Alex X-Health.show: 0:00

All right, so chocolate plus sex - we'll be healthy (laughter)

Dr. Colleen Fogarty Draper: 0:03

Yes(laughter).

Alex X-Health.show: 0:04

[INTRO] Hi, I'm Alex and welcome to the X-Health.show, where I talk to visionaries behind the latest innovations in healthcare. For the eXtra health of the future. We're speaking today at EPFL Innovation Park in Lausanne, Switzerland. The sun's shining on cobbled slopes of the city overlooking snow covered Alpine peaks. My guest today is Dr. Colleen Fogarty Draper, nutrition scientist, researcher, and entrepreneur, founder of PhenomX Health, a digital platform created to empower perimenopausal and postmenopausal women through personalised nutrition. The idea of PhenomX Health occured to Colleen while raising teenage daughters and experiencing hormone health challenges herself. Her startup connects minimally invasive biomarkers with a digital platform for self monitoring and learning. So we will hear today about period pain, Swiss FemTech, headaches, perimenopause symptoms, business strategy, AI powered nutrition, personalization ecosystem - all that's coming in a moment. But first, sex and chocolate. [INTRO ENDS] We've got this vulnerability windows throughout our life stages. And in one of these life stages, we should eat chocolate, isn't it so? I heard you saying something like that. Or I combined the two ideas together just for the benefit of... myself, basically.

Dr. Colleen Fogarty Draper: 1:41

I love starting our discussion on this topic of chocolate because it's a favourite food of so many. And so we have to start out talking about the benefits of chocolate. First of all, chocolate raises your serotonin and dopamine. That means, that it's pretty much guaranteed to make you feel good. And here's the thing, early research shows that it actually elevates serotonin and dopamine more in women than in men.

Alex Jani, X-Health.show: 2:11

Does it mean, that we need to eat less chocolate?

Dr. Colleen Fogarty Draper: 2:14

No, we need to eat more.

Alex X-Health.show: 2:15

More! Oh my...

Dr. Colleen Fogarty Draper: 2:18

No, I'm just kidding. But our hormones affect our neurotransmitters and so when our hormones change, whether it be the menstrual cycle or the menopause transition where we see major effects on our neurotransmitter levels and our mood. So let's continue on the topic of chocolate. What kind of chocolate should we eat? That should be dark chocolate.

Alex X-Health.show: 2:47

That's my favourite. I have no problem with this.

Dr. Colleen Fogarty Draper: 2:50

You're good, you're good. Even better if it has at least 4% flavanols because that means that it helps increase blood circulation and it protects your overall cardiovascular health. So we'd like that, too. But it gets a little better. Because actually chocolate... it's been suggested from early research that chocolate can help elevate your estrogen levels. So when your estrogen is starting to plummet and vary during your perimenopause to menopause transition, that can be quite helpful. But it also raises the level of a molecule that is actually an excitatory molecule that increases your libido.

Alex X-Health.show: 3:34

Oh, OK.

Dr. Colleen Fogarty Draper: 3:36

Now, here's another interesting fact, since we're on estrogen that when you have sex, when a woman has sex, she actually increases her estrogen.

Alex X-Health.show: 3:46

Right, so chocolate plus sex will be healthy! (laughter)

Dr. Colleen Fogarty Draper: 3:49

Yes.(laughter) At the various stages of a woman's life cycle.

Alex X-Health.show: 3:55

That's amazing. What's the stage then...

Dr. Colleen Fogarty Draper: 4:00

I think it's whatever stage that you're in, when you have a nice healthy sex life, you can be guaranteed that you're going to modulate your estrogen. And if you're struggling a bit with libido, a little bit of dark chocolate won't hurt. But I want to tell you one other thing. There was a research study, and I'm sorry, I can't cite the author's and the year of the study right now but there was a research study done in Europe, in one of the northern countries, that's what I can remember. It was a weight loss study on women. And they actually had one group where they used a nice healthy approach to a diet. Probably Mediterranean kind of lifestyle, really super healthy. And those women lost weight. And in the other group, they actually added... I think it was around 300 calories in their luteal phase of the menstrual cycle. And they added that in chocolate.

Alex X-Health.show: 4:52

Oh, what were the results? I'm so curious now.

Dr. Colleen Fogarty Draper: 4:56

Those women lost more weight.

Alex X-Health.show: 4:59

Oh my...

Dr. Colleen Fogarty Draper: 5:00

Oh, my gosh (laughter)

Alex X-Health.show: 5:01

But that's dark chocolate they were eating?

Dr. Colleen Fogarty Draper: 5:03

We're talking about dark chocolate, we're talking about modulating the amount of dark chocolate that you eat. So I'm not saying go eat regular chocolate three times a day, because there's also research that shows that if you do that you gain weight, and you perturbed your metabolic health. So the amount, the frequency really matters, and the quality of the chocolate really matters. That's where the platform PhenomX

Alex Jani, X-Health.show: 5:26

So you basically need to adjust the Health comes in.

Alex X-Health.show: 5:27

So you are just on the verge of launching amount of chocolate to yourself, right? And that's where your your... is that a beta version of the platform, platform comes in. phenomxhealth.com?

Dr. Colleen Fogarty Draper: 5:45

Yeah, thanks for asking. So we're just about to launch our pilot test of our prototype, just in the next two to three weeks, very excited, we will have our smartphone app available. And also, we'll be validating our fingerstick blood tests focused on optimal nutrition and women's wellness and menopause hormones.

Alex Jani, X-Health.show: 6:10

That sounds so fascinating. I wanted to try it. Try what you already have. So I basically went to the website, again, phenomxhealth.com, and I wanted to test the test that you have there. So what I did, I hit the"Start here" button, and I ordered Biostarks Optimal Nutrition Test kit for 179 Swiss francs. Is that available only in Switzerland right now? Or where is that available?

Dr. Colleen Fogarty Draper: 6:45

Yes, that's a good question. On the website, phenomixhealth.com, you will find the kit that is available in Swiss francs. You can buy that from anywhere, but you're going to end up converting your currency to Swiss francs. We also have the kit available in the US on phenomx.health. So if you go to phenomx.health, and you're in the US, you will buy the kit from the US it's $199. And your sample is actually processed in a lab in the US. Our lab partner also has a lab in Singapore. That's something else to consider that soon, we'll offer that test out of Singapore.

Alex Jani, X-Health.show: 7:25

That's lovely. Yeah, so I ordered that. After a couple of days I received a Biostarks box. I have it with me here, you can see that it's a box that is in the dimensions of 12 by 20 centimetres – not too big. And inside I found two lancets, alcohol swab, gauze bandage, and a band aid. There were also instructions in German, French and Italian, and a blood sample box. Now the instruction said to, basically, use the lancet on one fingertip, which I did use and then you are supposed to squeeze the blood. So two drops of blood, not a huge amount, right?

Dr. Colleen Fogarty Draper: 8:15

Not a huge amount.

Alex X-Health.show: 8:17

So I was actually trying to squeeze it out my one finger. And I didn't manage! I had to use two finger tips. So two lancets to...

Dr. Colleen Fogarty Draper: 8:27

Thank goodness they give the second

Alex X-Health.show: 8:29

Yes! Wow, that's great. So I used two lancet. drops, OK, I made it, right. Then I was worrying a bit, can I just send it by post because it was unusual, also for Basel, it

Dr. Colleen Fogarty Draper: 9:12

So why these? OK, first of all, I want to just highlight that the laboratory we're working with is was -2 degrees Celsius, it was Sunday. Could it just lie out called Biostarks. And I want to give this team full credit for there, outside, in this temperature? But everything the amazing work that they've done putting together this kit. worked just as it should. So I received my results. But I'd In terms of why these 33 biomarkers? There's a couple of different ways to look at this. First of all, the overall question is, well, how many different biomarkers of nutrition status can we test. And so if you look at your micronutrients in terms of vitamins and minerals, these are like to ask you about the measuring. There are 33 kind of the traditional components of nutrition that we biomarkers now that are measured. Why these? know about. And so of course, we'd want to understand how all of these different components look in your blood. However, we have to go a little bit further. Because we also need to look at how we can measure, what we can measure easily for someone in the comfort of their own home. So that's what you did, even though you had to use two lancets. And maybe it's not comfortable to try that at first.

Alex Jani, X-Health.show: 10:17

It's definitely more comfortable than going somewhere outside to a lab, yeah, definitely.

Dr. Colleen Fogarty Draper: 10:24

And so, the key is that you only had to give two drops of blood for this test. So the group at Biostarks had to choose which assays they could do on very microscopic amounts of blood. And that is also a key piece of this decision making. And then we have to also choose assays based on the reliability of the information. But that goes a little bit deeper into mass spec here. But really, the point is to do a comprehensive overview of an understanding of your nutritional status. And what is unique and special about that is if you go to the medical doctor, you can't get that. They can do some nice standard tests on you, which you did at your doctor's actually, and they can do key specific focused nutrients. And that's it. So if you want something like this, you have to really do some research. And most people don't do this. And yet, it's kind of crazy, because we have the capacity for this and to me, it's a fundamental human rights issue that everybody knows their nutritional status. For me these 33 micronutrients give you an understanding of your biological nutrition status.

Alex Jani, X-Health.show: 11:48

I was expecting also some hormones, especially estrogen, progesterone – are you going to track them too?

Dr. Colleen Fogarty Draper: 11:57

Yes, so that's a good question. So with this test, we have the capacity to track your progesterone, your cortisol, and even your DHEA. And DHEA can also be an indicator of your overall hormone status, and also your stress as cortisol indicates stress. Now, there's something you have to consider when you start looking at estrogen and progesterone. And I didn't mention estrogen because, actually, we can't do it with this blood test. But stick with me here, there's another way. You have to actually know where you are in your menstrual cycle when you do those hormone tests because your estrogen and progesterone will change depending on where you're at. And actually, it can be quite informative for you. If you test it multiple times in your menstrual cycle. For the fingerstick blood test, we're not as focused on testing it multiple times in the menstrual cycle. However, there's a lovely company that we'll be working with in the future called Proov, PROOV, and they offer an at home hormone test that is urine based, and you can get the results right away. And those results you can actually do the test at the different times in your cycle in the convenience of your own home, and really track the changes in your hormones. And this is quite helpful for people with fertility issues. But I also believe it's quite helpful with PMS issues, with period pain, and with hormone imbalance issues as well. And so we'll look at using that in the near future. It's a little more complex to do that kind of repeat testing throughout the menstrual cycle. So because PhenomX Health is really launching ourselves out the door for midlife women, going through their perimenopause to menopause journey, and then touching on women kind of preperimenopause to help her prepare for that time. We're actually really excited about a new hormone test that we're validating with our Biostarks laboratory partners, which is actually focused on testing anti-Müllerian hormone. So that's actually a hormone that indicates your ovarian age. And it can tell you where you are on your menopause trajectory, even if you're not in perimenopause yet. So it will indicate for you when you will go into this phase of your life. And then you'll also know if you're in perimenopause or if you're in menopause. And the best thing about it is that it's not affected by the stage of your menstrual cycle, so that you can actually test it at any time.

Alex Jani, X-Health.show: 14:38

That's amazing, that's amazing. But how can we use it then? If we know where we are at this stage, why would we want that? I mean, don't get me wrong, I'm a fan of the quantified self, I love to know what's in my body, that's why I also did the test. So could you...

Dr. Colleen Fogarty Draper: 14:59

It's such a good question because I have to tell you from a biochemical perspective, when I looked at the different opportunities to understand hormones for what we're doing, it was actually more important to me, biochemically, to measure other things like the metabolic health, we'll discuss and also the micronutrient status. And I didn't see the exact action we would take on the hormones. And then we tested 100 consumers. And we had a questionnaire and a mock up prototype. And one of the questions that we asked was, do you want to know your menopause status? Because also, keep in mind, one year post period stop, you're in menopause. And you're in menopause for one day, and then you're post menopause. That's sort of depressing, you know. I think it'd be that for one day and they don't even realise it.

Alex X-Health.show: 15:54

That's also a funny misconception because

Dr. Colleen Fogarty Draper: 15:54

Yeah, it's perimenopause and it's menopause is something attributed to women at some age and they are "going through menopause". And it's actually postmenopause. But the reality is, so you can figure out if the perimenopausal period, isn't it? you're in menopause, just from that information, you don't have to do a test. But 100% of our women wanted to know, their stage of menopause.

Alex X-Health.show: 16:20

OK, they just want to know.

Dr. Colleen Fogarty Draper: 16:22

They just want to know. And when women asked to do this test, they say, isn't this gonna tell me my stage of menopause? And like you asking about the hormones, they're like, I'm disappointed, I thought I was gonna get hormones. So this was interesting for me. And it's also the humbling aspect of creating a startup, going from science to commercialization, is what we think is scientifically most interesting, isn't always what people want. And we have to start with what they want.

Alex Jani, X-Health.show: 16:54

OK, let's go back now to my results.

Dr. Colleen Fogarty Draper: 16:57

Sure.

Alex X-Health.show: 16:58

So I saw my results map on Biostarks' website, and I was quite happy with that, you know, I scored 80%.

Dr. Colleen Fogarty Draper: 17:14

You scored 80%, that's something to be proud of.

Alex X-Health.show: 17:16

Right? That's great. So I was deficient in selenium, magnesium and DHA Omega acids. What actually astonished me, magnesium the most, which I didn't think about I may lack this much. I mean, I got some muscles trembling from time to time and then I took some magnesium, but this was really deficient. What did you see when you looked at my results?

Dr. Colleen Fogarty Draper: 17:50

So let's talk about your minerals first, because not only was your magnesium low, but your selenium was low and then if you look at your zinc, and even your copper, they're not officially low, but they're trending on the low side. So I saw kind of low overall mineral status for you. And minerals – sometimes we forget about how important they are. They actually play key roles in your hormone metabolism, and your ovarian function. So when you tell me you have something like period pain, which indicates a hormone imbalance, and you've got this mineral imbalance, I say, OK, clearly, you need to do something here to remedy this. And magnesium also is often taken to help prevent PMS, premenstrual syndrome. And it's even used for migraines. And you mentioned that you had headaches

Alex X-Health.show: 18:49

Right.

Dr. Colleen Fogarty Draper: 18:50

And it's a relaxant. So to me, it was like, ooh, this magnesium thing is a huge deal for you. And you can take magnesium glycinate and see if it helps. And one thing that you have to realise though, whether you take it or you tried to just make some changes in your diet, is that it does take a little while. So if you decide to do this, you really have to give yourself a month, an entire menstrual cycle for you to see if it has the impact that you want it to have.

Alex X-Health.show: 19:20

But that's amazing, this menstrual pain thing is something women "just have" , right. "You can't do anything about it". Can you? I mean, it's like "all women have that", you know. I remember my mother, every month on Ketonal, really, because that was that big.

Dr. Colleen Fogarty Draper: 19:40

That's a major pain med that she was using.

Alex X-Health.show: 19:43

Exactly.

Dr. Colleen Fogarty Draper: 19:44

It's so amazing because 80%, or let's say up to 80%, because it's also geographic dependent, what studies have been done or not in different countries, but 80% of adolescents have period pain.

Alex X-Health.show: 19:56

80%?! That's huge!

Dr. Colleen Fogarty Draper: 19:59

It's part of the hormone change, when the hormones come in and their bodies are changing.

Alex X-Health.show: 20:03

So "just accept that," "we can't do anything about it"...

Dr. Colleen Fogarty Draper: 20:06

We just lived with it silently, with Advil. And so my girls, my teen girls take... well, now there's one that's a young adult... but they take Advil and Tums. Tums is like a calcium carbonate supplement that we use for gastric distress in the US. And so we actually import it from the US. And definitely take together, they want to make sure the Advil or the ibuprofen doesn't bother their stomach, plus, they get some stomach pain as well. And that's no different than what I did when I was a kid. And it's like, hey, wait a second here, this should be a societal issue, how we help women who are having period pain. Why do we have so much hormone imbalance? And can't we be doing something more about this? Now, this is a huge deal. This affects our capacity to do our work and take care of our families. And we're so like... we're the big decision makers for healthcare and for health purchases for our family. And here, we're not even tackling one of our biggest issues, which by the way, is not only caused by adolescent hormone imbalances but also PCOS, which is polycystic ovarian syndrome, and endometriosis, which we're learning more and more about, which also, by the way, connects to insulin resistance, and glucose metabolism. And all of this connects to inflammation, which would then connect back to your symptom of pain.

Alex Jani, X-Health.show: 21:33

Is there anything that you notice, while seeing the results, anything specific for any specific age of women? Like teenagers, women in their 20s, 30s, 40s, 50s, 60s, 70s, 80s – your name that. Or is it not specific to the age, it's specific to something else? Do you see any trends there?

Dr. Colleen Fogarty Draper: 22:01

Thinking about the micronutrient status piece of things, for the teens, I haven't looked at micronutrient status from this particular test, in particular. I would expect their micronutrient status to be all over the place because their eating is a bit all over the place. They're experimenting, sometimes they're eating healthy, sometimes they're not eating healthy. They're going out with friends, they're eating junk food. So you're gonna have a lot potential micronutrient wasting from just their experimental eating habits, OK. At the end, if and when they start experimenting with alcohol, you have some micronutrient wasting there. So that's just from their habits. And then, as we age, then we start seeing, for example, in the young adults, who might be more health-, nutrition-aware, increasingly, maybe moving into baby making phase, maybe not. But during that time period, where you've gotten more health awareness, you might see that whatever aberrations there are in micronutrients status could be caused by genetic polymorphisms that actually affect the way you metabolise your nutrition. So there's these inherent variations that we all have, we don't necessarily know about them, you can test for them, but they're not definitive. But this is where they can actually show some influence in maybe what is an otherwise healthy diet. The other piece of that is the microbiome, because microbiome affects digestion of food. So if you're poorly digesting your food, you're going to waste your micronutrients, right? And so microbiome health is incredibly important at this phase. And in any phase of life, we see that and then as we age, actually using B12 as an example, and let's even consider people that are 60 and up, this is a big factor for them. They actually don't make something as much called intrinsic factor, which actually helps utilise the B12, when you take it into your stomach area. So if they're not actually able to digest and use the B12 that they do take and they're naturally going to be more at risk of B12 deficiency. You can also have a gene variation that affects your B12 intrinsic factor as well so that it's not even age specific, but you can really see that get worse and harder and harder in the ageing population. The other point I'll just make to you, which is not age specific, is around the vegan diet. If you're on a vegan diet, you're super, super high risk of B12 deficiency and really serious B12 deficiency can cause some major neurologic and mental health issues, even beyond it no longer being there as a cofactor for your hormones, now it's affecting your neurotransmitter functioning, and can really affect the way you experience your your life. So it's actually a huge deal. B12 deficiency in veganism is something to be aware of.

Alex Jani, X-Health.show: 25:16

So here comes the supplementation, which like B12, is always recommended when you're going vegan.

Dr. Colleen Fogarty Draper: 25:23

Definitely, definitely. I wouldn't even challenge it. You want to be vegan, you want to eat the best vegan diet you can, go for it, and go ahead and find the best B12 supplement that you can so that you can really achieve the health that you're trying to achieve with what you're doing.

Alex X-Health.show: 25:37

Right. So B12 is dropping with age like this. We were at 20s, 30s, 40s, 50s. Is there anything that you would notice in these blood results?

Dr. Colleen Fogarty Draper: 25:56

I think it's geographic dependent. I don't know that there's, you know, in terms of if we think of all the micronutrients that we've looked at in this test, is there something specific. What I would look closely at would be fatty acids. That would be my first general place I would go where I would expect to see an aberration. Because most people don't take in enough omega-3 fatty acids which are anti-inflammatory, we know, which also help with hormone imbalance. But most people don't take in enough omega-3 fatty acids in their diet, particularly in our comfy Western diets, where we can eat whatever we want. And sure, we know fish is a nice source, but then we worry about it with the heavy metal toxicity. And most people don't eat fish every day. But I think there's also just the changing Western diet over time, it's just not a habit to choose a lot of Omega-3 rich foods every day. So I would probably start there, because I would expect I would see a lot of people in the population have those fatty acid imbalances. And I would start looking at how to emphasise those key fatty acids in the diet. And then, as a practitioner anyways, the next place I would look would be B vitamins. Because you can see multiple aberrations in B vitamins that can quickly affect hormones and also mood and neurotransmitter functioning. So I would want to, in that 20, 30, 40, 50 population, quickly correct any aberrations there as well. And then I'd go further down the list of the minerals, the other micronutrients, vitamins, and the amino acids as well.

Alex X-Health.show: 27:47

Can we go as far as to say that if we fix that, the minerals and the omega-3 fatty acids, we can get rid of the menopausal pain?

Dr. Colleen Fogarty Draper: 27:59

I wish. We really can't. It's not that easy. For me, it's the obvious fundamental place to start. It's the foundation and you start with correcting your micronutrient balance, absolutely. Because if you do other things to try to remedy your pain and whatnot, and you still continually have this micronutrient imbalance, it's going to work against you. But any symptoms that we have are multifactorial, we are a system, we are the sum of our parts. That means that your period pain is not just related to maybe an Omega-3 imbalance, induced inflammation, or hormone imbalance, but it also is related to how you handle stress, it's also related to the thoughts you think.

Alex Jani, X-Health.show: 28:47

OK, well, because we are a system, right? So everything works together.

Dr. Colleen Fogarty Draper: 28:52

Everything works together. It's a symphony. So you have to find the instruments in the symphony that aren't synchronised enough, and you have to correct them.

Alex Jani, X-Health.show: 29:07

[MID-ROLL] This episode is brought to you by the X-Health.show and me. So if you like this podcast, be generous hit follow, leave a review, that'll help me invite more such amazing guests for you, thank you. [MID-ROLL END]

Alex X-Health.show: 29:22

I know that you are a huge fan of personalised diet, that's where you want to start. That's why also PhenomX was born. So why not we all just embrace Mediterranean diet, eat avocados, fish for those who eat meat. Why do we need to personalise it?

Dr. Colleen Fogarty Draper: 29:46

It's such a good question because I got to just go back... it's almost 20 years ago when I started working in the field of what we called at the time nutritional genetics. Really connecting your gene polymorphisms with your nutrition requirements. And at that time, people were so excited, they're like, we're going to change the way we look at diet, the food guide pyramid, the Mediterranean diet, whatever you want to call it. It's not going to be considered the diet anymore because this is going to change everything. And guess what? It did not. We still see plenty of research that shows to us that the Mediterranean diet is a fantastic diet. And when we look at perimenopause and menopausal, postmenopausal women, the Mediterranean diet is a fantastic choice. So the way that I see personalization, I see it as an end. You start with, if we say Mediterranean, it's a plant based. But I'm not saying vegetarian, I'm saying heavy on the plant based diet with enough protein from variety of sources to meet your needs, OK, as well as your fats and your carbs. But really, a Whole-Foods kind of diet – you start with that. Everybody can start with that as a foundation. And in fact, this is where we have the right to choose where personalization is also about personal preference. Maybe I like fish, maybe you don't, maybe I like Brazil nuts, maybe you don't. That's OK. So that's where we choose from the wonderful variety of foods that we can eat that are whole foods that are healthy foods, and we choose what we enjoy. Now, once we have that foundation, where we're eating healthy diet, and we're making our choices, now we need to look at how we feel. What are your health symptoms, do you have headaches? When do they happen? What are you eating when they happen? Maybe there are some adjustments that you can make. If we stay on the headache thing, then we can say, OK, what if you continuously monitored your glucose levels, and you notice that when you have spikes when you eat certain high carbohydrate foods, so that means a spike, your blood sugar goes up very quickly. And what happens after that, that your blood sugar will then go down very quickly. So even in a normal range, we can look at this because we're really talking about parameters of health.

Alex X-Health.show: 32:12

Could we stop here for a moment - this Continuous Glucose Monitoring – it is actually trending, I'd say, now. Could you tell more about it? How does it work? How long do you need to wear it? Do you have to wear it all the time? And if you start, you need to wear it forever?

Dr. Colleen Fogarty Draper: 32:30

Let me tell you about that. And let me just finish the last thing I was saying with the fact that if your blood sugar drops low quickly, you can have a headache.

Alex Jani, X-Health.show: 32:41

Oh. So you can basically check that point before it goes down, right?

Dr. Colleen Fogarty Draper: 32:50

Yeah and before it gets worse before you have more of a problem, you can also understand if you're eating a big carbohydrate load that's causing a glucose spike, and you've got that reactive hypoglycemic kind of response, that maybe you can't eat like that. In the context of Mediterranean diet, it might be a difference between a half a cup of rice and a cup of rice with your meal. And it's those fine tuning adjustments that are important.

Alex Jani, X-Health.show: 33:17

That's huge, that's huge. OK, tell me

Dr. Colleen Fogarty Draper: 33:20

So let's talk about the Continuous more about it. Glucose Monitoring, which you hear the acronym all the time CGM, OK. I use that acronym as well CGM. The CGM involves a device that you put on the back of your upper arm, it has a micro needle but I assure you, you don't feel anything when you put it in your arm – it doesn't hurt, it does not hurt at all. You put it in your arm for two weeks, it lasts for two weeks, and you get an app that connects with the results of having that in your arm for two weeks. The micro needle is collecting information from your interstitial fluid. So that's a fluid in the cells in your in your lower layers of skin. And what it's detecting is your level of blood sugar, and it detects it continuously. That means that when you're sleeping, you're measuring your blood sugar. That means when you're exercising before and after you eat. And it's fascinating. So why is it fascinating. Because you can get an idea of how your body really reacts to the food that you eat. And if you look at it from the vantage point that you want gradual increases in your blood glucose and gradual decreases, you want to keep them in the normal range. And the less you have highs and the less you have lows, the better off you are. So that's what you have to know.

Alex X-Health.show: 34:56

Why do you need to avoid spikes?

Dr. Colleen Fogarty Draper: 34:59

The reason that you need to avoid spikes is that you're going to have a quick influx of sugar, that's going to challenge your cells, your cells have to get that sugar in, have to use it, or else you're gonna have too much sugar floating around in the blood, and then that can cause problems. And then when your body does that, your body makes a whole lot of insulin at once to take that sugar into the blood. Then once it's done its job, you've got all this extra insulin around. And now it's going to take too much sugar into your cells. And now you can have really low blood sugar. And that's when you could get headaches, that's when you can actually have changes in your mental health and your mental well being. But the same thing can happen with a glucose spike that can also affect some of your health symptoms, how you feel. But over time, these quick spikes and these quick lows are too much of a stress on your system. And over time, you can develop inflammation, and you develop this hyperinsulinemia where the insulin actually isn't as sensitive anymore to take the glucose molecules into your cells. Because with it being sensitive all the time, then you end up with hypoglycemia. So your body's actually trying to adjust, but it adjusts by creating this hyperinsulinemia. And now you're in this kind of vicious circle.

Alex X-Health.show: 36:21

OK, and how can you now combine it? I mean, using this glucose monitoring, and the estrogen, progesterone? I'm just starting to ask questions about how do you combine it all and I know that you want to have that all on the platform. So let's jump now into...

Dr. Colleen Fogarty Draper: 36:50

Sure, sure...

Alex X-Health.show: 36:51

...this and tell me why you wanted to create PhenomX and why "PhenomX"?

Dr. Colleen Fogarty Draper: 36:59

Yeah, why PhenomX, exactly. Well, first of all, I want to tell you that in midlife, when we go through these hormone changes, it actually affects our insulin resistance or insulin utilisation, and thus our carbohydrate utilisation. And when we go into that perimenopause to menopause, and even postmenopause trajectory, we've got 34+ symptoms that we get to experience and it's a very personalised experience. The perimenopause to menopause trajectory is on average 10 years. So it's not the same for everybody. I'm saying on average, it's very personal. But then postmenopause, you can have postmenopausal symptoms for up to another 10 years. I hope you don't but that can certainly happen. And those symptoms can also be very strong symptoms. So why CGM for that? Because I actually think, and we're going to learn a lot about this in the coming years, I think we're going to see how these changes in glucose, this glucose response to what you eat actually influences the preponderance of the symptoms. So why PhenomX Health? So what is my Why? My Why is big, because first of all, I've been in personalization my whole career, starting as a clinical dietitian in the hospital, we naturally personalised people's diets according to their disease, then moving into nutritional genomics, which was really synonymous with personalization for a while, and then moving into all the other omics technologies, wearables, and now digital health. This is my passion, because I can see, altering the way we do things nutritionally, to help keep you healthy. So that's there, foundation. Then there's the women's part of things. Well, how does that factor in? Started out my career in a female dominated profession, where we actually didn't have enough evidence base to help women with hormone changes that affected their health symptoms, but we would help each other, my colleagues and I, which were mostly when we talked about our own hormonal health issues and what we needed to do. But we weren't prepared. We didn't have the evidence to prescribe to our patients. And then fast forward to doing my PhD research where I honed in on women's health particularly because I had a big research project where we were focused on personalised nutrition, which would translate beautifully to women. And it was decided in the room that we would do men because they don't have the menstrual cycle and all that variability and noise.

Alex X-Health.show: 39:21

I can't believe that!

Dr. Colleen Fogarty Draper: 39:22

I know! And this is what happened. This has been happening in research for years and years, and years. Because we didn't know how to handle all that variability. But now we can. We're very advanced in scientific research. We know how to statistically handle all that variability. But this became a huge gap in research. And when you look at the literature, if you do a search right now on PubMed, and you look for "health and nutrition"... "hormonal health research"... "nutrition and hormonal health research", you will find, like, 22 studies, one of them is my publication. Then you look at something like pregnancy and lactation, oh my God, you have over 50,000 studies. OK, that's where we thought women's health lie – pregnancy and lactation. So anything else we're researching, we got to study men or we have to actually control, so we put men and women in the study, and we put the male and female data together, and we control for the confounding effects of sex and gender. So we don't actually look at that difference. This is a huge thing that has been happening in history.

Alex X-Health.show: 40:27

Because it's that difficult to research or?

Dr. Colleen Fogarty Draper: 40:30

[laughter] Yeah, I think historically, the goal was to have very large numbers of statistics. So the more people that you had in your population group and in your, whatever characteristic you're analysing, the better. But we lost sight of this inter-individual variability that's so important in personalization, and so obviously important in sex and gender medicine. That's a huge part of my Why. But then also, I had a moment of reflection, as, at the time I started PhenomX, a perimenopausal woman with three teenage daughters, we were constantly managing our hormonal health symptoms. And I, being a nutrition hacker, naturally, because of my training, but just at home with my family, it kind of made sense that this was where I could personally be of service to the world.

Alex X-Health.show: 41:23

So you did your PhD and then you decided, OK, I need to fix that. I need to... yeah, how did you think about founding your own company? Were you sure you want to do this? What did you hesitate about?

Dr. Colleen Fogarty Draper: 41:45

I really went through this personal transformation before I founded my company. And this is something that a lot of women experienced during this menopause trajectory. Anything about your life that's not authentic will become very clear, and will be mirrored in front of you very quickly. And that happened for me. And so I was clearly not operating authentically in my life. And I had to make some changes. I had to change the way I was looking at my career and my personal life. And in that process of that evolution to authenticity is where I put myself in that uncomfortable position of starting PhenomX. Where I really had to say to myself, Coleen, what do you really want to do? There's this concept called ikigai, where you look at how you can be of service to the world, do something you're really good at, do something that you can make money at, and put it all in one place. And so I really challenged myself to find that ikigai, and one day, how I finally got there was I said, OK, I'm going to pretend right now – this was actually really hard – OK, I'm going to pretend right now that I've got all the money in the world. If I had all the money in the world, what would I want to be doing right now. And it was hard, because a lot of the ideas that I had for PhenomX had been turned down by colleagues that I'd wanted to collaborate with. And it didn't matter to me at the time but when I reflected, I realised they were mostly males. In science and leadership it's mostly men, so that influences decision making, with what you naturally identify with. And so I made a PowerPoint and that was PhenomX Health. That was the beginning, it was a PowerPoint slide deck of all the things that I thought were important and interesting, where I can make a difference, and possibly also make money, but really be of service to the world.

Alex Jani, X-Health.show: 43:42

And then how did you start actually making it happen?

Dr. Colleen Fogarty Draper: 43:46

It's such a good question. The way I did was I applied to a couple of accelerator programmes, which we have a number of in Switzerland, we're very lucky, and I learned from a friend that there was a new femtech accelerator programme in Switzerland, called Tech4Eva. So I said, OK, let me send my slide presentation there. And within a couple of weeks, had an interview with them and got accepted. And it was a nine-month programme. And it made such a huge difference in my success in building PhenomX.

Alex X-Health.show: 44:26

Let me just go back a bit, because what you called once the perimenopausal period, you call it a second adolescence - I really like this term. It's like... yeah, why would you call it that?

Dr. Colleen Fogarty Draper: 44:41

The reason that I call it that – and I'm not the first one to do this, right, so you can read about this – first of all, adolescence surprises you because you're a child and then you're going through this time, period, and it's hard to tell – eight or nine years – you're about to go through the most tumultuous period of your life. Because your life hasn't even been that long yet, so what is all of this? And actually, a lot of women don't realise what they're about to go through when they go through this transition period. It can be equally as tumultuous as that adolescent time period, especially if you're not prepared for it. And it's amazing because 50% of women don't even know that they're going through it. So they think they're going crazy.

Alex X-Health.show: 45:24

Oh, and they are tired, right? And they not sure what's happening in their

Dr. Colleen Fogarty Draper: 45:26

Yes. head anymore. Yes. And then maybe they're dying of a horrible disease, you know, Oh-oh, I'm going to be the one that gets the early death.

Alex Jani, X-Health.show: 45:37

Could you name a few of the symptoms?

Dr. Colleen Fogarty Draper: 45:39

Yes. The most common one, of course, is fatigue. And then we've got the mood symptoms, depressive mood, but also a great deal of anxiety. And personally, that actually surprised me, I had so much anxiety, just almost felt like it came out of nowhere. And this is when your hormones are really low, this can happen. Then heart palpitations, which also can be very sensitive to certain foods. And before some of those symptoms, you might even have just extreme PMS, maybe your period is longer, this perimenopause symptom, your period is longer, maybe it's more painful, maybe it's heavier, maybe you're more moody. So you have those kinds of symptoms. And then you just have the increased frequency of things like a urinary tract infections, or you might have more gastrointestinal bloating. And then there's also this creep in the size of your waist that we call the meno belly, where you've got more fat deposition in that area.

Alex X-Health.show: 46:45

Right... That's that's...

Dr. Colleen Fogarty Draper: 46:46

Sorry to be depressing!

Alex X-Health.show: 46:48

No, but these are the symptoms you can easily wave off, right? You may just think like, Oh, my, I'm just tired. Yeah, it's just this season, right? Here in Switzerland we've got December, January - it's so dark here, right?

Dr. Colleen Fogarty Draper: 47:05

I'm not handling my work well, I got to stop being so emotional about things, you know, I just... everybody else is more important than me, so this is small. I don't need to say anything, they don't notice, yeah.

Alex X-Health.show: 47:18

Yeah and then how to connect all of this, the symptoms with a diet with all the tech that you want to use.

Dr. Colleen Fogarty Draper: Exactly. This is the orchestra we're creating, we talked about the symphony in the body. So I guess we could also say that we're creating a symphony. PhenomX trying to actually piece together the different parameters that we can use to analyse a woman biologically, to understand what kinds of things need to be balanced in her system that she can rebound, that she can learn about herself to then affect the degree of severity of the symptoms. It doesn't mean that we can completely cure the symptoms but it's an imbalance that needs to be re-equilibrated. But even using the digital health component of this, which we haven't talked about as much, the self-awareness is so important, tracking symptoms in some easy way is so important to understand how those symptoms vary either in her menstrual cycle, or just in the range of a month, of the moon cycle, let's say. But also how those vary with her diet with her external stress. And we even have this speech to text option because of a collaboration we have with a company, ClearSky Edge AI, where we're actually trained the system with them, so that she can just speak into her smartphone and just say: 47:30

I ate a pound of cheese today, and I'm having lots of hot flashes. She can learn about and track these connections that she's making. We have to honour what the person knows about themselves and then help them see more about themselves over time so they can make their own changes. But we have to put together that orchestra or symphony of information, and then even providing recommendations and products to become kind of that one stop place of personalization. It's really an intricate art as well as a scientific challenge.

Alex X-Health.show: 49:35

From the idea to what you have now, what would you say changed? Because you actually research your clients, women who had the symptoms or didn't have the symptoms, or they wanted something or considered something useless. Could you say something about that experience of collaborating or cooperating with your clients.

Dr. Colleen Fogarty Draper: 50:03

We've actually learned a tonne about our clients over the last year, year and a half in PhenomX. It's been amazing. So the first thing was our 100 persons study. And what I got really surprised by what we talked about how 100% of the women definitely wanted to know hormone status. But there was also the prevalence of symptoms. I thought we would see maybe hot flashes, maybe PMS symptoms at the top most prevalent. But what we saw was this fatigue, 50% of the women were tired. And then I was almost embarrassed with myself that I was surprised with that because of course, everybody's tired in this society and what we expect of ourselves. But this was really their strongest symptom. And hot flashes didn't even show up. And what we've learned is that hot flashes are very important, because when a woman has those, she's definitely going to seek out treatment. But it isn't the most prevalent symptom that women have. That was just from the survey. We're now producing an even more comprehensive survey, and we're going to be doing our prototype tests, and we're going to learn even more. But the other area where I'm learning a lot is just working with our individual clients, who are taking the optimal nutrition tests that we already sell, and just talking with these women about how they feel. And what I've learned, that's very interesting, is that, and I think this is particularly true of the US marketplace, is, by the time a woman gets to her midlife, a lot of women have already experimented a lot with nutrition. They actually do know a lot about nutrition, even if they're not an expert. And they do know a lot about what works for them. But it's also kind of overwhelming, because they might have tried programmes that are very detailed programmes, or they have done things that involve more than one variable. So they know something about it, but they don't know what and they don't know why. And now women want to know what and why. So even though our programme goes from testing, to self monitoring, to recommendations: lifestyle and diet, and then to even product recommendations, I've been surprised to learn that these tests are actually the most interesting and potentially helpful for at least a subset of our women, definitely it's the empowered women, and it might be a lot of the US marketplace but it might not only be. We're still learning. Because women want to know why, and what exactly is working. And that can help you focus.

Alex X-Health.show: 52:43

It definitely speaks to me as you know, I was actually taking some omega-3 supplements. And then what I see in my results that I might be actually deficient in one of these acids, right, I'm deficient in DHA, which is like, No, I took some supplements, right?! I knew this is exactly what you told me, I knew I need to take supplements but apparently, it wasn't enough.

Dr. Colleen Fogarty Draper: 53:11

It was so interesting with your case, because what women typically take is an Omega-3 supplement that's high EPA, and it's got some DHA, but it tends to be lower, and the body is supposed to be able to convert the EPA to DHA, so it should be OK. And DHA, we know is particularly important for your brain health. Also important for your hormone metabolism. But there could be something with you, there's a couple of ways to look at this. Maybe it's just not the right supplement. So you could try different supplements, for sure. Maybe you need to do a little more in your diet. For example, if you take your Omega-3 with a meal that's high in fat, you will absorb them more. So that's something to know. You could also try taking different seeds, like flax seeds or nice and high in linolenic acid, which is then converted to EPA and DHA in the body. So you can do that. And that there's actually something called Seed Cycling, which is a whole other discussion that can also help with PMS and potentially period pain. So you can look at some of those ideas for yourself. You could also have a gene polymorphism that affects your body, its capacity.

Alex Jani, X-Health.show: 54:24

But this... this doesn't sound good, does it?

Dr. Colleen Fogarty Draper: 54:28

Well, I mean, gene polymorphisms are not definitive and they're not necessarily disease causing, it just means that you need to figure out how to overcome this. So for you, I would definitely take a high DHA supplement which they exist in the marketplace. I'm less worried about your EPA. So I do a high DHA supplement. I do some flax, and I would make sure that I took this supplement with a meal that you're having more fat in.

Alex Jani, X-Health.show: 54:53

Thanks. Thanks very much for that. Now let's go back to business and what are your plans to grow PhenomX? What's your business model? I know it developed, it changed shape. Tell me about that.

Dr. Colleen Fogarty Draper: 55:15

Understanding the PhenomX business model has been an intricate process for us that is ongoing. Because we're building this personalization ecosystem. And because we're building, we're trying to build something for all women, particularly between these ages of like, let's say 40-45, to, let's say, 60+, where we're really trying to address that hormone transition time. And, in fact, what we see, that is the most beneficial from just an economic point of view is a nice and basic subscription fee. And that way, just every month she can get new ideas, she can have access to new options, for testing for self analysis, new information. And we can also benefit from some of the affiliate products that we use. From that point of view, I think we can have a sustainable, scalable business model, because we're also digitising everything as much as we can. And our real secret sauce is in our fantastic recommendation engine where we've translated science into action, where we've got our expertise combined with Artificial Intelligence and where we actually learn from the user experience. So the machine gets better and the recommendations get better over time. So our system becomes more and more desirable, which also naturally makes it more scalable. Then we've got the geographic component of this, where we start with Switzerland, UK, US. And then we go to Australia. Now we've addressed the English speaking countries. And then we move to all of Europe, to the Asian continent. The idea of being global and also we have a social media platform that we're building, so women can share with each other what works for them all over the world. So they can cross benefit from their different cultural nutrition practices as well.

Alex X-Health.show: 57:23

It just reminded me about – what made you actually overcome this,"it's not worth it"? I mean,"don't pursue that" PhenomX, "it will not work".

Dr. Colleen Fogarty Draper: 57:39

It was the hardest part. When we talk about startups, and I've been on a few panels when we talked about what it's like to start our own companies, and a lot of people in their startups talk about the stress, every day of managing the budget and managing their people, and making sure they have enough money. But I think the most stressful, most challenging part was making that decision that this opportunity was there for me. Because I have a family, I've got people to take care of. And so that almost even felt selfish, That's there for me. Oh, so I have to... That means that I have to stand up. And I have to be the thought leader. And I have to say maybe some things that other people aren't saying so I have to have the most courage here. And making that decision, I think, it was fierceness and determination to be completely completely authentic. But it was so hard.

Alex Jani, X-Health.show: 58:47

And you didn't have any help from the outside or any push. You found it in yourself.

Dr. Colleen Fogarty Draper: 58:55

Yeah, there were people that wanted to help, my friends, my family. There were people that wanted to help for sure. But nobody could. Because these kinds of life decisions can only come from within.

Alex Jani, X-Health.show: 59:09

So congratulations on that decision. What's ahead, then? What are you looking forward to? What's the future?

Dr. Colleen Fogarty Draper: 59:20

I'm looking forward to having fun at PhenomX Health because we've got this incredible dynamic team. We have 12 people working with us, and we're self-funded garage operations still. And I am looking forward to continuing to build this company with Jérôme Michaud, who is my fearless partner and COO, who is absolutely fantastic and so thankful for him as well. Looking forward to getting funding so I can pay these amazing people we have on our team right now. So we can keep them going with PhenomX because I think that we're in the position to build something really beautiful. What's beautiful about what we're building is really being able to reach out to women all over the world, and really inspire them to step up to talk about their health, to take charge of their health for they're responsible, and making decisions for everybody else's health in their families, and to actually find the courage within that I had when I started PhenomX.

Alex Jani, X-Health.show: 1:00:24

Yeah, let me ask this question, is the PhenomY coming?

Dr. Colleen Fogarty Draper: 1:00:31

Such a good question! So really, in terms of how we are of service we start with midlife, then we extend across the entire lifespan of being a woman because so much of what we're doing for our midlife women on their menopause journey is translatable. The perimenopause work we're doing really translates to how helping the adolescents and young adults. And then the post menopause work, which really ties a lot into longevity science really goes to helping women 60+ beyond and our healthy ageing trajectory, where hopefully we've prepared them for that we've dealt with this vulnerable time and menopause. But then we can offer some of the great new science solutions that are coming out for that population as well. Then we also, concurrent with that I believe, we can tackle phenom Y. So what is phenom Y? Obviously, that's for men, that's to handle their hormone changes, which are important there, they don't have as much of an extreme effect as the female hormone changes. So it's fair that we're dealing with females first. But they're going to start feeling left out really fast. And there is actually a lot of interesting science coming out around testosterone microbiome. But also prostate health is a big issue for midlife men, for example. And I think that that population is not as well addressed as the younger male population. And then of course, all the longevity science has been more studied in men. So it will be easy for us to actually transition our platform over to PhenomY.

Alex X-Health.show: 1:02:09

That sounds like an exciting future ahead. Thank you, thank you very much, Colleen, and you may find Dr. Colleen Fogarty-Draper and PhenomX Health at www.phenomxhealth.com – that's for Europe. For Europe, you can also type phenomX.ch. And for the US, you'll find her at phenomX.health.

Dr. Colleen Fogarty Draper: 1:02:55

Perfect. Thank you for explaining that to our audience. And thank you everyone for listening today.

Alex Jani, X-Health.show: 1:03:00

My pleasure. Thanks very much.[POST-ROLL] I'm totally impressed by the audacity of researchers turned startup founders, doctors turned entrepreneurs, ordinary parents turned healthcare innovators. People battling the battles that no one fought before. For the eXtra health of the future. So if you see a startup posting on LinkedIn, show them some love, hit Like, comment, "That's fabulous". If you have a couple of drops more of that altruism, follow the X-Health.show, leave a review here. I'll be able to bring more of these visionaries to you. So a big thank you. You're awesome. See you next week.

SPEAKER: 1:03:43

The information in this podcast is for informational purposes only and should not be considered medical advice. If you have any medical questions, please consult your healthcare practitioner. The opinions on the show are Alex's or her guests. The podcast does not make any responsibility or warranties about guests' statements or credibility. While the podcast makes every effort to ensure that the information shared is accurate, please let us know if you have any comments, suggestions or corrections.