Have you ever wondered, “Why am I so tired?” These days the adrenal glands get blamed for all our fatigue. This is partly true, but not the whole story.
Peri-menopause - the 5-10 years leading up to menopause - is a common time to be diagnosed with a thyroid condition.
In this article, I’d like to address these questions:
• Why then?
• Why more in women?
• What can be done?
Peri-menopause may begin in your late 30s or early or mid 40s. You may notice that your PMS is worse. You may have spotting between periods. Over time, your periods will likely get more dramatic, with missed periods and heavy periods.
Other symptoms may be popping up too, like anxiety, brain fog and weight gain. You may be thinking, “these sound like thyroid symptoms,” and you could be right!
But before we explore the thyroid connection, let’s cover what is normally happening during peri-menopause.
What is Peri-menopause?
Peri-menopause is, in short, the opposite of puberty. In puberty your ovaries are waking up to start your reproductive years. Your brain and ovaries are learning to work together to coordinate a monthly cycle, and often the first few reproductive years are hormonally unstable.
In peri-menopause, the brain-ovary relationship is starting to shut down. The ovaries are closing up shop, but the brain keeps knocking at the door, trying to get the shopkeeper working again.
The sex hormone that needs to rise sufficiently in the first half of the month is estrogen. It is produced by the ovaries as they also grow eggs. If you produce enough estrogen and release an egg, you’ll ovulate. And if that egg is healthy and hearty, you’ll produce a good amount of progesterone in the second half of your cycle. (The egg sac, or corpus luteum, makes progesterone after ovulation.)
How Your Thyroid Could Be Impacted in Peri-menopause
Even though both estrogen and progesterone are declining in peri-menopause, progesterone declines more dramatically in this stage. This leads to a condition called ‘estrogen dominance.’
Too much estrogen can prevent the thyroid hormone from getting to where it needs to go and can prevent it from converting to its active form. For some women, their thyroid symptoms are simply a result of this high estrogen interfering with thyroid hormone activity. We’ll talk about how to address estrogen dominance shortly.
Another thing estrogen effects is the immune system. Estrogen is associated with stimulating the TH2 branch of the immune system (1). TH2 is short for T Helper cell type 2, a lymphocyte (immune cell). TH2 is part of the adaptive immune system, which mounts a specific attack against pathogens.+ Adaptive immunity is usually a good thing, but it can also lead to autoimmunity if the antigen activity is directed towards itself.
As estrogen is the dominant sex hormone in women, this helps to explain why autoimmunity and thyroid disease is more common in women.
As we age, we also experience decreased immunity, and a tendency towards TH2 response.
“In the aged, however, naive cells are less likely to become effectors. In those that do, there is a documented shift towards a Th2 cytokine response.
The elderly have impaired ability to achieve immunization but much higher levels of circulating autoantibodies, (due to the lack of naive effectors) impaired response to viral infections, increased risk of bacterial infections, and increased risk of both neoplastic and autoimmune disease.” (3)
However, there is hope and action we can take to keep estrogen in check!
What To Do
1. Improve Gut Health
If you’ve studied the thyroid, you know that gut health is key to prevent an autoimmune response and to convert thyroid hormone effectively. Did you know it’s also important to clear estrogen dominance? One way your gut helps clear estrogen is through the estrobolome, “the aggregate of enteric bacterial genes whose products are capable of metabolizing estrogens.” (4)
You can be friendly to your gut by avoiding:
• Genetically modified foods (GMO) - These kill off friendly bacteria
• Sugars - These feed troublesome bacteria
• Unnecessary antibiotic use - This kills everything, with bacterial imbalance often resulting in its wake
You can be friendly to your gut by including:
• Small amounts of fermented foods like sauerkraut or kimchi
• A wide variety of fibers from salad greens, fresh spices, berries, etc.
• A long period from an early dinner to breakfast - lets your gut bacteria grow in peace!
2. Boost Progesterone
Progesterone helps keep estrogen in check, so boost it by giving your body ingredients to make hormones.
• Hemp Oil - I’ve been very impressed with how 1 T of hemp oil a day helps my own peri-menopausal hormones
• Borage Oil - This oil, usually in pill form, has gamma linoleic acid (GLA) to spark hormone production
• Maca- This adaptogenic root herb helps boosts hormone production and can benefit your energy levels and sex drive
3. Help Out Your Immune System
If aberrant immunity could be a problem in your case, add some components that can balance your TH2 activity:
• Fish Oil- Fish oil has a balancing effect on the immune system and decreases inflammation. (5) Quality matters with fish oil, so do research to find a good brand.
• Vitamin D- Vitamin D deficiency is found at higher levels in people with autoimmune thyroid disease. (6) Talk to your doctor about getting your vitamin D tested and restoring it to a level around 60-80 NG/DL through sunshine and vitamin D3 supplementation.
Learn more about the thyroid at perimenopause from experts like Dana Trentini, Dr. Tom O’Bryan and Heather Dubé at the free, online Hormone Balance After 40 Summit!
The summit happens live June 5-11, 2017, but recordings will live on after the live summit.
Hormone Balance After 40 Summit
As I prepared for this article, I googled “tips for PMS.” Some suggestions were basic but good, such as stopping smoking. Others were very disappointing, like use ibuprofen for cramps or take antidepressants for severe symptoms. Yes those are solutions, but only temporary ones. They don’t get to the root of your PMS problem. And for actual prevention, that’s what you need.
PMS, or premenstrual syndrome, was first defined as a group of symptoms with no known cause that arises before or during your menstrual cycle. In our modern culture, it’s become a common term and an expected part of having a period.
PMS is actually not a required part of your life, and it does have a cause: low progesterone / estrogen dominance. Why you get into this pattern will vary with each woman, but there are a few main culprits.
For today I’m going to give some of my best tips for PMS I’ve learned over my 12 years working with women.
1. Drink Water
Ok, this one may seem too easy. You drink it everyday. But if you aren’t getting enough water for your cells to function properly or for your body to detoxify, you can have symptoms of PMS.
Some of my clients have relieved their symptoms just by making sure to drink eight 8 oz. glasses of water per day in the week before their period.
Ideally we should all drink that much pure water everyday. Tip: start right away with a glass in the morning, and keep water near you to sip between meals all day.
2. Get More Magnesium
Magnesium is a mineral that we need to make progesterone in the second half of our cycle, and the we need to prevent menstrual cramps.
Food sources of magnesium include sunflower seeds, beans, nuts, dark leafy greens, avocado and dark chocolate! That’s often why you crave it around your period!
If you are thinking, “well I take a multivitamin,” check the amount you’re getting on your bottle. Magnesium is very bulky and the RDA (recommended daily allowance) of 400 mg of magnesium can’t fit in a one-a-day pill.
Magnesium bisglycinate chelate is one of the best absorbed forms of magnesium, and this is the one that I have chosen to use personally. Click here to learn how to tell if you have a magnesium deficiency, or check out my favorite brand here.
3. Take Fish Oil
Fish oil is anti-inflammatory, and quelling inflammation allows your cells to receive hormonal signals. Translation: your hormones won’t be going wack-a-doodle. Fish oil also prevents inflammation that can cause cramps. And it helps regulate the immune system in cases of autoimmunity that can be involved in female disorders such as endometriosis.
However, finding a high-quality fish oil is essential, and it’s not always easy. Read my article on healthy fats (including fish oil) here, and check out my favorite brand here.
4. Eat Fiber
Fiber is an unsung hero for hormones. To have balanced hormones, you need to clear out old hormones. How do you do that? You need to support your liver and digestive tract.
Fiber helps you move your bowels so toxins aren’t reabsorbed. It also supports a healthy gut microbiome (the community of organisms in your digestive tract) so that you make vitamins and brain chemicals, which further keeps you balanced. You also get all the good stuff out of food through a healthy gut. If I haven’t totally convinced you yet, fiber keeps your gut healthy. An unhealthy gut is a major source of inflammation, which as you learned is no bueno for your hormonal health.
I’m not talking about that weird fiber you buy from the drugstore and mix into water. Aim for eight different sources of fiber a day from a variety of leafy veggies, root vegetables, fruits and gluten-free whole grains and seeds. In a week, aim for twenty different sources. The more variety is the better, so try new foods from the produce section and from your farmers’ market.
You want to get 30 gm of fiber a day, which is kind of a lot. I get extra by adding hemp seed and chia seed to my smoothies.
5. Dose Up on Vitamin B6
Vitamin B6 is a power compound for women’s health. B6 is needed to make progesterone in the second phase of your menstrual cycle. If you are deficient, you could end up with PMS, a short cycle or spotting. This factors into fertility issues as well.
If you take a good-quality multivitamin, you are getting a dose of B6. But if you have severe PMS, you may want to try a high dose for a few months, along with some of the other tips in this article.
Some food sources of B6 are brown rice, liver, beef, lentils, tuna, banana, cashews, cabbage and turkey.
The RDA for B6 for women in their childbearing years is 1.3 mg. I would try taking 100 mg a day for 3 months. You can use the same dose (divided into 25 mg doses) for morning sickness.
6. Try Borage Oil
Borage oil is derived from cold-pressing the seeds of the borage, or starflower, plant. This oil is anti-inflammatory, anti-oxidant and is high in GLA (gamma-linoleic) fatty acids. You may have heard of using evening primrose oil for PMS, and that is good too, but borage oil is higher in GLA; it’s the highest of any seed oil.
It may be that, like black cohosh, it’s the potent anti-inflammatory and antioxidant properties of borage oil that enable your glands and organs to function correctly, thus alleviating PMS.
I recommend 1 capsule a day in the two weeks before your period.
7. Get Sleep
When you sleep, you heal. You make growth hormone and repair tissues. When you don’t sleep, you get cranky and have food cravings. Then you eat a doughnut, feel guilty and feel sick.
When you are trying to fix PMS, you want to create as much stability as possible in your body. This makes the changes that come with a menstrual cycle much easier to endure.
So please get about eight hours of sleep each night. Some of us need a bit more, and some a bit less. Your sleep timing is also important. At 10 PM your adrenal glands start to repair, so you want to be sleeping like a beauty by then.
8. Avoid the Sweet Stuff
What do processed sweets and starches, pumpkin lattes and wine have in common? They all disrupt your blood sugar and contribute to PMS. I know it’s not what you want to hear, but it’s so, sister.
When your blood is often high is sugars, your cells block more sugars from coming inside. This is called insulin resistance. (Insulin is the hormone that helps delivers the sugars.) This insulin lingering in your blood can cause increased production of testosterone, which converts to estrogen, and now you have that estrogen dominance / low progesterone state of PMS.
I invite you to spend a full menstrual cycle avoiding the sweet stuff and trying these other tips and see what happens in your cycle. If you think about giving up lattes forever, it’s too much. But you can commit to a month, and once you fall off the wagon and symptoms resurface, it’s much easier to choose to avoid the sweet stuff.
If you are going to eat a processed carbohydrate or sweet, pair with protein, fat and fiber so it won’t spike your blood sugar as much.
Tips 9 & 10: Acupressure and Essential Oils
These times are brought to you, in video form, by my friend and colleague, Brodie Welch, LAc. Enjoy!
What are YOUR best tips for PMS? We'd love to read them in the comments below!
Have a friend who is struggling with PMS? Please post this article on social media and tag her.
More Help for Your Hormones
Do you wake up groggy and tired, turning to coffee or pastries to get you going?
Add in a simple 5 minute routine to have more energy for the day!
Grab our Five-Day DIY Detox Guide and get some spring back in your step, naturally.