Real Talk, Whole Life

This week Dr. Sarah and Stacy discuss current events!Don’t forget to subscribe to this channel and visit realeverything.com and thepaleomom.com! If you haven't yet unlocked our bonus content, checkout Patreon for exclusive behind-the-scenes content and how Stacy and Dr. Sarah really feel about the topics they discuss. Your subscription goes to support this show and gets you direct access to submit your questions! Learn more about your ad choices. Visit megaphone.fm/adchoices

This week Dr. Sarah and Stacy discuss Common Misconceptions about the AIPDon’t forget to subscribe to this channel and visit realeverything.com and thepaleomom.com! If you haven't yet unlocked our bonus content, checkout Patreon for exclusive behind-the-scenes content and how Stacy and Dr. Sarah really feel about the topics they discuss. Your subscription goes to support this show and gets you direct access to submit your questions! Learn more about your ad choices. Visit megaphone.fm/adchoices

This week Dr. Sarah and Stacy discuss teenagers going through a vegan phase.Don’t forget to subscribe to this channel and visit realeverything.com and thepaleomom.com! If you haven't yet unlocked our bonus content, checkout Patreon for exclusive behind-the-scenes content and how Stacy and Dr. Sarah really feel about the topics they discuss. Your subscription goes to support this show and gets you direct access to submit your questions! Learn more about your ad choices. Visit megaphone.fm/adchoices

This week Dr. Sarah and Stacy discuss PCOS.Don’t forget to subscribe to this channel and visit realeverything.com and thepaleomom.com! If you haven't yet unlocked our bonus content, checkout Patreon for exclusive behind-the-scenes content and how Stacy and Dr. Sarah really feel about the topics they discuss. Your subscription goes to support this show and gets you direct access to submit your questions! Learn more about your ad choices. Visit megaphone.fm/adchoices

This week Dr. Sarah and Stacy answer all your FAQ about turkey dinner.Don’t forget to subscribe to this channel and visit realeverything.com and thepaleomom.com! If you haven't yet unlocked our bonus content, checkout Patreon for exclusive behind-the-scenes content and how Stacy and Dr. Sarah really feel about the topics they discuss. Your subscription goes to support this show and gets you direct access to submit your questions! Learn more about your ad choices. Visit megaphone.fm/adchoices

This week Dr. Sarah and Stacy discuss powdered veggies.Don’t forget to subscribe to this channel and visit realeverything.com and thepaleomom.com! If you haven't yet unlocked our bonus content, checkout Patreon for exclusive behind-the-scenes content and how Stacy and Dr. Sarah really feel about the topics they discuss. Your subscription goes to support this show and gets you direct access to submit your questions! Learn more about your ad choices. Visit megaphone.fm/adchoices

Welcome back Paleo View! (0:41) This week Stacy and Sarah had intended to bring a science-heavy vegetable show to listeners. However, once you hear Sarah talk you will find out why the hosts have decided to no let her talk for an hour. Sarah is on day six of the bug she is fighting. She feels that her voice has improved. There was a twenty-four-hour window where she wasn't able to talk at all. Stacy thought it would be great to give Sarah's voice a rest and to share an update on life. She has even done research on a topic she would like to share with listeners. Matt and Stacy's house is officially on the market. The day before the house went to market, Stacy's back completely seized up and she is on day nine of this flair. This is the longest stretch of time she has been down from her back injury. Stacy learned a lot from this flair, as she wasn't doing the things she normally does to take of herself. In the midst of a stressful period in life, Stacy got a tattoo in memory of Andrew, along with Matt and Matt's youngest brother. The tattoo is very tiny. However, as shared on this podcast episode, tattoos are an immune agitator. There were many stressful factors piling up on Stacy, and the minute that the house went to market her back started hurting. It's not a coincidence. The stress causes muscle tightness, the muscle tightness constricts her spine, causing the nerve to be pinched. Stacy knows what is happening and has physical therapy exercises, supplements, and time to rest. Luckily, now she is one the up and up. As a reminder to listeners, whatever health issues you have had previously or have ongoing flairs with, stress management is vital. Bone broth can only take you so far, and if you aren't listening to your body you can miss the warning signs. Stacy has been utilizing the hot tub while recovering, and through research has found that there are multiple benefits.(9:12)  Through her research, Stacy has found that there are multiple benefits to hot baths. There are also some risks, so this might not be for everyone. There were significant studies that showed that taking a couple of hot baths a day would reduce your chance of heart attack and stroke. The research showed, that the hot soak increases your heart rate while decreasing your blood pressure at the same time. You also sweat while in the hot tub, which allows you to detoxify additional toxins. For Stacy, the hot water relaxes her muscles, which is a trifecta of goodness. Stacy also read in a study that time in hot soaks reduces inflammation, which makes sense. Sarah really hears Stacy on the importance of looking after herself. When Sarah doesn't have control over her environment when she is traveling, or if she doesn't have the ability to recover after traveling, the chances of her getting sick are really high. Sarah use to get sick far more often before Paleo. However, now Sarah gets sick when traveling or publishing a book. In particular, with this last trip, between the physically stressful travel itinerary, the jetlag, the emotional stress from the family crisis, and then going into work mode, set her up for a crash. Sarah also was exposed to someone with laryngitis, while dealing with a weakened immune system from traveling. It doesn't hurt for Sarah to swallow, but she can feel the burn of the inflammation and her neck hurts. Sarah doesn't feel good and hasn't for the past week. She has been sleeping as much as she can and working as little as she can. Sarah is also trying to reschedule things that can be rescheduled, or making the choice to simply not do things that don't have to be done right now. It is frustrating to have a body that doesn't allow Sarah to abuse it. However, at the same time, it helps Sarah to stay on the straight and narrow. One of the most common questions that Sarah receives from people is, 'how do you do it all?'. And this is how she does it. It sometimes takes everything out of her and then she has to drop everything for one to three weeks while she recovers. Stress management is always Sarah's challenge. The things she wants to do, while they make her brain happy, don't always make her body happy. She has to balance what Sarah physically needs to be healthy, versus what she wants to do with her knowledge base, her talents, and her passions. This often feels like Sarah is walking a tightrope trying to balance these things. She didn't balance these things, and now here she is sick. Stacy is glad that Sarah is on the up, but thinks she needs more of the things that will help her recover. Sarah and Stacy plan to talk next week and return with an energized Sarah. Listeners, thank you for tuning in and for having patience with Stacy and Sarah's peeks in their journey. If you are feeling well, appreciate it. Think about the things you are doing that make you feel that way, so that the next time you are not feeling well, you too can have a path to recovery. Thanks again for being here! And thank you, Sarah, for coming on and pushing through! (20:21) Learn more about your ad choices. Visit megaphone.fm/adchoices

Welcome back Paleo View, and Sarah welcome back to the state! (0:41) Sarah is feeling super jet-lagged. On her trip to Canada, Sarah visited her Dad for a few days. While there she cooked about a month's worth of food for him and reviewed dietary changes. They also reviewed the details of his medications and how these will impact his life. Sarah found out that her Dad was actually dead for 10 minutes. He had a widowmaker heart attack and less than a 10% chance of waking up from the medically induced coma. Once he did wake up, he had a minuscule chance of not having a crippling level of brain damage. However, he is fine. While Sarah's Dad is still recovering and healing from all that happened, he beat all the odds and it is amazing. He is feeling motivated by all that he can do from this point forward. It was a busy few days with her Dad, followed by a trip to Santa Rosa, California where she gave a presentation for a medical school event. Sarah is home and trying to get back to Eastern times and into a routine. In a lot of ways, this trip was very stressful. This week's episode is a science-y one. Postpartum thyroiditis is a topic that Stacy wishes she would have known more about early on in her health journey. Stacy's first thyroid crash when she was done nursing Wesley. The research Sarah did for this show explained a lot of why she felt the way she did when she was pregnant, and how she felt after birth, and then after weaning. It was actually because of the way Sarah was feeling after she weaned her youngest daughter that brought her to Paleo in the first place. All of the symptoms she was struggling with were very much hyperthyroid symptoms. This episode is sponsored by EverlyWell; a brand that Stacy and Sarah love because they provide at-home testing kits for a huge range of lab tests. Most relevant to this episode, they offer a thyroid panel. For more on the many tests they offer and how the at-home testing works, visit here. If you get the thyroid test and are looking to understand those results, these podcast episodes (245, 341, 134)  would be good resources of information.   Reader Question Heather's question that sparked today's episode theme: (11:28) Hey Sarah and Stacy! I love you guys so much and am so grateful to have you and all of the amazingly helpful resources you’ve created as I navigate my life with Hashimoto’s. My question is this: I’m getting back to exercising after having a baby and am noticing that my heart rate goes wicked high (180, sometimes 190+ when I’m really pushing) during a cardio workout, even if my perceived effort is only a 7 or 8. I’ve backed off the intensity but am still getting readings into the 170s when my perceived effort is only maybe a 5. (Note: this is based on the readings on the treadmill/elliptical/bike etc. which I know aren’t the most accurate, but until I get a new HR monitoring device it’s all I’ve got). This is SO FRUSTRATING because I want to push myself but am afraid I may be doing more harm than good. Is this situation common among people with an autoimmune disease? All I can find online is that people with this situation should “see their doctor to make sure it’s not something else” (but they never say what the something else is!). Since so many things are affected by my Hashimoto’s, I can’t help but think it’s playing a factor in this. PLEASE tell me that this is something I can train back to “normal” or cope with in some way! I NEED to run for my sanity!! Thanks Ladies!   While Stacy does not understand someone who runs, she gets what it is like to feel like you can't do something you love and trying to solve that problem. Stacy wants to first note that they are going to assume that all of the things like sleep management, sunlight, and grounding are all being incorporated as well. While these pieces are a lot to put on your to-do list, these are important aspects in hormone health. The thing that Sarah wants to talk about is that when she sees these symptoms, the first thing she thinks about is postpartum thyroiditis.   Thyroid Health & Pregnancy On this episode, Sarah is going to share information on how the thyroid changes throughout pregnancy and upon delivery. They will also discuss what postpartum thyroiditis is and who is at risk for it. Postpartum thyroiditis is a relatively common condition but is rarely diagnosed. However, the sooner you get the diagnosis and start working on the treatment, the more effective that treatment can be. Sarah does recommend that Heather go to a healthcare provider and talk about these symptoms. She also suggests that Heather brings her thyroid test results with her. The number one thing to do is to go get your thyroid checked. Excess thyroid hormone causes heart palpitations and exercise intolerance. This is due to an increase in heart rate and fatigue. The normal increase in heart rate during exercise is exaggerated with thyroid hormones, which is what Heather is describing. Rapid heart rate is the most common sign of hyperthyroidism. During pregnancy, the shift in the immune system puts some autoimmune conditions into remission. For some autoimmune diseases, pregnancy can make them flair. (17:20) The immune system is changing modes but isn't in remission. The thyroid also changes as a result of pregnancy hormones, which is normal. Having sufficient thyroid hormones is really important for supporting a healthy pregnancy and a healthy baby. During the first eleven weeks of pregnancy, it is mostly maternal thyroid hormones that are driving development. At around eleven weeks, the fetus's thyroid starts to take over producing thyroid hormones. The two hormones that are driving the change in thyroid function are HCG and estrogen. HCG accelerates thyroid hormone production. It is increasing the production of thyroid hormone, which results in a slight decrease in thyroid-stimulating hormone. This impacts the feedback loop. Levels typically return to normal within the second trimester. Estrogen increases the amount of thyroid hormone-binding proteins. So we have this stimulation of the thyroid to produce more thyroid hormone, which lowers TSH. Then we have this increase in thyroid hormone-binding protein, which binds up some of the excess thyroid hormones. This essentially levels out its activities so that levels are not swinging up and down. If a woman has preexisting Hashimoto thyroiditis you can end up suppressing thyroid hormone, especially in the first trimester. It is very common for somebody with preexisting Hashimoto thyroiditis to require higher thyroid hormone replacement throughout pregnancy. Physicians who specialize in this would typically recommend dialing in thyroid hormone replacement doses prior to a woman becoming pregnant. They would then recommend checking thyroid function as soon as pregnancy is detected. (23:19) Typically thyroid function would be very closely monitored throughout pregnancy in somebody who goes into pregnancy knowing they have Hashimoto thyroiditis. They would then get their levels checked every six to eight weeks, but even up to every four weeks depending on how much they are having to adjust the hormone. Then as soon as the baby is born, the mother would be directed to go right back to her prepregnancy level does of the thyroid hormone she is on. This is the standard procedure that is done to avoid postpartum thyroiditis that is medication caused. If somebody has Hashimoto thyroiditis pre-existing and they don't have endocrinologist that is monitoring them throughout pregnancy it can be dangerous. The combination of not having enough thyroid hormone throughout pregnancy can increase the risk of adverse pregnancy outcomes. There is also this need to adjust immediately upon birth to avoid going hyper.   Medication & Supplements It is also worth noting that the iron and calcium in prenatal vitamins inhibit the absorption of thyroid hormone in the gastrointestinal tract. It is standard operating procedure if you are on hormone replacement to take it at least an hour before even drinking coffee. Sarah's super pro-tip when it comes to thyroid replacement medication is to put one in a pill bottle next to your bed. This prevents you from taking more than one. Any mineral supplements shouldn't be taken within four hours of a thyroid hormone dose. If you are pregnant and taking a prenatal vitamin, Sarah recommends taking that vitamin in the afternoon to separate it from the thyroid hormone.   Postpartum Thyroiditis Postpartum thyroiditis happens in this one situation of women with preexisting Hashimoto thyroiditis, but it also happens in women who had no idea they had thyroid issues before pregnancy. (28:32) Studies have shown that women who develop postpartum thyroiditis typically have high concentrations of antithyroid antibodies early in pregnancy. Antibodies are measurable upon childbirth. Generally, measurable antibodies would be diagnostic for Hashimoto thyroiditis. However, in a fairly large percentage of women postpartum thyroiditis might need some treatment to control thyroid hormone levels for a chunk of time. Then the thyroid will sort of return to normal. What this can mean though is an even higher risk of subsequent postpartum thyroiditis in a subsequent pregnancy. Also, the subsequent risk of developing Hashimoto thyroiditis or a more chronic form of hyperthyroidism. We know that this condition is sensitive to hormonal shifts. So the most common times to develop Hashimoto thyroiditis is puberty, pregnancy, and menopause. If you have had postpartum thyroiditis and your thyroid has returned to normal afterward, make sure that you are on guard on what your thyroid is doing as you approach perimenopause. Postpartum thyroiditis is this very acute level of inflammation but does seem to be driven by autoimmune processes that are enhanced because of the hormonal environment after childbirth. You get two phases of postpartum thyroiditis. First, you get a hyper phase, which is what Heather is describing in her question. This means the thyroid is too high. This is a get thee to a doctor time. The symptoms include things like anxiety, panic attacks, irritability, heart palpitations and rapid heartbeat, unexplained weight loss, increase sensitivity to heat, fatigue, shaking like a tremor, and insomnia. Typically in postpartum thyroiditis, the hyperthyroid phase lasts one to four months after delivery. Although, not all women will have a hyperthyroid phase. Some will jump straight into a hypothyroid phase. (32:49) This is a pendulum swing in the other direction, into an underactive thyroid, which is hypothyroidism. The classic symptoms include crippling fatigue, increased sensitivity to cold, constipation, unexplained weight gain, dry skin, and typically depression. The hypo phase of postpartum thyroiditis begins as the hyper starts to go away, which can be anywhere from a few days after birth to a few weeks after birth. The swing into hypo can last six months up to a year, even a year and a half at most. Some women will never recover from the hypo phase. While it is less common, some women will have just the hyperthyroid and not actually experience the reactive hypo-phase. Sarah covered the risk factors and noted that it is really important to be testing thyroid.   Treatment & Care Graves disease is life-threatening. Hashimoto thyroiditis typically is not, although it is incredibly impactful on the quality of life. It is really important to dial in diet and lifestyle, but also maintain an openness to conventional medical treatment. Be willing to accept when conventional medical treatment is the best course of action. Sarah really wants to remind listeners that medication is not a failure. Stacy reiterated this to listeners. No matter how hard you AIP it, you may still need medical intervention. This is ok, and this is why modern medicine exists. This is also not an excuse to do the hard work of diet and lifestyle. The healthiest approach is to prioritize the diet and lifestyle changes that are going to support lifelong health while using conventional medicine judiciously and in an informed way. It is a matter of using all the tools available to us. (41:29) We are talking about close medical supervision and frequent thyroid testing, which is why EverlyWell's affordable testing may be a great option for anyone going through this. It is important to know that needing this close medical supervision and needing to take medication, doesn't make you a failure. It also does not get you off the hook and mean that it is ok to go eat all the fast food.   Closing Thoughts Stacy thanked Sarah for all of her in-depth science and dose of reality. What has been interesting for Stacy on her health journey is that she has different thyroid symptoms from Sarah. She technically has thyroid disease, but she doesn't need medication. Stacy knows that she needs to retest, which is what she plans to do through EverlyWell. There is a variety of different health conditions, and they impact you differently at different phases in life. (44:54) The path to healing and health is not linear. Stacy thanked Sarah for reminding her to check on her health from a numbers perspective. If you need to do some self-checking, you can do that through EverlyWell and get 15% off your order with the code 'ThePaleoView'. No matter how nervous you might be about the results, it doesn't actually change what your health condition is by avoiding testing for it. The testing gives you actionable information. Thank you again for tuning into this week's episode! Stacy thanked Sarah for doing all the research she did while jet-lagged, and that we are happy to hear that her Dad is on the path to recovery. Sarah and Stacy will be back again next week! Learn more about your ad choices. Visit megaphone.fm/adchoices

Welcome back Paleo View listeners! (0:41) It has been a week for Sarah, but just a few days since Stacy and Sarah last recorded, as they recorded episode 369two days ago. Sarah thanked Stacy for pre-recording with her. While she hasn't talked about this much on social media, Sarah wanted to give this special group of listeners a unique window into her life. Sarah wanted to share what has been going on in her life. She has been in crisis mode, working through the steps of what she needs to get done. The next step is going to require that she travel all next week. She knew she wouldn't be able to record a full topic show. By the time this show goes live, it will have been almost two weeks since Sarah's father had a massive heart attack. He was on a city bus at the time that it happened, going into full cardiac arrest. Sarah's Dad was dead for three to four minutes, and there happened to be someone on the bus who really knew CPR. They were able to do CPR effectively until paramedics arrived. Once the paramedics arrived, it took two shocks to get his heart beating again. They were then able to transfer him and treat him at the hospital. Sarah's Dad will have a long recovery ahead of him, but he seems to be on the road to recovery. One of Sarah's big takeaways from this all was that her Dad didn't have emergency contact information attached to his identification or his file. The hospital didn't know who to call. Sarah's Dad was in the hospital for two days before Sarah and her family knew about what happened. Sarah was still waiting to receive her passport from her change in citizenship and hasn't been able to be with her family during this time. However, Sarah has been so impressed with how her brothers rose to the occasion. Once her passport did arrive, Sarah looked to her brothers to tell her how to jump in and help. The family doesn't yet know the endpoint of her Dad's recovery. If he will be able to live independently or if he is going to need someone to come into his apartment. There is no heart disease in Sarah's family that she knew about. This situation felt very out of the blue. Sarah shared more about how she is processing this event. In addition, Sarah shared more about how this is changing her habits around diet and lifestyle. Sarah is walking more, making sure that she is going to bed early, eating more vegetables, and eating sardines for breakfast daily. (11:50) Soon Sarah will be heading home to help out as much as she can. The plan is to take this all one step at a time. Stacy shared her love for Sarah and her family during this time. When Matt was in a terrible car accident, Stacy learned the importance of having emergency contact information on hand. Stacy thanked Sarah for pointing this out. Sarah has found many life lessons throughout this whole experience. Stacy asked Sarah to share more about the healing and recovery foods she mentioned earlier in the show. (17:36) Sarah is trying to make soups and stews that will be easy for her Dad to reheat. She is also focusing on the nutrients that will help with his healing process. A really big thing for heart health is omega-3 fats and monounsaturated fats. One of the things that Sarah will be doing is making sure he has high-quality olive oil to cook with. When taking fish oil, capsules are better. Capsule form protects from oxidation. Sarah particularly looks for tuna oil as an ingredient, as it is high in DHA. Sarah will also put her Dad on Just Thrive probiotic. In addition, Sarah will make sure she is helping to increase her Dad's vegetable intake. At home, Sarah uses pumpkin or overly cooked cauliflower, to then blend and thicken the stew. This is a great way to hide extra vegetables and increase vegetable intake. Stacy loves this method of stew prep as well. She personally loves to use roasted butternut squash as her thickener. Before leaving to be with her Dad, Sarah is also working to fill her own freezer with nutrient-dense meals for her husband and daughters. Sarah will be also checking her Dad's snack supply once she arrives at his house. She will make sure that he has unsalted nuts around, like pecans, walnuts, macadamia nuts, and cashews. To make it even easier for him, she will likely measure out the portions and prepare individual serving sizes for her Dad to grab. In addition, Sarah plans to talk to her Dad's doctor about adding a CoQ10 supplement. Sarah will also be looking at her Dad's potassium intake and adding in potassium-rich fruits and vegetables. When you are sick and recovering from something you don't want to eat something that feels foreign. (27:13) Sarah has had other friends in her life, where she has seen how challenging it is when you are recovering from something to modify your diet at the same time. If her Dad doesn't like something he simply won't eat it. So Sarah needs to find a way to get the nutrient-dense foods into him while he is recovering and not feeling well. Eventually, Sarah will also look to get her Dad's vitamin D levels tested. B vitamins, all of the antioxidant vitamins and all of the electrolyte minerals are really important when it comes to heart health. As long as you are eating good vegetables, you will be meeting these needs. However, since Sarah lives so far away, she isn't sure what her Dad is eating on a regular basis. Sarah also plans to get her Dad walking on a regular basis, but it will be a slow start as his heart heals. If any of The Paleo View listeners have cardiovascular disease risk factors and you are interested in digging into it a little bit more, Sarah recommends that you get enough sleep every night. Sleeping less than six hours a night doubles your risk of stroke and heart attack. Stress and activity are also very important. (30:39) The only other key thing that Sarah recommends, is getting genetic testing for APOE. If cardiovascular disease runs in your family, getting tested for APOE is a really good thing. Sarah personally likes MaxGen Labs for genetic testing. However, even a functional medicine doctor can add it to a blood test and just check for your gene variance of that one gene. Stacy thanked Sarah for taking the time to both tell listeners what is happening and to share this helpful information. If you have further questions on this topic, please feel free to pass those questions on. They may be incorporated into future shows or blog posts. Thank you for tuning in and being here! Stacy and Sarah will be back next week! (35:17) Learn more about your ad choices. Visit megaphone.fm/adchoices

(0:40) Welcome Hey listeners - welcome back to The Paleo View! Stacy and Sarah geeked out over the math specialties of this episode number 369 Sarah wished Stacy a Happy Birthday! Stacy talked about what happens when you get older and what she is noticing Today on the show, inspired by Stacy's own aging journey, the hosts are going to talk about aging as a woman Specifically perimenopause and menopause As we get older what happens from a physical perspective What can we do about it from a lifestyle perspective Stacy wants to remind people before they dive into this topic that the great think about heading into perimenopause and aging is that you are still alive Stacy feels like this is lost on a lot of people Feeling gratitude to be alive and to focus on finding your best health Sarah gave a shoutout to this week's episode sponsor, EverlyWell Stacy and Sarah love this at-home lab testing company that offers a variety of tests, ranging from Food Sensitivity to Metabolism, to a Thyroid Test, Vitamin D to a comprehensive Women’s Health Panel The Paleo View listeners can use the link below to get 15% off their order with code ‘ThePaleoView’ https://everlywell.com/thepaleoview (5:42) The Science Often the term menopause is used as this catchall It actually means the end of the change of life The time in a woman's life when she can no longer reproduce It is marked by at least a year without a period Perimenopause refers to that period of time that is the transition between pre-menopausal (reproductive years) and menopause (no longer reproducing) For most women, the transition will start sometime in their 40's, usually late 40's Some will start to notice some changes in their mid 30's It can be almost instant to more than a decade in time Between 4 to 10 years is average What is happening during this period of time is that estrogen levels are starting to drop As estrogen drops, it can drop rapidly, and that hormone shift can cause a lot of the symptoms Throughout perimenopause, estrogen can cycle in a weird way It stops being the regular cycle that we have during our menstruation cycles It starts being more unpredictable This is what drives all the symptoms Symptoms: Hot flashes Sleep problems Vaginal dryness Irregular periods Worse PMS Breast tenderness Weight gain that isn't linked to diet and lifestyle Changes to your hair More rapid heartbeat Cardiovascular disease risk factors will often increase Headaches Loss of libido Cognitive challenges Challenges conceiving Muscle aches Urinary tract infections Night sweats Fatigue Dry skin Overactive bladder or urinary incontinence Hyperthyroidism Chronic disease risk implications Stacy is feeling a bit of anxiety over all of the symptoms Sarah mentioned Stacy's mom hasn't gone through perimenopause yet and it is interesting to Stacy how much variability there is in one person's experience to the next and the role that genetics play Sarah and Stacy discussed if/how pregnancies impact one's menopause timeline When looking at this list of symptoms, Sarah wants to emphasize that some of these can be driven by stress levels and/or early perimenopause If you have a hormonal imbalance this is a good situation to work with a functional or integrative medicine specialist and do some hormone balancing These symptoms can be alleviated by balancing hormones Hormone balancing protocols are typically very personalized and involve tweaking hormonal doses to get them into the normal range The way to test is to look at the female hormones specifically EverlyWelldoes offer a very comprehensive Women's Health panel Sarah's non-medical recommendation would be to combine this with a cholesterol and lipids test Also measuring Vitamin D levels would be helpful to measure at this point Stacy recommends going back and listening to the Functional M.D. podcast episodeif you are wanting to figure out how to find someone who can help you with some of these things Taking these tests yourself and looking at the information is going to be the best way to not just hear someone tell you that your only option is to get old and medicate Educate yourself with these tests and know where your inflammation markers are so that you are educated when you talk to a medical professional Sarah notes that the conventional medical model is symptom alleviation with prescription medications There are situations where women are on 8 to 10 different medications that are each for an individual symptom of menopause There are some really interesting studies that look at diet and lifestyle interventions and show that they are far more effective Given the link between nutrition and lifestyle and how easy this biological transition/tradition is that we go through, Sarah thinks that it is a real lost opportunity to educate people in terms of a healthy diet and lifestyle There have been studies looking at other cultures and their traditional diets These studies have shown that women in those cultures have a far lower rate of reporting symptoms of perimenopause Ex: Only 10% of women in China, 17% of women in Singapore, and 22% of women in Japan report hot flashes as part of perimenopause In contrast, in the US, 75% of women over the age of 50 report having hot flashes It does look like these diets are much higher in vegetables, fiber, lower in fat content There is a collection of research showing that the typical Western diet (high fat, low fiber, a lot of animal foods) can cause high estrogen levels in women Which means as these women enter perimenopause they are going to experience a more dramatic drop There have been studies now looking at vegetable and fruit consumption and menopausal symptoms These studies show that the higher vegetable and fruit consumption is, the fewer symptoms of menopause are experienced It's inversely correlated with sugars and fats There is a fair amount of evidence showing that fiber is really important Fiber helps to bind with excess hormones and eliminate them So it is a very important element to hormone regulation (36:20) The Role That Diet & Lifestyle Plays There is this new paradigm for understanding the symptoms of menopause where scientists are starting to make a case for them being largely driven by oxidative stress Oxidative stress translates to inflammation, but it means that there are a lot of oxygen radicals in the body Oxygen radicals in the body are not just driving inflammation, but they are also impacting cellular health They are impacting DNA Oxygen radicals are the things that cause aging One of the reasons why cruciferous vegetables are thought to be so beneficial for menopausal symptoms is because they are particularly high in antioxidants The data shows that deficiency in these nutrients can magnify menopausal symptoms, it is really mixed as to whether or not supplementation can help It emphasizes the importance of a healthy diet going into perimenopause and maintained throughout Vitamin E Vitamin C Vitamin B12 Vitamin D Vitamin B6 Vitamin A Sarah still thinks food sources are the best sources Menopause increases the likelihood of B12 deficiency This likely drives a lot of the insomnia symptoms that are experienced in menopause A diet that includes organ meat, seafood and lots of plants would be the best way to structure a diet to meet these nutrient requirements that mitigate the effects of low estrogen Stacy's favorite way to get the nutrients from organ meat is through liver pills To be completely upfront with the podcast listeners, Sarah noted that neither her nor Stacy are perfect They cycle in terms of what a good job they are doing in terms of diet and lifestyle They have both been really open about this on the show This is a lifestyle that does require a renewed commitment from time to time, as it is important Be able to recommit without guilt or blame Periodically we all need a reset One of the reasons why Sarah blogs and podcasts is to keep her accountable Perfection is an unachievable goal Stacy reminds people that the aging process happens the moment we are born When we can accept this process we can more easily learn how to manage the process Lifestyle is also really important for menopausal symptoms, especially exercise There is certainly a stress link and there are many recommendations in the mainstream health resources available about how to reduce stress Meditation In addition to mindfulness practices, getting enough sleep is another powerful tool when managing stress With sleep disturbance as a part of menopause, the way to get enough sleep is to exercise There have been a variety of studies that tackle this from two ways One: they look at women, their symptoms and how much they exercise Basically moderate physical activity has less than half the amount of psychological and physical symptoms of menopause than those who don't exercise much High levels of physical activity is not beneficial to menopausal symptoms An hour(ish) a day of low to moderately intense activity is what to shoot for here There is a consistent reduction in symptoms with activity over time One study did 50 minutes of unsupervised aerobic training, four times per week They saw a 2% improvement in hot flashes per week, continuously over the 6-month length of this trial Plus there are a lot of other benefits that come with consistent exercise Improve bone mineral density Maintain muscle strength Improve sleep quality Improve mood Reduce anxiety and depression Reduce irritability  Reduce hot flashes If we take all of this, we are boiling it down to: be active and eat a lot of vegetables These are the two recommendations that have the strongest support in the medical literature Make sure cruciferous vegetables make it on the plate every day If you feel like you are doing all the diet and lifestyle things, but the symptoms are still really impacting your quality of life, there is definitely a time and a place for hormone replacement therapy for menopausal symptoms Sarah recommends workings with a Functional Integrative Medical Practitioner who has training in hormone balancing and who is going to do testing and be up to date on the literature Stacy gets a lot of questions around skincare for aging skin, specifically as women enter their 30's This is when women's collagen and moisture in their skin goes down The number one thing to keep your skin from aging is hydration and moisturization  Also preventing oxidative stress with SPF and things like that Damage to our skin is caused by environmental factors, as well and genetics and all the hormones Stacy and Sarah have talked about on this show So you want to make sure you are addressing it from both angles if you want to reduce the signs of aging Hydroxy acids or fruit acids are a powerful tool These are widely studied as far as antiaging goes You can often find them listed as AHA or BHA This is essentially going to slough off the skin through exfoliation It should cause a reduction in acne, scars, and pigmentation Other ingredients that are helpful:  Hyaluronic acid Using a moisturizer with hyaluronic acid in it is going to help maintain the moisture in your skin Collagen Stacy takes it as a supplement every day, also drinks bone broth, and eats cuts of meat that is rich in collagen You can increase topically your use of Vitamin C which helps synthesize collagen Most of the antiaging skincare products out there targeted to women's skin that is aging contain hormone-disrupting ingredients purposefully Before Stacy uses any products she goes to EWG and uses their Skin Deep Database The two things that Stacy has found the most results from are: Dermabrasion  Stacy has a tutorial on this process on her Instagram stories Once you remove that top layer of skin, you are going to want to nourish that fresh skin Stacy uses BeautyCounter's Overnight Resurfacing Peel This product is free through the month of September  You can learn more here Sarah uses a mix of brands that work for her skin However, Sarah did use the Resurfacing Peel that Stacy shared with her and was very impressed with the results Stacy shared on how BeautyCounter tests their products for safety (1:15:27) Closing Thoughts EverylyWell offers a lot of really great testing kits for accessing that health piece Including addressing hormone imbalances, thyroid health, cardiovascular disease risk factors, cholesterol, vitamin D levels, and all the other things that are really important to women's health You can visit this linkto get 15% off your order with the ‘ThePaleoView’ Stacy knows that this was a topic that has been highly requested by listeners, and she hopes everyone enjoyed it Stacy thanked Sarah for all the time she put into the research required for this show If you have follow up questions, Stacy and Sarah welcome them Please remember that neither Stacy nor Sarah are medical professionals and they cannot give listeners specific advice for your particular health issue However, they are happy to address things from an overall perspective Use the comment forms on either Stacy or Sarah's site to submit questions Stacy and Sarah love to hear from listeners on social media Please keep tagging Stacy and Sarah when you share If you learned something and enjoyed the show, please be sure to share it with someone who you think could also learn from this episode Thanks for listening!  Learn more about your ad choices. 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