Perimenopause: Is it Causing Your Heavy Periods, Anxiety, Insomnia, and Weight Gain?

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Hormones are extremely complicated because they are changing all day, there are lots of them, they are hard to test in a meaningful way, and they take time and effort to balance.  However, they can also produce some symptoms that many women would really love to reverse, like yesterday!  So, I’m going to do my best to cover some basic concepts on what’s normal, one of the most common hormonal imbalances women encounter before menopause, and some insight on how to tackle it.

What’s a Normal Female Cycle?

Every month, women go through a hormonal cycle in attempts to create a window where they can get pregnant.  (We are animals after all).  We see 2 major things happening during that 28-31 day time period:

  1. Increase in estrogen in the first half of the cycle
  2. Increase in progesterone the second half of the cycle

These two hormones work in tandem and have a yin and yang relationship meaning if one is out of whack, everything goes off the rails. I’ve written about birth control before, so if you are currently on hormonal birth control, please read that now!  If you’re not taking synthetic hormones, then we can move on.  Many times, low progesterone is causing issues in a woman’s body, and it’s giving her symptoms of too much estrogen.  The catch here though, is that you may have normal levels of estrogen, but if progesterone is in the tank, you’ll have symptoms like you have too much estrogen because they aren’t in good balance. This is important to note, because if you start treating those symptoms like you have high estrogen, trying to lower it, you won’t be fixing the problem.

Symptoms of Low Progesterone

  1. Heavy Periods
  2. Autoimmunity or Allergies developing out of nowhere
  3. Anxiety
  4. Inflammation
  5. Weight Gain
  6. Insomnia
  7. Body pain syndromes
  8. Brain fog or memory issues

Tell-tale Symptoms of High Estrogen

  1. Breast tenderness
  2. Heavy periods
  3. Migraines

In perimenopause, which is about 7 years prior to menopause, you will see a drop in progesterone levels before you see a drop in estrogen.  That will mean you could experience all of the above symptoms.  Awesome.  However, toward the end, estrogen will lower too and you won’t experience most of things once you’ve reached menopause, which is typically around early 50s.

Should I Test My Hormones?

In many ways, symptoms are the best way to determine what your hormones are doing because they vary so much throughout the day, month, and years.  Sometimes trying to do everything based on testing can feel like a moving target.  Testing can be beneficial, but I would start with symptoms and lifestyle intervention first.

How can I fix low progesterone?

One way to address low progesterone is to take a bioidentical version of progesterone called Prometrium or Utrogestan.  However, I encourage you to see how you feel after 3-6 months of commitment to lifestyle changes because you may be surprised how far you can go without the prescription!

  1. Regulate that blood glucose and insulin! 
    1. That means cleaning up your diet to eliminate excess sugar, alcohol, refined carbs and making sure to include protein at every meal.
    1. In this way, testing your A1C and fasting insulin may do more for you.
  2. Avoid dairy
    1. Dairy can contribute to hormone imbalances for many reasons including animal hormones but also via activating mast cells which are connected to migraines and heavy periods
  3. Decrease stress
    1. Start a meditation or yoga practice, eliminate excessive commitments, hire a house cleaner, don’t feel guilty about getting a baby sitter, and go in nature.
    1. Here, heart rate variability is an easy thing to track through a wearable device or your phone.
  4. Lift weights
    1. Any exercise is beneficial for your hormones, but lifting weights or doing body weight resistance training seems to do the most for perimenopause, maintaining the muscle necessary to sustain metabolism, and aid in bone health.
  5. Avoid chemicals that are endocrine disrupters
    1. Every beauty product, plastic, and chemical in your home or on your body could potentially influence your hormone receptors and sensitivity, so use ewg.org/skindeep to determine if that’s a huge issue for you
  6. Consider supplementation of key nutrients like Magnesium, Taurine, Zn, Vitamin D Vitamin C.
  7. Consider the use of herbs such as Chasteberry, aka Vitex.

Feel free to see my favorite supplement blends and dosing here.

That sounds like a lot, but the good news is that the hormone fluctuation leading up to menopause won’t last forever and the healthier your lifestyle choices, the smoother the ride should be.  However, don’t be afraid to find a functional doctor that works with bio-identical hormones to assist you after implementing these lifestyle changes because bio-identical hormones can be a life-saver for many woman!

Patient Journey: Hormone Imbalance

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  1. What health issues were you struggling with when you began to work with Dr. Angela?

I had/have been really working through a few different issues. Mainly, trying to have a menstrual cycle without the use of drugs along with my mental well-being. I have struggled a great deal with self-image, self-worth, depression and anxiety for many years and am exhausted from the strain of these mental issues.

  1. What treatment methods had you tried prior to Dr. Angela’s program?

My main treatment for these issues was medicine – a pill for my period, a pill for my depression & anxiety, and yet another pill for my distracted and “busy” brain.

I had also been to see a few different therapists who were helpful at the time but never seemed to permanently resolve my issues.

  1. What health benefits did you gain from working with Dr. Angela?
  • Natural weight loss
  • More energy
  • Better sleep
  • Confidence in my state of mind
  • How to improve my self-worth

4. What was your biggest struggle during the transition to a healthier lifestyle?

The biggest struggle was learning/knowing what to eat and planning ahead in order to prepare meals.

I also struggled with not letting the very anxiety I was trying to get rid of, hold me back from getting better. It was scary to learn the truth about the meds and I wasn’t sure if I really wanted to give them up. I had no idea how to act or who I was supposed to be without my meds.

5. What did you find most beneficial to you in the program?

My favorite and most helpful parts of the program were the face to face meetings and the homework given.

Dr. A. gave me so much perspective and really helped me work on my frame of mind. The transition to a healthier lifestyle was less confusing and less frustrating knowing that she was there to help us!

6. Did your food options taste good?

The food took some getting used too but once my mind and taste buds got used to the change, the natural foods tasted delicious. I love eating fruits and veggies along with other clean food options and find myself seeking out those foods more – even at gatherings where other dishes are in abundance.

7. Did you have an ah-ha moment that helped you commit to the change? If so, what was it?

This has been such a huge transition in my life and because of that there was not been just one single “ah-ha” moment, there were several. A few of those being…

  • watching my husband become himself again with his improved mental and physical health
  • On a random day discovering that I feel strong and healthy mentally and knowing that it isn’t just a phase but who I really am ;)
  • Stepping on the scale after several months only to discover, without even paying attention, I had lost weight!
  • Really feeling and understanding what sleeping well does for me

8. If you were going to give a piece of advice to someone on the fence of following a program like Dr. Angela’s, what would you say to them in order to help them decide?

Please give the program a chance and just try it!!!

Be honest with yourself about who you are (or who you think you are) and where you REALLY want to go. Love Ok, at least try to “like” yourself enough to sit and just listen to what Dr. A. has to say – you just might be amazed what you can learn about yourself…

Dr. Angela’s perspective:

There were a lot of moving parts to this case including anxiety, hormone imbalance, low self-esteem, and many medications.   This case happened to have issues with low progesterone.  It took some tweaking with her supplementation to balance that, restore her period, and maintain normal cycles.  Along with her hormone balance came symptoms of weight gain, hair distribution issues, skin issues, mood disturbance, and blood pressure concerns. It was definitely more than supplementing to get hormones in balance; it was lifestyle work AND HEAD WORK.  What you tell yourself on a daily basis creates your reality.  It was such a pleasure to watch this entire family transform before my eyes.  I often did these appointments on Friday nights, and I wouldn’t have had it any other way.  It capped my week off with a full feeling because of their ability to be honest, vulnerable, and willing to examine all the aspects of life we brought to light.  Although many medication paths will lead women to believe there are quick pill fixes, or that it’s just your biology, I am here to tell you otherwise.  Your hormones decide so much about how you feel and look, and they should not be relegated to a mere band-aid solution.

Oral Contraceptives: What You Need to Know

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Oral Contraceptives AKA birth control.  As the name suggests, this a prescription that alters a women’s hormones in efforts to prevent pregnancy.  And let’s be real here, IT DOES A REALLY GOOD JOB!  I have no issues with anyone’s decisions about what is right for them or their young girls; however, I think knowledge is power and ignorance isn’t an excuse.  So, read forth and consider all the information before deciding what is right for you.

Why is birth control such a hot topic?  

Most people have 1 of 2 reasons why they are using birth control:

  • to prevent pregnancy
  • to balance hormones, which means they usually have a symptom of disruption such as, PCOS, heavy periods, irregular cycles, PMS, acne, mood disturbance, cramps, ovarian cysts

The reason this may be such a hot topic is because many moms don’t want to give their teen daughters birth control to control symptoms of hormonal imbalance.  OR, they feel as though preventing pregnancy through birth control is an invitation that it’s ok to have sexual intercourse.  The debate of abstinence is not what I care about, but the early use of hormones to regulate such important chemicals in a young female’s body, is.

The common story: “the pill” for period problems

Personally, this was my story, and the story of many of my friends in high school.  Heavy periods, painful periods, or irregular periods lead you to your first OB/GYN appointment, and you leave with a prescription to clear things right up.  You begin taking them, things are great, and you continue to take your magic pills for the next several years, maybe even a decade or more!  Most women don’t get off of them until they wish to start a family.  Let’s think about this, you go on them around the age of 16, and you may not go off of hormones until 10 years later!  What a crucial time in your natural hormone development.  Some women have real issues transitioning off with all the symptoms flooding back with a vengeance, and some women don’t notice a thing.

What’s the big deal with taking birth control?

Taking birth control to artificially “fix” hormone symptoms is like taking pain meds to forget something hurts.  It doesn’t address the source of the issue and it can have huge impacts on the endocrine system long term.  Synthetic hormones are the not the same as your own hormones being made inside your body, and they can have serious health repercussions such as stroke, pulmonary embolism, hormone cancers or infertility.  A side note to that is the new versions of the pill that are low dose like Yasmin, Alesse, etc, have huge increases in the risk of cardiovascular complications!  They know this, and  the FDA updated the risk level for any pills containing drospirenone. You can read more here.

The artificial supplementation of hormones doesn’t address the reason hormones were off in the first place.  Can you imagine the amount of dysfunction that could build up over the course of 10 years if left unaddressed?!  What if you had a thyroid condition that was throwing off your hormones and you were prescribed birth control without ever realizing your thyroid was in crisis?  I would call that an epic fail.  What if you were developing PCOS and had no idea that your blood sugar was such an issue?  Another birth control fail.

What do we do instead?

Regulating hormones comes down to foundations.  Stress, diet, and exercise are all part of the picture. Conventional  animal products contain unhealthy hormones and hormone disruptors.  Certain plants act like estrogens.  Dairy is a huge driver of androgens.  Stress requires cortisol production, which is a hormone.  Too much cortisol can cause someone to have major shifts in their sex hormones.  Lack of fiber means free hormones are not bound and eliminated.  Excessive exercise is notorious for altering body fat percentages that don’t support normal menstruation.  We have all heard of young gymnasts who don’t get a period until they quit training.  On the flip side, lack of movement can predispose young people to store more fat.  Fat produces estrogen!  You can see how lifestyle is so huge.

There are also options in the herbal department, too.

  • Chasteberry is an herb that has been used for many years to regulate hormones by acting on the hypothalamus and the pituitary glands.  It ends up naturally raising progesterone levels without acting as a hormone.  Low progesterone give women the blues, heavy periods, or bad PMS.
  • Maca is a root vegetable that has been used for fertility in certain cultures because it balances hormones.  It aids in estrogen balance, and supports adrenal and thyroid function.
  • Saw palmetto is an herb that balances testosterone that can cause acne.
  • Black cohosh is an herb that can naturally boost estrogen levels.

Depending on someone’s imbalance, a combination of these ingredients can be a lifesaver in the symptom department!  Hormones can really dictate how stable a young person’s emotions are, how confident they are in their body, and how healthfully they develop a fertile environment for child-bearing years.

Are there things I should do if I decide to take oral contraceptives?

Oral contraceptives deplete certain nutrients like B-vitamins, vitamin D, Calcium, Magnesium, Zinc, and Folic Acid.  Yup, folic acid, that B-vitamin necessary to keep a child from having a cleft palate. They can also alter balance in the bacteria living in the gut called the microbiome.  So, if you decide to take an oral contraceptive, I would NOT take one like Yaz or Alesse because of the increased risk in clotting.  I would also supplement with the following:

  • B-complex
  • Reacted mineral
  • Vitamin D
  • Probiotics

This is just scraping the surface, but I hope it helps you make a decision that is right for you!

 

PCOS: Where to Start

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Polycystic Ovary Syndrome, commonly termed “PCOS,” is something I am seeing more and more in my practice.  Often times, women have no clue this is an issue until they try to become pregnant.  Since infertility is one of the negative repercussions of such condition, trouble conceiving is often the red flag.  However, many women may notice something isn’t right before that and not associate it to PCOS.  For example, common symptoms of PCOS include things like:

  • Weight loss resistance
  • Blood sugar regulation issues
  • Increased hair growth in all the wrong places
  • Depression
  • Decreased hair in all the right places
  • Irregular periods
  • Sometimes high blood pressure
  • Pelvic pains that come and go
  • Often times high LDL levels

How’s that for a good time?  Overweight, with acne and facial hair, not knowing when you’re going to get your period, and depressed.  Then you feel like you can’t even do something as basic as get pregnant.  You know how many people get pregnant and don’t even try?!  This is the PCOS story.

What do doctors traditionally do about it?

They usually prescribe birth control pills and metformin (diabetes drug).  Since PCOS is an issue of hormone regulation, the birth control is supposed to put someone on a normal cycle with “normal” hormone levels.  The thought is also that the reason this occurs is due to blood sugar issues, which is why women often improve with diabetes medications.  This sounds great until you start asking why it started in the first place.  Not only does Metformin not address the issue, but it depletes your body of B vitamins and CoQ10, so you may even have decreased energy. If your blood sugar issues started it, why wouldn’t you change the habits associated with poor blood sugar?  Instead, those continue and everything associated with those is still taking place.  Your body is making too many androgens, which is what you can thank for those hair growth patterns and acne.  Taking a pill with estrogen does not remove the inappropriate hormone production patterns.  This treatment protocol is likened to adding green food coloring to water and to make someone think it’s juiced vegetables.  You may make things APPEAR differently, but once you look (or taste) further, you notice it doesn’t taste like green juice, it doesn’t have benefits of green juice, and it may be even worse because we had to add chemicals to the water just to make it APPEAR differently. Wouldn’t it be easier, and better, if we just made some green juice?!

What SHOULD your labs look like?  What should be the goal?

  • A1C should be 5.4 or less
  • fasting glucose should be 75 or less
  • Insulin should be 6
  • Homocysteine should be 6-8

Insulin levels are often not tested because we tend to test glucose more often; however, insulin decreases something called sex hormone binding globulin (SHBG).  The point of SHBG is to bind free hormones and if it’s ability to do so is impaired, we see elevated testosterone levels.  Testosterone is one of the androgens we touched on earlier.  This is why adding estrogen via a birth control pill can sometimes make your body APPEAR improved, but we are really just creating that appearance by adding green food coloring. Inside, we still have the issue of it just being dyed water.

Why does this even matter?  Is it that big of a deal?

For women who desperately want children, YES.  That can be a huge deal.  For the rest that don’t mind the childless lifestyle, having PCOS increases your risk for heart disease, hormone driven cancer, blood pressure issues, and if you have irregular periods, you are 7 times more likely to develop diabetes.  We don’t want to go down the rabbit hole of diabetes, but think diabetic neuropathy, limbs removed, eye sight issues, and a huge stealer of quality of life.

What things can we do from a lifestyle perspective?

  • Eat balanced macros with a focus on protein and healthy fats (this will help regulate blood sugar)
  • Increase fiber intake (think around 30g/day) (this helps bind hormones and cholesterol)
  • Avoid sugar and processed foods (this impairs normal blood sugar)
  • Avoid caffeine (this can drive androgens)
  • Decrease stress (stress drives cortisol and disrupts your hormone production)
  • Clean up your beauty products (these are often endocrine disruptors meaning they damage receptor capabilities for hormones)
  • Exercise (this sensitizes cells to normal blood sugar responses)
  • Drink spearmint tea (this decreases testosterone)

That’s great Dr. Angela, but I’m in deep.  Will I need more than just lifestyle changes?

This could be the case and often is by the time someone sees me.  THIS IS NOT MEDICAL ADVICE, and each patient is different, but I want to share some things that are often common with improvement.

  • Essential Fatty Acids-consider a good fish oil, cod liver oil, or fatty acid blend
  • Antioxidants- consider taking a spectrum of antioxidants because studies show one single antioxidant does not work the same
  • Detox- sometimes increasing detoxification pathways can be helpful
  • Herbs- Inositol, Fenugreek, Cinnamon, Vitex, Black Cohosh, Nettles, Green Tea, Licorice, Spearmint
  • Saw Palmetto-240-260mg 2x’s/day-lowers testosterone
  • Progesterone- day 14-25 days of the cycle taking 20mg transdermal or 110-130 mg oral (this should be started low and slow and directed by your health care provider who is testing)
  • Berberine-200mg 2x’s/day for those who also have high LDL levels

The take away message here is that cysts on the ovaries are a sign that something is going wrong with hormones and blood sugar regulation inside.  Taking medications for these issues acts like a bandaid and doesn’t address the underlying mechanisms.  I encourage you to take lifestyle changes seriously and find a knowledgeable practitioner who will talk to you about solutions to CORRECT the issue and not jump to birth control or metformin.  This is not a life sentence, and many women address these issues naturally.

 

 

Guide to a Coffee Sabbatical: Reducing Caffeine Intake

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I am a huge fan of coffee, and I don’t make that a secret. If you follow me on Instagram, you may have noticed that I recently took a 2 week coffee sabbatical. I kept getting asked why I was embarking on this caffeine-reduction journey, and the simply answer was:
“I love coffee, but too much of a good thing can be a bad thing.”
With my current work situation, I am waking up earlier, having more meetings, and doing more after lunch runs to Starbucks. I have always had coffee every morning before noon. However, lately it has been a venti bold before 10:30am, a 12oz before lunch, and an Americano for the afternoon. Let’s just say that this adds up to a lot of caffeine and lot of bad habits. I’m an all-or-nothing personality, so when I need a reset, I need to do the whole cold turkey thing. So, I decided to give up coffee for 2 weeks. I almost cried, got over it, and decided it was going to make it a mission to find alternatives! I have been giving alternative suggestions to patients for years, but wondered if there were new options out there. I’m here to report the deets! Keep a couple things in mind, number one on this list is really the only alternative that feels and somewhat tastes like coffee, and the rest are just fun alternatives to try. The other thing to keep in mind is that some of these options are completely caffeine-free and others have a little, so if you are trying to give up all caffeine, no green teas.

List of Coffee Habit Alternatives: (that aren’t sugar bombs and would be enjoyed by the health-conscious)
1. Dandy Blend

  • This stuff is by far the closest taste and feel to coffee!  It’s bitter, rich, and somewhat frothy
  • Caffeine free
  • Good for liver function
  • Buy on Amazon or at a health food store
  • Powder that just dissolves in liquid: hot or cold
  • Make coffee-flavored stuff with it like my Dandy Blend Ice Cream recipe!

2. Rebbl Maca Mocha

  • This you can find at Whole Foods
  • This tastes like a treat, let’s be honest
  • Dark cocoa, chicory, and coconut milk
  • Superfood addition: maca; I love maca for hormone health
  • Somewhat expensive if you want to have it often.  Think around $3 for 12 oz

3. Rebbl Reishi Chocolate

  • Buy at Whole Foods
  • This is like chocolate milk
  • Dark cocoa, vanilla, and coconut milk
  • Superfood addition: Reishi; I love the idea of using beta-glucans to improve immune function and liver detoxification
  • Somewhat expensive but remember you get a 10% discount at Whole Foods if you buy a case at a time

4. Starbucks Shaken Iced Tea: Passion Fruit

  • This is sort of fruity with a hint of cinnamon?
  • It’s pink and refreshing
  • Order unsweetened
  • Great option if you’re with people at Starbucks
  • Similar cost to your coffee

5. Starbucks Shaken Iced Tea: Peach Green Tea

  • If you like peach tea, this is a subtle version with a little bitter hint of green tea
  • This is also refreshing
  • Order unsweetened
  • Green tea has many anti-aging benefits and plant chemicals that improve health
  • Has some caffeine because of the green tea

6. Green juice

  • If you have a Whole Foods or Trader Joe’s nearby, you can buy these pre-juiced
  • If you have a juicery close to you, it can be a good “get out of the office” run
  • If you have a juicer at home, it can replace your morning habit of making coffee to making juice
  • FULL of nutrients and great for your health and beauty
  • Store-bought needs to be cold pressed and not pasteurized, which can be tough to find
  • Juicery prices can be steep
  • You’ll have to clean up if you do it at home

7. Herbal Tea

  • Experiment with all kinds of flavors. You may find one that you love more than coffee!
  • Mint tea is great for those with PCOS
  • Ginger and turmeric are great for inflammation
  • Chai is usually a black tea base so has some caffeine, but this is a great alternative

8. La Croix

  • This is a fizzy, store-bought drink that comes in a can like soda
  • Grapefruit is the only flavor I like
  • You can buy it by the case
  • May fill the afternoon drink necessity

9. Flavored water

  • Flat or carbonated water will do
  • Add herbs like sage or mint
  • Add citrus like lemon, lime, or grapefruit
  • Possibilities are endless and free

10. Dandy Blend Mocha Latte

  • Use dandy blend to make 10 oz hot water and 1 1/2 Tbsp
  • Add a splash of almond milk
  • Add a TBSP collagen
  • Add TBSP of cocoa powder
  • Blend until mixed and pour into travel coffee mug and feel like a starbucks treat has been served at home

Why would I take people off of caffeine or coffee?

There are many reasons but many people don’t realize that coffee is contributing to the following issues:

  • Headaches
  • Jittery feeling or racing heart
  • Anxiety
  • Diarrhea
  • Allergies
  • Sleep disturbances
  • Hormone issues
  • Acne
  • Energy dips

If you decide to take a coffee sabbatical, set a time frame and just monitor how you feel.  If you feel great, then maybe you shouldn’t have it daily.  Sometimes I will then set limitations such as one day a week and one day on the weekend.  Many times these issues are due to exceeding a threshold.  Maybe it’s fine to have on occasion, but not so fine to have daily.  It’s your body, and you know it better than anyone.  Experiment on yourself!

 

Adrenal Fatigue: Understanding Cortisol

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This is a condition that really doesn’t discriminate between healthy and unhealthy individuals.  I have had countless patients end up at my door with relentless fatigue when they believe they live a healthy lifestyle.  They workout, they don’t eat excessive carbs, they have successful jobs, and they take their daily supplements!  Then why are they SO tired all the time?!  These cases are almost always issues with cortisol production and the ability of the adrenals to keep up with stress.  Athletes especially can be affected by this issue because of overtraining, chronic stress, or lack of appropriate recovery.  Sometimes less is more, but let’s take a look at what actually happens in someone with adrenal fatigue.

Adrenal Glands: You’ve go these two little organs that sit on top of your kidneys that are responsible for releasing epinephrine and norepinephrine, aldosterone, cortisol, sex hormones, and precursors such as DHEA.  Cortisol is a steroid hormone that is responsible for all kinds of things in the body including:

  • mobilizing protein stores
  • water excretion and electrolyte balance
  • mobilizing fatty acids from adipose (fat tissue)
  • precursor to cortisone (and anti-inflammatory agent)
  • directing immune function
  • stimulation/inhibition of gene transcription
  • affecting bone calcium
  • affects behavior, mood, and hormones
  • affects numerous CNS biochemistry

Basically, it has a hand in tons of things.  Like most body chemistry, it is definitely not on an isolated island!  When stress levels are high, the demand for cortisol production goes up.  However, the building blocks are things like progesterone and pregnenolone which are needed for the production of other hormones.  When your body starts stealing these building blocks to keep up with stress, it will eventually let your other hormones like estrogen and testosterone suffer in order to keep up.  This is important because many people are known to have hormone imbalance, but if you never assess the adrenals, how do you know this isn’t the reason?  If it is, then the answer is not hormone replacement, the answer is stress reduction that will in turn lower cortisol demand.

When you start thinking about how important hormones are to the body, one may ask why on earth your body would make that kind of sacrifice?!  The simple answer is that our body is still expecting stress to be a short-lived event driven by a life or death incident.  In that moment, we would sacrifice anything in order to get out alive.  We never adapted a mechanism to take care of chronic stress.  Stress that never goes away. Stress that takes all we have.  Stress that leaves us feeling defeated at the end of the day and dread the start of the next.  Am I ringing any bells here?  Life is HARD these days!  We have all kinds of stress!  Work!  Kids! Relationships!  But, we also have stresses that people don’t think about like food sensitivities, sleep deficit, overtraining at the gym, and infections.  There are ALL stress to the body.

This is how people can function from day to day, still go to the gym, think they are doing it all, and still feel like crap.  When I run cortisol panels, it’s not uncommon for me to find cortisol levels that are in no way keeping up with the demand.  There are symptoms many complain about:

  • hypoglycemia
  • chronic fatigue
  • ligament/cartilaginous injuries
  • depression/anxiety (this one I see a LOT!)
  • insomnia
  • irritability
  • short term memory issues
  • pain that persists
  • poor wound healing and workout recovery
  • frequent colds
  • hypothyroidism (tons of my ladies out there have this along with adrenal fatigue!)
  • PMS
  • infertility
  • menopause symptoms (can we say hot flash club?!)
  • insulin resistance
  • fat around the trunk

The test for this is pretty simple, but it’s important to have it checked multiple times throughout the day.  So, many physicians will test it once.  That is not helpful unless there is pathology.  We are looking for optimal function.  Therefore, we want to see a high number in the morning and a gradual decrease until it bottoms out at night so you can go to sleep!  If we don’t see that, we need to assess where we are in order to know where to go from there.  In the early stages, people will make too much.  They usually don’t come in for help at this stage because they are “keeping up” as far as they’re concerned.  By the time we hit stage 2 or stage 3, we are starting to not be able to keep up and we start stealing those building blocks from other hormone pathways.  THIS IS USUALLY WHAT BRINGS THEM IN!  On top of fatigue, they now have stray hairs growing in random places, excessive fat that won’t budge, inability to recover from their workouts, trouble sleeping, up and down emotions, loss of sex drive.  At this point, we can’t just fix it with food, typically.  We need to “help your body over the hump” so it can catch up and produce enough cortisol again on its own.  This not only takes time, it takes lifestyle changes that may include cutting things out that are contributing to stress.  This is the toughest thing for patients to do.  If they don’t workout as much, say no to responsibilities, sleep more, etc, they feel LAZY!  You wouldn’t call a cancer patient LAZY!  This is taking care of yourself, and I can’t stress it enough (no pun intended).

If this sounds like you, and you like help, my door is open.  The saliva test I use to measure cortisol, DHEA, hormones, and melatonin is around $200 and it is done at home.  Doesn’t get much easier than that for a little piece of mind and direction.

Your Placenta: To Eat or Not to Eat

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Since I have approximately 100 friends having babies right now…ok, maybe not 100….I have officially turned into a maternity and pediatric doctor without asking for it.  Thanks guys.  One question that has come up that I didn’t necessarily have a good answer for is whether or not I thought it was a good idea to encapsulate your placenta and consume it.

The first question I always ask myself when I am not sure if something is appropriate for health is: “Did/do healthy populations do this?”  I have lived in other countries, done health work in other populations, and read extensively on hunter gather populations, and while some have rituals around what to do with the placenta, NONE OF THEM consume it (that I could find).  Other mammals consume their placenta after birth and there’s a lot of speculation and anecdotal evidence that doing so may help reestablish hormonal balance in women postpartum, but the science isn’t there.  I searched journals, asked some of the best ancestral medical professionals around, and contacted holistic women and children doctors.  No one could find legitimate research on the topic.

So, the science isn’t there, but does that mean you shouldn’t eat your placenta?  Not necessarily.  One good point that was brought up was whether or not you were administered drugs during the birth process.  Since the placenta acts as a nutrient transfer organ, there could be some real contraindications in consuming something that may have lots of residual chemicals present.  However, if you gave a natural birth without medication, you may be ingesting something full of nutrients.  As with any organ, there tends to be more fat soluble vitamins present in addition to mineral content.  Consuming any organ meats after birth could probably be a really good idea to restore some of these essentials, which play a role in energy, mood, thyroid function, adrenal health, and overall good physiology.  However, you may not be sh*t outta luck if you had an epidural or forgot to plan encapsulation.  If most of the benefit is potentially coming from the nutritional qualities of  the placenta as an organ, then it may be just as helpful to consume organs from grassfed cows such as liver.  If you don’t like liver, you can get similar nutrients from Cod Liver Oil.  I like the brand Green Pastures, and there is a link to their product in my amazon store across the task bar above.

Conclusively, things are inconclusive.  Did you like that statement?  I thought I was pretty clever.  But in all seriousness, I searched high and low for the research, I asked prominent professionals, I deferred to the actions of health populations, and there just isn’t a lot out there.  Therefore, I am left to assume that most of the benefits American women speak of is partly due to the nutrients they are gaining from consuming the placenta that could also be found in beef liver or cod liver oil.  Particularly, fat soluble vitamins like A, D, and K.  I’m not often left without an opinion, but my opinion here is very unsubstantiated.  If it’s a natural birth, you’re probably not going to hurt anything, so why not.  If it wasn’t a natural birth, then you may want to think about cod liver supplementation to aid your hormone levels after birth, especially since it’s a healthy practice for anyone to make sure they are getting these nutrients in their diet.