Perimenopause and Fatigue: How to Beat This Common Symptom

Transcript:

Leah: Welcome to Dishing Up Nutrition, brought to you by Nutritional Weight & Wellness. We are a family-owned Minnesota company that specializes in real food nutrition education and counseling. My name is Leah Kleinschrodt, Registered and Licensed Dietitian, and joining me today is Kara Carper, Licensed Nutritionist, and who has a master's degree in holistic health.

Possible symptoms during perimenopause

Today we are chatting about the chronic and sometimes crushing fatigue that hits around 50 to 55% of women in perimenopause. And Kara, I didn't know this until I was doing some background research on the show, but I came across several research papers. So these are actual research papers that you can go on PubMed, and if you typed in the phrase, I don't feel like myself, there's going to be research papers that pop up on that. I didn't know that, did you?

Kara: No, I actually didn't either until you told me about it and we were preparing for our show today. Of course I had to go look it up then as well. And I was surprised by that statistic that half of women are struggling with this really can be debilitating fatigue in the perimenopausal years.

I would actually hear this from women back when I was doing individual counseling. And sometimes, you know, they talked about the fatigue. Sometimes it was a little bit more related to moods.

They would say, I just feel more irritable, more on edge than I used to. Another thing that I recall is their stress resilience was lower than it used to be, and so maybe they were having a harder time managing some external stressors.

Leah: Mm-hmm.

Kara: It's not that the actual stressors in their life had increased. But they were more vulnerable so things just felt harder.

Leah: Yes, I hear that a lot too counseling today when I talk to women. So yeah, that stress resilience piece and when women say that phrase, “I don't feel like myself”, yeah, it could be related to, they just feel like there's a lot more stress on them. It could mean like yeah, that their moods, they're just a little bit more edgy, a little bit more irritable. I hear a lot of times like more anxiety creeping in around this time. It can kind of morph into more depressive types of feelings.

I remember talking about a statistic that showed that antidepressant use doubles for women in the perimenopausal years compared to the earlier reproductive years. It just goes to show that there is a lot of moving pieces that tend to happen around this time in a woman's life.

And not everyone feels so destabilized during this transition, but for some women it can be really unexpectedly rocky. So today we are going to focus on one common, yet sometimes unexpected aspect of perimenopause, and that's the fatigue. And we're going to talk about what can be underlying or contributing to that feeling.

And more importantly, I would say, is we want to offer some solutions. We want to talk about what can we do to reclaim some of that old energy and that spark again. And I can't promise that we're going to age in reverse, but we can give some practical things that we can try on for size.

Kara: Yeah, and I think a big, an important part of today's show is just really acknowledging that this is a pretty serious issue for many women. And so if you are experiencing fatigue in the perimenopausal years, you're not alone. This is a real thing.

Leah: Right. Yeah. And you're not lazy. It's not like a willpower thing. It's not a character thing. It's like there's, there are some hormonal undercurrents, kind of at play here.

Kara: Mm-hmm. For sure.

Leah: Yeah.

Kara: So let's just start with an example and say there's a woman who's 45 years old in clinic and she is working full time. She may also have a couple of school age children. And children these days tend to have a lot of extracurricular activities.

Leah: Yes, they do.

Kara: Maybe she's also in the sandwich generation, you know, perhaps caring for an aging parent. And there's just different things. There's the household responsibilities. And she would mention in clinic, you know, I'm not feeling rested in the morning, I'm needing extra caffeinated beverages, extra coffee just to get through my workday. Maybe she could even lie her head down on her desk and take a nap at any given time of day; doesn't feel like exercising after work. And just kind of either wants to go home, lie on the couch, maybe even crawl into bed by 8:00 PM. So Leah, with that example, what kind of questions would you ask that client?

Troubleshooting sleep issues in perimenopause

Leah: Hmm. Good question. I would start, and maybe this is the obvious choice, but first I'm going to ask her about her sleep. You know, with perimenopause we're sometimes we're busy watching for the hot flashes and we're busy watching what our periods are doing, but sometimes those perimenopause hormone shifts sneak up on us during the night.

And I mean, this could range the gamut from maybe you're having trouble falling asleep. And often I'll hear, it's usually because you have that busy, I always call it hamster wheel brain, like you're just spinning, spinning, spinning, can't get off the hamster wheel.

So you might be on that hamster wheel brain at night. You might sleep well for a few hours, but then you might wake up once, twice, three times during the night; you have trouble getting back to sleep. It might be waking up extra early before the alarm goes off. So say your alarm doesn't go off till six, but now you're waking up at four 30 and you're just kind of up for the day at that point.

And then not as commonly, but I do sometimes hear from women, like they feel like the sleep that they're getting, that they're only like dozing, like they're very lightly sleeping and not getting into any sound deep kind of sleep,

Kara: Kind of that surface sleep.

Leah: Yeah. That's a great way to describe it as a surface sleeping experience. And for some women, these like little hiccups in their sleep. It only creeps in, in like that week or so before their period. But for other women, especially as we progress through perimenopause, this can become the new norm all month long. So, of course like if your sleep shifts around, you're going to feel it the next day. You're going to feel it the day after that. Like, it, it's going to compound over time.

Kara: And with the example, most women, 45 years old with kids and aging parents and responsibilities and work are not able to go back to bed or sleep in, or often even nap. And so that fatigue can really kind of snowball. About 50% of women in the workforce who are in the perimenopause age range report having trouble sleeping. So interestingly, that matches up with the 50 to 55% of women who are reporting fatigue in perimenopause.

Leah: Yeah. Imagine that.

Kara: So you can't sleep and you're fatigued. It makes sense. And so you have to think that sleep deprivation can exacerbate a lot of other perimenopausal symptoms; things like the anxiety or depression you mentioned, stress, brain fog, fuzzy thinking and various aches and pains that kind of pop up out of nowhere. And then weight gain. We hear that a lot with perimenopausal age women. And really no one's going to be at their best if they're chronically sleep deprived.

Leah: Absolutely. I'm, you can't see me, but I'm up here raising my hand because I definitely don't feel like I, I'm never at my best when I've had a bad night's sleep or had a couple of bad nights in a row. So yeah, we've done many past shows on Dishing Up Nutrition, troubleshooting sleep issues in perimenopause and post menopause.

We've offered a lot of solutions for women who struggle with their sleep. And it could be as simple as swapping out your evening snack of popcorn or chips, which are a little more processed and higher in sugar, and you switch that to something like berries and cream or apple and peanut butter, so something a little lower in sugar.

We'd get some of those natural sugars in there, but then you pair that with some fat, stabilizes those blood sugars through the night. So sometimes it's just a matter of kind of tweaking some of what you're eating later on in the day. For some women it's swapping the nightly glass of wine, which keeps you surface sleeping.

Kind of to what you said there, Kara, like alcohol is one thing that keeps you from getting down into those deeper stages of sleep. So if we can kind of get the alcohol out of the system, especially before bed, we stand a better chance of getting a good night's sleep. So maybe it's, maybe we're going for a caffeine free tea.

Maybe it's a little low sugar kombucha, just so you feel like you're sipping on something a little fancier. Sometimes it's a little bit more complex than that. Maybe we've done what we can do from the nutrition perspective, and so we might tinker with some Magnesium Glycinate as a supplement. We might try some progesterone cream for a few weeks. GABA is absolutely an option. I know that's one of your favorites, Kara.

Kara: Absolutely. We call that or it's known as nature's Valium.

Leah: Yeah. Yes. So GABA is an excellent choice. For some women, melatonin works really well, especially for the falling asleep part. L-theanine, I love l-theanine. It, it does, I love, it's one of my personal favorites. I love it for stress in general or if I'm going to do a presentation, or sometimes if I'm doing the show, I'll take a little l-theanine. It just kind of takes that edge down a couple of notches.

Kara: I took my L-theanine before I came today. I've been doing that probably for every single podcast for the past 10 to 15 years.

Leah: Oh nice. Good. So that's part of your arsenal. So yeah, again, like that's a great option. I will use it too if I do wake up during the night; sometimes feel like I have that hamster brain going on, and then usually it might take 20, 30 minutes, but it does kind of help lull me back down and like calms my brain down enough where I can get back to sleep.

So lots of different options that we can kind of play with in terms of some supplements. I will talk to women sometimes about maybe getting a sleep study done, you know, to see if there, if sleep apnea is part of the picture, if that's interrupting, rest and repair. So again, like there's a lot of different avenues we can pursue there.

Kara: I like that. So you had, just to kind of summarize, you talked about looking at food. You know, not only what are folks eating during the day and striving to keep that balanced. But also having a balanced bedtime snack and avoiding the higher sugar.

And then next step could be potentially looking at some calming supplements. And also, you know, maybe a sleep study is necessary. My understanding is that some of those CPAP machines have really improved over the years. They're not as bulky and hard to use.

Leah: Yeah. Luckily technology usually gets better over time. So we just need, need a couple extra years sometimes.

Kara: So we'll move on to another topic. Let's not underestimate the amount of time that we spend doom scrolling, and that might be on social media: Instagram, Facebook, could be the latest Netflix series in the evenings. Sometimes we need to reallocate that downtime, which is actually not really downtime to actual sleep time.

And you know, if the first effort doesn't pan out, you can always go to the next thing in line. I would say sleep is so critical for mental health, for physical health that we don't want you to just give up if the first effort doesn't work.

Leah: Right. Or even the second, like there's, we've got a lot, a lot of things in line.

Kara: There are a lot of solutions and I know all the registered dietitians are fantastic at putting together an individual plan. And really kind of getting to the bottom of the root cause of the sleep issue. So lack of quality sleep can definitely lead to more of that fatigue during perimenopause. So Leah, what else might you think about for our example, our 45-year-old woman who's working with a family?

Optimize eating & beverage patterns

Leah: So sleeping number one, I would say. And then I would also want to look at her typical eating patterns throughout a normal day, and what I'm on the lookout for is skipping meals, over caffeinating, low protein intake, how much processed food is coming in on a regular basis, eating out frequently.

Alcohol use, as we mentioned before, I mean, I will say this is a common time in life where I see busy women, busy moms. They slide into a pattern of not taking the time to eat, like really good, regular, substantial meals. What I tend to notice is it's usually either breakfast or lunch or sometimes both breakfast and lunch. Those are the meals that usually suffer a little bit more than dinners. And maybe it's a schedule thing. I think some of it is a schedule thing. I'll also see it just might kind of be an easy pattern assigned into just generally under undereating.

So more of this kind of just dieting type of mindset. And usually it's in an effort to either lose some weight or prevent some of the weight gain that tends to happen in menopause. So in other words, like it's, it's that messaging in our brains that the less I eat, the less I’ll weigh. And that tends to lead into some of the erratic meals or meal skipping tendencies.

Kara: Yeah. And some of it may not even be done consciously. Because those old, we'll call them old messages, have just been kind of programmed from so long ago. And we know that that isn't accurate though. Because eating less isn't going to always lead to weight loss. In fact, it can lead to overeating, binge eating.

Leah: Right.

Kara: Weight gain.

Leah: swings the other way. Right?

Kara: Yeah. And it can be really easy, like you said, to slide into those habits. It might be like, oh, hey, one less meal that I have to think about, or one less thing to plan. And that might be appealing if the schedule is very busy or maybe someone just isn't even hungry. You hear about that?

Leah: Yep. All the time.

Is caffeine ok to drink?

Kara: They're not hungry in the morning. Now we'll talk for a moment about coffee and I am a coffee drinker. I personally love to have a cup or two of caffeinated coffee. Coffee, though, it's very good at making us feel like we have fuel in our tank.

Leah: It does.

Kara: It's like a false energy though.

Leah: Yeah. Mm-hmm.

Kara: And Leah and I can pretty much guarantee that if you're waking up and starting your day with caffeinated beverages, you'll be more likely to skip breakfast. And just kind of get on that caffeine train where you feel like you're nourished, but you're really just kind of going on the caffeine fumes.

Leah: Yeah. Yeah. A hundred percent. And, and yes, it's like you get started on the coffee. We don't have actual nutrients and nutrition coming in and eventually, somewhere down the line that's going to cost you, it might not necessarily be right away at lunch. I'd say the more common thing is like it catches up to people at dinner or after dinner.

Because then the snacking, the cravings, all of those types of things tend to come in. And many times this is at the cost of your energy also. So one, one thing is, I was kind of thinking about this, putting together the show. I was thinking, well, for women who are looking for a high performance or a high octane life, we need to fuel with, we want to fuel premium gasoline.

Fuel the body right for real energy

So that's four to six ounces of real protein. So that's somewhere in the ballpark of like 30 to 40 grams of protein at a meal. And we're talking protein like eggs, turkey, chicken, fish, beef, dairy products if you can tolerate dairy. We want about 30 or so grams of real carbohydrates.

So this includes our vegetables and our fruits, but we can have some of those starches, like a half a cup or so of some sweet potatoes, some beans, some quinoa, things like that. And then we want to also have, we want to tack some healthy fats onto that protein and those, those carbohydrates. So this is 14 to 15 grams of added fat.

So this could be olive oil or butter that you're cooking your foods in. This could be a fourth of a cup of some raw or dry roasted nuts. This could be a half of an avocado. I love avocado oil mayonnaise. I know not all my clients do. The taste is a little bit different, but a tablespoon of avocado oil mayonnaise is great as an add-on for a lot of different things.

And we're trying to hit these parameters again at three meals a day, getting a good breakfast, a good lunch, and a good dinner. I'd say most of my clients usually do at least one snack during the day.

Kara: Also just to keep their blood sugar or their glucose levels stable and not crashing.

Leah: Right, exactly. Yeah, and I honestly, I think we're all just a little nicer when we've eaten a well-rounded breakfast in the morning.

Kara: And I wonder too if that doesn't sound like a lot of food for some people.

Leah: Oh, it does.

Kara: Yeah. But you know, especially with folks that might be used to skipping breakfast, having a very light lunch. But I like what you said, how it almost always catches up when people aren't eating enough nutrients during the day, you know, then there's like the hunger at night and the overeating of processed carbohydrates. So if we can just get a, stay ahead of that hunger, you know.

Leah: It makes a huge difference. We’ve seen that with the energy and the moods. Yeah. Yeah. It makes a big difference.

Kara: We're going to pause for a quick break, but we'll be back in a moment to continue our conversation about how we can navigate the fatigue of perimenopause using food as medicine.

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Leah: Welcome back. Before we went to break, we were talking a little bit about balanced whole food, eating protein, carbohydrates, and healthy fats with every meal and snack to help steady the blood sugars, which can be very helpful for mitigating some of that fatigue that women experience or can experience in perimenopause. Now, maybe. I mean, maybe not so fitting. I am going to share a story real quick about a male client.

Kara: Yeah. Great.

Leah: But I thought this was a great example, that this person, he came in, it was, he was coming in actually for kidney stones. But as I got to talking to him and we were kind of bouncing ideas around for breakfast ideas for him, he had already made this connection and we talked about this. He had already made this connection between if he started his morning with a gas station breakfast sandwich, he would say, I am always starving by 9:00 AM.

So if he's eating this, 'cause he would start work really early in the morning, like 6:00 AM or something. So he would be eating at like, you know, yeah, 5:30, 6, kind of around the time he would be starting work and just a couple hours later he would be starving and like rooting for some food if he had that breakfast sandwich. But if he started his morning with a balanced protein shake and had like a really good amount of protein in that breakfast, he would motor along really well, almost up until lunchtime, which would be several hours later still.

So, so that, I mean that was just one glaring example and I've heard similar things and that's something I do always ask women about, I mean, any of my clients, I'm like, I always ask what they're doing for breakfast and I ask them like, how much mileage do you get out of that breakfast?

Like, does it, are you hungry after 90 minutes or two hours or does it stretch you for a good four to five hours and you can make it till lunch? So that's always something I'm kind of looking at with clients.

Kara: That’s a great barometer as well, because the example of your client with the breakfast sandwich crashing about two hours later, that's just a sign of low blood sugar. So what that is telling him is either the breakfast sandwich was too high in carbohydrates, maybe low in protein. Or if somebody is just undereating at breakfast, they may also crash after 90 or 120 minutes.

Leah: Yeah. Yeah. Yeah. Perfect. That was a perfect summary.

Balanced food examples

Kara: That's where that balance comes into play. So, well said, you know, the premium gasoline for high performance life, I really like that analogy, and I'll just share, it's, you know, we're having some nice days here in Minnesota. It's almost summer, technically summer.

And so what I've been craving lately is I want to still get my 30ish grams of protein. But instead of having a lot of hot or warm food, I kind of crave more cold foods.

Leah: Sure. Yeah.

Kara: So I've been having a lot of cold protein salads. Some examples are, you know, I might take three hard boiled eggs. And just chop those up and make a very simple egg salad.

Leah: Nice.

Kara: With a tablespoon of that avocado mayonnaise. Just some salt and pepper. I put it on a bed of greens. I mean, very quick and easy. I do that also with canned tuna, wild caught tuna, wild caught canned salmon. Leftover chicken breasts, maybe from the grill. And I chop up four ounces and make like a cold chicken salad, and I often will just have that on some greens. And that's a, it's a great lunch I've been enjoying, but it also gives me plenty of energy, I would say, for the next four hours or so.

Leah: Yeah. I'll bet you can coast really good with that for a while.  

Eat whole, natural foods for a good working metabolism

Kara: Very satisfying. And so I just want to add to your analogy, Leah, in order to put that gasoline to good use in the body, we also need spark plugs to ignite it, you know, which can be burned for energy by the engine. And so the spark plugs are vitamins and minerals that ideally we're getting from eating whole natural foods.

And that could include the B vitamins, our important vitamin D, important minerals such as magnesium, potassium, zinc, iron, iodine, and copper. Those are all micronutrients and they power the enzymes in our body that make the magic happen when it comes to metabolism. And when we talk about metabolism, we often think about weight loss. But metabolism is a form of energy.

Leah: Yeah, that's a great carryover on that analogy. So that spark plugs, like we need those nutrients to actually kind of light the fire of our metabolism, right? And so we can choose to eat foods that give us calories, but if those foods don't have many vitamins and minerals along for the ride, then the body isn't going to use those calories effectively.

And these are the foods that we typically tend to think of as more processed, like our canned soups, our refined breads, hot dogs, mac and cheese, chicken nuggets, cereals, sugary yogurts, things like that. So we can kind of think in general, the more processing of a food that's gone on, the fewer nutrients that are going to remain in that food by the time it gets to the store shelf or by the time it gets into your pantry. And so, and of course this is, unless the nutrients have been added back by the food manufacturer, but that's a whole different rabbit hole for a different show. Yeah.

Kara: And like you said, ideally we're choosing foods that are close to their original form. And they haven't had a lot of processing done to them. And so, you know, those foods are going to retain the vitamins, retain the minerals, and the fiber and all the enzymes and all the, all the good stuff. So a couple examples might be eating a baked potato instead of French fries.

Leah: Mm-hmm.

Kara: Eating a chicken breast or maybe, maybe you like legs or thighs in the dark meat. That's fine too in place of a processed chicken nugget.

Leah: Mm-hmm.

Kara: We want to avoid things like juice, like avoid apple juice, orange juice, and just eat the actual fruit, eat the apple or the orange. So you get the idea and the goal is real, it's not perfection. None of us are perfect by any means. The goal is not to have zero processed foods, but the goal is to shift the majority of what you're eating and focusing as much as possible on food in its original form.

But we still need to have some flexibility. And there might be some convenience foods that pop into our diet occasionally, and, and that's okay. You know, maybe we look at it like the 85/15 rule. You know, focusing on getting whole foods 85% of the time.

Leah: Yep. Yeah, that's an excellent point. I do really try to reiterate that with my clients also. It's not perfection, it's just consistency over time that's going to take you where you want to go. So, yes, more whole foods; foods as close to nature as possible versus the more processed foods. So that's a shift that we make for everybody, but especially women in those perimenopausal years.

Iron status & thyroid function: 2 more factors when it comes to fatigue in perimenopause

And so let's take a minute. I want to pivot over to two more items that could be at play when it comes to fatigue and perimenopause, and that's iron status and also thyroid function.

So let's chat about iron for a minute. One of the biggest symptoms of low iron in the body is fatigue. So that's because iron is a crucial part of the red blood cells ability to carry oxygen throughout the body. So low iron means you don't carry as much oxygen around as you should, and low oxygen means that you're going to feel more tired. No matter how much you sleep, you're going to feel sluggish and unmotivated to do anything.

Kara: And so we get iron in the body from foods that we eat, mainly from animal meats, but we also get some iron through things like spinach, other leafy greens, some nuts and seeds, such as pumpkin seeds. But women do tend to lose a lot of iron every month with a menstrual cycle. And as women are transitioning through perimenopause, sometimes those periods and cycles can get pretty heavy.

They may last a little bit longer, even longer than a week. So of course with that increased blood loss comes a greater risk that somebody could be anemic and have low iron status. Another kind of root cause could be low stomach acid production and poor intestinal health in general. Because we are, we're not absorbing the iron. Yep. That's right.

Leah: Mm-hmm.

Kara: And so if you're listening and you personally have seen a shift in your periods and you're having heavier bleeding, maybe they're lasting longer; also, if you know that you have some gut or intestinal issues such as acid reflux, maybe you're someone who takes an acid blocker on a regular basis, you could also be low in stomach acid. And so we just encourage to, you know, if you're having fatigue, get your iron levels tested.

Leah: Mm-hmm. Right. Yeah. At the very least, get your hemoglobin level checked by your doctor. Usually that's part of a CBC, your complete blood count panel. So that's the panel where they're looking at your red blood cells and your white blood cells. But hemoglobin will be kind of tucked in there as well. Your hemoglobin for women should be at least 12 grams per deciliter.

And I believe, I can't remember what the top of the range is. It's 16 ish, something along those lines. So, but at minimum it should be 12. I also encourage my female clients to ask for a ferritin level also. That is something separate. You have to ask your doctor to have that run.

And usually I don't get much pushback from when I have clients go ask their doctors about it. Usually that one's pretty, they're pretty open to doing that one. And ferritin is just a check of like the iron storage levels in the body, so that should be, and, you know, around 50 milligrams per deciliter or so.

Some providers will run some other iron markers, like there might be something called total iron binding capacity and transfer in saturation. And so all of these numbers together can give you a more comprehensive picture of, of just what's going on with iron in the body. But I would at minimum do the hemoglobin, ask if you can get the ferritin as well. And then maybe some of these other ones will be in there as well, just depending on the provider.

Kara: Yeah. I think that's perfect. Like getting a full iron panel, like more information is always better. And I just wanted to give a couple examples, personal examples. There were two times in my life where I was actually very low in iron. And one was after childbirth.

Leah: Yep. I was the same way. Yep.

Kara: And the other one was after a major surgery that I had. And I will say that one of them went undiagnosed. Because I was able to receive a hemoglobin reading. But at the time my doctor did not provide a ferritin reading. So this can happen where the hemoglobin appears to be in the normal range. But my ferritin was very low. And it wasn't until we did some further testing because the fatigue wasn't going away. And my ferritin, I believe it was like 17. And you had mentioned 50 or higher really for optimal energy for women. So I had to take quite a bit of supplemental iron to boost my levels up and start feeling like myself again. I, I remember driving home and sitting on the bottom of my stair because I couldn't, like I had to rest before I could get to the top of the stairs, 'cause I was, you know you have that low oxygen sensation.

Leah: Yeah, yeah. Yep. That's a very real experience actually. And I remember one of my professors when I was going to grad school kind of gave that same example of like, if you feel low in iron, like even climbing a flight of stairs can make you winded or feel like you look up at the stairs and you feel like it's a mountain and not just like the next 12 stairs in your house.

Thyroid labs to consider 

Kara: Yeah, just it's important to just kind of rule that out with the hemoglobin and ferritin tested. And since we're talking about blood work, let's also discuss thyroid labs. Those are some other important labs to get done. Women are five to eight times more likely compared to men to have thyroid dysfunction. Part of the reason for that is that women have major hormone shifts happening throughout our lives. You know, it starts with puberty, then there may be a pregnancy and postpartum timeframe.

Leah: Mm-hmm.

Kara: And then it switches into perimenopause and post menopause. And so while there's already some hormonal chaos going on with our reproductive hormones, estrogen, progesterone, and testosterone, the thyroid is also a hormone and that can kind of become collateral damage in that process.

Leah: Yeah, and I've heard many wise practitioners talk about hormones being part of a symphony. So you think about they, they never operate alone by themselves. Like they're always in coordination with everything else that's going on around them.

Kara: Right. And it makes sense that as the ovaries move into retirement, levels of estrogen and progesterone get pretty erratic and eventually decline. This is a prime time for other hormonal issues such as thyroid to show up. Perhaps hypothyroidism, which is another term for low thyroid.

Leah: Right. And that's the more common of the thyroid issues. Like more, it's more common to be hypothyroid versus hyperthyroid. Right? Yeah. And the symptoms for hypothyroidism, so that's low thyroid function can look an awful lot like some of those perimenopausal symptoms. So fatigue, unexplained weight gain, hair loss, high cholesterol, brain fog, anxiety, menstrual irregularities. So, gosh, what's a girl to do? Is it perimenopause? Is it thyroid? Is it low iron? Like, what's going on here? So that's where, again, like doing a little digging into some of the lab work, like get that iron level checked out, check in on your thyroid with some lab work.

Also, some of this can at least rule out or might rule in some things. And usually the only test that's run for thyroid is something called the TSH or Thyroid Stimulating Hormone, and that's just kind of measuring the signal from your brain to your thyroid on how much thyroid hormone to make. The normal range, it kind of depends on the lab, but it's usually for that TSH is between 0.3 to 5.0.

You know, the more ideal range is around 1.0 to 2.0. You know, maybe give or take a little bit there. So I do encourage my clients like, let's for sure get that TSH done. I have them ask if their provider will test the actual thyroid hormones, which is free T4 and free T3, and then we may even push a little bit more for some thyroid antibody testing just to see if the immune system is mounting a response against the thyroid.

So I will definitely encourage my clients to do this if they already have an autoimmune condition. Maybe they have something else going on with their immune system. Or if they have a family history of autoimmune conditions or if we have a strong family history, especially in the female side of things, like mom's side of the family, if we know there's a long line of thyroid dysfunction in the family history. So I will encourage women to ask for some of that more extensive testing.

Kara: And some of our listeners may be familiar with the term Hashimoto's Thyroiditis, which is a term when there are, a certain amount of thyroid antibodies present. And that's just an indication of the thyroid essentially attacking itself.

Leah: Right.

Kara: Creates inflammation in the body. And of course that could easily lead to perimenopausal fatigue for sure. So there's so many different places in that hormonal chain where the thyroid can go awry.

Leah: Mm-hmm.

Kara: So it just really makes sense to be looking at all those checkpoints. You know, like you said, the iron, the thyroid. Ideally getting like a full iron panel and a full thyroid panel, including those antibodies. Some providers are very open to running those types of thyroid labs. Others are more reluctant.

Leah: Mm-hmm.

Support the thyroid nutritionally

Kara: Either way, there are things that we can do proactively or we can we can do from a nutrition standpoint to really support and nourish the thyroid. And the first thing is eating adequate protein. That's really key. And if you're okay, if you can eat fish and seafood and you like it, you're also going to be getting iodine, zinc, and selenium, all those great minerals that are important nutrients for our thyroid.

Leah: Mm-hmm. Yes, absolutely. Vitamin D and omega threes are also really key for helping actually turn the inactive forms of thyroid hormone into the active forms. So yeah, like if you, hopefully if you're open to eating fish and some seafood in there, that's helpful. Hopefully you're in a part of the world where you can get out in the sun at least a part of the year, like up here in Minnesota, like right now it's a good time. But yeah, vitamin D and omega threes are really helpful from a thyroid perspective also.

Kara: So if you've been listening and you're someone that is struggling with energy and you really want to get some of that pep and that zest back in your life, you're not alone. And there are steps that you can take right away today to improve your energy, to improve your resilience to some of those external stressors.

A lot of them we can't control and completely get rid of. So you don't have to feel like your best years and your most vibrant years are in the past. If you're feeling stuck and you want to get some momentum, please do reach out to us. You know, you can check out our website, weightandwellness.com. There's a lot of information about our company and classes and counseling.

Take a Class or Schedule Nutrition Counseling!

Leah: Yep.

Kara: You can connect with a licensed and registered dietitian. Also, want to note that we are taking a lot of health insurance. We do accept a lot of different health insurances. So one-on-one nutrition counseling very well could be covered at no cost to you. So you'll want to check that out with your insurance provider.

Check Into Insurance Coverage for Nutrition
Counseling

We also have an online menopause solutions series, and that's really great for anyone in the perimenopause or post menopause age range. And we, in that seminar, we look at how food choices can impact whether we're just kind of surviving, trying to get through the years or whether we want to thrive during that important transitional time.

Take the Menopause Solutions Series – Online!

Leah: Yeah. A lot of great information in that little series right there. Like, so much going on. So I, I am constantly recommending my clients like, take a peek at that. So yes. Our goal at Nutritional Weight & Wellness is to provide each and every person with practical real life solutions for everyday health through eating real food. It's a simple yet powerful message. Eating real food is life changing. Thank you for listening and make it a great day.