Episode 357: Before You Jump to HRT - What Your Perimenopause Symptoms Might Really Mean
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Perimenopause is trending - but are we oversimplifying a complex hormonal transition?
In this episode, Erin unpacks the rising buzz around perimenopause and hormone replacement therapy (HRT). She shares why HRT isn’t always the magic bullet it’s hyped up to be and explores how symptoms like mood changes, fatigue, brain fog, and cycle irregularities may actually stem from deeper root causes.
From thyroid dysfunction to estrogen clearance issues, Erin dives into the hormonal nuances that can actually “mimic” perimenopause and why lab testing and nervous system support might be more important than rushing into prescriptions. You’ll also hear why symptoms are your body’s way of communicating and how a functional, whole-human approach could be what you've been missing.
In This Episode:
Erin’s experience getting “Instagram-diagnosed” with perimenopause (and what she found in her lab tests instead)
HRT is unfairly villainized thanks to outdated studies - here’s what the research says now
Non-hormonal imbalances that can mimic perimenopausal symptoms (like low thyroid and gut dysbiosis)
How stress, cortisol, and nervous system regulation are key to hormone balance at ANY age
Why it’s important to “self-regulate before you replace” as a guiding philosophy
Erin’s FREE Hormone Food Guide
Organifi supplement powder (save 20% on your order with code FUNK)
Qualia Senolytic (get up to 50% off and an extra 15% off your first purchase with link + code FUNKS)
Bon Charge (Use code FUNK to save 15%)
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These endocrine transitions are a natural part of our life that we will all go through. God willing, women can spend half their life in peri in post menopause. The decline in hormones can negatively impact many aspects of our body and our health and how we feel. We do need support here and we should not be okay with allowing women to suffer through this time and just being told like, suck it up. I'm Erin Holt and this is the Funk’tional Nutrition Podcast where we lean into intuitive functional medicine. We look at how diet, our environment, our emotions and our beliefs all affect our physical health. I've got over a decade of clinical experience and because of that I've got a major bone to pick with diet, culture and the conventional healthcare model. This show is for you.
If you're looking for new ways of thinking about your health and you're ready to be an active participant in your own healing, I would love for you to follow the show, rate, review and share because you never know whose life you might change. Perimenopause Are you guys ready? Are you ready to do this? Let's talk about it. Perimenopause is so hot right now. As a 41 year old woman, it's pretty much all I'm hearing about personally and not even just on social media. It's coming up in a lot of conversations too. And the stuff that I'm seeing, the dialogues that I'm engaged with, the content I'm receiving, conversations I'm having, I just feel like there's something missing from the conversation or there's aspects of it that leave me scratching my head. So I'm gonna bring some of that to the table today with the perimenopause conversation. HRT is coming in hot too.
A lot of people talking about that, so I will reference that quite a bit. HRT RT stands for hormone replacement therapy. There are different types. There's different hormones, estrogen, progesterone, testosterone, and there's different types of HRT. Bioidentical hormone replacement therapy is 1 or B HRT. There's different hormones, like I said, there's different modes of application. So today I'm kind of using HRT as a catchall term. It's really not the point of today's show, but it's really hard to have the perimenopause convo without at least acknowledging the the HRT conversation because they seem to be happening in tandem.
Part of that is due to the destigmatation of hrt. The stigma that was attached to it is pretty outdated so the Women's Health Initiative was a series of clinical studies initiated by the National Institute of Health to address major health issues causing morbidity and mortality in postmenopausal women. And in 2002, the news pretty much globally reported findings from this study. And it said that estrogen causes breast cancer. So estrogen as hormone replacement therapy causes breast cancer. So basically a whole generation of women lost access to hrt. It was strongly discouraged. There was a lot of fear around it, rightfully so, based off of what was coming out of these studies.
So doctors and, you know, prescribing physicians thought they were doing right by women by being like, this is actually really dangerous. However, 20 plus years later, the conclusions have pretty much been walked back. So further investigation of the research really indicates that estrogen alone decreases the risk of breast cancer. Not only does it not increase it, it can actually decrease the risk of breast cancer. It decreases the risk of death from breast cancer and decreases the risk of death from all cause in postmenopausal women. So whoopsies. This is like a big yikes situation. And this is really looking at estrogen only preparations in body identical or bioidentical hormones looking at progesterone.
So this is a really big conversation and a much larger conversation than I can do here. It can be a podcast in and of itself, but those are really the broad strokes. And it's important to understand because it's part of the reason why we're seeing so much more talk about HRT lately. It's because it's been unfairly villainized. And because of that, a lot of women did not have HRT as an option. And we're starting to see the downstream side effects of that. And some of them are negative. And there's a lot of anger associated with that from women, righteous anger, and even some grief of being dismissed and not having this as an option in their post menopause years.
So the HRT conversation is a good conversation. It's an important conversation. It's a necessary conversation. But this conversation isn't just being presented to postmenopausal women. It's also being presented to women in their late 30s, in their early 40s, like myself. And that's kind of the conversation that I want to have with you today. Because HRT is not a magic bullet. And quite honestly, I'm not a practitioner that can prescribe hrt, but I've talked to a lot of my colleagues in this space who are, and those of us who are taking more of a holistic root cause, functional approach will back up this sentiment.
Even the ones that are prescribing HRT will tell you it isn't a magic bullet. In some situations it really can feel like that, but it's not always. And we still need to take a 360 degree approach when we're talking about hormones. Even in perimenopause and even menopause, these endocrine transitions are a natural part of our life that that we will all go through. God willing, women can spend half their life in Perry. In post menopause. The decline in hormones can negatively impact many aspects of our body and our health and how we feel. We do need support here and we should not be okay with allowing women to suffer through this time and just being told like, suck it up.
But we need the right kind of support and we need to filter through all the information that we're receiving. So I'd like to unpack the perimenopause discussion today. And I'm going to come at this two ways. One, as a human being, a person, a woman, navigating this myself. Question mark, potentially. Are we sure? Are we there yet? I don't know. So I'll come at it from that angle. And I will also hit you with some practitioner speak as well as a practitioner who does work with women and works in women's health and works with a lot of women's hormones.
So here's the lay of the land. Today I'll discuss symptoms of perimenopause. It's probably important. I'm going to talk about my experience. I really want to personalize and humanize this conversation. I'm receiving the same messages as you guys are. So heads up. This episode's probably going to be a little bit of a longer one.
I kind of think it needs to be. I think we deserve to have a full conversation about this. I think we owe that to ourselves rather than just like sound bite information. So take me on a walk with you today. Listen to me while you cook dinner. Pretend we're in the car together. I don't know, I'm just your pal here. Let's really have this convo.
Send it to a friend, send it to a sister, a cousin, a co worker. Let's all have this conversation together because we're all in it together. I'm also going to share my own considerations with HRT in what I am doing for first and why I'm doing that. I'll explain what's happening hormonally in perimenopause. So if you're like, well, what's happening to my body? I'll explain that. And then I want to talk about other things that can be contributing to the same exact symptoms. So perimenopause has this cluster of symptoms, but other things can also contribute to those same symptoms. So it can get a little confusing.
It can get a little bit tricky to parse out. Am I in perimenopause or not? That's a question that I'm getting A lot. A lot, lot, lot. It is. How do I know this is perimenopause? Is it perimenopause or is it something else? And then I'm also going to invite you into our upcoming hormone program, your hormone revival. I've been running this program since 2018, I believe we haven't run it live in almost two years. So I know some of you guys have been waiting for this to come back live. And I want to let you know that the cart is officially open as of today.
It's open for a very limited time. We're kicking things off May 6th. And yes, if you're a postmenopausal woman or perimenopausal woman or somebody way earlier than that, it is good for you. So this kind of covers the whole hormonal lifespan. Okay, so let's get into it. What is perimenopause? It is a transitional period, and it can last anywhere from six up to 10 years before menopause kicks off. The average age is 47.5 years. That's the median age.
So it's sometime in the mid-40s. It can happen earlier. Menopause is the cessation. So, like the end of menses for 12 months. So after you have lost your period or you have not had a period for 12 months at an appropriate age. So if you're 25, this is not you. After 12 months, you are officially post menopause. And the median age for that is 51.
So it's a time frame. It's a transitional period. And symptoms can kind of drag on throughout this whole transition. So if you're in this transitional period for 10 years, that means that you might be symptomatic for 10 years. That's no bueno. So what are those symptoms? Irregular periods is a biggie. Variable cycle lengths. So let's say Your cycle is 28 days, one month.
It might be 45 days, another month. So they're changing in length. You might see some skipped cycles. The periods themselves might get a little bit wonky. So you Might see heavy bleeds, they might see more pain or discomfort. Vasomotor symptoms are really the ones that we tend to talk the most about when we're thinking about perimenopause and menopause. So those are your hot flashes in your night sweats. We can definitely see those.
Decreased sex drive, mood swings, anything from anxiety to depression to irritability to anger and rage. Body changes, there tends to be more of an accumulation of belly fat. There's a reason for that. We'll talk about that later. Thinning hair, brain fog, memory issues, a hard time concentrating, joint and muscle pain and heart palpitations. So everyone's going to experience this differently. And we'll talk about why that is later. But these are some of the more common symptoms.
So some people around my age, I'm 41, like I said, but like late 30s, early 40s, they might be experiencing some cluster of those symptoms. And because they're hearing so much about perimenopause, they'll be like, I think I'm in perimenopause because I have these symptoms. Is it possible? It is possible, but a lot of other things can cause those same exact symptoms. So that's again why we need to take a whole human 360 degree holistic approach to a perimenopausal woman. We are right to put more of an emphasis on this huge endocrine transition period. You know, women of the past and previous generations were just kind of like in it by themselves. So let's take a closer look at this. Let's examine what's going on, let's talk about it, let's be open to these dialogues.
We just want to make sure that we're not centering it so much that it's all we see to the point that we are overlooking other important root causes. So here's what I mean by that. I'm going to use myself as an example. The past few months, and honestly, I don't know how many months, just a cluster of time. One day I woke up and I'm like, I have these symptoms. Low mood, that was the one that caught my attention the most. Feeling sad and blue. Because that's just, that's pretty atypical for me.
So really kind of just feeling sad a lot. My period started getting wonky. I had a late cycle, which is never the case. Tender breasts, like, but a lot more tender than typical. More intense cramps, more intense fatigue, swelling and pain with my period. And leading up to my period, period aside, I just noticed that my Like, I didn't have as much focus, mental focus. I had to stop work most days by like, 3, 3:30pm I mean, I would set up my computer. It just, like, wouldn't get anything done.
My brain kind of felt cashed. I didn't feel as productive as I normally do. I felt a little bit more scattershot. And then the other thing is more weight gain around my middle. Just puffier, I would say. I don't think if anybody looked at me, you'd be able to identify it. It's like just one of those things where, like, oh, the jeans are tight. The jeans are tight.
You know? You know, it was one of those situations. So I'll be honest with you. And you guys, this is the work that I do, like, literally every single day for almost 15 years now, okay? And even I, with the omnipresent perimenopause talk, even I found it very easy to blame perimenopause. Essentially, I'm like, you're 41 now. You know, there's no stopping it. Here comes the boom. The only path forward is hrt. So I was even, like, looking into hormone clinics to be like, do I need to get on hrt? HRT is everywhere.
Do I need it? This is kind of the internalization of the messages I was receiving. And again, this is somebody who works as a root cause practitioner. Even I was like, give me that band aid. I think that's what I need right now. And, you know, I certainly. There's. I have absolutely no problem with hrt. I want to just go out on the record of saying that.
And I'm so glad that women have that as a resource for me right now. I don't know if I feel emotionally, mentally prepared to do that in that I can have that experience as an autonomous being. And that does not have to mean anything negative about anybody who's on hrt. Okay? Right. We're all, like, adults here. Like, I can have my experience, you can have yours. We're all good with that. But it was kind of like this, like, Carrie Bradshaw moment where it's like I couldn't help but wonder, when did turning 41 become a medical emergency? Had perimenopause become the new villain of the wellness world? Or, like, I couldn't help but wonder, was perimenopause actually happening to me? Or had I just been diagnosed by Instagram again? So I had to, like, really ask these questions of myself.
When I. Again, like, when I caught myself Googling like, HRT clinics, I was like, wait, A second, the root cause researcher in me was like, really? Are we really going to do this? Typically, I'm pretty good at cutting through the noise and distortion of the wellness world. I mean, I've been in it, like I said, for 15 years. I kind of have to be. And typically, if I'm experiencing symptoms, what I do is I look under the hood to understand those symptoms. I allow the symptoms to reveal what's happening inside under the hood, both from a biochemical perspective and also a belief system perspective. I know that repetitive messaging over time can influence beliefs. I also know that beliefs can inform our biology.
So the beliefs that we're carrying around based on the messages that we're constantly hearing. For example, once you hit 40, you're can have real time effects on what's happening physically in the body, including hormones, including energy levels, including weight, all of it. And by the way, if you're new to the show, if, like, a friend sent you this and you're like, what is she talking about? Totally fair. I've spent hours unpacking this concept and the science behind it, how our beliefs inform our biology. So I've, I've done that for the sake of time and for the sake of this discussion. Just take my word for it, you know, just like, just believe me. Or of course you can dive into the archives, do your due diligence. But the premise is that what we believe absolutely dictates what's happening at the level of the physical body.
Rather than just accept these messages as truth, like, oh, you're 41, ergo you are in perimenopause. You will experience these symptoms in the path forward is hrt. That's kind of like the. That's the summary, that's the snapshot, that's the log line of what I have been receiving from Instagram. Okay. Rather than just accept that as truth, I'm not resistant to it. I'm not saying it's not real. But I also want to do my own diligence before just accepting that as my truth.
I decided to do a little investigative research into my symptoms, and I do that by way of lab testing. So I actually took myself through my own. Your hormone revival journey. My own YHR journey. It's been a few years since I did this. I think it was time. So what I did is I ran the YHR labs. This includes a Dutch plus test in addition to our root cause hormone thyroid panel.
So that's blood. So I'm looking at my hormones different ways. Through saliva, through urine, through blood because they all show us or show me different things. And I wanted to get that full spectrum 360 degree view. And then I'm also looking in those labs at the drivers of imbalance as well. By the way, all those labs are included in the cost of yhr. You get the labs, you get an analysis, you get one on one support from my team. You also get a protocol, something to really know and understand.
Because I'm sure this question will pop up. There is no one test for perimenopause, so there's no one lab you can run to just be like, yep, you're in it all right. But there are clues. There can be some clues. And looking at my set of labs, those clues were not there. None of those clues were present for me. What I did find, however, were other things that were going on contributing to my symptoms, other significant things. The biggies were that one, I was not clearing out estrogen very well.
So even though I didn't have like wonky estrogen levels, my body wasn't flushing it out appropriately. Two, I had functionally low thyroid levels. So this would not have been picked up like if I had my PCP test my thyroid, but they were functionally low. And I also had an issue converting T4 into T3. We discussed that last week. We went into that concept in a lot of depth. So this was leading to some hypothyroid symptoms for me. Some of the symptoms really were due to A, not clearing estrogen out of my body and B, the thyroid sort of dysfunction.
I also had some cortisol imbalance, if I'm being perfectly honest with you. We'll get to that in a second. So I put myself on a protocol because I can do that. Lucky me. And just like we do for you and yhr. So mine included thyroid support, conversion support again to convert that T4 into T3, because it's the T3 that like makes you feel good. I did estrogen clearance support, including gut support, because that's a big part of clearing out estrogen. And then I put myself on a very specific type of adaptogen that works on the hypothalamus, pituitary, adrenal ovarian, access to balance out estrogen and progesterone levels and just supporting things from the brain down.
So it's more like regulating instead of replacing. So I didn't need to swoop in with estrogen and progesterone in the form of hrt, but I do want the brain down signals to balance out to the best of my ability to make me feel good. That was my strategy. And I'm intentionally not mentioning specifics here in terms of, like, supplements and exactly what I use, because this plan is truly so individualized to me. My best friend has been, like, seeing the results that I've been experiencing, and she's like, I want to do what you're doing. But I'm like, okay, totally. But first we have to run your labs, and then I will set you up with a protocol. Because putting her on my exact plan might not work.
It actually might make her feel worse, and that's the same for you. So even though it's probably super annoying to not have me tell you exactly what I'm doing, trust me when I say it would be a lot more annoying for you to run out and snatch up all the products that I'm taking and then feel worse or feel the same. So I'm not going to share the exact ones, but that was my strategy. Right now, at the time of recording, I'm about a month into this protocol, and what I'm noticing is the first thing is mood. My mood dramatically improved pretty quickly. Blessings to that. Because I don't like feeling sad, especially when, like, there's looking around my life. I'm like, there's nothing to be sad about.
Why do I feel sad? The next thing that happened is I've had one cycle since then or one period, and my cycle length went back to normal in my period was just much more normal for me. So I had normal bleed, easier period, less pain, less fatigue overall, just way more energy. I can stay focused later. I just have more motivation to get things done, and I'm just staying more focused on my tasks and then also more regular bowel move movements. So I think that that's kind of interesting. Yeah, I'm doing a little bit of gut support, but I. I actually think it's the thyroid support. I wasn't feeling constipated, but I'm, like, pooping a lot more in a good way.
So those are my results. I will also say, because I didn't mention the weight thing, you know, the YHR process, your hormone revival, hormone balance process that I have taught up to this point, hundreds of women. It's an inner process, too. And how do I want to say this with weight gain? You know, were there some things on my lab that could be a head nod to the weight gain? Yeah, totally. Like specifically thyroid and cortisol, and maybe, you know, maybe that's part of it, but when I sat with it And I did some internal reflection. I realized that I think the weight gain, particularly around the midsection, is a little bit more protective than anything else. I want to say it's energetic, but it's a lot more than just like energetic. It's like get, you know, physical too.
I spent the most of the past year in a highly over functioning, in hyper vigilant state. My body felt like it was in survival mode more often than not. I even had to wear a heart rate monitor for a couple of weeks there for the sake of time. I'm being kind of intentionally vague. I promise I will share the whole story soon. I know some people that listen to the show deeply care about me and they worry about me. So I will say family is good, health is good, friends are good, life is good, do not worry. I know exactly what was causing the stress.
It wasn't an overnight fix. It took some time, a little bit of an identity work to get there, but I am now on the other side of it. So that's the good news. But the body can take some time to catch up and I think that that's kind of what's happening now. And it's my job. If the body is kind of holding on to weight to protect me, which the body does because the body like has your back like through thick or thin, literally, pun intended. It's my job to really continue to send safety signals to my mind, to my nervous system, to my body, so my body can feel safe. Because right now it's probably still bracing for impact.
It was like, Erin, we went through a lot for a lot of months. You were like locked in, not in a good way, like locked into hypervigilance for a long ass time there. Really over functioning, really stressed out. So the body's like, I think I just have to teach it to trust me right now, like, we're good, we're good. So the way that I'm doing that is through specific nervous system practices, specific meditation practices, one of which is EFT or tapping. Oh my God, I love it. For cortisol, cortisol regulation, for just calming the body down. It can be really good for weight loss as well.
These are all tools by the way, that are included, included in yhr. I genuinely don't know how people are balancing their bodies without nervous system support. It's really crucial. So all of this to say, is this approach to hormonal health multilayered? Yeah, it totally is. Health is multi layered. Is HRT arguably easier than what I'm doing? Maybe, maybe. But does it solve for root cause issues? Probably not in this case. Is what we're seeing that I don't think that would have been the magic bullet that I was hoping for.
So what my body was requiring, as evidenced by these labs, is a deeper dive, more investigation, and not just saying like, hey, take some progesterone, everything's going to be fine. And I've said this for years, supplements won't correct the imbalance in your life. And the same can be said for hrt. HRT is not going to correct the imbalance in your life. So I had to do some work as well. This is a quote from Jane H. Collings. She says the menstrual cycle is a stress sensitive cycle.
Everything that is and isn't working in your life shows up in your cycle. Negative symptoms are a sign that something needs to change. Your menstrual cycle is a compass for your well being. Listen to her. So my cycle got a little wonky. Is that because I was in perimenopause? If I had written that off as like just perimenopause, I might have missed the underlying messages that really needed to come through. My philosophy, what I teach in yhr, and just my overall philosophy has always been self regulate before we replace. And look, I understand female physiology.
I recognize hormones will naturally decline and there's no amount of lifestyle change that's going to have estrogen magically rip roaring back once it's gone. Baby gone. Like I understand that. And there's a lot we can do to optimize the structure beneath. So when I say self regulate before we replace, notice that I'm not saying never replace, never replace the hormones. I'm saying let's get our health house in order before jumping into replacing hormones through hrt. Especially for those of us in this long ass perimenopause phase. Bum rushing hrt.
The second we get a symptom, the second our cycle gets wonky, which is kind of the message that we're getting right now, it can potentially mask underlying issues that will still be problematic later on. So earlier I said everyone experiences menopause. Excuse me, Perimenopause and menopause transition differently and there are certain things that can impact how rough that transition is. So let's talk about some of those things. 1. Like some of them are just the obvious or like the basics. I should say maybe they're not obvious. The basics, the foundations of health, Sedentary lifestyle, lack of physical activity, inflammatory diet, metabolic dysfunction, blood sugar dysregulation, insulin Resistance, immune dysregulation, visceral adipose tissue, chronic stress, that includes feelings of isolation, lack of socialization, lack of community toxic load, environmental exposure or exposure to environmental toxicants.
All of these things contribute to an inflammatory load in the body and that is increasing as we age anyway. Basically as you age, your body's ability to regulate inflammation decreases. It's called inflamma aging. Isn't that cute? So we can see an increase in pro inflammatory markers and a decrease in anti inflammatory markers during perimenopause and menopause. There's lowering progesterone levels, there's fluctuating and declining estrogen levels and that shifts us more into a pro inflammatory state and it's nicknamed inflamma. Pause. Isn't that cute? So knowing that the endocrine transition, perimenopause and menopause, knowing that this is more of an inflammatory situation going into it with a baseline of chronic inflammation, you're going to have a much tougher time. This is why we're always, when we're running lab work on people, we're always looking for markers of inflammation.
Oftentimes when we're running inflammatory markers through lab testing, through like a blood test, they're nonspecific. So they're not telling us where the inflammation is coming from. They're just telling us that it's there and that it's our job as the practitioners to go inflammation hunting and figure out where that inflammation could be coming from. Is it diet? Is it gut? Is a blood sugar dysregulation? What's going on? Here's the deal with all of that. Estrogen alone isn't always going to save you. HRT alone might not fix the problem. We cannot neglect all the important aspects of health and just go on hrt. It doesn't really work that way, unfortunately.
Wouldn't it be so good if it did? So this is where a well rounded root cause approach really comes online and really comes into play. A quick jump into HRT without first addressing and supporting your inner landscape, the foundations, things like sleep, stress, gut health, metabolism, detoxification, inflammation, it's just not going to be as successful. We want to be working on all of the things at all of the times. Essentially we have to honor the whole system rather than try to spot treat and there's about 112 like disclaimers and spin off conversations that we can have here where sometimes estrogen helps sleep, sometimes estrogen actually helps to regulate blood sugar, sometimes estrogen actually helps the gut and yes, all of that is true, but again, it's that 360 degree perspective that we're taking. So what is happening with hormones in perimenopause? The first thing to go is your progesterone. Usually progesterone starts to dip, it starts to drop in perimenopause, and then estrogen kind of does this roller coaster thing where it's up, it's down. And so that fluctuation can lead to a lot of the symptoms. Eventually, over time, it declines altogether.
Your body, for a while, your body is trying to kind of figure out the communication between the brain and the ovary. So it can be a little bit all over the map. And if progesterone has declined, then we don't have the buffering effect of progesterone. Progesterone drops before estrogen, and a big feature of progesterone is it really counterbalances estrogen. So when progesterone is low, estrogen can have more excessive effects. So you can see things like heavy bleeds, heavy periods, painful periods, tender swollen breasts, things like that. With low progesterone, we can also see some mood changes as well. Progesterone converts to aloe and that really acts like gaba in your brain.
So it can promote relaxation, it can promote sleep. It's kind of a natural antidepressant, anti anxiety, mood stabilizer. So low progesterone really is a huge part of why we're seeing the symptoms that we do in perimenopause. But here's the deal, super, super, super important. We are seeing low progesterone in younger and younger and younger women. It's probably, I would say, probably the most common hormone imbalance. We see low progesterone, and this is outside the perimenopause age. So, yeah, dropping levels of progesterone is a normal part of perimenopause, what we would expect to see.
But just because you have low progesterone levels does not automatically mean that you're in perimenopause. Okay, so let's talk about some other reasons for low progesterone. If you suspect low progesterone or you see it on a lab, what could be contributing to this? The first thing is an anovulatory cycle. So, meaning you have a cycle but you don't ovulate. Typically that's because the body, for whatever reason, doesn't feel safe enough to ovulate. Episode 310 of the podcast, I talk about ways to naturally increase progesterone but the big underlying thesis of that episode is that there is no progesterone without feelings of safety. So we have figure out where the body is not feeling safe. Part of safety signals is appropriate fuel.
We talked about this recently here on the show. Eating to maintenance needs, getting inconsistent fuel. So we can see low progesterone with constant dieting, undereating caloric needs. We can see low progesterone with low body fat. We need to have a certain body fat percentage as women for ideal hormone production. If we're under a certain percentage of body fat, we might not ovulate, and so therefore we won't be producing that progesterone. Body fat percentage can get so low in women that there's like complete suppression of hormones. And we can see hormones in postmenopausal range.
We have definitely seen this in women that when we're looking at their hormones, it looks like they're in menopause, but they might be in their mid-20s. And this is due to undereating, sometimes fasting, constant dieting, over training, eating disorders. All of this can really kind of just suppress hormone production. Blood sugar dysregulation is another one. So high blood sugar can play a role in low progesterone insulin sensitivity. Whenever we're looking at hormones, we're always looking at your blood sugar markers as well, to factor that into the picture. Mine, I am very happy to report, are very, very good, which I'm very glad to report that because I've been talking about blood sugar regulation for so many years, seven and a half years of this podcast. So imagine if my blood sugar markers were not on point.
Yikes. So that is awesome to see, but that's something that I like to look at specifically. Fasting glucose, fasting insulin and hemoglobin A1C stress. Yikes. Do you want to have this conversation or do you just want to, like hit the 15 second skip button a few times so you don't have to hear me say that I'll make it fast. I'll rip her off like a band aid. Production of progesterone is stimulated by the pituitary gland in your brain. The pituitary can kind of get a little off balance when it is constantly stimulated by the stress response.
Cortisol production can suppress luteinizing hormone. We can see lower progesterone with that. So we know that our HPA access the hypothalamus, pituitary, adrenal access our stress hormones. Our stress response can impact our sex hormones, progesterone estrogen. One thing that we often say here at TFN is that you have to be an active participant in your own healing. So if you are too busy to participate in your own care, if you're always stressed, maxed out with work, family, other commitments, if you're always go, go, going, if you're overwhelmed, if you're, like, too busy to eat breakfast or too busy to eat lunch, this can lead to hormone imbalance and decline. Perimenopause is a time where stress resiliency decreases and it, like, kind of catches up to you. So a lot of women think that they're in perimenopause and they might be in that age bracket, but really it's that their adrenals are taxed, and that's what's contributing to some of the symptoms.
So adrenal dysfunction can look like being stressed or overwhelmed, exhausted and burnt out, sleep issues, feeling tired and wired. So you're exhausted, exhausted, but you actually can't fall asleep at night. You rely on caffeine for energy, don't have the energy or motivation to exercise, have a hard time losing weight around the midsection. Can feel anxious, irritable. You can feel blue, emotionally exhausted, no sex drive, dizzy, lightheaded. So you can see how some of these symptoms of adrenal dysfunction overlap with perimenopause. So I do like to see an adrenal panel for somebody who suspects perimenopause for this reason. Let's look at your cortisol levels.
Let's look at your dhea, which is kind of a marker of resiliency. Let's see what they're doing. Is there a way we can support those adrenal hormones to get you feeling better? I think that we can look at this phase as an opportunity to recalibrate before resilience recedes. I've talked about this a lot on the show. When DHEA starts to drop, we just become a lot less resilient to stress. So is, are there ways that we can bolster that production? And this really, it has a lot to do with our lifestyle choices. What we're saying yes to, what we're saying no to all of that. But it becomes super, super important to maximize and optimize your adrenal function now, before, during, and throughout the menopause years, because it's the adrenal glands that take over for production of these hormones.
So Prior to menopause, 90% of of your estrogen is made by the ovaries. Afterward, the adrenals take over they're not creating like large amounts, but they are creating some. Your adipose tissue, your fat can also do it as well. So this is one of the reasons that some women can hold on to fat, especially around their midsection. And then progesterone is kind of the same. So pre menopause, your ovaries, the corpus luteum and the placenta during pregnancy is what's making your progesterone. After menopause, your adrenals are pumping some out. So keeping adrenal health at the forefront of your mind, your priority list.
I don't know what to say. There is important for overall hormone health as you make transitions into perimenopause and menopause. Other things that can contribute to the same symptoms of menopause. Thyroid. I talked about my own experience, but some symptoms of hypothyroidism, brain fog, low energy, fatigue. We can see cycle changes, cycle irregularities, weight gain, weight loss, resistance, low mood, anxiety, depression. We got into thyroid health a lot last week. So like I had said earlier, there's no one test to confirm perimenopause, but there is testing that can confirm or rule out hypothyroid.
And I'm not just talking about running a tsh. I'm talking about a full blown thyroid panel, which we do run in yhr, but we can see and assess. Is this what's contributing to your symptoms? So for me, I was like, is it perimenopause or is it thyroid? It was looking a little bit more thyroid for me, to be honest with you. As I shared with you, my approach is to support thyroid health. It wasn't to just immediately swing into hrt. And again, I am not villainizing or stigmatizing hrt. It just wasn't the right appropriate strategy for me right now. Anemia is another thing that can mimic the same symptoms or similar symptoms to perimenopause.
And anemia can become pretty common with women, especially if you have heavy bleeds because you are bleeding out a lot of iron every month. I just had a discovery call with a woman a couple weeks ago and she was bleeding, obviously this is a problem, but she was bleeding for up to two weeks out of the month. Month. So you can imagine how much you know that's a lot of blood loss. So we can see low iron levels, we can see ferritin, low our iron stores. So symptoms of anemia or low iron deficiency. Anemia can be fatigue and weakness, feeling tired even after a lot of rest, shortness of breath, dizziness, lightheadedness heart palpitations, cold hands and feet, headaches, hair loss, brittle nails. Gee, doesn't this sound a lot like hypothyroid symptoms? Yeah, it does.
Do some of these symptoms overlap with perimenopause symptoms? Yes, they totally do. So this is where it could get confusing. And this really is where appropriate lab testing can be so clutch and so crucial and so useful. And so that's another thing that we're looking for in yhr. I've told this story before, but early in my practice, I missed anemia, and I have never forgotten this case. She was hypothyroid, so I just kept attributing to her symptoms as thyroid symptoms, but I completely missed anemia. So it's like, fool me once type of vibe now. I.
We're always screaming for this, especially when we're talking about women's health and then gut dysbiosis. So I want to share with you a story of a client that came and worked with us. She originally did your hormone revival, and the reason she signed up for your hormone revival was primarily because of irregular periods. She had multiple doctor's visits and she just kept holding, oh, it's nothing, it's nothing, it's nothing. By the way, if your period is irregular, that is like knocking on your door trying to get your attention. Like, something is off here. Red flag. Lisa Hendrickson Jacks, who's been on the show before, refers to our menstrual cycle as our fifth vital sign.
That's how crucial and important it is. So if you have practitioners telling you it's not a big deal if your periods are irregular, say bye bye, see you later. Because that's not true. It's a big deal. Luckily she found us and she came to us. She also had low energy, she had unexplained weight gain, and she had this high tsh, thyroid stimulating hormone that nobody was really doing anything about. Like, her practitioners weren't really paying attention to that. They're like, yeah, that'll be fine.
So the YHR labs, the hormone labs that we run in this program revealed quite a lot. So we saw positive ANA antibodies, antinuclear antibodies. So that can be indicative that there's autoimmunity going on. We saw elevated TPO antibodies, so that's indicative of Hashimoto's. So the reason that her TSH was elevated was because she had Hashimoto. She had an autoimmune condition going on that nobody was paying attention to, nobody was willing to do a deeper dive on. We did recommend it, because there can be a link with Hashimoto's and gluten intake. So we recommended she follow up with a Gluten sensitivity panel, which we ran for her. And she was sensitive to gluten, so that was also contributing to some of her symptoms. And we, of course, encourage her to follow up with endocrinology. We are nutrition professionals. We cannot diagnose or treat stuff. So we're always sending somebody back to. If we find signs that, like, hey, something's off here, we are sending them back to their doctor and working as part of their team. Okay, so she felt great.
Like, she left feeling awesome. We put her on a protocol. She was improving, was like, rode off into the sunset, feeling good. Two years later, she came back and worked with us as a one on one client. She had gotten Covid, so things were going great. Her TPO antibodies came down. Her health was really stabilized. Her periods got back to normal.
Like, things were good. Her symptoms went away. Things were good. But then she got Covid and she had to take antibiotics, and she had a lot of GI symptoms that popped up, up, and she just wasn't feeling like herself. She was getting hot flashes. She had a lot of low energy, and she lost her cycle for six months. So because of this, she actually thought she was in perimenopause. So she came to us being like, I'm in perimenopause.
So, of course, we ordered some labs. We did a stool test on her. We did blood work on her. We found that her TPO antibodies were jacked back up, and her thyroglobulin antibodies were as well. So it was either the COVID so the virus, or the fact that she went on antibiotics that disrupted her gut, that really brought her autoimmunity out of remission. And it was the thyroid dysfunction that was really contributing to the cycle irregularities. We also found on a stool test that she had a lot of dysbiosis, elevated secretory IgA. So that just basically means the immune system was screaming.
It was like, help, help. And so the intervention was to put her on some antimicrobials to bring down the dysbiosis, to bring down those, like, negative bacteria that were contributing to immune dysregulation. It was to stabilize the thyroid. It was to stabilize the immune system. And with that, the symptoms went away and her cycle returned back to normal. So this is kind of why this episode is a little bit of a rally cry with, we are centering the perimenopause discussion so much. We are centering the HRT conversation so much. My concern is that we are going to miss the root causes because again, she's another example of somebody where HRT would not have solved her problems.
So she was raising her hand, tagging herself in saying, like, hey, I've got the perimenopause on me. And through lab testing and through a deeper dive, we were like, oh no, this is actually. There's other things going on that are contributing to your loss of cycle, contributing to hot flashes, and contributing to your symptoms. You know, in summary, how do I want to close out here? I think I'm so glad that we're talking about this, but I. I sort of hate that we vilify or pathologize this natural part of life. Because when we're talking about perimenopause and menopause, we're not really talking about it very positively. We tend to view it negatively. And I want to let you know that not all cultures view this endocrine transition the same.
Some of it, they view it through a very positive lens. Jane H. Collings says menopause is a portal, not a flaw. She says the end of fertility is not the end of vitality. So we can look at this transition as an initiation. We can look at it as a recalibration. We can look at it as clarity, calmness, self, knowledge, kind of stripping back the layers, becoming more of yourself, getting to know yourself on a deeper and deeper layer. It is, and it can be an invitation.
Not really the point of this conversation, but I just want to like open the doorway to that line of thinking for you and maybe we'll revisit it on another show. But when we pathologize it, we miss that invitation. When we pathologize it, we kind of, we lose the medicine that can come from this time. So if you're like anywhere on this journey, or if you're like nowhere near it, but you're like, I'd love to prepare for it, or you are like, really anywhere in your hormonal lifespan. I do want to invite you once again into yhr, your hormone revival. It is a time. It's a three month program. It's a really good vibe.
I love it. I'm pumped to be running it live. We finally have the bandwidth to offer this again. In addition to hormone lab testing and creating an individualized protocol for you and walking you through it with one on one support, we also do get into like the deeper stuff. If you want that sort of thing. We can address your hormones as this, like, deeper learning how to know yourself better. I just love that stuff. There's so much healing that happens and I really think it's those two things combined.
Rachel Mistry [00:47:59]:
I really like to take a whole human approach. So I'm not just looking at your labs, we're also looking at you in your life. Lived hormones tell the story of your life. Live like, let's get to know you too. And I think it's that approach that is why people have the results that they do. Somebody recently just said, I have so much more respect and compassion for my body now that I understand more of what's happening. It's such an invaluable course in not a moment too soon as I navigate perimenopause. So if this is the type of support that you're looking for, I'm happy to help.
You can grab the link in the show notes, you can join us for this live round and I just hope that this discussion was helpful for you in some way, shape or form. I don't feel like I'm the only 40ish woman out here that's like, you know, maybe I'm not totally ready for hrt. Maybe I want to look at other ways to maintain my resiliency and vitality. And I'm certainly not taking it off the table as an option for me at some point in the future. I just kind of have this gut sense that it's like, that's not what I need right now. I think I need a little bit of a deeper dive. I have to ask more questions. You know, maybe this is an opportunity to learn about myself on an even deeper level.
And so I invite you into that as well. As always, thank you guys so much for being here. I love you and I will check you next week. Thanks for joining me for this episode of the Functional Nutrition Podcast. Please keep in mind this podcast is created for educational purposes only and should never be used as a replacement for medical diagnosis or treatment. If you got something from today's show, don't forget, subscribe, leave a review, share with a friend, and keep coming back for more. Take care.