Perimenopause: The Hormone Connection To Anxiety

July 15, 2023

Women are forced with changing hormone levels their whole lives from puberty to pregnancy to perimenopause, menopause, and post-menopause. At each of these stages, nutrition makes a difference. Today we’ll take a look at the perimenopause part of the cycle and share tips on how to balance hormones, how to reduce anxiety, and how to increase your quality of life if you feel like the shift in hormones has left you feeling cranky, anxious, tired, or not feeling like yourself.

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TERESA: Welcome to Dishing Up Nutrition brought to you by Nutritional Weight and Wellness. Today we are discussing women's hormones and will focus on perimenopause, which is the beginning stage of menopause. Perimenopause is often the time of life when many women experience more anxiety and irritability, and I think many husbands out there, you know, nodding their heads or significant others are like, yep, that sounds about right, especially on the irritability part, right?

BRITNI: Yep.

TERESA: The reality check is that, or the reality of this is that women generally lack knowledge about perimenopause and menopause. And so sometimes they don't realize why all this is going on. So the National Institute of Health, the NIH, published a study on June 26th, 2022 that found that women are usually not taught about menopause, and that many general practitioners have very little knowledge about menopause. So all these changes are happening and we don't know what's going on a lot of times.

Perimenopause and menopause have affected approximately, or are affecting approximately 1 billion women worldwide. But for the most part, women have very little awareness of symptoms. Actually to overcome the lack of knowledge about menopause and perimenopause, in 2019, the United Kingdom Department of Education made it mandatory for menopause education to be included in schools. So that's progress.

BRITNI: Absolutely.

Overviewing common symptoms during perimenopause/menopause

TERESA: Today we are going to discuss symptoms that many women experience during perimenopause and help everyone understand that many of these symptoms such as anxiety and weight gain and irritability, can have many causes. Usually these perimenopausal symptoms are not just an estrogen deficiency, but often a combination of lifestyle factors or other nutritional deficiencies. Some of my clients have told me that they feel anxious, and when they do, they have this crawling feeling under their skin. Or maybe it's more of kind of a, a buzzy feeling that they're, that they're, they just feel like, you know, maybe like there's just this electricity kind of running through their body.

Is that one of your perimenopause symptoms? Perhaps that's something that you can identify with. There are many other signs and symptoms that can occur during these hormonal changes, and I think as women, we experience them different and describe them different, and that's why it's maybe sometimes hard for people to, to talk about because it's just very, you know, subjective.

BRITNI: Yeah, that's a great point.

TERESA: Before we go any further, let me introduce myself. I am Teresa Wagner. I am a Registered and Licensed Dietitian, and I have been working with clients at Nutritional Weight and Wellness for the past eight years. And during this time, I have learned a lot about the benefits of eating real foods and how this really can touch any part of the life cycle, and also just how important it is for just maintaining health and longevity.

Joining me as cohost is Britni Vincent, also a Registered and Licensed Dietitian, who because of her own hormonal challenges, has read and researched and enjoys women in helping women in those perimenopause, menopause years feel like themselves again. Britni, what symptoms do clients come to you to help with? I was talking about like that buzzy feeling or creepy, crawly irritability.

BRITNI: Yeah.

TERESA: But is there anything else that you hear about?

BRITNI: Yeah, I think that's a great question. I asked some women that are taking our Nutrition for Weight loss class series to describe the hormonal symptoms that they have. You know, one woman, woman in her late thirties said, “I'm tired all the time. I don't have any zip, and I feel like I'm dragging my body all day.” Another woman said, “I am irritable. I don't like to be irritable around my kids and husband or at work, but my body just feels irritable.”

TERESA: Yeah, that's, that sounds familiar, that irritability.

BRITNI: Yes.

TERESA: Yes.

BRITNI: And women just, they explain it like, I feel like I don't have any control over it.

TERESA: Mm-Hmm. What's happening?

BRITNI: Yeah.

TERESA: Who moved into my body? There are many different hormonal symptoms, but don't worry. We will attempt to answer some of these hormonal concerns and talk about anxiety and some of the other things that, some of those other symptoms we were talking about. But again, there are many hormonal concerns during perimenopause. If you are in your late thirties, but probably more in your forties or early fifties, maybe even later fifties, you may feel as if your body and nervous system are changing and probably not happy with those changes. But on a good note, some women actually really don't have any symptoms or very slight symptoms and just sort of sail through that phase, while other women experience a wide range of symptoms that can be quite severe.

BRITNI: And if you are a woman experiencing symptoms that are affecting your quality of life, I encourage you make an appointment with one of the nutritionists at Nutritional Weight and Wellness.

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I mean, we work with a lot of clients in this perimenopausal time, and many of our clients in that late thirties to 50 year range grew up eating foods low in fat, high in processed carbs, exercising a lot to try to control their weight. I mean, I've been there. I think a lot of people can resonate with that. But as they got closer and closer to perimenopause, their food choices no longer work for them. Now, by eating that low fat, high processed carb foods, a variety of symptoms started to creep in. You know, many women begin having difficulty sleeping, waking up several times a night, which can become so incredibly frustrating.

Extra body fat can start to show up, especially around the midsection, feeling anxious a lot of the time, having a decrease in libido, breast pain, constipation, headaches, or migraines. All of those can start to occur during this time of life. And clients often tell us, I no longer recognize who I am. That self-confident can conquer anything person has just lost her self-esteem and positive self.

TERESA: You know, what's interesting is I had a client mention to me that she remembers her mother starting menopause at age 62.

BRITNI: Wow.

TERESA: Yeah. And she really didn't have any symptoms. And I would say, well, that must be why it was also later than what is normal, right? Or considered normal. Just symptoms being a sign that things aren't going as well.

BRITNI: Yeah. Yeah.

TERESA: So anyway, but this client was sharing that her mother ate eggs for breakfast. She ate vegetables and meats for lunch. And, you know, an example of a dinner that the client gave me that her mom would eat would be like, you know, she'd just make a small burger patty and or a burger patty and have a small potato with that and maybe some veggies with that, just keeping it simple. And then she had a garden and she would eat her vegetables that she grew from her garden and, and, and lots of them.

BRITNI: Wow. So basically she was just eating real food.

TERESA: Eating real food. And when she cooked, she cooked with butter or even maybe lard. She wasn't a dessert person and just ate real foods unless maybe she was at a party or something. And then in those occasions, she would just have a small serving of maybe the dessert that was there for those special occasions.

She did drink coffee, maybe one or two cups, but if she wanted cream in it, she would just use real cream. You know, none of the “foofy”, sugar ladened coffee, coffee creamers, and never really went to a coffee house and ordered those fancy coffee drinks with, you know, nine teaspoons of sugar or maybe even more sugar in them. And so this client's mother, at age 62, she likely still had sufficient hormones to feel good and not experience those symptoms that we were talking about.

She wasn't drinking or eating any of those hormone robbers that would, would make her maybe have some of those symptoms. So if you're thinking about yourself, are you eating or drinking any of those hormone robbers? Maybe it's alcohol or it's a high sugar diet. Maybe it's more processed carbs like chips and crackers and those type of things. So those, those are the examples of food things or drinks that can really rob those hormones.

Building blocks for maintaining adequate hormone levels

BRITNI: So on the flip side, thinking about what are the building blocks for maintaining adequate hormone levels? You know, real animal protein and most people need 12 to 14 ounces a day; healthy fat incorporated every time you eat and vegetables. I mean, getting adequate vegetables is also key to having balanced hormones. You know, before we move on, it is already time for our first break.

You are listening to Dishing Up Nutrition brought to you by Nutritional Weight and Wellness. I just want to remind listeners that for the month of July, all of our bone building supplements are on special. You can save 15% this month. Many clients buy several boxes of Key Osteo Plus cause 15% off, that's a good savings. Key Osteo Plus is a total bone building product and has many positive reviews. Order it online at weightandwellness.com or stop by one of our six offices. We'll be right back.

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TERESA: Welcome back to Dishing Up Nutrition. The World Health Organization recommends that you should consume no, no more than six teaspoons of sugar daily, but guess how much the average American consumes?

BRITNI: Way more than that.

Sugar causes inflammation in the body

TERESA: Yeah. 19 teaspoons each day. Eating this much sugar causes inflammation in our body. And if you think about what inflammation is, the root word is flame, right? So it's your body on fire. So after eating sugar, your blood glucose spikes causing pro-inflammatory chemicals to get delivered through your body, resulting in inflammation. So, and if you think about this, we eat excess sugar like that. So if we're eating 19 teaspoons of sugar, then our body releases insulin in order to bring that blood sugar level back down. And we know that high levels of insulin is also related to inflammation in the body. So turning the flames up in your body and, you know, that's just not what we want to do.

So that's why that recommendation is no more than six teaspoons of sugar daily. That's the amount of added sugar that's in foods and products. So if we're talking, we, we often use coffee as an example. Right? Well, when you go to Starbucks or Caribou or wherever you like, it's the, it's the pumps of sugar or the pumps of syrup that they're putting: that's that added sugar. Or when you're baking bread, it's the amount of sugar that's added to the bread to make the yeast and the bread rise; that, that type of thing. So that added sugar. So no more than six teaspoons per day. But that's not a requirement. You don't need six teaspoons.

BRITNI: Yeah.

TERESA: You know, you don't have to have any at all, and your body would function just fine.

BRITNI: I like that flame. I think that gives a really good visual to think about.

TERESA: Yeah. It's really, your body's on fire, so, I mean, think about when you have a hangnail, you know, you're, that your finger turns all red and it feels like it's hot and it's on fire. That's inflammation, you know? So, yeah, it, flame is a really good way to think about that inflammation.

Before break, Britni was talking about the building blocks of, of, you know, of hormones, right? And we were talking about it's important to have animal protein, natural fats and vegetables to help maintain your body, which in turn helps to maintain good hormone building. And I think it's interesting too, you know, when we think about the sex hormones, that being progesterone, estrogen, testosterone, all of those hormones actually have a, a cholesterol backbone. And so it's really important to have those healthy fats in our diet.

And even having those animal fats that have some cholesterol in it or eggs, you know, that have some cholesterol in it because it really is an important part of hormone building. So getting those, you know, as we talk about proteins, fats, carbohydrates in our daily diet from real foods.

Weight gain: a sign or symptom of perimenopause for some women

Alright. So getting back to some of the symptoms of perimenopause. One of the signs or symptoms many women experience when they are in their forties and fifties, maybe their late thirties as well, is weight gain: the dreaded weight gain.

BRITNI: Yep. We hear it a lot.

TERESA: And it's so frustrating, right? Because it's like, I haven't changed anything. I eat just like I did before. I do the same workouts, like, what is going on? Nothing has changed except for my waistline. In the past, you know, we talk about this all the time. You could just skip lunch and drop and drop five pounds, right?

BRITNI: Yeah.

TERESA: It just wasn't a big deal.

BRITNI: It used to be easier.

TERESA: Yeah. You could just cut out a few calories and lose five to 10 pounds no problem. But now cutting calories out, it just doesn't work.

BRITNI: Yeah.

TERESA: And people, and then it's like, well, I must have to cut more then. So we just keep cutting and cutting, exercising more, exercising more, and, and it's not resulting in what we want.

BRITNI: Ultimately it just makes things worse.

TERESA: Right. Probably more that irritability we were talking about.

BRITNI: Yeah, absolutely. It's not only are that hungry…

Insulin resistance: a major cause of weight gain

TERESA: Hormone; yeah, right. Not only are hormones all off balance, but we're also hungry and hangry on top of it. So when I have clients that are in that mentality where they need to exercise more, exercise more, cut calories, cut calories, I read them this article that was published in 2020. It was a study from the American Journal of Clinical Nutrition, and it clearly points out that weight gain or obesity is not just an energy balance problem or what is often called a calories in, calories out plan, but it's more of a hormonal disorder.

Processed carbohydrates & sugar cause excess of insulin

Then I explained that the hormone, insulin, is what may be causing the weight gain and not necessarily the lack of estrogen. The cause of almost three quarters of the population to have too much insulin is usually that we're eating too many processed carbohydrates such as muffins, you know, the muffins at the, at, you know, your local coffee, coffee shop. There's 20 teaspoons of sugar in that.

BRITNI: Wow.

TERESA: It's like having a cupcake with no frosting.

BRITNI: Yeah. Yeah. It's a great point; with a little fruit in there.

TERESA: Yeah. Yeah. It's just, it's very high in sugar and certainly when you're there, those coffee drinks high in sugar, maybe the tea, you're thinking tea is better, but, you know, some of those are super high too. The chai tea is just as high as the, as the other, as the other coffee drinks, you know. We snack on convenience things that come in bags and boxes, whether it be crackers or chips or cookies. And like we said before, it is recommended that we consume an upper limit of six teaspoons of added sugar a day. And that's not required, but that's the upper limit.

Step # 1 to reduce perimenopause symptoms: reduce sugar consumption

If we want to reduce these perimenopause symptoms, the first step is to reduce sugar consumption to six or less teaspoons of sugar daily, of that added sugar daily. For many of us, this is not an easy task. It, I mean, it is hard, right?

BRITNI: It is hard cause it, it adds up so quickly.

TERESA: It adds up so fast. Yes. But it can be, you know, really an important step to getting over some of those symptoms that we might be having during perimenopause.

BRITNI: You know, you talked about the insulin resistance and that weight gain. That is definitely a piece of the puzzle here. And unfortunately at this time in life, because of the shifts of hormones during perimenopause, the rate of fat gain doubles and your lean body mass really begins, begins to drastically reduce. So that reduction in progesterone, that little bit of reduction in estrogen also makes it easier to become insulin resistant.

So with all that being said, it definitely is easier to gain weight during this time of life, but there are things that you can do to, to prevent that. You know, it is already time for our second break, so we will talk more about this when we come back. You are listening to Dishing Up Nutrition brought to you by Nutritional Weight and Wellness. During the pandemic, several of the nutritionists put together a series of support sessions for clients who wanted help and support to practice good nutritional habits.

Ongoing clients told us, I don't know what to do, or I know what to do, but I just don't do it. I mean, we hear that probably every day. So we started with a Zoom format because of COVID restrictions, and then a year ago we were able to offer them both in person and virtually. So one of the support group members said, “It is so refreshing and helpful to have this oasis of health choices and constant contact to help fight the unhealthy ones.” So we offer these Ongoing Support and Education sessions at all six locations in person and several Zoom options. To get signed up, call 651-699-3438. We'll be right back.

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TERESA: Welcome back to Dishing Up Nutrition. I love to teach both the Nutrition for Weight Loss 12-week Foundations classes, and I also really enjoy the Ongoing Support and Education sessions. What I like about these classes is they are real. They have some science in it, but it doesn't go overboard in the science. And certainly if, you know, with the people who teach the classes, we do enjoy science. So people want to dig a little deeper, we're happy to go there. But generally speaking, we try to keep it, you know, more fun, less like you're sitting in your science class at school.

We offer suggestions on a variety of questions, such as how to drink enough water and why would we want to do that anyway, how to avoid the drive-through on busy nights, maybe after you are driving your kids around for soccer or softball or baseball. We talk about how to get good nights of sleep and, you know, it's just really nice to be with like-minded people making healthy choices. It's just nice, you know, we come a part of a tribe.

BRITNI: Absolutely.

TERESA: And, and you fit in with those people because you're all doing some of the same things. And that can be hard in society right now because it's so much more. There's, there's so many yummy but unhealthy, maybe not hormone supporting foods out there. And sometimes people just, you know, it's, it, people just question, well, why do you eat the way you do?

BRITNI: Yeah.

TERESA: So then when you come to these classes, you're with people who understand, oh, this is why we're doing what we're doing.

BRITNI: Yeah.

TERESA: And it's really nice to have that support. You know, we're not perfect either. I think that's one thing I like about our classes too, is that none of the people who are leading these classes act like they're perfect. They, a lot of times our best examples come from personal experiences of…

BRITNI: So true.  

TERESA: …where we have a hard time. So, but these classes, they just keep getting better and better as we are teaching them more and more. I invite you to join us this summer or maybe this fall. You can call for more information at (651) 699-3438 or check out our website at weightandwellness.com.

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BRITNI: So before break we were talking about some perimenopausal symptoms. We were talking about weight gain and we hear it all the time. “I haven't changed anything and all of a sudden I've gained five or 10 pounds or the scale just keeps creeping up.” And, you know, you gave a great explanation of insulin resistance, Teresa, and also I was describing before break, you know, because there, the shifts in hormones during perimenopause, it makes us gain weight much faster and our lean body mass starts to reduce pretty drastically.

And that reduction in progesterone and estrogen makes it easier to become insulin resistant. So most people at this stage of life are already insulin resistant, so then they become even more insulin resistant. Again, all of that said, there are things to do to help all of this.

TERESA: To support your hormones and to support muscle mass and to support the reduction of body, body fat.

BRITNI: Yeah.

TERESA: You know, there's things that we can do.

Anxiety: another common symptom of perimenopause

BRITNI: Absolutely. Yes. So, you know, anxiety is another symptom many, many women experience during perimenopause. I mean, I've heard women tell me anxiety is not something that they ever really struggled with, and then all of a sudden they're feeling anxious all the time.

TERESA: Yeah. Well, do you think it's, you know, that time of life where it's increased pressure? You know, when you're in your forties and fifties, you might be at the top of your career. You may have young kids at home or maybe teenage age kids at home. Your parents might be aging and so you might be taking care of elderly parents. There's just a lot of pressure at that time of life for some women. And I think, you know, we know that stress can affect our blood sugar levels. We've talked about that.

BRITNI: Yeah.

Alcohol is a hormone robber & increases anxiety in the long run

TERESA: But it's also, how do we cope with it? I mean, many women turn to alcohol, you know, it's just, we just need a minute to just relax and just, you know, self-care. Right? And while I, we don't agree that good self-care is having a glass of wine, it's the idea of I just need to do something for myself.

BRITNI: Yes.

TERESA: And drinking alcohol can significantly increase anxiety in women too. We were talking about hormone robbers and alcohol is one of those. And man, as far as anxiety, it might calm the anxiety while you're having that drink. But there's sort of a rebound effect where afterwards you have that increase anxiety because you are, I think it's your levels of serotonin drop.

BRITNI: Yep.

TERESA: Increasing that anxiety.

BRITNI: And if you're doing that every night, even if it's just one glass, you know, that's negatively affecting sleep. You're probably waking up more anxious. Your, your hormones are changing, stressful life events. I mean, it all has this cumulative effect.

TERESA: Right. And then you're tired and anxious.

BRITNI: Yeah.

TERESA: And want more wine.

BRITNI: Yeah. Yeah. It can be just this vicious cycle that happens and yeah, that's a great point. This time of life is just, there's a lot of stressors. And I think, that's even more a reason to control what you can. And food is a huge part of that. So changing your food is going to affect how you handle stress. And definitely reduces anxiety. So for my clients that come in, I have them eat, you know, three to six ounces of animal protein for breakfast, lunch, dinner. Along with that protein, you know, include as many veggies as your heart desires. I would say at least one to two cups of veggies. At meals, you know, you throw some fruit in there and at least one tablespoon of those healthy fats because fat helps you make hormones in the body; also is really the anchor to our blood sugar.

Healthy fat anchors blood sugar

So fat helps you stabilize your blood sugar levels. I encourage you, you know, if you want to jump all in, give this a try for 14 to 21 days, and before you start, write down how you're feeling as kind of a baseline and then follow this and at the end, check back with your symptoms. You know, everything's relative. A lot of times people don't realize how poorly they're feeling until they feel better.

TERESA: Right. Yeah. We say that a lot.

BRITNI: Yeah. We do. So tracking those symptoms really helps to make you realize how much better you can feel. You know, if it feels too overwhelming to, to jump all in for 14 to 21 days, that's okay. It's a process. So just think about what's one thing that you could modify that we're talking about today?

TERESA: I think that's a, a great way to think about it too. Some of us are all or nothing people and we like to jump in.

BRITNI: Yep.

TERESA: And some of us just like to take, take it slower; baby steps. It's progress over perfection, you know?

BRITNI: Absolutely.

TERESA: Well, let's talk a little bit more about how anxiety might be related to what you are eating. Britni, you had said you recommend that your clients have a tablespoon of fats along with their meals. So this is not just the fat that's in the maybe some of the foods but it's additional fat. And I have so many people say, “I can't eat that much fat, or I'm going to gain weight.”

BRITNI: Yeah.

TERESA: You know, we've really been trained that eating fat will make you fat, right? Like that has just been kind of ingrained in our brain, but actually that tablespoon of natural fat will help you lose weight.

BRITNI: Mm-Hmm.

Healthy fats: building blocks of hormones

TERESA: And natural fat, like we've been talking about, is one of those building blocks of our hormones. We need fat and cholesterol to build estrogen and progesterone. In fact, fat helps to maintain normal blood sugar levels, like Britni was saying. So when we have those normal blood sugar levels, we feel really good. But when blood glucose levels or blood sugar levels drop below normal, our brain becomes depleted of glucose. And that's when we experience anxiety.

So I tell people like when we're talking about blood sugar, that, you know, having spikes and drops in blood sugar doesn't necessarily cause anxiety, but those drops in blood sugar is the is the fertile ground for anxiety to grow.

BRITNI: Yeah.

TERESA: So you have a low blood sugar and then you go into a situation that would cause you to be anxious, it's going to like trigger that so much greater. Or if you're a person that has that underlying anxiety where you just kind of feel it all the time, you may feel those when your blood sugar drops, you just might feel that so much more strongly during those times.

How to combat drops and spikes in blood sugar

So to combat this, you know, instead of having the, the spikes in drops in blood sugar, what we recommend is during perimenopause, and actually any time of life, it's critical to eat regularly probably every three to four hours every single day to avoid attacks of anxiety. And sometimes when I tell people that they're like three to four hours. That's a lot. But really, let's think about that just a little bit. If you have breakfast at eight, that would put lunch at noon, a snack somewhere around three, dinner: 6, 6:30.

BRITNI: Yeah.

TERESA: And potentially a bedtime snack around nine. So it's kind of like a lot of people just typically eat anyway.

BRITNI: Yeah.

TERESA: And that's what we recommend is eating that, just being consistent with that. And I also tell people it's better to eat this way than to graze all day.

BRITNI: Yes.

TERESA: You know, have your meals, have your snacks, and then have breaks away.

BRITNI: Yep. That's a good point.

TERESA: It's good for blood sugar balance as well. Instead though, many women think that cutting back on their food will help with weight loss, but it only leads to fatigue. We're running out of fuel. And then that anxiety we were talking about. So in addition to not eating sufficient natural fats, what other foods do you suspect are connected to the anxiety you're having?

Sadly, today, many of the foods that we love to grab and go because they're so easy, are those processed “carby” types of foods like chips, cereal bars, sugar sweetened yogurts, you know, things that come in containers that are very portable because we're very busy, right?

BRITNI: Yeah.

TERESA: It's easy to just throw those types of things in our bag and, and runoff. Certainly high sugar drinks like soda and teas, energy drinks, coffees, these are things that can create that anxiety. And then also, when we're having a lot of those high carb foods, what we're not having generally speaking is that those “carby” foods are replacing the protein in our diet.

BRITNI: Yep.

Protein makes necessary brain chemicals to stabilize mood, energy & sugar cravings

TERESA: And our brain needs protein to make our brain chemicals called neurotransmitters. When you are low in the neurotransmitter, dopamine, you lack focus and motivation. You struggle with your energy and you crave sugar. The building blocks for dopamine, the are the amino acids we get from animal protein. You can eat eggs, cottage cheese, burgers, tuna, salmon, chicken sausage, and of course pork, beef, chicken, and turkey. All of these are the building blocks for the neurotransmitter, dopamine.

BRITNI: Now Teresa, it's already time for our third break, so let's dive more into that when we get back. You are listening to Dishing Up Nutrition. You may not be aware, but we offer demo type cooking classes. Marianne, our culinary cooking educator is wonderful. And she has put together a Zoom class on August 2nd called Cooking for One. You know, it's often easy to cook for others, but sometimes we need extra encouragement to cook for ourselves. Marianne offers that encouragement. You can sign up online at weightandwellness.com. And Marianne is really great at inspiring people to just get back into the kitchen. We'll be right back.

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TERESA: Welcome back to Dishing Up Nutrition. Currently there are many podcasts to listen to, but 20 years ago, Dishing Up Nutrition was one of the very first. For the past 20 years, every week we have shared realistic and effective nutrition advice. If you've gained even a small piece of wisdom that helps you, share our podcast with a friend or family member. Our mission is to help you feel better through eating real food nutrition. We thank you for your support in listening to our podcast over all of these years. Go ahead, Britni. Were you going to continue on about, I feel like I was about to interrupt you.

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More on the importance of & how to balance blood sugar

BRITNI: Well before break we were talking about blood sugar and the importance of, of blood sugar and that anxiety piece. And I think, you know, you gave the example of people being fearful of fat and but when we think about the fat and anchoring our blood sugar, if you get that in, that's going to prevent you from like, a lot of people say, the witching hour. Mid-afternoon: three to four.

TERESA: Yeah. Yeah.

BRITNI: You're anxious, you're tired, you're hungry. That's when you start craving things.

TERESA: Yeah.

BRITNI: So adding that fat is going to help to prevent that, that witching hour.

TERESA: Yeah.

BRITNI: Right?

TERESA: I also find it's kind of around the, the, the happy hour time too, like five o'clock coming home from work when you know, and maybe it would be that earlier hour, but you're maybe still busy at work where it's; yeah. And I find that, that that hour is so tough.

BRITNI:  It is; get home, you want to like eat anything in sight; pour yourself a drink.

TERESA: Yeah. Yeah.

BRITNI: So by, by eating to keep your blood sugar balanced, you're going to prevent that anxiety, that fatigue, those cravings and, and then you're going to, it's make it a, going to make it a lot easier to go into dinner and make those, those real food choices.

TERESA: Yeah. It's really interesting how well eating in balance and then eating consistently throughout the day can really help manage symptoms of anxiety.

BRITNI: Yes. Yeah. You know, I recently had a client who's in perimenopause. One of her biggest complaints was waking up with night sweats so severe having to change her clothes, but she was starting to feel more anxious, which wasn't necessarily, you know, something she dealt with in the past. She gained a little weight. She was really frustrated and she wasn't eating a whole lot of processed carbs actually. But what we did is we just tweaked things to make sure her blood sugar was more balanced. And when we checked back in after a month, she, those night sweats actually completely went away.

TERESA: Wow.

BRITNI: She was so happy about, so she was sleeping better.

TERESA: I bet she loved you.

BRITNI: Yeah. And she was feeling less anxious, which I think was a combination of she was sleeping better, but also her blood sugar was better balanced throughout the day. She had, you know, started to lose a couple pounds. And again, it sometimes isn't always that easy and happens that quickly, but I think that really just goes to show the power of balancing your blood sugar.

TERESA: Right. Cause you can eat real, real food, as we talk about. You know, sort of the, the base of what we tell people is eat real food. And then the next level is well, let's balance out what we're eating.

BRITNI: Yes.

TERESA: And then let's balance out the timing of what we're eating. It's sort of a layered effect. And so it sounds like your client, she's doing really good at that base where it was eat real food, but there's lots of real foods out there that while they're healthy for us, and they're not bad foods, but if we eat too much of them that they will raise our blood sugar and then we can have symptoms of that. You know, I have clients that have what seems to be these wonderfully healthy breakfasts where it's like oatmeal and then they'll put raisins in it or maybe banana and you know, I it like all this fruit or make the fruit smoothies. You know, where there's no protein. It's just a bunch of fruit and it's just very real food.

BRITNI: Yep.

TERESA: But very high in carbohydrate. Which would, doesn't have that anchor you were talking about with the, with the fat and doesn't have the protein there. And so they just start their day off on a rollercoaster and perhaps it continues through the rest of the day.

BRITNI: Yeah. Just exacerbating all of these perimenopausal symptoms and anxiety. You know, you were talking about dopamine before the break and, but your brain also needs ongoing supply of serotonin, which is another neurotransmitter. I think, you know, a lot of people have heard about serotonin. And again, the building block to make more serotonin is animal protein. The current research has found that most women feel the best when they eat about four to six ounces of animal protein at least three times a day.

Balancing hormones naturally: more on estrogen & progesterone

So we talked a lot about balancing blood sugar and in brain chemistry playing a really big role in perimenopausal symptoms and in anxiety, which is our topic today. But I want to dive a little deeper into how the hormones specifically affect anxiety. So we get, yes, we hear a lot about your reduction in estrogen. Yeah. That happens. But really it's more about the drop in progesterone. So as your progesterone starts to drop in your forties, your stress response system becomes destabilized, and progesterone starts to drop before estrogen does. And progesterone is really calming. It actually binds to the same receptors as Valium.

TERESA: Interesting.

BRITNI: Yeah. So I think that's a good example of how, how much progesterone can help to reduce anxiety. And basically what happens is when you start having irregular cycles or you're not ovulating every cycle, that's when your body starts to reduce progesterone. And there was this Swiss study called “Estradiol and Progesterone as Resilience Markers”. That's what the title was. And researchers in this study found that lower progesterone during perimenopause is associated with lower life satisfaction, higher perceived stress, and increased risk of depression and anxiety. And the same was not true for lower estrogen.

TERESA: Oh wow.

BRITNI: I know. So, you know, again, we can't, that's inevitable. You're going to have a drop of progesterone at this time in life, but by modifying lifestyle, food, you could be one of those women that kind of sails through perimenopause or if you do have symptoms, you can, can improve them. And you know, we see clients who are able to get rid of those perimenopausal symptoms.

TERESA: Yeah. That's so interesting. In fact, I had a client too who I won't really go into her story, but she did make a lot of changes with food and she, her cycles became regular again and she's like, I'm aging backwards.

BRITNI: Yeah. Which is a good thing.

TERESA: Yeah, yeah, absolutely. Absolutely. You know, women's bodies, they're just very wise and when we feed them well with the correct food, hormones will naturally rebalance for most women. Certainly it's more difficult for different women in different situations. But hormones really can rebalance naturally. As nutritionists, we not only assist you with the correct eating plan, but also we address sleep issues, estrogen dominance and insufficient progesterone like Britni has been talking about. All of these are client specific though, so it's very important or it's very helpful to meet with somebody to have an outside set of eyes on the situation.

Schedule Nutrition Counseling

Women are faced with changing hormone levels their whole lives, from puberty to pregnancy, to perimenopause, then menopause and post menopause. At each of these stages, nutrition makes a difference. Hormones are complicated and many women need knowledgeable and understanding nutritionists or healthcare providers to help them feel their best at each stage. We understand it and we have the expertise to help you.

Our goal at Nutritional Weight and Wellness is to help each and every person experience better health through eating real food. It's a simple yet powerful message. Eating real food is life changing. Thank you for joining us today.

BRITNI: Thank you.

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