In this episode of The Integrative Continuum, Dr. James S. Nagel—internal medicine specialist and president of the Clinical Advisory Team for the Women’s Hormone Network—joins me to unpack physiological estrogen homeostasis and why rhythmic BHRT may address gaps left by static dosing. We dig into estrogen’s whole-body roles (growth, repair, brain, heart, bones), the gut microbiome’s impact on HRT tolerance, environmental endocrine disruptors, and practical nutrition that supports hormone physiology.
You’ll hear:
- Why estrogen is central to female health across organs and life stages, and what “physiological” replacement actually means.
- When someone may not be a good HRT candidate and why gut health often predicts HRT success.
- How rhythm and receptor signaling differ from simple “low-dose forever” approaches.
- The difference between myths and evidence on estrogen and breast cancer (plus why metabolites like 2-methoxyestradiol matter).
- Food, light, sleep, and toxin-load strategies that support hormone balance—without getting dogmatic about diet .
Chapters
00:00 Intro
01:44 Dr. Nagel’s path to integrative & preventive medicine
04:39 Women’s Hormone Network—mission & physician training
06:45 “Do all women need HRT?”—thinking before prescribing
08:44 Estrogen’s whole-body roles (growth, repair, brain, heart, immune)
15:20 Who may not tolerate HRT yet—why the microbiome comes first
17:09 Rhythm vs static dosing; brain thresholds & function
18:54 Estrogen, insulin resistance & autoimmunity (30s–40s)
20:29 Restoring biological rhythms; estrogen–progesterone receptor interplay
24:50 Brain benefits, mood, neurotrophins—signals you miss without rhythm
26:42 Safety & outcomes from years of rhythmic practice (clinic insights)
28:06 Endocrine disruptors & toxicity—what to do about the “exposome”
31:03 Testing philosophy—history first, then targeted labs
33:52 Myths about estrogen & breast cancer; role of 2-methoxyestradiol
42:44 Food quality, fermentation, fats & bioavailability (real-world tips)
54:24 Light, vitamin D/A/K2, skin & the “right” fats
58:10 The Estrogen Revolution physician education platform—coming soon
1:01:50 Where to start as a patient (books/resources)
1:04:30 One myth Dr. Nagel would erase forever
Guest
Dr. James S. Nagel, MD – Internal Medicine; President, Clinical Advisory Team, Women’s Hormone Network; founder, Quality of Life Medicine (Chico, CA); creator of the Estrogen Revolution training platform for clinicians. Author of Estrogen: A Girl’s Best Friend and the Estrogen Revolution Manual (course companion).
- Website: jamesnagelmd.com
- Training waitlist: theestrogenrevolution.com
Resources mentioned
- Estrogen Matters (for patients & clinicians getting oriented)
- Women’s Hormone Network—physician training & patient education
- Practical pillars: real food, adequate protein & healthy fats, fermented foods as tolerated, sleep, light/rhythm, toxin reduction (education-only; see your clinician)
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⚠️ Medical disclaimer
This podcast is for education only and is not medical advice. HRT decisions are individual—please consult your licensed healthcare professional for diagnosis and treatment.
#HRT #Estrogen #BHRT #WomenHealth #Perimenopause #Menopause #HormoneHealth #FunctionalMedicine #IntegrativeMedicine #Microbiome #EndocrineDisruptors #EstrogenRevolution #WomensHo
