INTERMITTENT FASTING

Written By: Brittani Kolasinski (BHSc Nut, AdvDip Nut Med)

The term ‘Intermittent Fasting’ is broad, vague and very generalised. There are multiple methods of intermittent fasting that have more recently become popularised in the media for its health benefits. A quick Google search of intermittent fasting brings up a list of health claims ranging from improved mental clarity and concentration, weight loss and fat loss, lowered insulin and blood sugar levels, reversal of type 2 diabetes, increased energy, increased growth hormone, lowered cholesterol.

The thing is, although intermittent fasting can provide a number of benefits to your health, bio-individuality needs to be considered and this practice, like many others, must be tailored to suit you as the individual.

What is Intermittent Fasting?

Intermittent fasting involves a period of time during the day or the week where you abstain from foods or calorie-containing drinks. Intermittent fasting has been around for centuries, historically we were hunters and gatherers, food wasn’t as readily available as it is to us now. We wouldn’t wake up in the morning to be met with a fridge full of food, supermarkets down the road or fast food delivered straight to you. Periods of feasting and famine were of the norm, and with this, we were able to progress and evolve. The types of intermittent fasting differ in their time spent feeding and fasting. Some of the most common methods are outlined below:

The 5:2 Diet

Intermittent fasting was first really popularised by Michael Mosely when he wrote the book on the 5:2 diet. What this entailed was eating your normal diet 5 days of the week but only consuming 500 calories on 2 days of the week. These 2 days could be consecutive or randomly throughout the week.

The 16:8, 18:6, 20:4 Diet

This style of fasting restricts food intake to a specific timeframe. It can be anywhere from a 14 hour fast with a 10-hour feeding window, 16-hour fast to an 8-hour window, 20-hour fast to a 4-hour window and so on (you get the drift, right?).

Alternate Day Fasting

This style of fasting is simply eating one day and fasting the next. An intense approach especially when first starting out and one that I wouldn’t recommend without the monitoring of an appropriate health professional.

Fat-Fasting

Fat fasting has been popularised in mainstream media with the beginning of the bulletproof coffee, an idea coined by Dave Asprey which involves consuming calories in the form of fats only and restricting protein and carbohydrates. This style means you still get some of the benefits of fasting but also with the inclusion of calories and energy to the body. When implemented appropriately it can induce a state of ketosis short term which also provides additional benefits.  

Time-Restricted Feeding

Time-restricted feeding is similar to intermittent fasting but involves complete avoidance of foods and drink apart from water for a select period of time. Sachin Panda’s approach is focusing on a practice known as ‘Time-Restricted Feeding’ (TRF). This concept is a daily eating pattern where nutrient intake is limited within a window of a few hours, usually less than 12, however, the quality and quantity of nutrient and calorie intake is not changed. He looks into the effects of food and drink intake on the circadian clocks of our organs. We have our master clock that regulates all sleep-wake cycles, but each organ will have their own circadian clock and rhythm that is dictated by food and drink consumption. Anything that your liver will metabolise, even herbal teas that contain no caloric value, will trigger a response by the liver and will, therefore, reset its clock. This means that outside of your allocated feeding window, you are to take in water only. No teas, coffee, juices, none. As these will reset the clock via the effects it will have on the liver.

Fasting Mimicking Diet

Formed by Valter Longo, this style of eating is considered as ‘fasting with food’ so patients are still able to have some form of calorie content but with altering where these calories come from it will trick the body to remain in a fasted state, and therefore increase client compliance in doing so. The diet is primarily a high-fat diet, with low amounts of protein and carbohydrate, giving about 10-50% of their normal caloric intake and participated for about 4 days. The diet is still able to produce effects on some markers of aging and disease states, very much the same as would a water fast for 2-3 days. In studies, fat loss has been observed, most of which was surrounding the organs, known as visceral fat (the type of body fat you don’t want to have) while there was no loss in muscle mass. 

How Does Intermittent Fasting Work

  • Autophagy

    Fasting induces a reparative state. A process known as autophagy (‘self-eating’) is the body’s system of spring cleaning, so to speak. Any dead, damaged, diseased or worn-out cells are eaten up, stripped for parts and the end result is molecules that are used for energy and the synthesis of brand new shiny cells, thus improving the overall efficiency of each cell.

 

“It’s our body’s innate recycling program, autophagy makes us more efficient machines to get rid of faulty parts, stop cancerous growths and stop metabolic dysfunction like obesity and diabetes” – Colin Champ, M.D.

 

  • Immunity

    More so with longer term fasts (fasts that are longer than 48hours), stem cells are produced. Stem cells are quite remarkable, they have the ability to become many different cell types, replicating at a rapid rate and may then aid the body’s own healing process by regenerating new cells and ultimately new tissues. Stem cell injections are becoming more of a well-known practice for injuries, although transferring someone else’s stem cells may not be so compatible, the best option is to create them yourself, which you can do through fasting. In mice, periodic fasting promoted a stem cell-dependent regeneration of immune cells.

    There are also effects on autoimmunity to take note of, more information on this can be found here  

  • Ketosis

    Ketosis is a physiological state that occurs in a fasted state or when following a diet that is limited in carbohydrates, with moderate protein and higher amounts of fat. You see the body has alternate fuel sources, in most cases, the body will utilise glucose from dietary carbohydrates or from glycogen (stored glucose) for fuel, but when this is depleted through fasting, carbohydrate restriction and exercise the body will then switch to ketones that are produced by the breakdown of fats for fuel. Ketones are an excellent source of energy for the brain specifically and add to the cognitive effects that intermittent fasting may have on the brain.

  • The Benefits on Blood Sugars

    The work in this area has prompted the thought that intermittent fasting could be of benefit when addressing blood glucose dysregulation. From the 1950s until today it has been advocated by many to consume 3 large meals and 2 snacks, encouraging foods to be eaten at 3-hour intervals with promises to ‘balance blood sugars’ and ‘speed up your metabolism’. However, now with more recent studies conducted, we can see that food restriction and periods of fasting can be of great benefit in regulating blood sugar fluctuations as well as other metabolic markers. Limiting the amount of food eaten and how regularly you are eating means that there is less glucose present and therefore less insulin needed.

    Studies conducted in humans diagnosed with type 2 diabetes assessed the efficacy of intermittent fasting on blood sugar levels. The results concluded that intermittent fasting may reduce blood sugar levels to a healthy, normal range, favoring the implementation of fasting as a safe and effective tool. It makes sense, type 2 diabetes is caused by large amounts of carbohydrates which leads to a flood of insulin in the body that the pancreas just cannot keep up with, so why are they then given insulin to treat it.? Think about it. Why would we give someone insulin to treat a condition that’s caused by too much insulin, to begin with?

  • Benefits on Gut Health

    There are also benefits on the gut. When we have a break from food between meals, and not spending the day picking, snacking and grazing it induces our migrating motor complex. This complex acts as a broom, sweeping away debris and build up from within the intestines. This can only occur during a fasted state and is particularly beneficial with sufferers of SIBO (small intestinal bacterial overgrowth). Please see a medical professional for support in this area, like a Nutritionist (like me, hello) or Naturopath

  •  Endurance

    Fasting has been shown to benefit physical endurance, this I’ve noticed within myself. With periodic fasting overnight, going for a run the following day I’ve found that I am able to run longer, faster and more efficiently. Funnily enough, I was more energetic in a fasted state than if I had eaten food.

  •  Brain Function

    Mentally, it’s been noted that when in a fasted state many experience a sense of euphoria. Consider this, without food we should experience better brain function, cognition, and energy. Not the other way around. Our hunter-gatherer ancestors needed to be vigilant and agile when hungry, to be able to hunt and kill to feed again. Now with the health issues, we are facing largely due to the poor diets we are eating coupled with sleep deprivation and stress an onset of symptoms including lightheadedness, irritability, and fatigue commonly occur… Basically the feeling of being ‘hangry’. Not exactly a healthy response.

    Intermittent fasting has been shown to enhance cognitive performance, due to its effects on neuroplasticity and synapses in animal studies. Regeneration of myelin sheath, the protective outer layer of our neurons has also been attributed to fasting’s effects, as was observed in the condition of Multiple Sclerosis, an autoimmune condition characterised by the degradation of healthy myelin sheath. It’s also been shown to reduce cancer size by 45%, highlighting the effects that fasting has on disabling the growth of a number of tumours as well as increasing the effects of chemotherapy drugs to target the malignant cells and spare normal healthy cells.

  • Chemotherapy Tolerance

    Research has shown that fasting can enhance the effects of chemotherapy. This occurs as the cancer cells become more sensitive to the chemotherapy itself whereas normal healthy cells don’t seem to have the same effect.

    More on this here

  •  Longevity

    In animal models, it’s been shown that intermittent fasting does lead to a longer life. Fruit flies are commonly studied as they have a rather short lifespan, making it easier to note the effects. Results from one study, in particular, found that intermittent fasting (using the 5:2 method for just one month) was sufficient to extend lifespan. It was shown to improve resistance to oxidative stress as well as improved gut barrier function and a reduction in age-related pathologies. Dr. Valtor Longo is really leading the way in this field of longevity and healthy aging and is worth looking into for more information on this topic of fasting and longevity. For the sake of the length of this article, I won’t go into it too much more.

    You can read more on his work and the work of Satchin Panda here 

  • Fat and Muscle Mass

    During a fast fat is oxidised to provide fuel, this can result in weight loss for most or improved body composition. What’s more is that protein is generally spared, meaning that short term fasts will not lead to muscle breakdown but can actually stimulate the production of human growth hormone that is involved in the synthesis of new tissue, muscle, and even bone. 

The Difference Between Men and Women

There is so much information on the benefits of intermittent fasting, however, in the research, there is so much to consider. For example, in women fasting can induce anxiety, insomnia, irregular periods and weight gain. Which is quite the opposite effect than what is claimed by health and wellness advocates everywhere.

Women have a much more sensitive hormonal system, from a biological perspective we want to be fertile and reproduce. So in a state of deprivation, this is shut down. This is how fasting may trigger negative effects for some. Studies have shown that a 2 day fast in women shifted their nervous system state to a more sympathetic dominant one (fight or flight), whereas in men it was the opposite as they were in a parasympathetic state (rest and digest).

More recently the function of hypocretin neurons has gained interest. These have the ability to inhibit sleep and lead to feelings of wakefulness. Their excitation occurs in reaction to the body detecting a starved state. They can act on the female hormonal system and lead to insomnia or trouble sleeping. Male neurons seem to respond to starvation with autophagy far more readily than women, although this is conflicting in the research and more is needed to confirm this effect. Fear not as there are other ways to induce autophagy if this is what you’re after. Exercise and infrared sauna use can also stimulate this effect.

When Not to Fast

  • If You’re Stressed

    Fasting is a stress on the body. When blood sugars dip, cortisol is released to bring blood sugar up to a regular range. Fasting can increase cortisol levels within the blood which can lead to detrimental effects leaving you feeling worse off than before. What can you do? You can practice time-restricted feeding, eating within a 12-hour window and maintaining a 12 hour fast, you will still reap some benefits in terms of cancer risk reduced and longevity benefits without putting too much of a stress on the body.

  •  If You’re Pregnant or Breastfeeding

    As we have already noted, fasting elicits a different response in women than it does in men. Pregnant and breastfeeding women should not participate in any form of fasting, restriction of dieting. A nutrient-dense whole foods approach during pregnancy and breastfeeding is crucial, this is a time of rapid growth and development and places huge nutritional demands on the body.

  • If You Have or Had an Eating Disorder

    In no way would I encourage any form of restriction if you’re still working through an eating disorder. Eating regular is important to ensure that your body is nourished and well. I understand how easily information like this can be used to fuel unhealthy habits and encourage more restriction and deprivation.

  • Thyroid Conditions

    Hyperthyroidism is a condition where the thyroid is overactive. It involves a dysregulated HPA axis or HPT axis to be more specific.  Managing hyperthyroidism requires adrenal support, reducing inflammation and improving sleep quality. Because of the effects on the metabolism regular food intake and antioxidant consumption is needed to maintain body composition and reduce oxidative stress that can occur.

  • If You Have Irregular or Missed Periods

    Hypothalamic amenorrhea occurs when the brain stops communicating with your female reproductive organs because there is too much-perceived stress. This condition is commonly driven by undereating or over-exercising. In this instance, the body will produce stress hormones at the expense of sex hormones estrogen and progesterone.

How To Start

Now, the point to reiterate here is that fasting is practiced intermittently. Not on a regular day-to-day basis. That just takes away the intermittency of it. We don’ know exactly how often, how long or how much people should fast, and of course, know that we are all so uniquely different. Fasting is a stress on the body, and this needs to be considered. When facing high stress in your day to day life, fasting would not be advised for you. I’ve said it before, and I’ll say it again – always consult your health care professional before making any radical changes to your diet and lifestyle and respect their opinions on it.

It you are adamant about starting here is how:

  1. Start slow

  2. Switch first to a wholefoods diet first – limiting refined sugars, carbohydrates, and packaged foods

  3. Trial cyclical low carb days, eating more fat from whole foods and restricting high carb foods like grains, legumes, potatoes, and fruits.

  4. Trial an intermittent fast for 1 day of the week and note how you feel - listen to your body with this. If you feel worse, then stop.

You may feel some hunger when you first start, but if you start having issues with sleep, feeling sick, light headed and shaking then most certainly honour this and what your body is trying to tell you and stop.

For women do it less frequently on non-consecutive days and on days that you are not doing a high-intensity activity, you can also incorporate more of a fat fast to provide some calories but still getting some of the effects – this can include bulletproof coffees or teas. This will induce ketosis and give you still some cell renewing properties and can provide fuel to the brain.

Please let me know if you do intermittent fasting and how you include it in your life – how has it made you feel? I’d love to know in the comments below!

Yours in health,

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SEED CYCLING

Written By: Brittani Kolasinski (BHSc Nut, Adv Dip Nut Med) 

Seed cycling is, in a nutshell (excuse the pun), a method of using certain seeds to support female hormones during the different phases of their menstrual cycle. Seed cycling has been used to support women suffering from absent periods, PMS, infertility and perimenopause symptoms as well as providing healing support for chronic conditions like PCOS and endometriosis. Seed cycling harnesses ‘food as medicine’ to support the intricate hormonal dance that occurs in a woman’s body in a delightfully inexpensive and non-invasive way.

Who’s Involved?

•    1 Tbs Flaxseeds

•    1 Tbs Pumpkin seeds

•    1 Tbs Sesame seeds

•    1 Tbs Sunflower seeds

How this works

During the first stage of your cycle, the follicular phase, you consume 1 tablespoon each of both flaxseeds and pumpkin seeds and continue this every day for 14 days. After this, you will switch over to 1 tablespoon each of sesame and sunflower seeds, again every day for 14 days during your luteal phase. Its recommended that you have the seeds ground fresh before consuming. One of the easiest ways I’ve found to do this is to add them to a morning smoothie. This way they are blitzed to a finely ground liquid gold that’s easy to get into my diet.

The First Phase (Days 1-14)

Day one of the follicular phase is your first day of bleeding with your period. During the follicular phase, estrogen should rise. Estrogen is needed to stimulate the endometrial lining to thicken in preparation for a fertilised egg to embed. Without fertilisation this lining will shed, you will bleed, and that is what is a woman’s period. Estrogen is also needed to peak for ovulation to occur, and this should ideally happen between days 12-15. Ideally day 14.

Flaxseeds contain phytoestrogens, phytoestrogens are a plant-based source of estrogen that adapt to the body’s estrogen levels. They increase estrogen levels where needed, yet they also can decrease excess estrogen in the body. This is thanks to the lignans they contain, which bind to estrogen receptors and help to modulate estrogen production. Flaxseeds are also rich in omega 3 fatty acids that help to reduce inflammation in the body.

Pumpkin seeds are rich in zinc, zinc nourishes the ovarian follicles (the eggs) and promotes ovulation to occur. Ovulation is important as it establishes regular cycles and provides a balanced supply of estrogen and progesterone.

The Second Phase (Days 15-28)

Around day 14 ovulation should occur, and so then you will enter into the luteal phase. The luteal phase should last at least ten days, any less may indicate low progesterone levels and possible concerns with fertility. During this phase, estrogen should drop and progesterone will rise. Progesterone is needed to enhance the uterine lining (endometrium) and to facilitate egg implantation. Estrogen levels may increase again during this phase but when they rise too high they can trigger symptoms of PMS, so the key here is balance. Ideally, progesterone and estrogen should be within a specific ratio. So during this phase, to keep progesterone levels high and maintain hormonal balance the focus is on seeds rich in omega 6 fatty acids that convert over to gamma-linolenic acid (GLA) within the body.

Sesame seeds are rich in lignans which act on modulating estrogen and progesterone levels within the body. They are also a great source of omega 6 to be converted into GLA in the body. GLA is anti-inflammatory and helps to balance out female hormones.

Sunflower seeds are rich in selenium, an antioxidant mineral that supports liver function and the elimination of excess hormones. Without the appropriate detoxification of hormones, they can be reabsorbed and enter back into the bloodstream, creating imbalances. Sunflower seeds also contain omega 6’s to convert to GLA.

Things to Remember

With anything relating to hormones, it's important to know that to see results and improvements it takes time. You won't see the results within a day, or a week, but rather over 2-3 months or more. The time it takes will depend greatly on your current hormonal health and health history. For women who have been on hormonal birth control for some time it’s expected to take longer than someone who has had only minor hormonal imbalances.

Additional considerations to seed cycling are addressing lifestyle factors that may be affecting hormones. Stress is a huge factor to address. Cortisol, our main stress hormone uses the same precursor that’s needed to create progesterone and estrogen, so under stress, the body will focus more on making cortisol at the expense of those hormones. Over-exercising, undereating or other underlying pathology also have a part to play, and for these conditions I strongly encourage you to work with a trained practitioner such as a Nutritionist (like myself!).

Got questions or need more information? Get in touch and let’s chat!

E| wellfed.health@gmail.com

IG| @well_fed_

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HEALTHY HORMONE SERIES PART III

TREATING PMS NATURALLY  

Written By: Brittani Kolasinski (BHSc Nut, Adv Dip Nut Med)

If you’ve missed the previous parts of this series, I encourage you to go back and read them from the beginning, to give you more understanding and insight for the blog posts to come.

As we’ve previously talked about, hormonal imbalances can lead to PMS. As excess oestrogen can manifest as irritability, tension, and aggression, breast tenderness, bloating, water retention and constipation before your period. A lack of progesterone can lead to feelings of anxiety, low libido, headaches, and migraines. Low progesterone can be due to the excess estrogen present as it may throw off the intricate balance of these hormones. We also know now the role that stress, and inflammation play in this PMS picture. So, with all this in mind, how do we go about treating this in a natural & non-invasive way.

To maintain hormonal balance, we need to ensure that we have the required substrates to make the hormones necessary but also have our detox pathways functioning well to ensure that we are able to metabolise and clear out any excess. Detoxification of hormones happens within both the liver and the gut. Poor digestion, food intolerances, excess alcohol, medications and consumption of coffee can all impact on these pathways and disrupt hormone levels. When hormones are not eliminated effectively it can lead to the reabsorption and contribute to conditions of hormone excess like heavy periods, fibroids and endometriosis as well as some common symptoms that can be attributed to hormonal excess.

WHAT CAN YOU DO? 

1. Support detoxification of excess hormones:

Specifically oestrogen and xeno-oestrogens that are in abundance in our chemical-filled worlds. Try swapping out coffee for green tea as coffee may inhibit oestrogen detoxification whereas green tea supports the liver to eliminate toxins sufficiently. Green tea also provides antioxidants in abundance, is anti-inflammatory and modulates the microbiome to protect the intestinal barrier from dysbiosis. Use turmeric and parsley liberally and include cruciferous vegetables like broccoli, kale, cauliflower and brussel sprouts. Drink plenty of water and increase vegetable fibre to promote bowel clearance and hormone excretion.

2. Take magnesium: 

Magnesium is typically lower in women suffering from PMS compared to matched controls. It supports oestrogen detoxification by stimulating certain enzymes and inducing the pathway in the liver known as glucuronidation, this is the key pathway to detoxify oestrogen. It’s also anti-inflammatory and quietens oestrogen receptors. Magnesium also supports the nervous system to protect against the effects of stress, ensuring cortisol is regulated and hormone production is balanced. The combination of broccoli sprouts and magnesium together, typically through supplementation, can relieve breast pain, support serotonin and GABA production to relieve emotional tension and promote bowel clearance, protect against migraines, support thyroid function, insulin signaling and balance blood sugars.

3. Consider Calcium D-glucarate:

A calcium salt that is synthesised in the body in small amounts. Supplementing with this, however, has been shown to promote oestrogen detoxification, reduce inflammation, and support gut function as it inhibits an enzyme known as beta-glucuronidase that are produced by bacteria within the gut and is involved in liver detoxification of excess hormones.

4. Reduce Inflammation:

Turmeric is a God-send when it comes to reducing inflammation and supporting hormones. It works on the liver to support healthy hormone metabolism and detoxification, as well as reducing oxidative stress and downregulates the production of inflammatory cytokines NF-KB, MCP-1, TNF-a and IL-6. Elevated levels of these means there’s inflammation present. Turmeric also provides pain relief thanks to its analgesic properties. A whole-foods dietary approach that’s rich in colourful vegetables, fruits, nuts and seeds and lower in the common inflammatory culprits that are gluten, dairy, vegetable oils and sugar.

5. Manage your stress:

Stress is unavoidable, but how we support our bodies to equip them to manage daily stressors is a vital part of establishing a healthy cycle. Stress can come from a number of sources from relationships, toxin exposure, psychological and emotional strains, trauma and even from things like exercising, dieting & food restrictions and a lack of sleep. Common stress combaters include mindfulness, meditation, and breathing techniques. Additionally talking to someone can help, either a friend or trained professional, learning to say no and take a step back, staying in for the night to wind down and relax – however that looks to you personally, or simply by turning off your phone for a day (I do this often when I feel I need to take a step back from life, a few hours in the evening or the morning with no contact from the outside world can be all I need to feel human again).

Eating enough and of the right things is essential. Think protein for neurotransmitters, like serotonin and melatonin for sleep, fats from olive oil, avocado, coconut products, butter, nuts and seeds can reduce inflammation, balance blood sugars and support brain function and slow release carbohydrates from starchy vegetables like sweet potato, or grain-like seeds quinoa, millet and buckwheat to provide B group vitamins that are depleted during times of stress. Starchy vegetables are calming for the body as they boost the anti-anxiety neurotransmitter GABA.

6. Get some sun:

Vitamin D levels are shown to be lower in those suffering from PMS compared to control groups. Low vitamin D is also more prevalent in women with endometriosis and is associated with pelvic pain. Vitamin D is obtained from food sources including free-range egg yolks, grass-fed butter, cod liver oil, and some types of mushrooms that are exposed to UV light. However we get most of our daily requirement from sunlight exposure. Although Australia may be a wonderfully sun-kissed continent, vitamin D levels are often low and deficiency is common. Optimal levels of vitamin D should ideally be around 200ng/mL, yet doctors advise that you’re ‘fine’ if you’re above 50ng/mL – I don’t think that’s enough. Vitamin D is an immune modulator, indicating its efficacy in preventing against autoimmunity. It is also known to regulate cells in the body to help protect against cancer – two health conditions that are on the rise within Australia, a vitamin D deficient population. More on vitamin D in another article “What’s the Deal with Vitamin D?”

7. Be good to your gut:  

 Your gut is one of the major elimination pathways for the body to rid itself of excess hormones, like oestrogen. Constipation is a clear indication that hormones are out of whack and it would warrant further investigations and appropriate treatments from a trained health professional. There is also a direct correlation to dysbiosis and conditions like endometriosis, with the microbiome of endometriosis sufferers having a larger number of pathogenic bacteria strains and a reduction in beneficial species like lactobacilli. The increase in pathogenic strains influence the levels of glucuronidase, meaning that oestrogens are reabsorbed by the body back into circulation. Chronic dysbiosis is commonly observed in cases of PCOS as well – more on this in future posts!

8. Nourish your being:

Getting enough macronutrients in the form of starches and carbs, healthy fats, quality proteins of both animal and plant origin, and fibre to support your bowels is, of course, important however a focus on nutrient dense foods are essential. As previously mentioned, being properly nourished supports your body through periods of stress. It’s also beneficial to include foods rich in zinc, vitamin B6, magnesium, iodine, selenium and calcium as these all support thyroid function, ovulation and progesterone synthesis. Speak with your nutritionist or naturopath about specific dietary advice or possible supplements to consider.

I always encourage you to work with your healthcare practitioner about appropriate supplementation in doses tailored to you. Stay tuned for tomorrows article “Lifestyle Factors that Affect Your Hormones”

Yours in health,

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HEALTHY HORMONE SERIES PART II

THE PMS CODE - YOUR BODY IS TRYING TO TELL YOU SOMETHING 

Written By: Brittani Kolasinski (BHSc Nut, Adv Dip Nut Med) 

Premenstrual Syndrome (PMS) is believed to affect approximately 90% of women each month, with the presentation for each being vastly different. I’m certain the men in our lives think that we make most of this stuff up, that we are just being sensitive or overly emotional and irrational, which I must admit I have been more than a few times. But, unfortunately PMS is a real thing, but although it might be so common its most definitely not normal. Our periods should not be this way, they should not impact our lives to such an extent or the lives of our loved ones and people around us.

When PMS rears its head it’s not something for us to just suck up and push through, but to stop, take a moment to listen and really feel what your body is showing you, and from there address the underlying imbalances that are causing such discomfort. PMS can be a thing of the past, once you understand what is driving it.

There are many, many different presentations of PMS with symptoms effecting our physical, mental and emotional worlds. Mood swings, appetite changes, fatigue, irritability, acne, fluid retention, anxiety, depression, brain fog, insomnia, pain, migraines, breast tenderness, indigestion and constipation are just some of the many presentations of PMS. The timing of these symptoms may also differ woman to woman, for most these may occur during the second half of their cycle and pass with the onset of their period or very soon afterwards.

The development of PMS is not exactly clear cut. Its hypothesised that PMS can be due to fluctuations in sex hormones, a result of too much stress and disruption of our hypothalamus-pituitary-adrenal axis, from abnormal GABA function (a neurotransmitter responsible for calming the body), altered serotonin levels leading to feelings of sadness and altered bowel movements, a reduction in opioids and blunted response to endorphins.

Our reproductive hormones impact on many of our neurotransmitters and chemicals within the brain, hence why mood is affected when suffering with PMS. Progesterone for one, influences GABA. GABA is responsible for feelings of relaxation, is calming on the body and promotes restful sleep. Therefore, with lowered progesterone levels, GABA is affected and can cause changes to mood, inducing feelings of anxiety and impairing sleep.

Dysmenorrhea is the term used for painful periods. This pain is described as a dragging, dull ache or a heaviness with episodes of cramping and is generally located around the lower abdomen and pelvic region but may also spread to the lower back. Pain can be from the muscular contractions needed to shed the lining to induce the bleed, however extreme pain or pain that occurs at different times during the cycle, not relating to the bleed itself can all be indications that something else is going on and would warrant further investigation.

Endometriosis is a condition that can be responsible for such severe pains and its worthwhile to have this properly investigated if you suspect something is not quite right. There are slight differences to the pain of endometriosis in comparison to dysmenorrhea. Endometriosis pain may begin up to 10 days before the day of bleed and remain for up to a week after, there may also be pain present around ovulation (mid cycle) whereas dysmenorrhea is generally felt the day prior, or the day of the bleed and will pass shortly after, within a couple of days. More on Endometriosis in future articles, stay tuned!

Cracking the Code

Firstly, its best to log the symptoms you experience and when in your cycle they are occurring, as we have previously discussed in the last article there are many hormones fluctuating at different points during your cycle. Doing this can also give you an understanding of what is going on internally. For most, the symptoms present indicate signs that there is too much estrogen or too little progesterone. Although it’s a much more complex and intricate hormonal dance that’s happening within the female body, these two are centre stage and worth looking at in more detail.

Signs you have too much oestrogen

Feeling particularly aggressive and irritable, with fluid retention and bloating, breast tenderness as well as constipation, which then leads to more oestrogen reabsorption and further sustaining the distress.

Signs you don’t have enough oestrogen

A common sign of oestrogen deficiency is vaginal dryness, but other symptoms include dry skin, insomnia, weight gain, fatigue, hair loss and depression – I mean who wouldn’t feel depressed with symptoms like this! But more technically speaking, the low mood is to do with the relationship oestrogen has to serotonin, our ‘happy hormone’.  Oestrogen deficiency may occur when you’re unable to ovulate, this can be due to a number of things – under eating, stress or an underlying pathology. If you’re still ovulating it may just be that your oestrogen is on the lower end, and this might be noted with a lighter bleed with your period, referred to as a scanty flow. Changes to diet and lifestyle can rectify this and restore the balance.

Signs you have too much progesterone

To be completely honest, it’s not often you’ll come across this – progesterone is difficult to make. The more common scenario is a progesterone deficiency with oestrogen excess. Too much progesterone can occur with progesterone supplementation (note this does not include hormonal contraceptives, these contain a synthetic progesterone – not the real thing). Pregnancy is another time that progesterone may be high, or with oestrogen deficiency as this throws of the balance of these two hormones. In other instances, it may also indicate underlying pathology that would warrant further investigation, adrenal related problems may throw out your progesterone levels. Signs that you have too much include fatigue, morning brain fog, dizziness, water retention, sense of physical instability, anxiety and changes to libido. As these symptoms can be vague and an indication of a multitude of other health conditions its always best to work with a health practitioner to help guide you.

Signs you don’t have enough progesterone

Your luteal phase is shorter, and you will notice fertile mucous within the luteal phase, rather than around mid-cycle when ovulation should occur. If tracking your basal temperature, you may find that your temperature is lower during the luteal phase. Weight gain, low libido, irregular periods and problematic skin may also indicate that progesterone is too low. Progesterone can be more difficult for the body to create and requires consistent ovulation each month. Remember the corpus luteum mentioned in the previous post? This 4cm gland is formed from a single cell within a small window of time every month, meaning that you must be well fed and nourished. Underlying conditions that effect thyroid or to do with blood sugar imbalances must be addressed as these can impair ovulation. It takes 100 days in total for your eggs to reach maturation, so when it comes to healing hormones, be patient – it’s not an overnight fix.

A deficiency in progesterone could be due to increased stress or inflammation within the body, meaning that these will also need to be addressed to support healthy hormone production.

Apart from oestrogen and progesterone, both stress and inflammation can contribute or be the causative factor to what’s behind your PMS;

Stress is a major factor in the presentation of PMS. Cortisol, our stress hormone is synthesised from the same precursor that both oestrogen and progesterone are made. This means that during times of stress more cortisol is made from the precursor, leaving less available to make adequate hormones and leads to an imbalance that can affect your cycle as well as trigger PMS.  

Inflammation also comes into play. PMS is associated with higher levels of inflammatory cytokines, and this can manifest as pain and cramping, fatigue and migraines. Increased blood sugar levels also promote inflammation and lead to excess production of oestrogen.

When it comes to supporting your body naturally to reduce the monthly burden that your periods might often bring, it’s always a good idea to track your symptoms across the month, this allows you to gain more understanding of what exactly your body is crying out for.

Looking forward to the next part of this hormone series, ‘Natural Treatments for PMS’ where we will be considering all of the aforementioned information and breaking it down into some simple tips & tricks you can do for your body to make you menstruation more enjoyable.

Stay tuned xx

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HEALTHY HORMONE SERIES PART I

WHAT IS A HEALTHY PERIOD? 

Written By: Brittani Kolasinski (BHSc Nut, Adv Dip Nut Med)

Starting this 5-part series, where we will be talking all things hormones & health, with the topic of periods. This is our menstrual cycle. A topic near & dear to me, and often times one that comes up in conversations with girlfriends as well as in clinic with my female clients. It’s something that should be celebrated, talked about, and something that we as women (and our male companions) need more education and clarity around as many of us don’t truly understand the intricacies of the women’s cycle and the hormones at play - or how to appropriately support them. 

The menstrual cycle

This is the cycle that occurs, involving a number of hormonal and physical changes that makes pregnancy possible. The ovaries, fallopian tubes, uterus, thyroid, and brain are all involved with a number of different hormones at play. The process, in a nutshell, involves the development of an egg (ova) by the ovaries that are released (this is ovulation) to travel down the fallopian tubes and become embedded within the uterus ready to be fertilised. The lining of the uterus thickens each month in preparation for a possible pregnancy. Without fertilisation the uterus contracts to shed the thickened lining of tissue (which is our endometrial tissue) and this is the bleeding that occurs with menstruation which is known as the woman’s period.

The first day of the cycle is the first day of bleed, and the cycle finishes once the following months bleed occurs. The average length of a woman’s cycle is between 28-32 days. Anything outside of this time window is worth investigating. The entire cycle can be broken up into three stages:

1.     The follicular phase – this stage lasts typically from days 1 to 14, it is the first stage of the cycle in which the follicles in the ovary begin to mature. The follicles are tiny sacs in which an egg is contained.

2.     Ovulation/The fertile window – once an egg has reached maturity, it is released to enter the fallopian tube and make its way to the uterus. This usually takes place between days 13, 14 or 15. This ‘window’ is the fertile window, the ideal time to have sex if you’re wanting to conceive. Worth noting that not all women will ovulate at this time, so it’s important to understand and look for the signs that you have ovulated to know the ideal time for you and your partner to conceive. Ovulation does not need to occur to still experience a menstrual bleed, this is known as an anovulatory bleed.

3.     The luteal phase – the finale, in this time the lining of the uterus has thickened in preparation for a fertilised egg. Without fertilisation the lining will break down and contractions allow this to be shed as the bleed and signaling the beginning of the next cycle.

The Hormones

Hormones are chemical messengers produced by the body that stimulate a number of reactions and responses from tissues. There are a number of different hormones needed throughout a woman's cycle for it to be completed.

Follicle Stimulating Hormone (FSH) – this is needed for puberty and healthy ovarian function. As the name indicates, its required for the stimulation of growth and the maturation of follicles to become the egg that is ultimately released during ovulation. FSH is also needed to stimulate the secretion of oestrogen. It's highest in the follicular phase of the cycle and peaks just prior to ovulation. 

Oestrogen – this is secreted by the ovaries and has a number of functions throughout the body. It's stimulating and is responsible for the drive we as women have, it promotes the growth and development of tissues, from breast to uterine lining. It halts the production of FSH so as to ensure that only one egg is matured and released with each ovulation, it stimulates the release of luteinising hormone (LH), it allows the secretion of fertile mucous (a clear indication of ovulation), which is a creamy egg white discharge that provides the sperm with an easier trip to the fallopian tubes to reach the egg.

Oestrogen levels peak during the follicular phase with a particular spike around ovulation – this triggers LH which allows ovulation to occur. Oestrogen is also needed for healthy bones, muscles, brain, heart, sleep, skin and metabolism. It tapers off during menopause, a time where there is an increased risk of bone, heart and metabolic conditions.

Luteinising hormone – a spike in LH mid-cycle triggers ovulation to occur, it’s also required for the development of our corpus luteum which is needed for the synthesis of our hormone progesterone.

Progesterone – almost opposing the effects of our stimulating oestrogen, progesterone is our calming hormone. It's secreted by the corpus luteum and also by the placenta during pregnancy. Progesterone is anti-inflammatory, involved in muscle growth, promotes sound sleep, protects against cardiovascular diseases and supports the nervous system during times of increased stress. Progesterone is needed to maintain pregnancy, its levels are highest during the luteal phase of the cycle. Without fertilisation of the egg, progesterone levels will then taper off which stimulates the contraction of the uterus to shed the lining and induce the monthly bleed.

Signs you’re ovulating

It’s common for women to experience anovulatory bleeds on the odd occasion, but regular occurrences may indicate hormonal imbalance is warrants further investigation. Without ovulation, there is a lack of progesterone made which can contribute to premenstrual symptoms including breast tenderness, insomnia, changes in mood (anxiety, depression) and increased appetite and food cravings. A lack of progesterone can also shorten the length of your cycle as the lining of the uterus cannot be maintained as long.

One way to track ovulation is by checking your basal metabolic temperature. This is a simple, effective and non-invasive tool to use. Using a thermometer which you can purchase from your local chemist, you take your temperature the moment you wake and can chart it using a hand-written method or through an app on your phone (I use Kindara). You can see what you have ovulated as you will find a rise in temperature. 

Additionally, you can watch for physical signs such as fertile mucous, this will appear as an eggwhite consistency that you will note around mid-cycle or during the luteal phase and is an indication that you are ovulating.


Premenstrual Syndrome – PMS

PMS is common, with a variety of symptoms occurring for each woman that can significantly impair their quality of life. Although incredibly common, PMS is certainly not normal. A healthy period should not cause distress, it should not induce significant pain or cramping, or be responsible for changes in weight and mood or disrupt your normal sleeping pattern. If you’re experiencing such complaints month to month it's worthwhile to work with a healthcare practitioner to make the appropriate changes to diet and lifestyle or include nutritional supplementation to restore balance and harmony.

Changes or irregularities to your period are a clear indication that something needs to be addressed, a great resource for further understanding this is the book by Sydney naturopath Lara Briden, where she refers to your period as your monthly report card. A great analogy in my opinion.

Our periods are a gift and a healthy period is a sign of balance, health and wholeness. Further articles to come will address natural treatments for PMS, look into lifestyle factors that are affecting your period, discussing what pathologies might be underlying your menstrual irregularities of pain – things like PCOS, endometriosis, fibroids etc, to finish up the week with healthy hormone foods and recipes. Here’s to happy, healthy hormones ladies!

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