In Episode #9, Dr. Jill talks to Sarah Morgan about her new company, EVEN  providing solutions to nutrient depletion for common medications.

Sarah Morgan's EVEN: https://feeleven.com/

Dr. Jill

Dr. Jill Carnahan is Your Functional Medicine Expert® dually board certified in Family Medicine for ten years and in Integrative Holistic Medicine since 2015. She is the Medical Director of Flatiron Functional Medicine, a widely sought-after practice with a broad range of clinical services including functional medical protocols, nutritional consultations, chiropractic therapy, naturopathic medicine, acupuncture, and massage therapy. As a survivor of breast cancer, Crohn’s disease, and toxic mold illness she brings a unique perspective to treating patients in the midst of complex and chronic illness. Her clinic specializes in searching for the underlying triggers that contribute to illness through cutting-edge lab testing and tailoring the intervention to specific needs. 

A popular inspirational speaker and prolific writer, she shares her knowledge of hope, health, and healing live on stage and through newsletters, articles, books, and social media posts! People relate to Dr. Jill’s science-backed opinions delivered with authenticity, love and humor. She is known for inspiring her audience to thrive even in the midst of difficulties.

Featured in Shape Magazine, Parade, Forbes, MindBodyGreen, First for Women, Townsend Newsletter, and The Huffington Post as well as seen on NBC News and Health segments with Joan Lunden, Dr. Jill is a media must-have. Her YouTube channel and podcast features live interviews with the healthcare world’s most respected names. 

The Podcast

The Video

The Transcript

#9: Dr. Jill talks to Sarah Morgan, creative entrepreneur and founder of EVEN

Text:

Dr. Jill 0:12

Hey, Sarah. I think we're live on Facebook. It's so great to have you. It is so much fun to interview my friends and the people that I respect most. It's so cool when they're one and the same—people that I have this great respect for who are also friends. I want to give you a formal introduction, but I love thinking back to when we met. We will both share it later. We were cracking up laughing because, [as] I remember, it was eTown. There was an event with James Maskell, I think, maybe two years ago, right?

Sarah Morgan 0:41

Yes.

Dr. Jill 0:42

You were presenting “Buddies in Your Belly” with your daughter. I was presenting on some really interesting cases with gut and dysbiosis and something called “auto-brewery syndrome,” where you actually can make and brew alcohol in your gut from the microbes that are resident there. So it was really fun. I remember just walking in and seeing the other people who were presenting, and you were just gorgeous and put together. I mean, the dress was perfect, [and the] hair [was] perfect. It was just like, “Wow, she's just got it all together.” I actually felt kind of frumpy. I was sitting next to you. It's so funny—perception, right?—because you're so unpretentious. You're down to earth. You're the most genuine, beautiful person, and one of my dear friends. And then later we talked, and it was kind of this mutual girl crush thing.

Sarah Morgan 1:31

It totally was. I remember. I think I saw you in the bathroom. I was like, “Oh my gosh! It's ‘the Dr. Jill Carnahan.'” I'm like, “Should I say hi right now or no?”—because we're in the bathroom. So yes, that was a fun night.

Dr. Jill 1:44

I remember! And isn't it funny? I love actually starting with this because people are people. No matter where God takes us or what he's going to do with our lives, our books, our careers, or your company, which we're going to hear about, we're still just totally human beings trying to do the best we can. I always realize that nobody's any better than anybody else, and I'm certainly not better than anybody else. It's really humbling because, as I got to know you, you look like a superstar, and you are, but you're just this girl next door and one of my dear friends. It was really fun just to get to know you after that and then to joke about our story.

Dr. Jill 2:24

I want to formally introduce you, and then I want you to tell me a little bit about your story and how you got into being this brilliant inventor-entrepreneur. So Sarah is a modern-day inventor—and I love this bio because she really is. I love going on hikes and walks with her because ideas just flow, and we're bouncing [ideas] back and forth, and you can just see that energy. I'd love for you to tell [me], if you'd like, a little bit about something that happened in your life that really changed your brain and changed some of the ideas that you shared with me. She's known for her innovative ideas that connect science to everyday life. She delivers impactful, science-based solutions for common health problems. 

Dr. Jill 3:04

She created Even, the first wellness company focusing on providing nutrient support for those taking prescription medications to minimize side effects caused by nutrient depletions. We're going to dive into this today and the science behind it. The other pill in particular, one of her products, is designed as a companion for women on hormonal forms of birth control. And statin support is designed as a companion for individuals on cholesterol-lowering medications. Even believes individuals can get benefit from the medications without compromising their quality of life. And I love that you've developed such a practical company; we'll dive into that. But let's talk about your story first. Tell us just a little bit about what got you into this.

Sarah Morgan 3:44

Yes, absolutely. So I kind of have two stories: One is how I got into the health space in general, and the second is how I got into Even. So the health space—I was a kid who loved the human body. I was always fascinated. I remember always asking the ‘why' questions and [being] like, “Oh, why does it work that way?” I came from a family of physicians and got to watch a triple bypass surgery in high school. I was planning on going to medical school [and] went through my pre-med training. I worked on a neuro-pediatric and trauma floor in a hospital that was associated with the Mayo Clinic. I remember as I was working there, I'm like, “I'm so disheartened that the reality of the situation is different than what my ideal was in my head.” I remember going on shifts and seeing these people who needed care, and I was like: “I really believe there's a better way to do this or a different way to do this.” 

Sarah Morgan 4:55

It's really where I've developed my passion for the power of nutrients to really impact the body and have a really key player, which I didn't know at the time how significant that would be in my story. But [in] my journey really, I had a lot of “noes” [as to] how I've gotten to where I want to go. Like, “I actually don't want to go to medical school,” which was a really hard decision for me. It just wasn't right. I saw that really early on. I just started digging, and I was like, “Okay, well, if it's not that, what is it?” I really discovered my passion for nutrition and started a program that was kind of a traditional program. I was like, “Uh, this isn't for me.” So I was like, “I don't know, I'll find something else.” I finally found a program that was really teaching biochemistry. Nutrition at its core is biochemistry, and it's very complicated, awesome, and powerful if we use it properly. So that was really exciting for me to really find my place. It took me a good decade. 

Sarah Morgan 6:10

So on a personal side, my journey to getting to where I'm at with Even now, there are lots of different things I've gone through—like all of us do in our journeys here on planet Earth. For me, I actually went on the pill when I was in my early 20s, and it served me well. I was going through my educational process. I was married, and it wasn't really time to have kids. So it served a great purpose. But quickly, when I started birth control, I was like, “I just feel weird and off, not myself.” I was like, “What is going on?” I remember I started talking to some of my friends, who I also knew were on the pill. I said, “Do you feel anything? Like, are you different on the pill?” And they're like: “Oh, yes. I'm moody. I have gained weight. I'm tired. I have headaches. I have low libido.” It was like, “Welcome to the club.” And I'm like: “Wait a minute. Why do we as women kind of have to take the hit for this?” And like, “Well, that is how it is; you choose one or the other.” And it was this moment that just sat for me; I knew there was something there that I was going to figure out later. I just intuitively and instinctually knew that. 

Sarah Morgan 7:32

So fast forward: I go through my educational process, I start working in clinical practice, and I start seeing this pattern. I've learned that I'm a pattern thinker. That's what I love: Figuring out what the patterns are. I saw that the people I was working with were on these medications that were giving them benefits. They were important and needed. And then I'd look at their micronutrient status—their vitamins, minerals, antioxidants, and oxidative stress markers—and they had all these pretty blatant micronutrient deficiencies that, knowing what I know about nutrition, there's a direct correlation there between these nutrient depletions and their side effects or these complaints they had. So again, here I go, digging in, and I'm like, “Oh, this is actually something called ‘drug-nutrient interactions.' It's extremely well documented in scientific literature.” And then I was like, “Why isn't anyone doing anything about this?” I kept digging and digging and digging. So that's really what led me to this idea: I want to create something that builds a bridge between the fact that modern medications are so powerful and important and serve a crucial role in our lives, but we also have to put that with the other truth: that these medications are really powerful and deplete nutrients. And if we don't meet the unique nutrient needs of a medication user, they can experience side effects associated with these nutrient depletions over time. That can impact even their compliance on their medication. 

Sarah Morgan 9:12

For me, it was like, “I believe [that] we have this ability to usher in a new era of medication use, where people can get the benefits of their medications and really have a good quality of life.” There's way more involved in that. You noted it, but part of the creativity that has been unlocked for me to think in patterns, I really believe, has happened. Part of my journey, too, is that I've actually had three traumatic brain injuries. I played hockey in high school and college. And about four and a half years ago, I was in a pretty bad car accident with my husband in Mexico that left me almost unable to walk or talk. They thought I had hemorrhaged. I was bleeding into my brain. It was a journey; it took me about a year to heal. I did a lot of really cool therapies to really allow my brain to heal. And as it healed, it was like, “Whoa, I'm more creative! This is really cool.” I had things that were connecting that didn't connect before in terms of concepts.

Dr. Jill 10:22

Wow. That is so fascinating. I have a really good friend who's an MD, and she was struck by lightning. After she had that incident, [her] intuitiveness and creativity literally skyrocketed to a whole different level. We don't know exactly how this mechanism happens, but it's not uncommon. I've heard stories about these. It shows to me—I'm getting goosebumps—the resilience of the human body and how things that should be either fatal or severely incapacitating or cause severe damage or long-term sequelae sometimes actually catapult us to a different level. In a very different way, I've seen that with my life with cancer, Crohn's [disease], and mold illness. At the time it was horrible, there was suffering, and it was difficult, but now I realize that was the greatest gift I could have ever gone through because [of] the understanding, knowledge, and experience that we have [gained] through those things. And then your brain rewired [itself], and you have new connections. It's amazing to me how that happens and then how it can be this really difficult thing and then a blessing. I think it's relevant because, right now, listeners, I'm sure every one of you listening has something difficult [going on] in your life.

Sarah Morgan 11:32

Oh, yes. 

Dr. Jill 11:33

Right? And what's hard is when you're in the midst of it to understand that there are going to be blessings from it because, when you're in it, it's a lot harder to see. In hindsight, we can both look back and be like, “Oh my gosh, that was amazing how that happened.” But at the time, it still kind of sucks. 

Sarah Morgan 11:47

Yes, the darkness is real—it is. And that's why, Jill, I have to say, I have my little toilet paper earrings on. 

Dr. Jill 11:54

I was going to comment [on that], I love it!

Sarah Morgan 11:57

My mom sent them to me the other day, and I was like: “You know what? This is exactly what we need. We need a little levity and humor in our lives right now” because it is tough.

Dr. Jill 12:07 

I saw those the day. I was like, “What in the world is on your ears?!” If you guys can't see, they're little toilet paper rolls. Like, this is the coolest thing ever. The problem there is that you're so cool, everybody's going to be like, “Where can I get me a pair?” You could have a whole separate business. 

Sarah Morgan 12:20

Right? My mom—it's all my mom—she made them. 

Dr. Jill 12:24

I love it. I love it. One other thing you were talking about, and then I want to hear about the company and what you've been doing, is pattern recognition. This is something that's so cool because you're not an MD, but to me, you're one of the greatest thinkers in this world of integrative [and] functional [medicine], and “How do we actually bridge [the gap]?” I actually chose allopathic medical education because I wanted to make the change within the system that's already there because there are some great things about it. Medications aren't all bad, and again, they're super helpful for a lot of people. But the thing that you're doing and that I hope to do as well in my own realm is: How do we use the best of Western medicine to help people? But then also, [how do we] go deeper and have a bigger toolbox to actually help [people with] these nutrient depletions and help them live an optimal life [with the proper] food, air quality, water, and all these other things that have a huge impact? The other commonality between us [is that] we're both kind of detectives. We love diving into the biochemistry and physiology and asking the question, ‘Why?' Like, “Why is this happening and how can we fix it?” So how did you get the idea for Even? And tell us about how the company started and a little bit more about it. 

Sarah Morgan 13:29

Yes. I would say the biggest thing I saw was that it's almost like medication use sometimes feels very polarizing. For the people using [it] and even, I think, physicians, it's like: “Okay, well, I know this is a really great tool.” But then somebody comes back and they're like, “Well, I'm on my birth control, and now I feel,” maybe, “depressed,” or “I'm really moody,” or “my energy is lower.” Or I go on cholesterol-lowering medications, and I have muscle pain. And then, as a physician, it's like, “Well, what other tools do I have in my tool belt? I want my patient to have really good outcomes,” and [that includes] accomplishing their health goals too. So for me, it was like, “How cool would it be to build this bridge and give these healthcare providers new tools to use, and then also the patients to be like, ‘I can actually support my unique nutrient needs while I'm on my medication' in a very scientifically validated way?” And that's something I'm really passionate about doing. It's also why we're actually entering a unique space of medical foods. 

Sarah Morgan 14:41

We can talk about what a medical food is. It's not a supplement; it's not a medication. It's actually a crossover between the two. But it has to have some substantiation behind it, and you actually use it under the supervision of a physician. So there's this give-and-take relationship with medications, and they give you benefits, but we need to complete the story [by pointing out] that they actually do use more nutrients. They can take these nutrients from you. My passion—the big vision here—is that I want to bring nutrient therapy to the forefront of medicine. Doing that and giving people these new tools and a new way to think about things can help so many individuals. I get so excited about that. That's why I wake up every day.

Dr. Jill 15:30

I love it. I love that you mentioned medical food, because I've been aware of this term and aware that it really is a crossover and has a different depth and weight to it. Tell everybody listening just a little bit more about: What is a medical food? How is it defined?

Sarah Morgan 15:42

Yes. That's a great question. It's under the FDA's Orphan Drug Act—medical foods. Basically, what it means is that it's a product that's used to manage a certain condition or disease, but it's not a medication that goes through the FDA approval process. So it's a little bit different. Most medical foods use nutrients as therapy. So you'll see a lot of nutrients used that maybe would even be in [something] like a dietary supplement, but they're going to be at therapeutic doses or in certain forms that have been shown to be more impactful [or] beneficial for certain reasons. So what's cool about a medical food is that you can actually be a lot more clear in terms of its intended use. Like, “What is this for?” [With] a lot of supplements, you kind of have to use coded wording of what they are. And supplements are highly unregulated. There aren't really any standards. Companies decide to have standards themselves, but it's like: “Okay, I'm going to swallow this capsule. Is it green tea extract, or is it somebody's grass they mowed a month ago?” I don't know. And I'm not knocking supplements. I love them; I use them. I believe in them heavily. [With] medical foods, in terms of their quality, there's a lot more that you have to report on, [and there are] certain things that you have to do in terms of your manufacturing. We can say things like, “Hey, this is actually for the dietary management of nutrient deficiencies that are caused by this medication class,” which is awesome. So it's very clear why you're using them. There are a lot of different medical foods. [For] example, Deplin is one; that's high-dose methyl folate that can be used for the treatment of depression because of the way that it impacts neurotransmitters. So medical foods are a way we get a little more geeky about our biochemistry and [are] very targeted for somebody's needs in terms of their conditions that have been identified.

Dr. Jill 18:04

And it sounds like you can make claims, basically, because you've proven… So it just gives it a whole other level. As a physician, say I have your product and I know it's a medical food; I know that there's been a certain level of testing and integrity in the production, and [that you've] actually checked in with the FDA. So we can say it is what you say it is, which is great for patients or for physicians.

Sarah Morgan 18:30

Yes. There's got to be scientific substantiation behind a medical food. It can't be just like, “Hey, we just want to say this,” because we say it. There has to be good scientific research behind it.

Dr. Jill 18:43

So let's talk about ‘the pill,' because so many people listening are women. Those who aren't [on it] probably know women who are on ‘the pill.' Or [some of those listening] are women on ‘the pill.' So let's talk a little bit about that. What's going on with ‘the pill'? What nutrient depletion does it cause? And tell us more about the other pill.

Sarah Morgan 19:01

Yes, absolutely. So ‘the pill' is [referring to] oral contraceptives. There are a lot of different kinds, and there's a combination with estrogen [or] progesterone. I say that saying there are different types that are in the different types of oral contraceptives. And then there are other forms of hormonal birth control like IUDs, implants, and shots. And they keep coming out with more and more—patches, rings, and all kinds of stuff. So, in terms of what are some of the nutrient deficiencies? The big categories are B vitamins, specific minerals, especially zinc, selenium, and magnesium, and then certain mitochondrial antioxidants as well as a lot of the nutrients and the detoxification support that the liver needs to get rid of hormonal metabolites. A lot of OB-GYNs that I've talked to have this phrase: “Estrogen is a use it and lose it hormone.” We want the effects. We want it to hit the tissues it's supposed to act on because there are a lot of benefits of estrogen, but then you want to get rid of it. You don't want it to, like, hang out and make its home and start poking on different receptors and doing things that you don't want it to do. And to do that properly, it's got to be metabolized through your liver. And then it's sent into your gallbladder, and you release it into the intestinal tract, [where] hopefully it gets out of the body. There's a lot more to it than that. But I call that pathway “poop out your problems.” We all have to get rid of the garbage that our bodies make just to be alive or things that we're exposed to. So those are some of the big categories of nutrients that are depleted or needed. 

Sarah Morgan 21:51

And this isn't just from me; the World Health Organization has an official stance on [how] birth control [is] depleting the body of these key nutrients, and a call to action that clinicians should supplement with these nutrients as a first-line therapy. When I was digging into literature and reading that, I'm like: “Holy cow! Like, why aren't we talking about this more?” And if you look online, if you're a physician prescribing birth control, what should you do if your patient comes in and reports depression? I was just looking at this yesterday, and it's like, “Tell them they'll probably get better,” like, “just to stick with it.” And it's like, “Wait a minute, though!” We know that the literature shows that 80% of women within 30 to 90 days of going on birth control have altered tryptophan metabolism. And tryptophan is a precursor amino acid to our feel-good serotonin and our sleep-well melatonin. So if we alter that pathway, would it make sense why somebody all of a sudden has mood alterations and [is] like, “I'm anxious, I'm depressed, I feel overwhelmed, [and] I'm angry and agitated”? Yes, it does. And it's a simple solution. That's what's so cool about it—[that] women can still get the benefits of birth control. They can be on it for the different reasons they need it, and they can feel great and feel like themselves.

Dr. Jill 22:20

Yes, Sarah. I see this all the time in clinical practice for young women. In fact, just today I had an appointment. I talked to a young woman who was talking about [how], for PCOS, she was put on birth control at 17 and no one told her that it would cause mood alterations, decreased libido, and multiple other symptoms. She's like, “At 17, you don't even think to ask.” And doctors, I can tell you, are not telling their patients that these are the risks—in general. Granted, there are probably some of them who are really giving informed consent, but in general, that is not common practice. And I would also say: Here I am; I'm in functional medicine, [and] I really understand biochemistry and nutrient depletion. And of course, I probably prescribe a little bit less medications than average, but I still prescribe medications. But the average physician isn't trained on nutrient depletion—doesn't even know it exists. I would say that if I pulled 10 of my OB-GYN colleagues, I bet you nine of the 10 would not even know that birth control pills in general will deplete B6 and some of those. And tell us what other nutrients it depletes. 

Sarah Morgan 23:20

Yes. So maybe I can tie them to symptoms too, because I think that's always fun. So B6 is a big one. Vitamin B1, which is thiamine, and vitamin B2 are also depleted on birth control. And what's really interesting about that is that a common side effect of birth control is that women can feel nauseous; they have gut issues. It's like, “Oh, I just don't feel good as I'm on birth control.” And there are a lot of reasons for that. I always start digging into the literature. Like, “I'm not going to assume anything. I don't know anything. I'm just going to start looking.” Well, I found studies that went all the way back to the 1940s that did these really thorough different models using… They were looking at estrogen metabolism; this was in rats, so it was an animal study. But they were depleting them and their livers of B1 and B2. They completely lost the ability to metabolize estrogen. I mean, it was very thorough. So they did that, then they—

Dr. Jill 24:28

Let's stop there real quick, because I'm thinking, “Okay, you're giving this exogenous—exogenous means from the outside in, extra, foreign—estrogen to the woman to suppress their natural cycle so that they don't ovulate and they don't get pregnant. And then what you're saying is that the mechanism of the birth control [you mention] actually uses a process that makes it impossible for them to break down this extra estrogen. 

Sarah Morgan 24:53

Yes, it makes it harder. They start depleting these nutrients that their liver needs to metabolize it properly. And what happens is, one, you need vitamin B1 and B2 and a bunch of other stuff to metabolize estrogen properly in your liver. But what happens is, when you don't have enough thiamine, you have this shift from aerobic to anaerobic metabolism, and you have more lactic acid or lactate that builds up specifically in the gut. It makes you feel nauseous and have a lot of GI pain, which is really interesting. And then, on top of that, we talked about mood with serotonin and melatonin. Well, serotonin—as you know, but something that's a great reminder—doesn't just function in our brain, right?

Dr. Jill 25:43

In the gut.

Sarah Morgan 25:44

Exactly. Yes, so if you don't have a lot of serotonin, even your ability to secrete digestive enzymes is lower. So all of a sudden, it's like, “Oh, I'm eating food,” and now I'm like, “Ugh, I don't feel as good when I'm eating my food,” because you can have lower serotonin production in your gut as well, which is going to impact your pain perception, digestive enzyme secretion, motility—all these really vital functions that are super important just for overall health and your quality of life. When you have gut issues, it is a destroyer of your quality of life. So those are really interesting, B1 and B2. In terms of the other B vitamins, folate is another one that's depleted—so is B12. I'm highlighting the key ones—bigger depletions. We'll even see that sometimes women who go on birth control will have different forms of anemia. 

Sarah Morgan 26:44

Folate is such a tough one, right, to measure status. I love a FIGLU [test], an organic acid measurement of it, to get a really good status. And that's actually what they looked at in a lot of these studies. They looked at their FIGLU levels, which is an earlier marker of deficiency or insufficient folate levels. A lot of these women had that. Well, I talked to a lot of OB-GYNs about this, and I'm like, “Hey, just the fact that we know birth control depletes a nutrient that's super important in early pregnancy, before a woman knows she's pregnant, to develop that neural tube and allow it to close properly, isn't that enough to tell all your patients they should be on a product like this?—a supportive companion while you're on your medication?” So that is interesting. And then folate also plays a really crucial role in mood regulation, neurotransmitters, and a ton of other stuff, right? There's a lot of it.

Dr. Jill 27:44

I'm [inaudible] thinking about my own history, and I've never really talked a lot publicly about this, but it makes perfect sense. I met my ex-husband at 19. I got married at 21, and I was on birth control all the way up until [I developed] breast cancer at 25. Unbeknownst to me, I grew up on a farm, [which] had lots of estrogen-like chemicals that probably predisposed me to cancer. So these are chemicals that act like estrogens on your body and actually make the cells in your breasts divide and grow more quickly, so I was, among other things, causing this. That was one factor. And then, [with] birth control, there's no doubt in my mind that that probably accelerated the process. And as you mentioned this, I also didn't know that I was [suffering from] celiac [disease] for many years, which also led to pernicious anemia, which is a B12 deficiency. So I came into this with excess estrogens from chemicals or estrogen-like substances. Then I had birth control on top of that, which depleted folic acid, which is key for the repair of rapidly dividing DNA [and] makes you prone to cancer. And I had a full deficiency prior to that. And then you throw in riboflavin and thiamine—it's the perfect storm. I'm not saying that caused my cancer, but there is no doubt in my mind that that was one of the factors that contributed to the cascade that led to my getting cancer at 25.

Sarah Morgan 28:58

Yes, absolutely. Another one to throw in there, when we're talking about these different nutrient depletions, [is] some of our antioxidants that I mentioned earlier. So in these studies, they looked at women who went on birth control, and they measured their oxidative stress markers. A lot of them were lipid peroxidase markers, which I think are really great to look at. Every woman who was measured in the birth control group had higher oxidative stress markers when they went on birth control. And then what they did is they intervened and gave these women a more therapeutic dose of vitamin C and vitamin E, which we know are antioxidants in and of themselves, but they also participate in the glutathione cycle, which is our body's main antioxidant. I call it Batman fighting the crimes of inflammation in our bodies. Glutathione is really important. So what happened is that when they got that, within a week, their oxidative stress markers normalized. Oxidative stress is a big deal, right? I think about women with fatigue and headaches [from] oxidative stress: It's like you're inflamed, right? So your little energy buddies that make energy for you, called your mitochondria, aren't going to work as well. You're going to have issues with nitric oxide, which dilates your blood vessels. So, would it make sense that you don't feel so great and maybe you get headaches because all those little cranial vessels just… [making a crunching sound]. With more of that oxidative stress, you have issues. So that's another one that's really interesting. 

Sarah Morgan 30:30

And then, one of the things that is in the other pill, our formula, is calcium D-glucarate. I love that because it supports Phase 2 conjugation. I like to say that when we have something our body wants to get rid of, it kind of needs to marry something else. And then it escorts it out of the body into the GI tract [and] out in the form of a bowel movement. We need a little extra support; it needs to be gentle support. Another thing I'll note is that it's important to not support Phase 1 detoxification when you're on hormonal birth control. And actually, if you look at genes, which I love doing, women who have an upregulation of their Phase 1 detoxification, [which] takes care of hormonal metabolites, are actually more likely to get pregnant on birth control, especially [at] lower doses, because they're just burning through all those metabolites. Their liver is karate-chopping it too fast, so much so that you might still ovulate, right? The impact of the pill isn't there. So that's another thing that's really important. Then we have a couple of other things in there that are mitochondrial antioxidants. These energy buddies make ATP properly for you because if you can't—

Dr. Jill 31:50

Thyomine, riboflavin, B12—these are core for mitochondria. It's so key and also core to liver detoxification [and] biotransformation. And just to clarify if you're listening, [it's] super simple: Your liver is like your detox organ; it's like the oil filter in your car. So you have Phase 1, which takes nasty, toxic chemicals like pesticides or even estrogen—because estrogen is toxic if your body doesn't get rid of it—puts them into an intermediate. And then that intermediate is taken by Phase 2 [and] excreted into the bile. And then Phase 3 is when you excrete it through the stool with the bile acids. The interesting thing you mentioned, Sarah, is if you get stuck where your Phase 1 is going really fast and you have those intermediates building up, they're actually more toxic than the original. So you can get stuck in between if Phase 2 isn't working. And Phase 2 is a lot more driven by glutathione and cruciferous vegetables in our diet. So it's not something where you can always just take one pill and fix it completely. It's a lot more related to diet, lifestyle, and oxidative stress. So this is a really, really key process that you're addressing.

Sarah Morgan 32:54

Yes, it's so important. And I love what you're bringing up too, which is so important for women. When you're on birth control, right, it's like the c-word, [and] everybody's like, “Well, okay, so if I'm on birth control, is there a risk for cancer? And it's kind of like, “Well, for some yes, for some no.” But it's kind of like if you don't get rid of your hormonal metabolites, whether your ovaries are making them or you're taking them in exogenous form outside of the body, that's a problem. It's so important to make sure that happens properly. And then a lot of these nutrients too, just to come back and do a full circle, are important for thyroid function. A lot of women who are on birth control are like, “Oh, my thyroid is problematic.” Well, sometimes it has to do with the thyroid not getting the nutrients it needs to function properly, which is a big deal. And then we can also talk about libido because I think that's a big one. It's really important.

Dr. Jill 33:57

Raise your hand, out there, if you've experienced a birth control pill in the past and had it affect your libido. Oh yes, I see everybody is raising their hands here. 

Sarah Morgan 34:05

Yes, and it's one of those like, “Wait a minute! I went on the pill or [on] birth control because I don't want to get pregnant. And while I'm on my birth control, I don't want to have sex. Like, how ironic is that?” Right? That should have been in Alanis Morissette's Ironic song, you know? So what's really important [are the] testosterone and estrogen ratios. The aromatase enzyme that converts those two is really important for that to function properly. We don't want all of our testosterone to be converted into estrogen. So zinc is a nutrient that actually makes sure that the aromatase enzyme is functioning properly, so we can still have adequate ratios of testosterone along with estrogen.

Sarah Morgan 34:53

And then the other thing that's important there is sex hormone binding globulin, which is our little taxi cab for our hormones. When that gets higher, what happens is that not only is it gobbling up estrogen and our free hormones, but for a lot of women, it gobbles up the free testosterone that's there that's contributing to their sex drive, and then all of a sudden it's gone. I had an OB-GYN reach out to me, and she's like, “Sarah, I saw a patient. She just came in. She's been on the other pill for 40 days, and she told me she wants to work out now, she has better energy, and she actually wants to have sex again. Then she was like, “And I can't wait to try it myself.” [laughing]

Dr. Jill 35:39

I love it. Yes, because women are—

Sarah Morgan 35:41

We need to support women, right? Women deserve to feel good while they get the benefits of their birth control, and I don't think it has to be one or the other. And that's really the option that's out there in the world. To me, I'm like, “It's not a good enough option.” Birth control isn't going away. Women need it for different reasons. So let's help them feel awesome while they're on their birth control and meet those unique nutrient needs.

Dr. Jill 36:08

Gosh, I love that. And I know this is so relevant, whether it's someone and their mother, their daughter, their sister, themselves, or a man who's hearing for his wife. So this is relevant to everybody. I would definitely touch briefly on the statin support that you have. And then I want to dive into, in the last few minutes, tips on overall health and stuff. So [give] us just a little, brief overview on statin support and what it does.

Sarah Morgan 36:34

Yes, statins are a group of medications that lower cholesterol. HMG-CoA reductase inhibitors is the technical name of that. But basically, what they're doing is lowering the “bad cholesterol.” Now there's lots of debate about that, but they also have other benefits on top of that. They improve endothelial function, [and] they stabilize plaque. In some ways, they reduce inflammation. So I always like to show the positive [side] of the medications and just highlight the fact that they really have their place. So at the same time, while people are using these medications, a lot of times they get different types of side effects that are really common for this category. That can be muscle pain and weakness, which is really common. I would say… I want to say it's underreported or underrecognized. I think it's estimated [that] 40 to 50% of people on statins have muscle pain. I think some people are just like, “Well, I don't know if it's just me getting older.” And I'm like, “Just because you're getting older does not mean you should have more pain.” Brain fog, fatigue, headaches, and immune changes are some of the things that we see; even GI issues can happen on statins. And it's interesting to look at them because they're impacting an entire biochemical pathway. Cholesterol is one of the things that it inhibits, and there are multiple others. 

Sarah Morgan 38:07

So when we're talking about statins, they have [a] unique subset of nutrients that statin users really need to balance their biochemistry and even out their body so that they can feel great that they can stay on their statin, get the benefits of it, but not have these issues. So some of those nutrients, again, going back to the mitochondria—the little energy buddies—are crucial for statins. And CoQ10 is something that a lot of people maybe have heard of. With statins, I'm going to tell you, there's a whole other mechanism of the muscle pain that happens with statins that has nothing to do with CoQ10, and it's something we're going to be talking a lot about in the coming months because there are some solutions that are very easy and very effective. And I'm so excited for cardiologists to have this tool for their patients and for people who are on statins. Everybody knows somebody on a statin, right? It's like they need to be on this supportive product. 

Sarah Morgan 39:09

Another thing that's really interesting about statins is that they can deplete vitamin K2. Vitamin K2 looks a lot like CoQ10, and it's also really important for mitochondrial health. One of the things that K2 does is help what's called matrix Gla proteins (MGP), [which] makes sure that calcium goes where it's supposed to go in the body. And it keeps calcium from being deposited in the arteries. So what's really interesting about statin use that we've been able to document is that there can be increased arterial calcification over time, which we can see with a calcium score when people have that image. There's some really cool research coming out of Europe where they've actually used therapeutic doses of K2, and they've seen a reversal, a decrease in these calcium scores, which is phenomenal. 

Dr. Jill 40:07

[inaudible] love that because even without statins, I'm using K2 for people with calcification of the carotid arteries or the heart. This is really important information. I would love to know, you may not know the exact numbers, you probably do, but what percentage of people are either on birth control or statins? I mean, to me, those are big, big ones. You've chosen a good market because both of these affect so many people, both men and women. 

Sarah Morgan 40:29

Yes. There are about 100 million users of birth control globally. Birth control is a little bit more transient. They say that about 95% of women have, at some point in time, used birth control. It's one of those [things where], we use it, sometimes we switch what we're doing, and we kind of move [on]. But in general, at one point in time, there are about 100 million women using hormonal birth control. In the United States, there are about 45 million statin users; globally, there are about 200 million, and they're on the rise because of our lifestyles—that's a huge contributor. So another thing I'm really passionate about [is that] while you're using your medications, we always address lifestyle aspects of people's action plans of what they can do to really improve their quality of life, because that's a big piece. Those are foundational aspects that always need to be addressed. 

Dr. Jill 41:31

Yes, I love, love that, Sarah. This is so exciting. And I'm sure people who are listening didn't even know what's coming out, and [neither do] any of the physicians as well. This is really exciting stuff. In the last few minutes, let's switch to just practical things. I would love to know: What's your routine like? How do you stay healthy emotionally, physically, and mentally? Do you have any tips or tricks for people [who are] listening on some of your best hacks for optimal health?

Sarah Morgan 41:57

Yes, I love that. So for me, I really believe that health is about wholeness and that our health and wholeness is physical, mental, emotional, and spiritual. The thing about life is [that] sometimes we have one of those areas really dialed in, and then one of the other areas is kind of out of control and not so dialed in. Some of us are really good at focusing on our physical health, like getting [enough] movement, eating the right things, or getting enough sleep. But maybe we're in relationships that are toxic, or we don't really know how to healthily interact with our family members. And that impacts our wellness, right? So for me, I always view it [through] all of those different meters. I'm driving my car, and I'm like, “Okay, where are my RPMs? What's my speed? Where's my gas tank at?” I try to look at all of those things in my life. 

Sarah Morgan 42:59

I had an eating disorder—another part of my journey. So I really understand the connection with our physical health and our mental, emotional, and spiritual health. What helped me overcome an eating disorder was really understanding my spirituality, like who God is [and] my identity in that space, and allowing myself to live out into the world based off of that truth. It shifted everything for me in a really cool way. My husband and I love to talk about spirituality with people, and it doesn't have to be this intimidating conversation or something that's like, “Oh, well, I don't know” or “This is how I was raised.” It's just kind of cool to start asking yourself some questions in that realm. That's how I started. 

Sarah Morgan 43:52

Physically, I am a huge movement person. It doesn't always have to be intense, but I love to walk. I walk most days of the week. Right now, because I can't get to the gym, I'm running. I love running, and I run and I pray, and I just process my thoughts for the day. I eat healthily, but I don't eat perfectly. I am so not a black-and-white person that way. It actually came out of a place of being very black-and-white with an eating disorder and learning how to live beautifully in the gray. 

Dr. Jill 44:29

I love that. I remember Gretchen Rubin. I love what she said because I always think about this as I'm seeing patients: There are abstainers and there are moderators, and we all usually fall into one side or the other. I happen to be an abstainer, so I do like rules because, for me, it's easier; I don't have to make a decision. I'm like, “I just don't eat gluten, period—never, ever, ever.” But that black and white for me gives me freedom because then, if someone offers me gluten, it's just like, “Sorry, I don't eat that.” But on the other side, there are a lot of people, [including] many of my patients, who are moderators; they do not do well with black-and-white rules. They're like, “I need one day where I just eat what I want.” And then the rest of the days, they'll be perfect or eat really clean. And I love that there's a spectrum. And I always try to recognize the patients: Where are you?—because some of them want a rule. It helps them. That box actually gives them structure. And then for other people, actually, it's a problem because then they feel restricted, which is not healthy either.

Sarah Morgan 45:22

Yes. I had to dance between those two groups because I was like a box person, and then I had to learn to heal. I had to learn to go outside of that, and that was terrifying in its own journey. But then, in terms of other things that I do, I think community is so important for our health. [As well as] having people in your life like you, Jill, who are life-giving, who encourage you, who are champions for you. And right now is a tough time, right? We're living more in isolation. So we have to be a little bit more creative [about] what that community looks like and how we connect in these times. But I think that's so crucial. [As well as] finding ways of connecting with yourself like: “How am I doing?” And “Why do certain things bother me?” On the emotional and mental sides of our health, digging into those and journaling and self-discovery a little bit more—those are all things that are important because they drive even our stress response that then impacts our physical body. So it is all of the above on a multiple choice. On my test question, I'm going to answer D—all of the above.

Dr. Jill 46:34

Yes, all of the above. I love that. And you mentioned something really important: Just to speak, because we are socially isolated from friends and family. And hopefully, that's going to start to change. But it's really good to think of creative ways. I know even you and I and some of our friends here will text encouraging things in the morning, or we'll send songs. This morning I sent everybody a picture of a little baby pig that was jumping and missed and fell off into the [inaudible] between the furniture. I don't know about you, but I was laughing so hard.

Sarah Morgan 47:07

That was a highlight. Yes, that was the highlight of my day for sure—while it was like chewing on a snack, you know? 

Dr. Jill 47:07

[inaudible] snacks. And if you fall, get up and try again. But it was just like those little things. 

Sarah Morgan 47:12

Yes, absolutely. 

Dr. Jill 47:13

And you guys do the same to me, [along with] those many other friends in my life, [as] I know in yours as well. Maybe it's a text, maybe it's a phone call, maybe it's Zoom connection [or] coffee, but these kinds of things are still really important for connection. It's a little harder now. We have to be a little bit more deliberate on that in encouraging one another. I love that. And I would say, very, very similar to you, finding that movement [is very important]. And I know we talked to you about movement and ideas. For me, whether it's prayer, meditation, or getting ideas for projects, when I'm moving, my brain is very creative. So I do feel better when I'm hiking, walking, or [otherwise] moving because that creativity kind of flows. And it's fun to use that [as an excuse to] get out and move, but also to create and dream and get some big ideas. Well, that is so cool. I want to know: Where is your company headed, and what's on the forefront? And then I want to know where people can find you and read more about your products.

Sarah Morgan 48:08

Yes. We will be launching a complete line this fall for a lot of different medication categories. We have a lot in the works that is, I would say, kind of like stealth mode right now, and a little bit of our R&D. So if something we talked about today isn't relevant to you, I promise that come September/October, we'll have things that are very relevant to almost everyone in America, which will be really exciting. We're very excited to give physicians new tools, to give people new tools, and to talk about medication use in a new way, where it's empowering; it's not like, “I'm choosing the lesser of two evils.” So I'm very excited for people to just have a new way to think about the topic. Our website is feeleven.com, so if people want to check anything out, our contact information is there. My email—I'm a person who's available. I really, highly believe in transparency and accessibility. So my email is Sarah@feeleven.com. So if you have any questions, you can email me directly.

Dr. Jill 49:23

Gosh, thanks for sharing that, Sarah. That's so rare nowadays [inaudible].

Sarah Morgan 49:25

I know. 

Dr. Jill 49:27

I remember one of my favorite authors; he's a big author, a big speaker, [and] an attorney. He wrote Love Does. If you know Bob Goff, in his first book, he put his personal phone number and email in the book. I'm like, “What balls does that guy have!” I think it's really, really cool because it was like this personal approach. And he said, “Sometimes I get these calls from random people.” Thanks for sharing. 

Dr. Jill 49:49

And I love most of all—what many people didn't hear about you—is you're a visionary. You're an innovator. You're an inventor. And what's neat that we share too is that we believe in miracles and we believe in these big dreams. And then we come together and [are] like: “Sarah, guess what happened? Oh my gosh, I got a contract for a book next year!” Or you'll tell me, “Oh my gosh, I got funding on the company!” And it's so fun to share that and to have a friend like you who is able to think big and then believe for big things because a lot of people are like: “Oh, that's too big. I can't do that.” And we can, right? We know our own limitations; at least for me, I'm always like: “Oh God, I cannot do that. But it can help me; I promise I'll show up.” A friend of mine once said, “The thing about Jill is her childlike faith.” I was like, “Oh, if that's what people say on my tombstone, I'm so happy because I love the fact of showing up with faith.” It makes miracles happen, and we've both seen that. And I know for you, you're going to see many, many more. 

Sarah Morgan 50:54

Well, you as well; I'm excited for the journey ahead.

Dr. Jill 50:57

Yes, me too. Well, thank you for joining us here.

Sarah Morgan 50:59

Yes. Thank you!

Dr. Jill 51:00

And everybody listening, we'll be sure to put Sarah's website and other information [up]. And I'll come back in and if Sarah would like to as well, we'll answer your questions. So thanks for joining us today, everybody. Have a great evening!