Ask Me Anything (About Women’s Health) With Parsley Health Founder & CEO Robin Berzin

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There’s so much going on “out there” on the internet, which makes it completely impossible to know what’s real and what’s just hype. We’ve decided to turn straight to the source to answer our burning questions directly. Ask Me Anything is giving us 1:1 access to credible experts across beauty, lifestyle, wellness—well, everything. Go ahead, ask away.

Is anyone else frustrated by how little women’s health is researched in comparison to men’s health? Apparently only 7% of health research funding is dedicated to conditions that exclusively affect women—like perimenopause (new), menopause, endometriosis, PCOS, and [name anything related to female hormones].

With so little information available to the western medical community, women have taken to social media, pilates classes, wine nights, and more functional, holistic practitioners to educate themselves on the constant hormonal changes that happen throughout multiple seasons of a woman’s life—words that are currently being written by a woman who cannot believe the daily impact of hormones on her life!

Rather than continuing to guess about why we have acne, whether or not we should be on birth control, if peptides are even safe, or what the hell is up with creatine at the moment, we decided to open The Quality Edit forum for yet another Ask Me Anything with Parsley Health’s CEO and Founder, Dr. Robin Berzin, so we could get to the root of all of our problems.

Berzin has essentially changed the name of the functional medicine game, by making Parsley Health the first functional and longevity medicine clinic to accept major insurance in-network nationwide. As a Columbia-trained physician, a leading voice on root-cause medicine, women's hormonal health, and the future of longevity, Berzin seeks to give women the tools and information they need to optimize their health during all stages of their lives.

What are your thoughts on creatine for women?

RB: Well, I'm a big fan of creatine for women. Women naturally store twenty to thirty percent less creatine than men, and there's some really good data on creatine for cognitive function—specifically focus, memory, and processing speed in women. And then most notably, creatine is great for improving how hard you can work out, so improving workout performance. If you're trying to lift heavy, having creatine before your workouts will help you get through that tougher workout, and you don't need to do a loading dose. There's not really any evidence of that. 

You can take three to five grams a day. I recommend five grams. Take it daily for a month. See how it improves your workouts, if it does anything for your focus and cognition. I'm a big fan.

Thoughts on peptides? My acupuncturist said it's unnatural to inject yourself with anything from a metabolic POV and, if anything, they should be ingested. 😊

RB: So first of all, what are peptides? Peptides are just little strings of amino acids, and these are the building blocks of our proteins. And these strings of amino acids have been used for a very long time in medicine. Insulin is a peptide. GLP-1s are a peptide. And then of course, there are some of the experimental peptides that people are using for performance enhancement and longevity.

So am I a fan of peptides? Yes, absolutely. GLP-1s are an incredible class of medication and have a lot of really interesting use cases, not just weight loss and diabetes, but we're finding out more and more every day.

And then there's some of the experimental peptides like BPC-157 and others that, quite frankly, don't have a lot of human data behind them, if any. And we really don't know how much, for whom, how long, are they safe, for what condition should we avoid them… And all of that is to be determined.

And so while I'm friendly to peptides, and I'm excited to see their great potential outside of insulin and GLP-1s, the jury's really out as to whether or not these molecules have a real impact on our health, our performance, our longevity. And I for one am skipping them for now—the experimental ones—and I'm waiting for more data.

Do women actually need more sleep than men?

RB: Well, there isn't really strong data showing that women truly need twenty to thirty minutes more sleep than men. This stat gets more play than the science actually deserves.

But women go through different periods of time in their life when their sleep can be disrupted by their hormones, and that is very real. Perimenopause and menopause, shifts in progesterone absolutely impact sleep. And women are sixty percent more likely to report insomnia than men. So because sleep is so important, it's when our brains wash themselves out. It's when they clear out the junk. It is when our nervous systems reset. It is when our immune systems reboot. So if you're having trouble sleeping, definitely pay attention to that, and your female hormones can absolutely be one of the culprits that are causing you to lose that extra sleep.

What’s one thing women in their 20s/30s should be doing now to support their hormonal health long term?

RB: This one is a slam dunk. Build lean muscle mass. Weight train two to three times a week. Why?

Our muscle mass is what we use to dispose of eighty percent of our glucose (our blood sugar). And when we have good muscle mass, we have blood sugar balance. We have good metabolic flexibility and a good metabolism, and we keep our hormones in check. Polycystic ovarian syndrome, which is now called polyendocrine metabolic ovarian syndrome (they just made it more of a mouthful) is really about insulin resistance and your metabolic function, which causes a huge cascade into your hormones.

So when we're thinking about fertility, when we're thinking about perimenopause, when we're thinking about weight gain, energy, even conditions like acne, having good metabolic health is critical, and that means having good lean muscle mass. I was never a weight trainer growing up and in my twenties and thirties. I just got to it in my forties. And wow, it makes such a big difference in my hormones. Huge.

Biotin breaks me out! What else can I do to make my hair healthy and strong?

RB: What to do about thinning hair and biotin supplements? Well, biotin supplements are okay, but very few people are actually deficient in biotin.

And if you take too much biotin, you can get acne and break out. And I rarely see biotin as the answer when you're experiencing hair loss or thinning hair. Hair loss and thinning hair can come from a number of different underlying causes. It could be iron deficiency. It could be postpartum or changes in your menstrual cycle. It can be thyroid conditions that are often undiagnosed. It could be due to inflammation and undiagnosed autoimmune disease, which I also see all the time. 

There are different types and patterns of hair loss, and so if this is something that's been going on for you in a significant way over more than a month, say a couple of months or more, this is definitely something to see a doctor for versus experimenting with a lot of different supplements to try to fix it.

While there are some good hair loss supplements out there on the market, usually what I see is that they're not actually treating the root cause of your hair loss. And so while the hair loss might get a little bit better with the supplement, it doesn't actually get better, and that's another sign that you need blood work, so you need to work with someone to look at the root cause.

What are the most common deficiencies in women? Do you have any recommendations for supplements in nutrition? What should women be eating more of?

RB: Well, there are a few, and it's not just iron.

Yes, iron is the most common. One in five women have iron deficiency. Make sure your doctor is testing for ferritin levels, by the way, because those can show up low far before you become anemic or have low blood cell counts.

So make sure you're testing for that one. But there's a few others. Magnesium is really common, and magnesium is important for three hundred enzymatic reactions in the body, including our metabolic function. Magnesium is a big one. Ninety-five percent of Americans are low on omega-3s.

If you haven't gotten tested, get tested through the omega-3 index. It's a great way to know if you are low. Taking omega-3s, EPA, DHA, ideally in the form of real fish oil, which is the best formulation, is so important for all of you out there, which is most of you, who are low in omega-3s.

B vitamins, also incredibly common to be low or suboptimal. B12, folate—these are some of the ones I see most often. And then of course, vitamin D3. We do not get enough full body sun exposure, most of us these days, to be at the levels of vitamin D we need for optimal bone, mood, and brain health—let alone immunity. So make sure you're getting tested for vitamin D3 and taking a good supplement there if you need it, which also most of you do.

Do you have any tips for managing hormone balance after stopping birth control after long-time use?

RB: First of all, if you've been on hormonal birth control for a long time, know that that birth control is masking your regular cycle. So you don't actually know what's going on under the hood, and going off, things might show up that surprise you. 

I see a lot of women discover that they have fibroids, endometriosis, PMOS (also known as PCOS), thyroid conditions, or other issues that they were covering up or were covered up when they were on the pill and now they're seen. And so if you're thinking about fertility soon after going off the pill, yes, your cycle may come back right away for many, but for others it doesn't, or there are other issues that you wanna deal with.

I definitely recommend tracking with an app or with your wearable as soon as you go off of your birth control to see where your cycles really land. It may take a few months to get there. And then beginning to notice your symptoms and what's going on, and working with your gynecologist or your functional medicine doctor to look under the hood at your hormones and other related body systems that impact your hormones—like blood sugar, for instance—to understand how these things could be impacting your overall hormone balance or your fertility.

There's a lot we can do to optimize fertility after we go off the pill. Just make sure you're giving yourself enough time. You might need six-to-12 months after going off the pill. Not that you can't get pregnant sooner, but again, I just see a lot of women that have got other issues going on under the hood, and we need a few extra months to deal with those, and then we're ready to get pregnant.