[bernadette]

[bernadette]

Hi  – welcome to the roller coaster ride of the perimenopausal years! I’m right there with you! But there’s hope and if we can help you figure out the hormonal dynamics in your unique case, the good news is that it can be a much smoother ride.

When we enter the perimenopausal years (typically between 40 and 50 years), progesterone declines at a much faster rate than estrogen which can leave a woman estrogen dominant (i.e. a relatively higher ratio of estrogen compared to progesterone), which leads to symptoms like sore breasts, heavy periods, and PMS.

However, since you’ve mentioned that you historically have had heavy periods, I’m going to assume that you were already estrogen dominant, and now with the gradual decline of progesterone due to the natural aging process, the imbalance might be exacerbated.

If you haven’t already seen it, I would encourage you to watch the presentation that we had with hormone guru, Dr. Carrie Jones. It’s called “Estrogen Gone Wild” and it was all about estrogen dominance. It will help you gain a better understanding of how this dynamic happens; 1- high estrogen to progesterone ratio, 2- lack of clearance of estrogen (gut health!!), 3 – xenoestrogens (outside sources of estrogen which mimic estrogen and aren’t measurable in blood tests, but they have hormonal effect in the body).

So before I guide you further, we need to start getting clear on what are the potential causes in your case. Is it simply due to the decline of progesterone? Is it because of constipation or gut dysbiosis allowing estrogen to go back into recirculation? Or is it lifestyle related based on the choices of hygiene and personal care products used on a daily basis? Here’s a viral post that I did which visually displays some of the common sources of estrogen mimickers.

It could be 1 or all 3 dynamics at play. So before going any further and overwhelming you, please make time to watch that presentation, and then come back to my post and tell me what your intuition says about the possible 3 dynamics, and which ones you feel it could be.

Also, have you ever had your hormone levels tested? Please remove any identifying information, and feel free to upload them here for us to take a look at as well.

Once we begin to zoom in on the contributing factor(s), then we can discuss way to correct it. Hope that makes sense.

[bernadette]

Hi  – you can find the castor oil handout in the Discounts & Resources section of your library dashboard, under “Tools & Guidelines”.  Here is the link to it directly.

You may also be interested in The Queen of Throne’s packs which make the process very convenient.

[bernadette]

 I face a similar situation with my son who refuses to get pricked now, so I completely understand your situation.

The good news is that the 24-hour iodine test is urine, and the H Pylori test can be breath or stool. The breath test can be done with a doctor so can be covered by insurance, but I have seen many false negatives. That’s why my preference is a PCR H Pylori stool test with Diagnostic Solutions. Here’s a sample report. The lab charges $173 USD plus $40 shipping/collection, and takes about a month for results approx.

I like Spatone for all ages, and have found it to be easy on the stomach and non-constipating.

If she can swallow capsules, I would prefer cod liver oil instead of vitamin A because it’s a fat soluble vitamin, and in the absence of testing, and not knowing her baseline levels, you don’t want to overdo it. I like Rosita Cod Liver oil and it’s available in Dubai through Ancient Traditions. I consider it safer since it’s a whole food supplement instead of a single nutrient.

When selenium levels are sufficient, kelp granules are ok to introduce. But low and slow, using it as a salt replacement until you know her baseline iodine level. A more therapeutic dose would be 1/4 tsp for 30-60 days, but in the absence of testing, a low and slow approach is safer.

Did you watch this gut healing video? Any of these therapies can be used – depends on what you feel she would accept. I also shared a few different multi-herbal supplement formulations if you prefer supplements. There are capsules and flavored powders. Please let me know after watching that video if you have specific questions about any of those remedies.

In terms of probiotics, I always recommend food first since it’s the most varied and highest in colony count. Would she eat a little sauerkraut for example, every other day? It has a pickled taste so if she likes pickles, she would like sauerkraut. Would she like coconut kefir? I have kefir grains to share if you’d like to try it. I give this to my kids almost daily in the form of a smoothie. Instead of regular milk, I use kefir milk. But since your daughter should go dairy-free, you can make coconut kefir milk instead. The process is very straightforward.

In terms of gluten-free bread options, please check out So Free Organics and Honest Kitchen. Honest kitchen makes flat breads that can replace pita bread. So Free Organics has gluten-free manakeesh and other gluten-free/dairy-free items!

I would also encourage you to join the Gluten-Free UAE Facebook group for additional support. They’re always sharing new brands and restaurants that cater to a gluten-free diet.

I know it’s tough, I’ve been through it, but we’re here for you every step of the way. Let me know if you have any other questions.

[bernadette]

 Ok, next step would be to start testing to confirm or rule out the possible hormonal factors.

Before ruling out estrogen dominance because it’s low on a blood test however, please note that you can still have relatively higher estrogen to progesterone ratio, IF:
 
• if progesterone is also low. Can you upload and share your tests with us here?
• if an enzyme called beta-glucuronidase is high allowing spent estrogen to go back into recirculation (this goes back to gut health and is measurable on a GI map test for example). Do you have gut-related symptoms like bloating, gas, acid reflux, belching, inconsistent bowel movements, loose stools or constipation that would warrant this test?
• if the sources of estrogen are coming from outside sources (aka Xenoestrogens from environmental factors like BPA, pthalates, triclosan, glyphosate chemicals, etc). Unfortunately, xenoestrogens are not measurable on a blood test but can still have hormonal estrogenic effect in the body because they mimic estrogen and can fit into the same receptor spaces as estrogen. So another question to you – are you aware of these sources and make an effort to reduce your exposure to them in personal care products, make-up, plastic bottles, etc? Here’s a viral post I did on Instagram with a visual representation of some common daily xenoestrogen sources.

In terms of figuring out if cortisol/insulin are at play, it also depends on your budget, but I can recommend the following tests:
• Blood sugar panel and full thyroid panel (blood tests). I can recommend Dr. Liliana Skorski at Health Bay who is a functional gynecologist who understands the importance of running the full panels and wouldn’t fight you on it.
• DUTCH adrenal to test adrenal/cortisol function. Here’s a sample report. The lab charges $309 USD plus $40 shipping, and results take 21 days.
• DUTCH Plus to get a comprehensive overview of ALL of your sex hormones, including adrenal/cortisol function, plus some organic acid markers that tell us the status of your B6, B12, oxidative stress and glutathione levels. Here’s a sample report. The lab charges $499 USD plus $40 shipping, and results take ~30 days.

FYI – we can arrange to give you access to these functional tests if you wish to pursue them. No doctor requisition needed – the lab will send the kits to you directly after purchase.
Please review the above videos/reports and reply to my questions above, and let me know what your intuition is telling you to do next. Awaiting your feedback.

[bernadette]

PCOS (Polycystic Ovarian Syndrome) affects a reported ~10% of women, but that’s a low estimate in my opinion. The estrogen dominance (and often excess androgens) present in these women will lead to many states of dis-ease downstream.
These women may struggle with a wide variety of symptoms including weight gain, fatigue, facial or excess body hair growth, thinning hair on the head, infertility, acne, irritability, insomnia, and headaches.
As usual, we want to focus on understanding the dynamics at play in this type of imbalance (and not the diagnosis).  Many women with PCOS are not ovulating optimally (or, therefore, not making much progesterone) and this puts them in an estrogen dominant state.  This anovulation is often caused by excessive testosterone as a result of high insulin levels from insulin resistance.  Checking her blood sugar levels including fasting insulin is good idea.
We know that insulin resistance is epidemic – hence why I created a whole course on the subject! And it is indeed reversible in many cases with persistent lifestyle change and targeted short-term supplementation to increase insulin sensitivity.

In the case of PCOS, I want to introduce you to the power of inositol.

Inositol has been shown repeatedly to restore ovulation (and here) and increase pregnancy in women with PCOS, in both normal weight and obese categories.   In many of the high-dose studies (and here and here and here,  from 1200-4000mg daily), there was a marked improvement in glucose, insulin, and testosterone levels as well, showing the nutrient is addressing the common metabolic and interactive hormones drivers of PCOS.   There were ovulatory benefits in lower-dose studies (e.g. 200-400mg/day)  but less or no other marked improvement in other metabolic markers (e.g. insulin). One study also identified dramatic improvements in two common symptoms of androgen dominance (acne and hirsutism)  in young women with PCOS.  Duration of treatment in the studies ranged from 3-12 months with significant benefits being demonstrated (where measured) by the three-month mark.  I typically recommend 2500-3000mg/day for my own clients.
Both myo-  and  d-chiro inositol  forms have been shown in most studies to be effective at reducing insulin resistance.  A couple of studies have looked at this opportunity more closely and identified  more rapid benefits achieved using a synergistic combination of myo- and d-chiro-inositol as opposed to myo-inositol alone.  Improvement in the end was equal in extent for the two scenarios; the combination was simply effective more quickly.   There is some evidence that a lack of availability or utilization of d-chiro inositol in tissues is a direct causative factor in insulin resistance.   Whether this is a primary or secondary effect is unclear.
Supplement options are readily available.  A combination myo- and d-chiro inositol product can be found in items such as Designs for Health’s “Sensitol” (capsules).   Pure Encapsulations offers the myo- form in “Inositol” which is a loose powder (a nice, easy option given inositol is sweet and quite palatable).   When using inositol separately in some way, I recommend doing so in combination with a broad-spectrum B-complex supplement to ensure availability of key cofactors.
High-dose inositol is contraindicated (as is true for the vast majority of supplements) in those with kidney disease.  Otherwise, none of the studies I reviewed identified any significant side effects or safety concerns after over a year of intake up to 4 grams daily.
Research into the use of inositol to counter depression or anxiety has used much higher doses (6-18g/day).  For example, a dose of 18g/day was found to be as effective as fluvoxamine (an SSRI) after a month of use in treating panic disorder.

Please note that the birth control pill is often given as a band-aid solution, and will lead to further consequences since it depletes B vitamins over time, and causes wear and tear on the gut lining. And not to mention, can increase estrogen states in the body, which can impact thyroid function and a whole host of metabolic consequences downstream as a result.
Hope this helps give you some direction and information to share with her. Please let her know we can help her if she needs the support.

[bernadette]

 just defrost them under running water and stick them in your air fryer if that’s how you want to cook them. No need to boil/steam them first.

[bernadette]

 before running expensive functional tests like an OAT or mycotoxin test for mold, there are simple steps you can begin implementing that will make a positive difference:
• eliminate dairy & gluten for at least 4 months (this will help not only with calming autoimmune activation, but it may help with her constipation as well)
• introduce magnesium citrate in the evenings for rapid relief of constipation
• in addition to removing likely food sensitivities, heal the gut lining
• since her selenium looks good, I would slowly begin adding in iodine rich food sources like kelp sprinkles but monitor her thyroid levels every 1-2 months to make sure her antibodies aren’t going up
• ensure she’s consuming VPF with each meal, to make sure she’s bringing on board all the macronutrients, especially protein for thyroid production
• begin introducing a variety of fermented foods every other day into her diet to help support gut health and immunity with beneficial probiotics. Please see recipes in Discounts & Resources. Coconut kefir would be the easiest introduction.
• check and rule out with a gynecologist the position of her uterus (yours too). A retroflexed uterus can lead to constipation.
• Request gynecologist to test her sex hormones estrogen & progesterone during days 19-21 of her cycle to see if there’s estrogen dominance or low progesterone production. Both of these can impact total and Free T4. But keep in mind that a young women just getting her period will need time for her brain to adjust and produce optimal levels of sex hormones so this may not be necessary. Just an FYI.
• Support her low vitamin D levels with a combination of more sun exposure and/or supplementation with cod liver oil or vitamin D3 supplements to support her immunity. 
• Given the autoimmune activation, I would also measure RBC zinc and vitamin A if she doesn’t mind getting pricked again. Otherwise, cod liver oil and chicken liver can also provide a good dose of vitamin A which thyroid & immune function both depend on.

In terms of additional functional testing, I would prioritize:
1. H Pylori (I’m suspicious of low stomach acid, and although it’s likely due to hypothyroid function, low stomach acid can create a vicious cycle that allows an overgrowth to happen)
2. RBC iodine or a 24-hour urine iodine test (not loaded since there is autoimmune activation)

Hope this helps give you some direction and areas to begin working on. If you focus on supporting her immune system, her body may be able to counter whatever overgrowth or pathogen that may or may not be present.

[bernadette]

Hi  – so I Iike the mustard. All whole food ingredients which is my first priority when looking at labels.

I personally wouldn’t buy the ketchup because it’s made with agave syrup which is high in fructose and only metabolized in the liver. Now, is this a big deal if you’re healthy and rarely consume ketchup? No, not at all. But I personally prefer cane sugar over agave. And I personally like to avoid corn starch – but the good thing is that it’s organic so it won’t be from a genetically modified source.

So as Daniel mentioned in his reply, they’re both good options, and it really depends on your dietary preferences.

[bernadette]

Hi  – you can also find all of these optimal ranges and additional information in the Blood Sugar Regulation course in the “Testing Considerations” video here.

[bernadette]

 – so so so happy for you! Periods SHOULD be asymptomatic and uneventful and like you said, it’s often a result of a multitude of small changes that add up. Keep it up!!

[bernadette]

 I can’t see any of the images. The .HIEC format isn’t supported I guess. Please upload .png or jpeg or pdf files if you can.

What about the Organic Larder brand of ketchup at OF&C?

[bernadette]

 I have no clue what these filters filter out and they don’t mention it on Amazon either. Please try to get that information from these companies directly, and then we can make an informed choice. Ask them for a list of contaminants that their filters have been tested to remove. If they don’t have it or won’t share it, RED FLAG!

But from the links you shared, the only one that checks one of the boxes is the ZeroWater since it’s NSF certified. That’s a good start.

[bernadette]

 if you want to steam your frozen veggies, then no need to defrost them. Buy a steamer basket (it’s a stainless steel basket that opens up like a flower and sits inside any size pot), and steam without defrosting. IKEA sells them in the kitchenware section.

Instructions: Add a bit of water in your pot, place your steamer basket inside (try not to fill it with too much water – you don’t want food touching the water to help preserve nutrients). Add your frozen veggies in the stainless steel steamer basket, cover your sauce pot, boil water then turn it down and simmer. 

To preserve nutrients in food, avoid putting them in boiling water, unless you plan on consuming the liquid (like in soups for example).

[bernadette]

Hi  – great question. The easiest way would be to follow the Ministry’s growing calendar: https://www.moccae.gov.ae/Content/Images/School/agriculture_calender_page_en.pdf

Obviously, given the climate in the summer months, nothing can grow here so we rely heavily on imported foods. 

But hopefully this helps for the remaining months!