practicing, he’s younger than me. He also took it home too, as well. But you know, he does counsel, you know, folks on nutrition, not to the extent to the level that you do, or I do, but it’s there. And I just think it wasn’t taught in medical schools and medical school is the Bible. So if anything is outside of what you’re learned in medical school and residency program, it’s almost like it doesn’t exist. And that goes with a lot of different other modalities of healing, not just nutrition, but nutrition is the foundation. And I also think that the curriculum is put together by people who might have been influenced by the Big Pharma and Big Pharma doesn’t want to have nutrition as a role in our education, because it’s going to ruin their big business.

Esther Blum 11:10
Amen. Yeah, that’s my impression, but I’m always curious, like, as a physician, what your perspective is on it.

Diva Nagula 11:17

Yeah, absolutely. And it’s something that I feel that should be front and center when we’re talking about how to heal because food is medicine, I mean, you can literally heal so many diseases, prevent many diseases, and treat just based on on understanding the body and prescribing the appropriate foods. And that goes with cancer, you know, if you have prostate cancer, you know exactly what they should be eating – any kind of cancer, you should be eliminating sugar and carbohydrates. And, you know, you should be implementing some sort of fasting, and I’m sure you do that with some of your clients too.

Esther Blum 11:52
Yeah, you know, I get so stoked about all of the pieces that we can now utilize in our practices – one of my favorite things to utilize is a continuous glucose monitor, and to just get people to dial into their sugars – especially when they’re not losing weight, and they don’t want to listen to me about going to bed earlier. I mean, to be fair, I have pretty compliant people who come to me because they’re investing time and money but not everyone is able to change lifestyle habits overnight and going to bed earlier is one of the hardest things to do for people. I get them to go to bed earlier and not eat so late at night. So I’m thinking my client, Greg in particular, you know, he is such a snacker – he eats a lot of carbs, and we got him to lose weight and get his cortisol down. He was also drinking like three to four espressos a day. I mean, his cortisol was off the charts. So I said we’re gonna put you on the calm down man program, and you’re gonna get you off all your caffeine, which we did, he was really amazing. But he was still kind of getting up to pee a couple times a night and eating late and I said, all right, fine, slap on a glucose monitor. And sure enough, his glucose runs high. Even his baseline is 100 to 114, which is high for baseline – pre-diabetic even though he’s not overweight. So I was like, now you really have to start fasting at night, you cannot eat after dinner and eat late and you got to go to sleep earlier. And that will fix your sugar and fix your gut. So the the beauty of a glucose monitor is you cannot lie. You can’t argue with the numbers, the numbers don’t lie. And when people have this hardcore evidence, staring them in the face around their app, then they say all right, I really have to listen to my body.

Diva Nagula 13:44

It’s a beautiful instrument and I went through just an experiment for myself just maybe two or three months ago. And it was really interesting because I was trying to understand, you know, how to modulate my numbers in if I were to eat a big meal. And if I went around and walked around the block with my dog, it it actually reduced my levels in my system – my sugar levels were a lot lower and then I did the same experiment with the same meal and not walking around the block and my sugars were higher. So it really does go to show you that how activity, postprandial activity is important.

Esther Blum 14:21
Yeah, one of my favorite studies is the one done on type two diabetics and Group A was given Metformin but was not doing any physical activity. And Group B was not given any Metformin but was lifting weights. Group B had much better insulin sensitivity and control because their insulin receptors were open – insulin could drop in after exercise. I know when I wore a continuous glucose monitor…you know, I walked my dog for 45 minutes to an hour in the morning before I strength train and even after the walk, my sugars were lower than they were when I woke up in the morning. And this was after a meal because I eat a meal and then go for a walk. And you know, they were still the lowest of the day, just from walking.

Diva Nagula 15:12

So you’ll find this funny – I was having bloodwork done, fasting bloodwork, and I was having my sugars in like the mid 90s, and high 90s. I was like, oh, what’s going on here? My hemoglobin A1c was like, you know, 5.4, which was on the borderline, not really on the borderline, but still, it’s high normal. And I was wondering what is going on? And I would always get my blood work in the morning, and I would be really religious about fasting, and wouldn’t even drink coffee – coffee doesn’t unless you add stuff to it to influence the sugar, and I was like, okay, I’m not gonna drink coffee. And still, my fasting blood sugar was high. And then I started to wear that glucose monitor. And first thing in the morning, when I wake up, the first thing I do is I take my supplements. And lo and behold, after my supplements, my sugar will go up. And I was like, wow, I had no idea because of whatever the the substance that the structure that’s in the supplement itself would would react in it would actually raise my levels. And so it was a false raise. It wasn’t really a false raise, it was all something based on on my supplements, which I had not even thought about tying that in, in regards to my my blood glucose levels. And so I went back and I had my bloodwork done, this time didn’t take any supplements, and my glucose was like 83.

Esther Blum 16:34
Okay, I’ve never heard this story. So tell me more like what was in your supplements that was raising your blood glucose? Or what was your body’s response?

Diva Nagula 16:41

Yeah I mean, it was just whatever was the structure of the actual capsule itself, you know, was enough to raise the sugar. And I would take, you know, eight to 10 capsules, and those just like that was just enough to boost my levels. So there’s like cellulose, which has sugar, that’s made of the capsule and some kind of starch that’s in the capsule. And so these are the things that you know, can influence the sugar.

Esther Blum 17:05
Fascinating. All right, well, you got to start mainlining those things, then forget, you know, oral route, you’ve got to just…..intravenously. You know, Metformin, too, by the way, let me tell you……have you been working with topical Metformin? Because I see that’s now available, and I am sending my patients to their doctors to get it. But I don’t know much about it, it’s pretty new.

Diva Nagula 17:31

It’s new to me, I have not heard of this. This is really interesting. I wonder if it’s much more effective because of the absorption and you’re bypassing the first pass effect. So I don’t know.

Esther Blum 17:43
Some people just don’t tolerate the GI side effects. And those are really rough to get through. And you know, you’ve got working professionals, you’re trying to get them on the sauce. And if they’re running to the bathroom every five minutes, it’s hard to get the deterrent.

Diva Nagula 18:51

Yeah, so that’s I mean, it’s really interesting. I mean, obviously the diet is such a huge role in what we put into our bodies. It’s a huge role in in terms of our health and wellness. Do you do anything in regards to counseling, preventative care? Or when you actually take a client on can you like, kind of elaborate on what you talk about with the client, how you take a client from the beginning to the end?

Esther Blum 19:32
So I take a whole body approach to weight loss through hormone balance and gut health and I do this primarily with women wo come to me but I certainly have a subset of men that I treat. Often when people come to me, they are in the midlife stages where they’re going through perimenopause or menopause. And all of a sudden, that gut microbiome – the estrogen gut connection which is called estrobolome….that completely changes. Women get massive bloating, they get IBS like symptoms, they start to get insomnia, which is also an issue with low progesterone. They’re really having digestive issues or they’ve had chronic, you know, pathogens, they’ve got excess amounts of H. pylori, or they have staphylococcus or some kind of GI infection or an invader that really shouldn’t be there. So why do I start with the gut? I used to start with hormone testing. Well, once you fix the gut, you can really repair the adrenal pathways, you can optimize hormone production. And at the end of the day, you cut inflammation and you make people happier. Because an inflamed gut is going to translate into an inflamed brain – you’re going to have people aren’t sleeping, who are irritable, are suffering from depression, brain fog, and really are suffering and struggling to get through the day or they’re having severe constipation or diarrhea, their bowel movements are not regular. So the first thing I will do is weed and receive just sometimes if somebody really doesn’t even have like a mucosal lining in their gut, I will build them up for a month, and just give them a lot of gut fuel and these mucilaginous herbs that help form that beautiful mucosal lining in the intestinal tract. So slippery elm, marshmallow, some glutamine in there, some zinc carnosine – to really heal some of the gut inflammation. Then we’ll start weeding out and getting rid of the pathogens that don’t belong there. And then phase three is is rebuilding and putting in good gut fuel and digestive enzymes. A lot of people are very low in hydrochloric acid. This can be from chronic stress, this can be from age, this can be from pesticides, and GMOs, pharmaceuticals, and that’s the other problem. People are getting a lot of heartburn, and then the doctors put them on h2 blockers, which is very short term, right? It’s great for healing an ulcer or treating, you know, some Barrett’s esophagus really quickly, but long term, it’s not going to get to the root of the problem, and you will suffer from osteoporosis long term and especially if your estrogen levels are bottomed out and you’re on h2 blocker, you’re really going to suffer from osteoporosis long term. So I fix the gut. And then I also do extensive hormone testing. I use the Dutch test which I love. It tests 21 different androgens, it looks at your pathways. If you have a family history of cancer, it can really tell us a lot about whether or not you’re a candidate for HRT, or hormone replacement therapy. And it also looks at, again, neurotransmitters in the brain. And the most fascinating thing that I’ve seen are people who come to me on Wellbutrin, or Zoloft. And their neurotransmitters are still very low in the brain. It’s not working because you have not…..it’s crazy. I wouldn’t have believed it myself if I didn’t see it on the test. Again, can’t argue with the numbers, that’s why I love tests. Because before I did tests, I was like, well, you could try this. And you could try that. And let’s try these supplements. And I think it’s this. Well, that is way too much guesswork and not enough certainty. So now, I really tighten things up over the years – I’ve been doing this for like over 26 years. I’m actually 100 but all the nutrients I take make me look much younger. So it’s really optimizing gut health first, optimizing hormones, putting people on hormone replacement if they’re a candidate or optimizing their body’s detoxification pathways, and as a result, they sleep better, their energy’s better. They can improve body composition, lose weight, get insulin under control, lower cortisol levels, and live a better life just feel better, stop hot flashing, get their libido back, clear out excess estrogens. I’m seeing more and more excess estrogens in men where men who are getting testosterone pellets are often aromatizing or converting to estrogen. So I don’t love pellets for men. I really like gels or just transdermal cream. And I’m also just seeing men who are obese who have very high estrogen levels. So we have to remove that too. So it’s not just women, it’s men who also suffer from high estrogens.

Diva Nagula 24:37

Yeah, and then obviously, you see the men who have the hyper estrogen. They’re manifesting with the manboobs. And that’s that’s kind of something that occurs and a lot of people who are chronic drinkers, you know, a lot of beer. Now this is something that increases the estrogen levels, prevent clearing, and this is what we see after you know, a couple of weekends or a month of bingeing, you know, this is what’s going to happen. And of course, if you’re sitting there not watching your diet, and you’re eating a lot of things that are that are pro-estrogen producing, then you’re just really making that cycle spin faster and faster.

Esther Blum 25:15
Yes, and the good news is, it’s all possible. You know, in case you’re listening to this, and you’re feeling very overwhelmed. The take home message I want you to know is there’s really nothing new that’s not reversible. I mean, save for an amputation or an amputated body part. Most things are reversible with the proper treatment. I mean, you’ve survived cancer, you know – you’re alive today, because of how you cared for yourself and your body.

Diva Nagula 25:42

Exactly. And with your approach, I mean, so it’s interesting, you’re taking an approach that’s very functional medicine-ish, that a lot of physicians that who practice functional medicine, that is the exact approach that they teach you when you take these functional medicine courses from IFM. And it’s very awesome that you’re using the same methodology. But you have ideally a step up than most of us practitioners because you’re able to educate on a diet aspect. And going back to diet, how difficult is it to really get someone to be consistent with what you’re recommending and adhere to the recommendations?

Esther Blum 26:21
The worst someone is off when they come to me, the easier it is because they’re much more motivated to get on track, or they’re afraid. I mean, fear is a great motivator initially – fear and physical pain or discomfort motivates long term right? So people are great out of the gate. My starting package to work together is six months because people need to – everyone’s gung ho in the beginning, right? The most excited enthusiastic dieter is the one who’s like on the first three weeks of their plan, right? So I try to make it very realistic. I’m the reality Barbie. I always asked like, what are your three non-negotiables? What are the things you will not give up? And if someone’s like coffee, booze, and chocolate, okay, great. Let’s figure out how to actually build those in. So I do have people tracking chronometer – tracking their food, because again, the numbers don’t lie. And I never shame people or ask them to do anything I wouldn’t do myself, I’m not like a big keto person or extreme diet person, because I rarely have to go to those extremes to get someone results. And I need to make sure that they’re gonna be on this in six to 12 months to two years to five years. And that what we prescribe sticks. So we play a lot. You know, I’ll customize their macronutrients for carbohydrates, proteins, fat and say, okay, this is about how many servings of carbs you can have and still lose weight. And this is how much protein you need. And this is how much fat you need. And usually a couple things happen. Number one, people have a really hard time often meeting their protein needs, I tend to prescribe about a gram per pound of ideal body weight. And that can be very hard….if they’re used to eating, you know, cereal for breakfast and a sandwich for lunch, and then dinners like their good protein meal, that’s a huge change to get people eat protein in the mornings. But the second thing is that over time, people really understand, okay, like booze is something that’s really hard to change for people. But you know, booze can bloat you up and prevent you from losing weight for up to four days after each cocktail.

Diva Nagula 28:41 Wow, I didn’t know that.

Esther Blum 28:43
It’s crazy. I have a client who just absolutely refuses to give up booze, but he has it twice a week. And he’s still losing weight. And the minute he started having it three, four days a week, he stopped losing weight. And he’s lost 25 pounds, but he wants to lose 25 more. So he discovered this on his own, he was able to connect the dots. So I really educate and empower my people to say, I can make these choices. But I’m also going to have these consequences. So they’re able to take ownership of it. And that often ensures longevity, because I’m not the one cracking the whip or shaming them or saying, you know, you really shouldn’t have done that. I can say okay, what’s working, what’s not working? Well, I didn’t lose any weight this week. Okay, what was different about your week? Just doing the detective work really ensures accountability. It releases the shame and judgment. It’s just, is this working? Is it not working? Okay, what do we need to adjust and they all know, they just need the coaching and they need someone to cheer them on and say you’ve got this, let’s just reset your focus. I mean, that’s the reason why I have a business coach, I have a straight coach, like I stink at accountablility and I’m lazy, and I don’t want to do the work. But when I’m paying someone money, better believe I’m going to do the darn work because I can’t look myself in the mirror. And I have goals, right? So people have to remember their goals, they have to remember their why. Sometimes losing weight is getting to a certain number on the scale, that’s not really motivating, but being able to get on the floor and play with their kids or grandkids and get up again, and feel good or just sleeping through the night. Right? That’s what got me off caffeine and booze. I was like, you know, what sleeps more important to me than caffeine and booze. You know, or really thinking like, what is the most important thing to you – that’s what keeps people accountable. And if you don’t have a good why or you’re not connected to it, that also makes it harder if people aren’t clear on their goals, or why they’re doing it.

Diva Nagula 28:46

Yeah, I totally agree. I also really appreciate the approach that you take, it’s really all about getting to the root cause and doing the detective work, as you alluded to, to really understand what’s going on. And that really is how you’re going to make the change. And, you know, with this person who saw for himself what alcohol was doing – that’s kind of the detective work that you needed to do and he needed to do to figure out that was really a bad choice, to increase the consumption of alcohol throughout the week. But also, what you’re doing is you’re probably getting a thorough medical history, and you’re probably getting some blood work and the Dutch tests. And so this is really integral in understanding what’s going on. And I’m sure you’re doing a lot more of a medical intake and an initial conversation with the client to really get an idea as to what their eating habits are. And there’s such thing as emotional eating. And you know, a lot of people do that, including myself, and don’t even know it, because it’s just something that we just do as a habit.

Esther Blum 30:52
Oh, yeah, I mean, please. Like who has not snorted a line of chocolate chips off the counter? It happens to all of us. And especially in the pandemic, you know, people are really struggling and gaining weight, they’re not getting enough exercise and overeating as a stress response. I mean, guilty as charged – we’ve all been there and it’s human, it’s your normal, you’re fine. There’s nothing wrong with you. But the key is to nip it in the bud and say, okay, how can I turn this around? And, you know, do I need to just pull some things out of my house for a while? Or do I need to really address my stress, you know, what’s the root cause? Do I need to meditate? Do I need to go outside for a walk and pet my dog and play with my kids and just unwind? Delete my social media apps? One of my favorite, most transformative behaviors is I turn off my cell phone by about 7:45 to eight o’clock every day – just offline, nothing. So I think even if we can just get off our technology, unplug, read a book at night, just chill, you know, take a bath.

Diva Nagula 33:03

It’s a good getting into a habit of winding down before bedtime. And then that actually kind of lowers the autonomic nervous system, gets people out of fight or flight, get into a better a sleep cycle, and going to bed like you said at a normal time. And interesting enough, I used to always eat late at night, like seven to eight and then go to bed, you know, a few hours after that. And then I started to, you know, I have a wearable, the aura ring, and it measures a readiness score, and then measures my HRV. And that’s all based on a complicated algorithm. But I would notice that if I would eat right before bedtime, that I wouldn’t have the best quality of sleep, and my HRV would suffer. And so I started to space my time out between my last meal and going to bed. And I realized that if I do this three hours or greater, I have the best impact on my sleep and my readiness score, my HRV. And then I started that online that you really need to do this on a regular basis to digest the food and have your system not work in the middle of a night on your GI system and have it actually work on rest and repair and recovery. And that’s what sleep is for. And so, if we’re sitting there eating a meal, right before we go to bed, our system isn’t repairing and regenerating. It’s more about eating and digesting.

Esther Blum 34:24
Right, you’re digesting not resting. That’s right.

Diva Nagula 34:37

How doyou deal with clients who might have a lot of resistance and how do you overcome that? What kind of resistance are you facing? Because I’m sure it’s commonplace among many people.

Esther Blum 35:04
Well, I do screen people pretty intensely before I even enroll them in my practice, if someone’s not ready, I don’t actually invite them in to work with me because there’s a difference, right? Some people say, I want to get there, but I don’t know how I need a partner – they would be a fit. But if someone is truly resistant and knows it and knows, they’re just not ready, then I let them wait. Some people need to hit a little bit rock bottom or be in a lot more pain and discomfort. You know, one of the questions I’ll ask people, I’ll ask them what’s going on? Hey, you know, tell me why we’re here. What do you want to work on today? And they’ll say, I really want to lose weight, I’ve gained 10 pounds during COVID. And I can’t lose it. Okay, what’s gonna happen if you don’t solve this problem? And from that question, I can usually tell if someone’s ready or not. If someone says nothing, I’m fine. They’re not going to be as motivated. As someone who says, well, my health is gonna suffer, I’m going to feel low energy, my libido stinks. And I don’t like how I look, and I have no clothes that fit. And I don’t want to walk around naked in front of my spouse, I’m embarrassed and ashamed. So therefore, I don’t want to be intimate either. So those are much bigger motivators than someone who’s like, I could take it or leave it, you know. So we really, I don’t write people off or discount them, but I definitely measure their readiness level, because if they’re not ready, I won’t be a fit for them either. Because I follow up with my clients, they don’t slip through the cracks. I’m constantly emailing them, time to book your appointment, get your follow ups in the books, where are you, what happened with this test, where’s the doctor’s prescription for this? So somebody who’s not motivated, you know very quickly, we learn. No, it won’t be a good idea to work with me.

Diva Nagula 37:03
And we’re also talking earlier about some bloodwork and the Dutch test. Could you review what blood work that you get, and what exactly is Dutch test and how it’s used?

Esther Blum 37:14
Yeah, so the blood work I get and again, I get a lot of pushback from doctors and often spend a tremendous amount of time calling doctors offices or insurance companies – I’ll do a metabolic panel. I will do cholesterol and triglycerides. I will also do fasting insulin, hemoglobin A1c, fasting glucose. I will also do a more extensive thyroid panel. Most thyroid lab tests….everyone says my thyroid is normal – it’s because they’re just getting their TSH. So I like 3T3, reverse T3, T4. And if I suspect someone has an auto immune condition, I’ll look at TPO which is thyroid antibodies. I will look at A and A levels as well which can detect antibodies. I will also look at ferritin. To look at someone’s thyroid I will look at vitamin D, I will look at inflammatory markers like homocysteine. Or if someone’s going through menopause, I’ll look at FSH and LH. And so I really try and paint a complete picture of inflammation, of thyroid, of blood work. And often I inadvertently pick up autoimmune conditions that a doctor has not. Or my favorite story is my client, Mary. I was like you have raging Hashimotos and she took it to her doctor. She had the same bloodwork a year ago. And her doctor said oh, yeah, okay, I guess we should put you on medication. After two years! I said, please fire your doctor and find a new one, like shame on them. And I don’t like being you know, bashing doctors – I’ve had so many wonderful doctors in my life who were taking exquisite care of their patients. But if your doctor isn’t willing to fight for you or writes you off, then find a new doctor. If they doesn’t listen to you or take your complaint seriously. I’m thinking of another client of mine, Jeff, who needs a continuous glucose monitor. He’s morbidly obese, but his hemoglobin A1c was borderline high, it was 5.6. So they wouldn’t prescribe it. And I said, okay, so here’s the deal. You can either pay for his Metformin and/or insulin, you know, have him pay for that the rest of his life or you can prescribe him a glucose monitor and they said, well, the insurance company won’t cover it. I said, then it’s your job to advocate for him and fight for it and get coverage because he’s morbidly obese. And so I ended up you know, I circled back with him. I said, do you want me to help you just find a new doctor? Yes, please. I don’t want this doctor anymore. So the doctors are missing things and just saying you’re normal. Well, Homer Simpson is normal in this country. Okay, normal is not optimal, just because everyone else has reflux, high cholesterol, hypertension, syndrome x, and is pre-diabetic doesn’t mean it’s okay. You know, I think that movie Wall-E, we’re like everyone’s obese at the end. I mean, that was just so depressing. It’s depressing because it’s true. And that’s our new normal. So the only way to change the paradigm, I think, is when the patients go back to the doctors and say, you know, how you told me diet didn’t do anything? Well, this is how we’re going to fix it. Or look what I fixed. Look at all the way I’ve lost by doing everything you told me that wouldn’t work. So I think the anecdotal evidence is going to have to come in and change things.

Diva Nagula 40:47

And it’s interesting, I’m wonder, and we’ll get into the Dutch test in just a second. But I want to ask a follow up question. But it’s interesting that some of these tests that you’re, you’re recommending, many practitioners probably aren’t aware of these tests. And so and you’re reading it in a different way than most western medicine practitioners are used to practicing. Because, yes, it could be within that normal window. But what’s the comparison to a year ago, you know, or a few months ago? And so those are important things, to look at the trends.

Esther Blum 41:20
Yeah, absolutely. Or, again, a lot of doctors will resist and say, well, these tests aren’t necessary, you don’t have to have these. You’re not this. If you’re not already, you know, it’s a sick care model. Unless you’re sick, you’re there for normal, even though you’re not and you’re not feeling well. A lot of people say to me, my labs are normal, and I feel like garbage. Exactly. So a lot of doctors will resist and I have to go back and explain and often I get resistance again. So we just find a new doctor. Doctors don’t even have to be in functional medicine – they just need to be open and receptive to try new things and admitting, it’s okay to bring in a team. Maybe you don’t have all the answers. I refer people out all the time. If I don’t have the answers, I don’t know everything. I’m not a doctor. So often that’s why I will pull in a functional medicine doctor, pull in a body worker or an acupuncturist or someone, some other modalities. It’s not about the ego, I don’t care who heals this person, just let this person get healed, for gosh sakes. They’re coming for help, heal them, take care of them, do whatever it takes, I don’t care. I even have a patient who works with another nutritionist in conjunction with me. And I laugh I’m like, you really want to pay two nutritionists? She’s like, well, I like this one for this. And I like you for you. As I said, fine by me, I don’t care, as long as you’re healthy. I don’t care. So to that end, to answer your other question, the Dutch test. It’s a dried urine test for comprehensive hormones and it tests 21 different androgens. So seven progesterone, seven forms of testosterone, seven forms of estrogen, and it looks at not only your production, through your ovaries, or testes, and your adrenal glands and your gut, but also your methylation pathways, how those are detoxified through your body, how they’re processed, you know, someone can be very estrogen dominant and not be removing estrogen well on top of it, not excreting it through – the liver can’t process it. It’s not being excreted through poop and pee. But also, if you’re very obese, you can have a harder time excreting excess estrogens. So I really look at the pathways and make sure they’re optimized and we’re bringing circulating estrogens down. Or the opposite. If someone’s very low. If they’re menopausal and hot flashing with horrible insomnia and anxiety and irritability, then we look at replenishing those hormones. Because what people don’t realize, especially women, say I don’t want to go on all of these hormones. Estrogen is so beneficial. The research supports the benefits for bone density. And for Alzheimer’s prevention and Alzheimer’s can start, you know, easily 10, 20 years before you fully see it manifest itself. And what’s happening during that time is menopause. So you want to make sure your estrogen, progesterone, and testosterone are optimized. Most women like it because it brings libido back, it gets rid of the hot flash, it restores sleep, and it improves body composition as well, and no woman ever complains about that. I also test neurotransmitters in the brain to see, is someone making serotonin, dopamine, what are their pathways like? Are they making melatonin?

Diva Nagula 44:55
If they’re not, their guts compromised, and that’s where you start.

Esther Blum 44:58
Exactly, and fortunately, you know, as a result of all this testing, I help people with the cooperation of their doctor, of course, come off their medications, people can come off their antidepressants, people can come off their heartburn meds in two to three weeks, when they correct their diets and put some digestive fire in there and kill off pathogens. There’s so much that you can do to improve people’s quality of life, their mood, their energy, sleep, all of those things.

Diva Nagula 45:30

Yes, I love your approach to your patients and clients. And it’s really wonderful to see that you’re taking a functional medicine holistic approach to to help them with their problems. And I wish more people would do that, and specifically practitioners, and you are a really awesome role model for many of your clients. So I appreciate that. And thank you for the work that you do. For our listeners who would like to find more information about you, what’s the best way to do so?

Esther Blum 46:01
Okay, so Instagram, first of all, go to @gorgeousesther. I’m posting there regularly, especially my stories. Also, you can get a free crush your cravings, three part video series with an E-book at the end, this is complimentary, my gift to you, you go to EstherBlum.com/cravings. And this is a really informative series – it’s not only about sugar, but you can really optimize your health with this. And then last but not least for your listeners, I have six spots I’ve opened in my calendar for a 30 minute complimentary consultation. This is for people who are ready to move the needle with their health, they have specific goals of what they want to achieve. And they take away three customized tools that they could start using right away. So that is at EstherBlum.com/call. I cannot thank you enough for this sacred space we shared today. This was wonderful.

Diva Nagula 47:11

Yeah, thank you so much for you know, allowing this gift to be offered to my listeners and whoever else may need, so this is fantastic. This was a really, really great gift because this is a approach that I think is a foundational step for transformation, for better health and wellness. So thank you again and it was such a great pleasure to have you on the show and meeting you.

Esther Blum 47:31
You too. Thank you so much.