Your Health Starts with Your Story: Meet Dr. Sara Gottfried

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In Episode 23 of the Big Bold Health Podcast, Dr. Sara Gottfried empowers everyone to tell their story as a bold first step in taking ownership of their health. Dr. Gottfried shares some of her own personal experiences and how they’ve informed her as she works to close the gap in women’s health

James Maskell:

Hello and welcome back to the ‎Big Bold Health Podcast. We are charting a new world of health independent of disease with my co-host, Dr. Jeffrey Bland. Doc, it’s great to be back here with you.

Jeffrey Bland:

Likewise. Thanks James.

James Maskell:

So, when we decided to interview female leaders transforming health, Jeff and I made a list and Dr. Sara Gottfried was right on the top of that list. And unlike all the other people that were on the list, this is the first time we’ve met. So I’m really happy and honored to be with you, both of you. Dr. Gottfried is a best-selling author, is a researcher, physician, and doc, you’ve been dedicating the last two decades to educating and really transforming women’s health.

Jeffrey Bland:

Can I say something quickly?

James Maskell:

Yeah.

Jeffrey Bland:

Yeah. I don’t want to break the continuity, but Dr. Gottfried also is a remarkable person in terms of her educational background that tells you something about her and her perspective. Not only having had her medical degree at Harvard Med School, but having a degree in engineering and the whole nature of bioengineering at MIT. So you know she’s got the highly developed left and right hemisphere of her brain. This is a very unique talent that she brings into her worldview, her practice, her advocacy. And there are very few people in the world that I would select to want to have as a quintessential example of women’s health and women’s health advocacy other than Dr. Gottfried, she’s a remarkable person.

Sara Gottfried:

Thank you.

James Maskell:

Well you said it better than I. So, Dr. Gottfried, to the question, what was it that really got you fired up to sort of made an impact in where you’ve gone so far and where you’re going in the future?

Sara Gottfried:

Well, it didn’t start with women’s health. It actually started with a grandmother who was diagnosed with Alzheimer’s disease. And at the time I was getting a PhD in bioengineering. And I just realized that the medical system had completely failed her. And so while I was working on the vascular, the angiogenic response in cancer at the time, I realized I could have so much more of an impact if I went to medical school. So I dropped out of the PhD program and applied, got into the Harvard program and that’s where I started to realize that there’s a massive gap, research gap, when it comes to women’s health.

Sara Gottfried:

And there’s various threads in our historical framework for that. In some ways I think that’s less relevant. What matters is the future. So what I realized also is that the research gap has led to a massive knowledge gap. So, my ambition, my big, bold hope is to close that gap.

Jeffrey Bland:

So I would say from my observation of what you’re doing is you’re making positive progress in achieving that objective. You are an opinion leader who’s stopping people’s talk so they can listen to what you’re saying. And you’re educating by example, which is the most useful way of educating. We can learn in different ways. Part of it is in our head, part of it is in our heart, and the best is when we combine those two and you do them well. Both those… that combination. So, maybe you could just quickly share a little of your own personal experience because I think that helps to contextualize your advocacy in your position.

Sara Gottfried:

Sure, sure. Well, let’s go back to my grandmother. So we know that women are diagnosed with Alzheimer’s disease at twice the rate of men. We don’t understand why. We don’t understand, is it hormonal, is it gender differences, is it differences in brain structure? And so that’s what initially got me motivated. But the more that I learned about women’s health and these gaps with men’s health, the more that I realized it’s not confined to Alzheimer’s disease, of course, it relates to anxiety, depression, autoimmune disease. There are so many conditions that women face at a much higher rate than men and we have no idea why that is. So, in terms of personal story, it sounds like you have something in mind, Jeff.

Sara Gottfried:

A lot of what motivated me, especially toward precision in personalized medicine, was listening to your tapes. Going back to the 1990s.

Jeffrey Bland:

Oh my word.

Sara Gottfried:

And hearing about… You have this level of scholarship when it comes to understanding the human body, understanding its signaling pathways, that made so much sense to me. And it really married my love of engineering and kind of the engineering mind that I have with an approach to medicine that was head and shoulders above what I was even learning at Harvard Medical School. So, that’s what really got me motivated. And from a personal perspective, I joke sometimes that I’ve had every hormonal problem that a woman can possibly have short of menopause.

Sara Gottfried:

And so, I’ve had sort of one issue after another. I didn’t have difficulty getting pregnant, but once I was postpartum, I had postpartum depression. I couldn’t lose the baby weight, which I think happens to so many women. They gain 20 pounds with their first baby. They have another baby, they gain another 20 pounds. And before they know it, they have metabolic dysregulation. And that’s at the root of so many of the conditions that we’re talking about. So I would say, my personal challenges have led me to the next step in terms of helping women understand their bodies, get informed about their function and get empowered about how to step into action.

Jeffrey Bland:

Yeah. And you’ve done that so remarkably. And I think part of that impact you have is your openness and truthfulness and there is a sense that this person is speaking a central truth. There is no kind of peripheral garbage here. This is a core truth. How have you gotten yourself comfortable to be able to create that truth-saying identity in a marketplace that often tries to channel us into some kind of persona?

Sara Gottfried:

Great question. I think… One of the things that I encountered in conventional medicine is that you don’t share your story. You stay focused on the patient’s story. And I think that’s really important. But I also really believe in Brené Brown, who talks about vulnerability as the path to wholeheartedness. And I would even say that vulnerability, kind of sharing your vulnerability along with credibility is the key to helping people realize their own vulnerability. And then to start to change their behaviors in the direction of better function, better outcomes, better health.

Sara Gottfried:

So, the most recent challenge that I went through was, I diagnosed myself based on genomic testing with a gene that puts me at about a 3-5x increased risk of breast cancer and a 2x increased risk of colon cancer. And so I made the decision after trying to modulate my estrogen pathways to have a prophylactic mastectomy.

Sara Gottfried:

So I went through that procedure. But here’s what was surprising, I took a month of antibiotics for the first time in my life. And after I finished that month of antibiotics, and I turned this into an N-of-1 study if you want to hear more about that, I felt anxiety for the first time in my life. And I also gained weight. I gained about 15 pounds without changing what I was eating. So remarkable change in the signaling pathways in my body, ended up getting diagnosed with small intestinal bacterial overgrowth. And that set me upon this path of really looking at, okay, the gut-brain axis, it really came alive for me in a way that it wasn’t as relevant before.

Sara Gottfried:

So that’s an example of kind of my most recent personal challenges, which I see not as a victim, but as, okay, this is the next step in my path. Something that was previously unknown to me or not known well enough that I need to understand better. Because if I struggle with it, if I struggle with anxiety and with insulin resistance as a result of what’s happening in my gut microbes, certainly other people are going through that too. Not just women, but men too.

Jeffrey Bland:

Yeah. Can I just, I want to turn this back to you, but I just want to take just a half a moment to honor you, because what you just said is not easy to say. It’s even maybe more difficult to go through, and then it’s more complicated to try to understand, and then communicate. And what you did in that sound bite is truly courageous. And I think it’s what then creates in other people the opportunity for them to be courageous about their health. And when we talk about ‎Big Bold Health, the reason we chose “big bold” is I think it requires us to step up and be more bold about our health.

Jeffrey Bland:

We often feel that we’re a victim and we have no control. And well woe is us if we got bad genes or the bad luck in life, and we’ve just kind of got thrust into this condition of not feeling well and there’s nothing we can do. To step up and be bold, to be the advocate of ownership of our health, to create this new ‘we’ or new ‘us’ is really quite a remarkable courageous thing to do. And your advocacy can help spawn many other individuals to take that step. So, thank you.

Sara Gottfried:

Thank you.

Jeffrey Bland:

It’s huge. So James, I’m sorry I interrupted.

James Maskell:

Well, you have multiple New York Times best-selling books and each one kind of evolves into the next one. And obviously you have your own experience. You have the research that evolves and then you have obviously, patient care. What were some things that led to this latest book and things that you felt that you wanted to share that you hadn’t shared up until now?

Sara Gottfried:

Well, there were a number of things. Certainly this experience with SIBO, small intestinal bacterial overgrowth, was huge. And I had another epiphany. You could even say I got hit over the head with another epiphany, which was in 2015. I was with a group of clinicians. We were filming a TV show in San Diego and we went all day long, not eating and drinking and taking care of our bodies. And I fainted at the end of this. We were standing in the kitchen trying to figure out what to eat for dinner at 10 o’clock at night.

Sara Gottfried:

So I think what happened was probably low blood sugar. I fell, hit my head pretty hard and when I hit my head I had what looked like convulsions. And at that point some of the doctors in the room called 911. So I had this experience of a traumatic brain injury that also got me to realize the essential nature of the integrity of the gut lining, the essential nature of the integrity of the blood-brain barrier, and how I was disrupting it right and left and I had no idea.

Sara Gottfried:

So I decided I wanted to write a book about it because I realized so many of the conditions that I see in my practice, anxiety, depression, addiction, weight gain, early memory loss, brain fog, all of these things are related to that gut-brain access. It’s related to other things as well. The immune system is part of that access. But that was what really motivated me to say, “Okay, even if you don’t have gut symptoms, you might have an issue with your gut-brain access.” Because that’s what happened to me.

James Maskell:

Wow. And how do you translate that into sort of actionable information for the reader?

Sara Gottfried:

Well I think there’s many ways to translate it. I think, and this I would say is my most sacred obligation, to try to make really complex scientific information, understandable, relatable, and actionable. So, I don’t think you can start with a microbiome. I mean I love to start there. I know Jeff loves to start there.

Jeffrey Bland:

Yeah.

Sara Gottfried:

You probably love to start there too. But for most people going about their busy days, the microbiome is not so relevant yet. We can make an argument that maybe it should be. But I think the way you start is, what are your pain points? What are you suffering with? So I know from quantified analyses that I did in my own practice that my patients struggle with mood, stress, weight gain, sex drive, although they’d like to lose weight first before they deal with sex drive. And so I know what the pain points are and I know that there’s proven ways to solve those pain points. So my books frame up against those particular pain points.

James Maskell:

And you mentioned earlier the research doesn’t really reflect for women what’s really going on, there’s some gaps there. What is unique about the female physiology that lends itself to these chronic illnesses that you’ve written about.

Jeffrey Bland:

Can I jump in there?

James Maskell:

Yeah.

Jeffrey Bland:

Because I think that’s a great question and I want to put an addendum to your question.

James Maskell:

Yeah.

Jeffrey Bland:

I had the privilege many years ago of meeting Bernadine Healy. And that was a life changing experience for me. Unfortunately she’s not with us any longer but her advocacy still lives on very, very strongly. And being the first kind of female, strong women’s advocate at NIH really got the whole nature of research to be changed. And when I bring this topic up today with my colleagues, a lot of them are male research or clinicians, and I say, “Do you realize that the approval of drugs starting off in early stage, which are animal trials, are all done on male animals?” Not even getting to clinical studies in humans yet. We’re just on the basic first level development, your kind of your basic science, that they’re done on male animals. And the reason for it is that it’s presumed within basic research that female physiology is too complex.

Sara Gottfried:

Mm-hmm.

Jeffrey Bland:

It’s a wild card. And when I heard that, I mean it was like a two-by-four alongside of my head. I thought, “What!? Because it’s complex, we go to only using male animals and then we eventually go to a drug that’s going to be used in females and males only with male subjects in clinical trials. There is just like no way you can even begin to rationalize this.”

Jeffrey Bland:

So, having met Dr. Healy and seeing her advocacy for the Women’s Health Initiative and that first big research cohort that the results are still forthcoming today. It was a wild card that changed… It wasn’t a wild card, I mean it was an agent of change that changed the whole domain. So your advocacy I see as an extension of Dr. Healy’s advocacy.

Sara Gottfried:

Well thank you. And I’m a huge admirer of Bernadine Healy as well. I think she really got us to turn left finally at the NIH and she is responsible for the Women’s Health Initiative, which was the first, it wasn’t the first randomized trial, but it was the first randomized trial looking at hormone therapy in women for primary prevention of a number of different outcomes. And it ended up showing that hormone therapy, at least conjugated equine estrogen and medroxyprogesterone acetate were dangerous and provocative in many situations.

Sara Gottfried:

And we got a lot more clarity about outcomes. But let’s go back to the 60 years before that where we had Premarin, conjugated equine estrogen, as the number one prescription without ever bothering to do a randomized trial until the HERS trial in 1999. So, I am so grateful for her and the way that she has helped us understand the role of hormone therapy as well as beyond.

Sara Gottfried:

And you’re right, I mean I remember coming to your Thought Leaders Consortium many years ago and talking about how it was presumed even back in the 1930s with Walter Cannon and his work on the fight-flight response. It was presumed in his work on men that the same applies to women and in women it’s more complex. Women tend to fight-flight-freeze. They’ve got this freeze component. They also rise above stress by going into tend-and-befriend. And that wasn’t discovered until the 1990s by UCLA professor Shelley Taylor.

Sara Gottfried:

So what are some of the differences? There’s that difference in stress response. There’s hormonal signaling differences. The major ones being estrogen is the master regulator in women, testosterone in men. We know that there’s various neurotransmitter differences such as with the oxytocin pathway, you have to hug a man three times as long to get oxytocin to spike.

Sara Gottfried:

So there’s a number of different, differences. If you look at the brain, for instance, and I’m a little cautious about saying this because I’m from San Francisco and we’re not quite as binary about sex and gender now, but if a radiologist looks at a brain image, an MRI or a CT scan of a brain, they can tell with 85% certainty whether it’s a male or female brain. And some of those differences include the hippocampus, which is the seat of memory consolidation and emotional regulation. It’s larger in the female, at least up until a certain point, probably the forties. The amygdala, which is the part of the limbic system where you search for threat in the environment, is larger in the male.

Sara Gottfried:

There’s other differences as well, but those are some of the key physiological differences. And then of course there’s sex differences which are biological. And then there’s gender differences such as more responsibility for care-taking, taking care of aging parents, societal and other cultural differences.

Sara Gottfried:

I was just reading a paper this morning about triathlon enthusiasts, and we now know that women participate in triathlons worldwide at about a 25 to 40% rate, which is higher than ever before. And the difference physiologically in terms of outcomes such as how fast you can run in an Ironman distance triathlon is only 7% between men and women. So women are catching up in many ways and I don’t want to talk about this in kind of a one up, one down way because I don’t think that’s very fruitful. I think what’s helpful is to understand these sex and gender differences so that all of our health can improve.

Jeffrey Bland:

Yeah, I think that’s beautifully, beautifully stated. And if I can just bring up a note of history, and I know I tend to now wax back maybe before people want to even think about this but…

Sara Gottfried:

We love it when you do.

Jeffrey Bland:

Maybe. Let me try it on and then you can tell me. So, I had a chance in my younger years to meet a gentleman, Dr. Robert A. Wilson, and he was the author of a book called, Feminine Forever, which in the 60s sold I think several million copies.

Sara Gottfried:

Yes.

Jeffrey Bland:

And I had met him and I have to say quite honestly, the first time I met him, I was really put off by him. Of course, I was a younger guy, he was kind of a senior guy. He was given credit for being the discoverer of Premarin and its positive effect on women’s health and mood. And he had kind of a golden reputation at the time. But I found it to be personally off-putting, quite honestly, and kind of self-absorbed. But the bottom line is when I finally read Feminine Forever, I was disgusted. I mean, I really couldn’t believe it that this book had sold to so many women and I believe it was probably out of a fear-based thing because it used terms, and I’m quoting now, this is not being made up, that women who did not manage their hormones at menopause would be suffering from bovine passivity.

Sara Gottfried:

Yes.

Jeffrey Bland:

That term is in the book, bovine passivity. And that men would have all the reasons to seek out other relationships from that of their wife if they were to be suffering from bovine passivity. I don’t even need to go farther than to just talk about the social and psychological angst I had when I was reading this, to think of how that contextualized the setting in stage of what became the number one prescribed drug for some period of time for the alleviation of symptoms that would keep women from losing relationships or feeling full and productive about themselves.

Jeffrey Bland:

So this legacy of not even medicine, of psychopathology is so deeply rooted. And when I see people like yourself that is advocating this kind of equality and opportunity, now having granddaughters, I only had sons, but now I have granddaughters. I really see this as a tremendous period of positive change. So thank you.

Sara Gottfried:

Thank you. Thank you. I appreciate that. I read Robert Wilson’s book as well and was horrified. But I also would say it’s a product of its time.

Jeffrey Bland:

It was.

Sara Gottfried:

And it’s hard to judge it with sort of today’s sensibilities. But yes, I remember the bovine passivity and it was, the taking hormone therapy was really framed as “Save your marriage.”

Jeffrey Bland:

Mm-hmm.

Sara Gottfried:

“Don’t be a castrated female that drives your husband away.”

Jeffrey Bland:

Exactly.

Sara Gottfried:

So as you described, very fear-based. And I hope now that women can approach decision making about their health, whether that’s hormone therapy or what to do about Polycystic Ovarian Syndrome or endometriosis or even just how to function better as we get older and extend the health span. I hope that they make their decisions from a place of empowerment with their clinicians in a collaborative partnership and not from this place of fear, which I think is unfortunately the foundation of conventional medicine.

James Maskell:

Well, just to go on there, if Jeff’s the past guy, then I’m the future guy.

Sara Gottfried:

Awesome.

James Maskell:

So, if we were 30 years in the future and we’re looking back on let’s say the last 10 years, at the moment that it became clear that chronic disease should be built on exactly what you just shared and not the way that it had gone before that coincides with your work. Isn’t it amazing to think that it was women going to see doctors who practice differently that actually facilitated the whole evolution? Because if you look at 75% of functional medicine patients are women, 75% of functional medicine doctors are women, and that’s women at a certain point just being like, “No more. This is not working for us.” And that journey and the learnings that happened in this community at this time sent us forward into this big, bold future. What do you think of that, Jeff?

Jeffrey Bland:

I’m right on target with you. And I think that’s our advocacy. That’s why we’re here. That’s why we’re doing this. That’s why we’re so fortunate to have Dr. Gottfried.

James Maskell:

And you’ll be 103 when we do that review. So I’m looking forward to that.

Jeffrey Bland:

I hope it won’t be that far in the future. So, as you move now into this next phase with your new book and the advocacy that it will bring and doing the book tour and all those kinds of things, where do you see your trajectory going as a person who is in this universe, as a leader, as an agent of change?

Sara Gottfried:

Well, a few places. I would say certainly research. I’ve got a research project that I’m working on right now looking at women in the ketogenic diet because I believe, based on my experience clinically, that men do much better on a ketogenic diet than women do. Women have, half of them have menstrual irregularity, they have thyroid and adrenal dysfunction. And so I want to figure out how do we make the ketogenic diet modified for women and much more effective because I think it is one of the strategies, not one-size-fits-all, not for everyone, that can really help with metabolic dysfunction.

Sara Gottfried:

So I would say research is one thread. Another thread is education. And I really believe that Nelson Mandela quote that education is a weapon that we have to change these injustices and struggles that we have. And even broader than education is media.

Sara Gottfried:

So I really believe that we are in an intention-based economy. I think economics have really changed over the past few decades. We’re heading toward an exponential global future and we have to be really smart, really wise and also circumspect and responsible about the media that we produce. That’s why I love your podcast. I think it’s really essential that we’ve got impeccable content that we’re sharing with the world, with the 75% of women who are part of this functional, personalized lifestyle medicine movement. But for men as well, I don’t mean to leave men out of the equation. We need everybody.

Jeffrey Bland:

Yeah. Yep. And I think what we’re seeing now is there is some harmonization and if we can unify this energy in such a way it promotes a positive harmonic oscillation, we can create global change. And I think that it’s not going to probably come from the top-down. It’s going to come, as you’ve so well educated, from the bottom-up of people just basically saying, “We’re going to be big and bold about our health, or our children’s health, or our family’s health, or our neighbor’s health, or our global health.” Knowing that a healthy planet is a healthy person and vice versa. All of that resonance can create extraordinary positive change. So you are a strong member of our leadership community that we’re privileged to have. And thank you for sharing who you are and what you are and where you’re going.

Sara Gottfried:

Thank you.

Jeffrey Bland:

Really exciting.

Sara Gottfried:

Thank you so much.

Jeffrey Bland:

Thank you so much.

James Maskell:

Well on that big, bold, bombshell, we’ll finish off today. We’ve been here with Dr. Sara Gottfried. You can find out more about her work, we’ll have links to the latest book in the notes. But thanks, I’m your host, James Maskell here with Dr. Jeffrey Bland. Thanks so much for tuning in to the Big Bold Health Podcast, and we’ll see you next time.

 

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Throughout the Site, we may provide links and pointers to Internet sites maintained by third parties. Our linking to such third-party sites does not imply an endorsement or sponsorship of such sites, or the information, products or services offered on or through the sites. In addition, neither we nor affiliates operate or control in any respect any information, products or services that third parties may provide on or through the Site or on websites linked to by us on the Site.

 

If applicable, any opinions, advice, statements, services, offers, or other information or content expressed or made available by third parties, including information providers, are those of the respective authors or distributors, and not COMPANY. Neither COMPANY nor any third-party provider of information guarantees the accuracy, completeness, or usefulness of any content. Furthermore, COMPANY neither endorses nor is responsible for the accuracy and reliability of any opinion, advice, or statement made on any of the Sites by anyone other than an authorized COMPANY representative while acting in his/her official capacity.

 

THE INFORMATION, PRODUCTS AND SERVICES OFFERED ON OR THROUGH THE SITE AND BY COMPANY AND ANY THIRD-PARTY SITES ARE PROVIDED “AS IS” AND WITHOUT WARRANTIES OF ANY KIND EITHER EXPRESS OR IMPLIED. TO THE FULLEST EXTENT PERMISSIBLE PURSUANT TO APPLICABLE LAW, WE DISCLAIM ALL WARRANTIES, EXPRESS OR IMPLIED, INCLUDING, BUT NOT LIMITED TO, IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. WE DO NOT WARRANT THAT THE SITE OR ANY OF ITS FUNCTIONS WILL BE UNINTERRUPTED OR ERROR-FREE, THAT DEFECTS WILL BE CORRECTED, OR THAT ANY PART OF THIS SITE, INCLUDING BULLETIN BOARDS, OR THE SERVERS THAT MAKE IT AVAILABLE, ARE FREE OF VIRUSES OR OTHER HARMFUL COMPONENTS.

 

WE DO NOT WARRANT OR MAKE ANY REPRESENTATIONS REGARDING THE USE OR THE RESULTS OF THE USE OF THE SITE OR MATERIALS ON THIS SITE OR ON THIRD-PARTY SITES IN TERMS OF THEIR CORRECTNESS, ACCURACY, TIMELINESS, RELIABILITY OR OTHERWISE.

 

You agree at all times to defend, indemnify and hold harmless COMPANY its affiliates, their successors, transferees, assignees and licensees and their respective parent and subsidiary companies, agents, associates, officers, directors, shareholders and employees of each from and against any and all claims, causes of action, damages, liabilities, costs and expenses, including legal fees and expenses, arising out of or related to your breach of any obligation, warranty, representation or covenant  set forth herein.

 

Online Commerce

 

Certain sections of the Site may allow you to purchase many different types of products and services online that are provided by third parties. We are not responsible for the quality, accuracy, timeliness, reliability or any other aspect of these products and services. If you make a purchase from a merchant on the Site or on a site linked to by the Site, the information obtained during your visit to that merchant’s online store or site, and the information that you give as part of the transaction, such as your credit card number and contact information, may be collected by both the merchant and us. A merchant may have privacy and data collection practices that are different from ours. We have no responsibility or liability for these independent policies. In addition, when you purchase products or services on or through the Site, you may be subject to additional terms and conditions that specifically apply to your purchase or use of such products or services. For more information regarding a merchant, its online store, its privacy policies, and/or any additional terms and conditions that may apply, visit that merchant’s website and click on its information links or contact the merchant directly. You release us and our affiliates from any damages that you incur, and agree not to assert any claims against us or them, arising from your purchase or use of any products or services made available by third parties through the Site.

 

Your participation, correspondence or business dealings with any third party found on or through our Site, regarding payment and delivery of specific goods and services, and any other terms, conditions, representations or warranties associated with such dealings, are solely between you and such third party. You agree that COMPANY shall not be responsible or liable for any loss, damage, or other matters of any sort incurred as the result of such dealings.

 

You agree to be financially responsible for all purchases made by you or someone acting on your behalf through the Site. You agree to use the Site and to purchase services or products through the Site for legitimate, non-commercial purposes only. You also agree not to make any purchases for speculative, false or fraudulent purposes or for the purpose of anticipating demand for a particular product or service. You agree to only purchase goods or services for yourself or for another person for whom you are legally permitted to do so. When making a purchase for a third party that requires you to submit the third party’s personal information to us or a merchant, you represent that you have obtained the express consent of such third party to provide such third party’s personal information.

 

Interactive Features

 

This Site may include a variety of features, such as bulletin boards, web logs, chat rooms, and email services, which allow feedback to us and real-time interaction between users, and other features which allow users to communicate with others. Responsibility for what is posted on bulletin boards, web logs, chat rooms, and other public posting areas on the Site, or sent via any email services on the Site, lies with each user – you alone are responsible for the material you post or send. We do not control the messages, information or files that you or others may provide through the Site. It is a condition of your use of the Site that you do not:

  • Restrict or inhibit any other user from using and enjoying the Site.
  • Use the Site to impersonate any person or entity, or falsely state or otherwise misrepresent your affiliation with a person or entity.
  • Interfere with or disrupt any servers or networks used to provide the Site or its features, or disobey any requirements, procedures, policies or regulations of the networks we use to provide the Site.
  • Use the Site to instigate or encourage others to commit illegal activities or cause injury or property damage to any person.
  • Gain unauthorized access to the Site, or any account, computer system, or network connected to this Site, by means such as hacking, password mining or other illicit means.
  • Obtain or attempt to obtain any materials or information through any means not intentionally made available through this Site.
  • Use the Site to post or transmit any unlawful, threatening, abusive, libelous, defamatory, obscene, vulgar, pornographic, profane or indecent information of any kind, including without limitation any transmissions constituting or encouraging conduct that would constitute a criminal offense, give rise to civil liability or otherwise violate any local, state, national or international law.
  • Use the Site to post or transmit any information, software or other material that violates or infringes upon the rights of others, including material that is an invasion of privacy or publicity rights or that is protected by copyright, trademark or other proprietary right, or derivative works with respect thereto, without first obtaining permission from the owner or rights holder.
  • Use the Site to post or transmit any information, software or other material that contains a virus or other harmful component.
  • Use the Site to post, transmit or in any way exploit any information, software or other material for commercial purposes, or that contains advertising.
  • Use the Site to advertise or solicit to anyone to buy or sell products or services, or to make donations of any kind, without our express written approval.
  • Gather for marketing purposes any email addresses or other personal information that has been posted by other users of the Site.

COMPANY may host message boards, chats and other private/public forums on its Sites and on other platforms. Any user failing to comply with the terms and conditions of this Agreement may be expelled from and refused continued access to, the message boards, groups, chats or other such forums in the future. COMPANY or its designated agents may remove or alter any user-created content at any time for any reason. Message boards, chats and other public forums are intended to serve as discussion centers for users and subscribers. Information and content posted within these public forums may be provided by COMPANY staff, COMPANY’s outside contributors, or by users not connected with COMPANY, some of whom may employ anonymous user names. COMPANY expressly disclaims all responsibility and endorsement and makes no representation as to the validity of any opinion, advice, information or statement made or displayed in these forums by third parties, nor are we responsible for any errors or omissions in such postings, or for hyperlinks embedded in any messages. Under no circumstances will we, our affiliates, suppliers or agents be liable for any loss or damage caused by your reliance on information obtained through these forums. The opinions expressed in these forums are solely the opinions of the participants, and do not reflect the opinions of COMPANY or any of its subsidiaries or affiliates.

 

COMPANY has no obligation whatsoever to monitor any of the content or postings on the message boards, chat rooms or other public forums on the Sites. However, you acknowledge and agree that we have the absolute right to monitor the same at our sole discretion. In addition, we reserve the right to alter, edit, refuse to post or remove any postings or content, in whole or in part, for any reason and to disclose such materials and the circumstances surrounding their transmission to any third party in order to satisfy any applicable law, regulation, legal process or governmental request and to protect ourselves, our clients, sponsors, users and visitors.

 

Registration

 

To access certain features of the Site, we may ask you to provide certain demographic information including your gender, year of birth, zip code and country. In addition, if you elect to sign-up for a particular feature of the Site, such as chat rooms, web logs, or bulletin boards, you may also be asked to register with us on the form provided and such registration may require you to provide personally identifiable information such as your name and email address. You agree to provide true, accurate, current and complete information about yourself as prompted by the Site’s registration form. If we have reasonable grounds to suspect that such information is untrue, inaccurate, or incomplete, we have the right to suspend or terminate your account and refuse any and all current or future use of the Site (or any portion thereof). Our use of any personally identifiable information you provide to us as part of the registration process is governed by the terms of our Privacy Policy.

 

Passwords

 

To use certain features of the Site, you will need a username and password, which you will receive through the Site’s registration process. You are responsible for maintaining the confidentiality of the password and account, and are responsible for all activities (whether by you or by others) that occur under your password or account. You agree to notify us immediately of any unauthorized use of your password or account or any other breach of security, and to ensure that you exit from your account at the end of each session. We cannot and will not be liable for any loss or damage arising from your failure to protect your password or account information.

 

Limitation of Liability

 

UNDER NO CIRCUMSTANCES, INCLUDING, BUT NOT LIMITED TO, NEGLIGENCE, SHALL WE, OUR SUBSIDIARY AND PARENT COMPANIES OR AFFILIATES BE LIABLE FOR ANY DIRECT, INDIRECT, INCIDENTAL, SPECIAL OR CONSEQUENTIAL DAMAGES THAT RESULT FROM THE USE OF, OR THE INABILITY TO USE, THE SITE, INCLUDING OUR MESSAGING, BLOGS, COMMENTS OF OTHERS, BOOKS, EMAILS, PRODUCTS, OR SERVICES, OR THIRD-PARTY MATERIALS, PRODUCTS, OR SERVICES MADE AVAILABLE THROUGH THE SITE OR BY US IN ANY WAY, EVEN IF WE ARE ADVISED BEFOREHAND OF THE POSSIBILITY OF SUCH DAMAGES. (BECAUSE SOME STATES DO NOT ALLOW THE EXCLUSION OR LIMITATION OF CERTAIN CATEGORIES OF DAMAGES, THE ABOVE LIMITATION MAY NOT APPLY TO YOU. IN SUCH STATES, OUR LIABILITY AND THE LIABILITY OF OUR SUBSIDIARY AND PARENT COMPANIES OR AFFILIATES IS LIMITED TO THE FULLEST EXTENT PERMITTED BY SUCH STATE LAW.) YOU SPECIFICALLY ACKNOWLEDGE AND AGREE THAT WE ARE NOT LIABLE FOR ANY DEFAMATORY, OFFENSIVE OR ILLEGAL CONDUCT OF ANY USER. IF YOU ARE DISSATISFIED WITH THE SITE, ANY MATERIALS, PRODUCTS, OR SERVICES ON THE SITE, OR WITH ANY OF THE SITE’S TERMS AND CONDITIONS, YOUR SOLE AND EXCLUSIVE REMEDY IS TO DISCONTINUE USING THE SITE AND THE PRODUCTS, SERVICES AND/OR MATERIALS.

 

THIS SITE IS CONTINUALLY UNDER DEVELOPMENT AND COMPANY MAKES NO WARRANTY OF ANY KIND, IMPLIED OR EXPRESS, AS TO ITS ACCURACY, COMPLETENESS OR APPROPRIATENESS FOR ANY PURPOSE.

 

WITH REGARDS TO CONTENT RELATING TO HEALTH & WELLNESS ON THE SITE:

THIS SITE OFFERS HEALTH, WELLNESS, FITNESS AND NUTRITIONAL INFORMATION AND IS DESIGNED FOR EDUCATIONAL PURPOSES ONLY. YOU SHOULD NOT RELY ON THIS INFORMATION AS A SUBSTITUTE FOR, NOR DOES IT REPLACE, PROFESSIONAL MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT. IF YOU HAVE ANY CONCERNS OR QUESTIONS ABOUT YOUR HEALTH, YOU SHOULD ALWAYS CONSULT WITH A PHYSICIAN OR OTHER HEALTH-CARE PROFESSIONAL. DO NOT DISREGARD, AVOID OR DELAY OBTAINING MEDICAL OR HEALTH RELATED ADVICE FROM YOUR HEALTH-CARE PROFESSIONAL BECAUSE OF SOMETHING YOU MAY HAVE READ ON THIS SITE. THE USE OF ANY INFORMATION PROVIDED ON THIS SITE IS SOLELY AT YOUR OWN RISK.

 

NOTHING STATED OR POSTED ON THIS SITE OR AVAILABLE THROUGH ANY SERVICES ARE INTENDED TO BE, AND MUST NOT BE TAKEN TO BE, THE PRACTICE OF MEDICAL OR COUNSELING CARE. FOR PURPOSES OF THIS AGREEMENT, THE PRACTICE OF MEDICINE AND COUNSELING INCLUDES, WITHOUT LIMITATION, PSYCHIATRY, PSYCHOLOGY, PSYCHOTHERAPY, OR PROVIDING HEALTH CARE TREATMENT, INSTRUCTIONS, DIAGNOSIS, PROGNOSIS OR ADVICE.

 

Termination

 

We may cancel or terminate your right to use the Site or any part of the Site at any time without notice. In the event of cancellation or termination, you are no longer authorized to access the part of the Site affected by such cancellation or termination. The restrictions imposed on you with respect to material downloaded from the Site, and the disclaimers and limitations of liabilities set forth in these Terms of Service, shall survive.

 

Refund Policy

 

Your purchase of a product or service or ticket to an event may or may not provide for any refund.  Each specific product, service, event or course will specify its own refund policy.

 

Digital Millennium Copyright Act

 

The Digital Millennium Copyright Act of 1998 (the “DMCA”) provides recourse for copyright owners who believe that material appearing on the Internet infringes their rights under the U.S. copyright law. If you believe in good faith that materials hosted by COMPANY infringe your copyright, you, or your agent may send to COMPANY a notice requesting that the material be removed or access to it be blocked. Any notification by a copyright owner or a person authorized to act on its behalf that fails to comply with requirements of the DMCA shall not be considered sufficient notice and shall not be deemed to confer upon COMPANY actual knowledge of facts or circumstances from which infringing material or acts are evident. If you believe in good faith that a notice of copyright infringement has been wrongly filed against you, the DMCA permits you to send to COMPANY a counter-notice. All notices and counter notices must meet the then current statutory requirements imposed by the DMCA; see http://www.loc.gov/copyright for details. COMPANY’s Copyright Agent for notice shall be annettegiarde@bigboldhealth.com.

 

Assignment

 

This Agreement shall be binding upon and inure to the benefit of COMPANY and our respective assigns, successors, heirs, and legal representatives. Neither this Agreement nor any rights hereunder may be assigned without the prior written consent of COMPANY Notwithstanding the foregoing, all rights and obligations under this Agreement may be freely assigned by COMPANY to any affiliated entity or any of its wholly owned subsidiaries.

 

Dispute Resolution

These Terms of Use shall be governed by and construed in accordance with the laws of the State of Washington and any dispute shall be subject to binding arbitration in Bainbridge Island, Washington. If any provision of this agreement shall be unlawful, void or for any reason unenforceable, then that provision shall be deemed severable from this agreement and shall not affect the validity and enforceability of any remaining provisions.

 

Class Action Waiver

 

You may only resolve disputes with us on an individual basis, and may not bring a claim as a plaintiff or a class member in a class, consolidated, or representative action. Class arbitrations, class actions, private attorney general actions, and consolidation with other arbitrations aren’t allowed.

 

The arbitrator may not consolidate more than one person’s claims, and may not otherwise preside over any form of a class or representative proceeding or claims (such as a class action, consolidated action or private attorney general action) unless all relevant parties specifically agree to do so following initiation of the arbitration.

 

Severability

 

If any clause within these Terms of Service (other than the Class Action Waiver clause above) is found to be illegal or unenforceable, that clause will be severed from these Terms of Service, and the remainder of these Terms of Service will be given full force and effect. If the Class Action Waiver clause is found to be illegal or unenforceable, this entire Provision will be unenforceable and the dispute will be decided by a court.

Privacy Policy

Effective Date: March 2019

 

The following Privacy Policy governs the online information collection practices of BIG BOLD HEALTH LLC (“COMPANY,” “we” or “us”). Specifically, it outlines the types of information that we gather about you while you are using the www.bigboldhealth.com website (the “Site”), and the ways in which we use this information. This Privacy Policy, including our children’s privacy statement, does not apply to any information you may provide to us or that we may collect offline and/or through other means (for example, at a live event, via telephone, or through the mail).

 

Please read this Privacy Policy carefully. By visiting and using the Site, you agree that your use of our Site, and any dispute over privacy, is governed by this Privacy Policy. Because the Web is an evolving medium, we may need to change our Privacy Policy at some point in the future, in which case we’ll post the changes to this Privacy Policy on this website and update the Effective Date of the policy to reflect the date of the changes. By continuing to use the Site after we post any such changes, you accept the Privacy Policy as modified.

 

How We Collect and Use Information

 

We may collect and store personal or other information that you voluntarily supply to us online while using the Site (e.g., while on the Site or in responding via email to a feature provided on the Site). The Site only contacts individuals who specifically request that we do so or in the event that they have signed up to receive our messaging, attended one of our events, or have purchased one of our products. The Site collects personally identifying information from our users during online registration and online purchasing. Generally, this information includes name and e-mail address for registration or opt-in purposes and name, postal address, and credit card information when registering for our events or purchasing our products. All of this information is provided to us by you.

 

We also collect and store information that is generated automatically as you navigate online through the Site. For example, we may collect information about your computer’s connection to the Internet, which allows us, among other things, to improve the delivery of our web pages to you and to measure traffic on the Site. We also may use a standard feature found in browser software called a “cookie” to enhance your experience with the Site. Cookies are small files that your web browser places on your hard drive for record-keeping purposes. By showing how and when visitors use the Site, cookies help us deliver advertisements, identify how many unique users visit us, and track user trends and patterns. They also prevent you from having to re-enter your preferences on certain areas of the Site where you may have entered preference information before. The Site also may use web beacons (single-pixel graphic files also known as “transparent GIFs”) to access cookies and to count users who visit the Site or open HTML-formatted email messages.

 

We use the information we collect from you while you are using the Site in a variety of ways, including using the information to customize features; advertising that appear on the Site; and, making other offers available to you via email, direct mail or otherwise. We also may provide your information to third parties, such as service providers, contractors and third-party publishers and advertisers for a variety of purposes. Unless you inform us in accordance with the process described below, we reserve the right to use, and to disclose to third parties, all of the information collected from and about you while you are using the Site in any way and for any purpose, such as to enable us or a third party to provide you with information about products and services. If you do not wish your information to be used for these purposes, you must send a letter to the Online Privacy Coordinator whose address is listed at the end of this Privacy Policy requesting to be taken off any lists of information that may be used for these purposes or that may be given or sold to third-parties.

 

Please keep in mind that whenever you voluntarily make your personal information available for viewing by third parties online – for example on message boards, web logs, through email, or in chat areas – that information can be seen, collected and used by others besides us. We cannot be responsible for any unauthorized third-party use of such information.

 

Some of our third-party advertisers and ad servers that place and present advertising on the Site also may collect information from you via cookies, web beacons or similar technologies. These third-party advertisers and ad servers may use the information they collect to help present their advertisements, to help measure and research the advertisements’ effectiveness, or for other purposes. The use and collection of your information by these third-party advertisers and ad servers is governed by the relevant third-party’s privacy policy and is not covered by our Privacy Policy. Indeed, the privacy policies of these third-party advertisers and ad servers may be different from ours. If you have any concerns about a third party’s use of cookies or web beacons or use of your information, you should visit that party’s website and review its privacy policy.

The Site also includes links to other websites and provides access to products and services offered by third parties, whose privacy policies we do not control. When you access another website or purchase third-party products or services through the Site, use of any information you provide is governed by the privacy policy of the operator of the site you are visiting or the provider of such products or services.

 

We may also make some content, products and services available through our Site or by emailing messages to you through cooperative relationships with third-party providers, where the brands of our provider partner appear on the Site in connection with such content, products and/or services. We may share with our provider partner any information you provide, or that is collected, in the course of visiting any pages that are made available in cooperation with our provider partner. In some cases, the provider partner may collect information from you directly, in which cases the privacy policy of our provider partner may apply to the provider partner’s use of your information. The privacy policy of our provider partners may differ from ours. If you have any questions regarding the privacy policy of one of our provider partners, you should contact the provider partner directly for more information.

 

Be aware that we may occasionally release information about our visitors when release is appropriate to comply with law or to protect the rights, property or safety of users of the Site or the public.

 

Please also note that as our business grows, we may buy or sell various assets. In the unlikely event that we sell some or all of our assets, or one or more of our websites is acquired by another company, information about our users may be among the transferred assets.

 

Google Analytics

 

We also use Google Analytics Advertiser Features to optimize our business. Advertiser features include:

  • Remarketing with Google Analytics
  • Google Display Network Impression Reporting
  • DoubleClick Platform integrations
  • Google Analytics Demographics and Interest Reporting

By enabling these Google Analytics Display features, we are required to notify our visitors by disclosing the use of these features and that we and third-party vendors use first-party cookies (such as the Google Analytics cookie) or other first-party identifiers, and third-party cookies (such as the DoubleClick cookie) or other third-party identifiers together to gather data about your activities on our Site.  Among other uses, this allows us to contact you if you begin to fill out our check-out form but abandon it before completion with an email reminding you to complete your order.  The “Remarketing” feature allows us to reach people who previously visited our Site, and match the right audience with the right advertising message.

You can opt out of Google’s use of cookies by visiting Google’s ad settings and/or you may opt out of a third-party vendor’s use of cookies by visiting the Network Advertising Initiative opt-out page.

 

Facebook

 

As advertisers on Facebook and through our Facebook page, we, (not Facebook) may collect content or information from a Facebook user and such information may be used in the same manner specified in this Privacy Policy. You consent to our collection of such information.

 

We abide by Facebook’s Data Use Restrictions.

  • Any ad data collected, received or derived from our Facebook ad (“Facebook advertising data”) is only shared with someone acting on our behalf, such as our service provider. We are responsible for ensuring that our service providers protect any Facebook advertising data or any other information obtained from us, limit our use of all of that information, and keep it confidential and secure.
  • We do not use Facebook advertising data for any purpose (including retargeting, commingling data across multiple advertisers’ campaigns, or allowing piggybacking or redirecting with tags), except on an aggregate and anonymous basis (unless authorized by Facebook) and only to assess the performance and effectiveness of our Facebook advertising campaigns.
  • We do not use Facebook advertising data, including the targeting criteria for a Facebook ad, to build, append to, edit, influence, or augment user profiles, including profiles associated with any mobile device identifier or other unique identifier that identifies any particular user, browser, computer or device.
  • We do not transfer any Facebook advertising data (including anonymous, aggregate, or derived data) to any ad network, ad exchange, data broker or other advertising or monetization related service.

 

General Data Privacy Regulation (GDPR)

 

The GDPR took effect on May 25, 2018, and is intended to protect the data of European Union (EU) citizens. 

 

As a company that markets its site, content, products and/or services online we do not specifically target our marketing to the EU or conduct business in or to the EU in any meaningful way. If the data that you provide to us in the course of your use of our site, content, products and/or services is governed by GDPR, we will abide by the relevant portions of the Regulation.

 

If you are a resident of the European Economic Area (EEA), or are accessing this site from within the EEA, you may have the right to request: access to, correction of, deletion of; portability of; and restriction or objection to processing, of your personal data, from us. This includes the “right to be forgotten.”

 

To make any of these requests, please contact our GDPR contact at annettegiarde@bigboldhealth.com

 

Children’s Privacy Statement

 

This children’s privacy statement explains our practices with respect to the online collection and use of personal information from children under the age of thirteen, and provides important information regarding their rights under federal law with respect to such information.

  • This Site is not directed to children under the age of thirteen and we do NOT knowingly collect personally identifiable information from children under the age of thirteen as part of the Site. We screen users who wish to provide personal information in order to prevent users under the age of thirteen from providing such information. If we become aware that we have inadvertently received personally identifiable information from a user under the age of thirteen as part of the Site, we will delete such information from our records. If we change our practices in the future, we will obtain prior, verifiable parental consent before collecting any personally identifiable information from children under the age of thirteen as part of the Site.
  • Because we do not collect any personally identifiable information from children under the age of thirteen as part of the Site, we also do NOT knowingly distribute such information to third parties.
  • We do NOT knowingly allow children under the age of thirteen to publicly post or otherwise distribute personally identifiable contact information through the Site.
  • Because we do not collect any personally identifiable information from children under the age of thirteen as part of the Site, we do NOT condition the participation of a child under thirteen in the Site’s online activities on providing personally identifiable information.

The HIPAA Privacy Rule

 

The US Department of Health and Human Services provides:  The HIPAA Privacy Rule establishes national standards to protect individuals’ medical records and other personal health information and applies to health plans, health care clearinghouses, and those health care providers that conduct certain health care transactions electronically.  The Rule requires appropriate safeguards to protect the privacy of personal health information, and sets limits and conditions on the uses and disclosures that may be made of such information without patient authorization. The Rule also gives patients rights over their health information, including rights to examine and obtain a copy of their health records, and to request corrections.”

 

You acknowledge that our operation of the Site does not constitute the practice of medicine, and specifically does not create a doctor-patient relationship between you and Dr. Jeffrey Bland, PhD (the “Doctor”).  The information provided on the Site is for educational purposes only. 

 

Notwithstanding the fact that the Site does not create a doctor-patient relationship between you and DOCTOR, our preservation of your personal health information shall be HIPAA compliant.

 

For purposes of this Privacy Policy, “patients” are those individuals who have secured the in-person services DOCTOR.  If you are a patient of DOCTOR, you will be provided with a copy of DOCTOR’s HIPAA Privacy Statement, which governs the information collection practices of patients’ personal information by DOCTOR.

 

How do we store your information?

 

Your information is stored at the list server that delivers the Site content and messaging. Your information can only be accessed by those who help manage those lists in order to deliver e-mail to those who would like to receive the Site material.

 

All of the messaging or emails that are sent to you by the Site include an unsubscribe link in them. You can remove yourself at any time from our mailing list by clicking on the unsubscribe link that can be found in every communicaiton that we send you.

 

Changes to this Policy

 

This policy may be changed at any time at our discretion. If we should update this policy, we will post the updates to this page on our Website.

 

Questions About this Policy

 

If you have any questions or concerns regarding our privacy policy please direct them to:

annettegiarde@bigboldhealth.com