One of the myths about menopause is that symptoms are related to a deficiency of hormones, either estrogen or progesterone. Yet if that was the case why wouldn’t all women get these symptoms ? My favourite assessment of menopause is that its a “report card” on the last 10 years. That’s great if you have been doing all the right things but it can be problematic if you live in a big city, work full time with kids or have dealt with a lot of stress.
Generally in practice the consistent triggers for menopausal havoc are adrenal fatigue, toxicity, dysbiosis (gut dysfunction), hormonal imbalance, excess weight and inflammation. In the more difficult cases it can be a combination of these factors and that’s why its important to ensure you review all these areas in your initial case taking and think about which areas you need to prioritise.
So how do you decide what’s contributing to your symptoms ?
- Adrenal Fatigue – also known as I am a full time carer, full time worker and full time nanny/housekeeper (also known as Mum) or combination of some or all of the above. Stress initially raises adrenaline to prepare us for fight or flight. Longer term it results in elevated cortisol which may result in fluid retention and weight gain.
- Dysbiosis or gut dysfunction – if your gut isn’t working properly its hard to digest the nutrients you need and also support your liver to detoxify effectively. This will result in hormone imbalance particularly through peri-menopause when the liver is already working harder to detoxify hormones. Signs of gut dysfunction could include flatulence, bloating or reflux. Treatment will often involve identifying and removing food intolerances whilst supporting digestive function to reduce reactivity.
- Toxicity – two big areas areas are Heavy Metals or Endocrine Disruptors which can be a little tricky to determine but think lots of plastics or old fillings (usually amalgams contain mercury and silver). Switch over to glass or BPA free plastic as much as possible to reduce your exposure to endocrine disruptors. Also look at your cosmetics and skin care products to ensure you are minimising your exposure to chemicals and reducing the burden on the liver. One problem with toxicity is that it makes it harder to lose weight as the body will push these toxins into fat and will resist releasing it to protect you.
- Inflammation can be due to carrying excess body fat but can also be due to chronic injuries which trigger constant inflammation in the body. Anti-inflammatory supplements such as fish oil and tumeric can be helpful but exercise has an important role to play here in reducing inflammation as well. Just make sure its not aggravating an existing injury and consider whether you may need more support such as in acqua aerobics in the pool for example which can take pressure off joints.
- Hormonal Imbalance for some women hormones will be imbalanced because of some of the reasons listed above however there are some good herbal and homeopathic options available which can help. The most widely used herbal medicine is probably Vitex or Agnes Castus which can assist women with menopausal symptoms. Usually with herbal medicine and certainly with homeopathic medicines it is preferable to prescribe based on the client’s specific symptoms. In the last few months I have found clients have had relief from symptoms with Glonoine, Sepia and Sulphur homeopathically, its never one size fits all . A 2008 study of 438 women with hot flushes showed a significant improvement in symptoms for 90% of women in the trial (1).
Christine Pope is a Naturopath and Nutritionist based at Elemental Health at St Ives. Appointments can be made on 8084 0081 or online at the website
(1) Treating Hot Flushes in Menopausal Women – an observational study accessed at https://www.ncbi.nlm.nih.gov/pubmed/18194760
The first blog I wrote was about Five simple strategies to Lose Weight was focussed on insulin resistance and how to approach weight loss for this common problem. Historically I haven’t really focussed on weight loss in clinic unless it was related to the client’s overall health. What I found was that more complex clients require more creative solutions in terms of adapting weight loss programs to suit them and their lifestyles. You need to get more specific about supporting their metabolism to really help them shed weight.
Different diets work for different people so whilst I generally recommend a low carbohydrate ketogenic diet I have had clients do well on a range of other programs. How do you know when you are on the right diet for you? Generally you find your weight stabilises. So my top tips regardless of which diet you are using are as follows;
- Food Intolerances – find out what foods you are reactive to and cut them out! Regardless of the diet you are following this will often result in a 2-3 kg loss and usually a smaller waist line due to the reduction in bloating. Often the side benefit is you feel better and are more energetic and better able to follow through on exercise and food preparation. Using Bio Compatability 500 Hair Test to determine what foods are compatibile with your body often speeds up this process.
- Hydration – Drink 6-8 glasses of water a day and at least one litre for each hour of exercise. Nothing works well when you are dehydrated.
- Herbal Teas – Support your liver with some herbal teas which assist with metabolism. This can include green tea, dandelion and ginger. Have a cup of hot tea with a squeeze of lemon on rising it really helps your liver function. Herbal teas also increase fluid intake and may reduce consumption of tea and coffee which often involve milk and sugar!!
- Fat Burning Exercise – Dietary changes will often produce slow and steady weight loss but if you really want to boot it up walking an hour a day is the key. The first 20 minutes you burn up the glycogen in your muscles and then your blood glucose but around 30-35 minutes you start burning fat. Consistently I have seen a significant improvement in results with adding regular walks to the program – in one case the client walked every morning and lost 7kg in 6 weeks.
- Get enough protein – how much is enough? To maintain your weight you need about 0.8g per kilo daily. BUT for weight loss you need to increase it to 1.2g per day. The protein is based on the desired weight so if you want to get to 60kg you need to eat 72g of protein a day. That is the equivilant of 2 eggs, a small can of tuna and a small chicken breast. Generally animal products are about 20-25% protein whereas plant based sources are around 10% so effectively you need to double up.
- Main meal at lunch eating your big meal in the middle of the day gives you a chance to really fuel yourself well for an afternoon of work but also plenty of time to really digest the meal.
- Fasting – this can be a good way to give your program a boost. Usually I would recommend starting with a 12 hour fast between dinner and breakfast. For details on who would do well with longer periods of fasting have a look at my recent blog Is Fasting For Me .
I have had a few other tips from friends and colleagues – one of my favourites was to diet when your partner was away and empty the fridge so you can’t snack on unhealthy options. Do you have any tips on weight loss? Please share in the comments section below.
Christine Pope is an experienced Naturopath and Nutritionist based at Elemental Health at St Ives. You can make appointments on 02 8084 0081 or through the website at www,elementalhealth.net.au .
Taking a week out in the sun in Winter is an ideal way to recharge the batteries. This year I went to Fiji for a week with the family and it made such a difference to have a mid year break. The question is how do you keep the batteries charged when you get back?
Think about incorporating some of the relaxing rituals from your holiday into your life on your return or use it as a chance to start eating better. Some useful options to consider could be:
- Daily walks – one thing you tend to do as a tourist is walk, often quite a lot more than you would normally. So once you have started why not keep it up. Walking along the beach is always relaxing and incorporating a weekly beach or bayside walk is ideal. The great thing about walking is you don’t need a lot of equipment and you can always walk to a coffee bar for a convenient top up.
- Being in nature – barefoot on the beach or on your back lawn. Walking the Corso in Manly is a great way to pick up your mood. Spending some time in nature each day really helps us stay grounded.
- Massage or other bodywork – incorporate this into your weekly or monthly schedule to help maintain your self and calm your cortisol. The village adjoining the resort in Fiji offered a one hour massage for about $30 Australian. Easier to afford at this price but with health funds rebating up to $30 for a treatment it could be a good way to add some self care on a regular basis. My clinic at St Ives has three excellent massage therapists offering lymphatic, craniosacral or remedial massage.
- Add greens to your diet. Again something simple and relatively easy to incorporate that will give you long term benefits. My breakfast in Fiji included sautéed okra and spinach, both locally grown so they were really tasty. Try adding spinach to your breakfast omelette or a salad at lunch.
- Eat seasonally it’s often cheaper and the food is usually in peak condition. The imperfect pick section in Harris Farm is usually a good indicator of what’s fresh , seasonal and well priced. At the moment lots of root vegetables and cauliflower as well as citrus and apples and pears.
- Hydrate ! If you can’t find someone to open a coconut for you at least drain the water bottle by lunch. We loved being able to enjoy the coconut water from a freshly opened coconut and then ate the young flesh from inside. Good hydration and good fats!
Christine Pope is an experienced naturopath based at Elemental Health St Ives. Appointments can be made on 8084 0081 or online at the Elemental website .
You are taking a probiotic and you think you understand what that does. Now people are talking about prebiotics and you’re not sure whether you should be taking that as well ?
A prebiotic is a food that feeds the gut bacteria whereas a probiotic is a combination of strains of various gut bacteria. Different types of prebiotics can feed different strains of bacteria so the prebiotic can be used therapeutically to promote beneficial strains at the expense of more problematic strains.
Lots of different foods are prebiotics as well as various supplements. For an appropriate list of foods look at my most recent blog Feed your Good Gut Bacteria . In terms of prebiotic supplements there are a number of interesting options to consider.
- Hydrolysed Guar Gum is a partially broken down soluble fiber which is extracted from the Indian Cluster bean.
- Galacto-oligodisaccharidases (GOS) are made from either a milk product source or from chicory roots. It is helpful if someone is also constipated and may increase bifidobacteria as well.
- Larch is the bark of a tree. It supports the production of a key fuel to support the integrity of the gut lining known as butyrate. It also has been shown to support the growth of good gut bacteria such as Bifidobacteria and Lactobacillus which reducing the growth of E Coli and Clostridia. It is thought that the larch stimulates the immune system and therefore keeps opportunistic bugs in check.
- Lactulose is made of up of two sugars galactose and fructose and is used to treat constipation. It is not digested like other sugars and therefore when it moves through to the colon the bacteria can feed on it and it draws water into the stool making it easier to pass.
Once you know the composition of your gut flora you can really assist in building better diversity by supporting the growth of beneficial strains or by crowding out problem bacteria. Ideally using testing such as a Comprehensive Digestive Stool Analysis or directly through a group like Ubiome you can improve your knowledge of your gut bacteria.
If you need assistance with gut health please make an appointment with Christine Pope on 8084 0081.
At the Bioceuticals Symposium in Melbourne recently I was fortunate to hear from keynote speaker, Dr Terry Wahl’s on the program which put her Multiple Sclerosis into remission. One of the refreshing things about this presentation was the strong focus on diet first, then exercise second and then supplements. The benefit of this approach is that it isn’t just suitable for MS but also anyone suffering from an autoimmune disease and current indications are that this could be in excess of 20% of the population.
Dr Wahl’s was diagnosed with MS in 2000 and used conventional therapies to manage the symptoms. She deteriorated to the extent that she was in a tilt wheelchair and needing to resign from her position at the hospital. Motivated by the downward spiral and with a background in clinical research she started looking for options in the medical literature and looked more broadly at other degenerative conditions such as Parkinson’s and Huntingdon’s disease. The drug therapies being tested were decades away so her research then led her to vitamins and supplements. What she found was a number of nutrients that slowed the pace of her MS but did not resolve the underlying condition. After discovering Functional Medicine in 2007 she decided to redesign her diet to try and incorporate those nutrients from food. This had such a significant impact that she went from a wheelchair to walking in one year.
The basis of her program is significant dietary change, basically flooding the body with nutrients. This is done by removing gluten, dairy and sugar and replacing it with a lot of nutrient dense vegetables and phytochemical rich fruit as well as small amounts of good quality protein and fats. The program encourages the use of butter which has been demonised for so long although ideally only the butter of grass fed cows so its rich in nutrients. It also includes small amount of organ meats, ideally organic, for their nutrient density. So pate is back on the menu but you can’t eat it with bread!
Key components of the diet are as follows;
- Up to 9 cups a day of vegetables and fruit of which ideally 3 cups are green leafy vegetables and 3 cups are sulphur containing vegetables and the remaining are brightly coloured vegetables and fruit.
- Small quantities of good quality protein ideally grass fed or organic.
- Fermented foods in small quantities initially to assist in feeding beneficial gut bacteria.
- Seaweed to provide adequate amounts of the essential mineral iodine
- Organ meats such as liver or heart once or twice a week, these should ideally be organic but particularly important to have organic liver as many toxins can be stored in the liver.
- Good quality fats such as olive oil and grass fed butter.
For more information on the specifics of this diet her book is invaluable and she also has many resources on her website including meal plans.
In addition to the dietary changes, adequate sun exposure for Vitamin D as well as regular exercise are critical. Typically exercise is often difficult for MS patients however she recommends working with a suitably qualified exercise therapist to ensure that activity is appropriate and builds up gradually. The advantage is that regular exercise increases the number of mitochondria which assist in building energy, so this is helpful with the fatigue associated with MS and other auto-immune conditions.
Christine Pope is a Naturopath based at Elemental Health at St Ives and can be contacted for appointments on 8084 0081. Christine works with clients to optimise the diet and support them with supplements and herbal medicine.
Chocolate in its raw state is an amazing mix of nutrients , both minerals and plant compounds such as polyphenols. Come Easter time is it possible to enjoy a little dark chocolate and support your health as well ?
1. Nutritional Content 100mg of good quality dark chocolate has 230mg of magnesium, which is 58% of the recommended daily intake (RDI) . It also has 12mg of iron (67%) 1.8mg of copper , 722mg of Potassium and 3.3 mg of zinc. That’s a nutrient dense package however it will account for 30% of your daily kilojoules intake as well.
2. Fibre content is actually reasonable as like many plants there is a good amount of fibre , around 8g in a 100g block. Usually 25-40g in a day is considered a good quantity of fibre so dark chocolate can contribute to that intake. Fibre is essential for the effective functioning of the bowel and it also provides a food source for beneficial gut bacteria.
3. Caffeine – well at around 80mg per block it’s equal to one cup of coffee so it’s good for an energy burst for at least an hour afterwards. Possibly best to avoid later in the evening if you have trouble sleeping.
4. Theobromine – one of the valuable anti-oxidants in chocolate is theobromine. It is a vasodilator which helps move improve blood flow to the brain and increase oxygen. Its the mental boost without having to suffer the effects of excessive amounts of caffeine.
Better energy and a nice shot of your daily minerals! Just keep intake moderate and enjoy a small amount daily!
Christine Pope is a naturopath and nutritionist based at Elemental Health St Ives. You can make appointments on 8084 0081 or online at www.elementalhealth.net.au .
Fasting is a time honoured Naturopathic tradition although its not really taught as part of main stream courses anymore. It is still a really useful protocol for some people. There are now a wide range of options with fasting, Juice Fasting, Five Two, Elemental Fasting, Six One and Intermittent Fasting, just to name a few . So what are the current options?
- Juice Fasting – this is usually a shorter fast such as a weekend or a few days and limits your intake to mainly vegetable juices, with a small amount of fruit. It floods your body with nutrition and hydration but can sometimes provoke extreme hunger on day 2. This is often used as a cleanse or weight loss starter and the usual feedback is about half the weight lost is water you do become more concious of what you eat after a juice fast.
- Five Two – a popular adaptation this allows you to eat on an unrestricted based 5 days a week whilst restricting calories to 25% of your normal intake on two of those days. This diet was popularised by Micheal Mosley a few years ago. Ideally to really minimise side effects and benefit from this approach you need to eat nutrient dense foods the other days and ensure that you are getting enough protein and micro-nutrients, such as vitamins and minerals on your non fasting days. Proponents of this approach suggest starting with a 12 hour fast overnight for a few weeks to make it easier.
- Elemental Fasting – this is used therapeutically for a digestive reset for those with serious infections such as parasites or severe SIBO (small intestinal bacterial overgrowth). This fast needs to be run under supervision and comprises shakes which contain adequate amounts of proteins, fats and carbohydrates. The approach is to starve out the problematic bugs.
- Six One – A slight variation to the Five Two it involves completely fasting on one day a week whilst eating normally on the other days.
- Intermittent Fasting – Routinely fasting for twelve hours overnight – basically eating dinner by 7.30 and then breakfasting at 7.30 – can be an effective way to improve your response to glucose and insulin. As part of the Bredesen protocol I studied in 2016 it is recommended as part of a strategy to improve blood sugar as well as specific sensitising nutrients if levels are elevated. In addition its recommended that people with the specific gene for Alzheimer’s known as APO4E fast for up to 16 hours a day. For more information on this protocol see my blog Delaying Alzheimer’s
So what are the benefits reported from fasting ? Micheal Mosley in his 5:2 diet cites three major areas which include weight loss, improved metabolic markers and reduced inflammatory markers such as C Reactive Protein. Research published recently on pubmed is also showing that intermittent fasting or time restricted feeding is proving beneficial for weight loss and metabolic health. (1)
Intermittent Fasting can be a good way to stabilise blood sugars at the early stages of insulin resistance. The 5:2 protocol can be helpful for people who want to lose weight but have trouble sticking to a restrictive diet. Ideally your fast days are separated and you include a small amount of protein in the meals to help stabilise blood sugar.
Christine Pope is an experienced Naturopath and Nutritionist based at Elemental Health, St Ives. You can make an appointment on 8084 0081 or book online at the website .