Recently, I interviewed Bria Gadd also known as The Period Whisperer, who is a Functional Diagnostic Nutrition Practitioner, holistic health coach, and certified personal trainer. We talked about her own perimenopause journey and the lessons that shaped her work from understanding health debt to managing stress and supporting gut health. We also discuss metabolic typing, including the concept of “oxidizers” how your body’s rate of turning food into fuel can influence whether you thrive on higher-protein or higher-carbohydrate foods.  If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

I am very excited to chat with Bria Gadd, as we are going to talk about hormone imbalances, something that pretty much applies to everyone. At one time or another, I think many, if not most, of us deal with hormone imbalances, especially Bria’s and my clientele. Let me go over Bria’s short but sweet bio here. 

Bria Gadd is a functional diagnostic nutrition practitioner, holistic health coach, and certified personal trainer, who specializes in female hormones, helping women with weight release and energy gain in pre- and post-menopause, and finding clarity in hormonal chaos. Her podcast The Period Whisperer is a top 1% wellness podcast in the world. With an Instagram following of over 17,000, Bria has been featured in Fox News, Women’s Health, and top women’s podcasts such as The Midlife Makeover Show, to name one. Welcome, Bria. 

Bria Gadd: 

Thank you so much, Dr. Eric. I am so happy to be here. I really appreciate it. I love your show. I hope everyone listening, who I’m sure have been listening for a while, leaves you a good review because I think the content you share is so valuable. 

Dr. Eric: 

Same with yours. I have listened to yours as well. I definitely recommend listening to The Period Whisperer. She has some great information to share. My interview is on there, too. 

Bria: 

Yeah, go listen to it. It was a really good one.

Dr. Eric: 

Let’s dive into your background. How did you start doing what you do now? How did you become The Period Whisperer? 

Bria: 

I love it. I will try to summarize this for everyone. I got into nutrition and fitness as a nutrition coach and fitness trainer in my late 20s when I was having babies and trying to find a way to feel good and also do something from home. That was a big driver for me. That was where I really fell in love with health and working with women specifically on finding time in their life to prioritize themselves.

Around the age of 37, I noticed a shift in my clients. A lot of my clients were around my same age box, which is pretty common. First, I started to notice shifts in them not getting the same results, not having the same energy, maybe having some actual cycle issues with their menstruation, fatigue, things like that. 

I remember thinking, what is going on? All of a sudden, it happened to me. I was like, I don’t have everything figured out. I’m a mom. There is a lot to figure out in life. I thought I had fitness and nutrition sorted. It started as a low-grade fatigue and then major energy drops, changes in my cycle, digestive issues. All of those things should have had me at least get checked out. 

But it was my sleep that went. I have always been a super sleeper. Suddenly, I started to feel like I was waking up every night in a sweat. All the things that come with that, what I call undeserved weight gain, where you ‘re not changing anything, but it’s changing. It didn’t make sense to me.

I went to my healthcare practitioner and had my bloodwork done and asked all the questions. She was great, but in the end, she said, “Bria, you’re the picture of health.” I remember thinking, if this is the picture of health, and I’m 37, this sucks. I don’t think I can do this. It was a pretty dark moment. I knew I was missing something here.

I am almost 44 now. Seven years ago, nobody knew what perimenopause was. I had never heard of it before. These days, you can’t open Instagram without seeing something about hormones or perimenopause or menopause, which is great in many ways and overwhelming in others. 

That was a real pivoting change for me. I have to better understand what’s happening. Because of my cycle changes specifically, let’s start with hormones. I learned so much better understanding with functional health as opposed to that physical health, what our doctors look at. Really what was within my control and the lack of understanding and education in this area for women. 

That pivoted my career and my education to specialize in this area and help women understand what’s happening in their body and know what they can control and what they can do to get the support that they need. 

Dr. Eric: 

That is awesome. Thank you for sharing. Are you sleeping better these days then? 

Bria: 

Yes. I feel better now in my 40s than I did in my 20s. Sleep is absolutely much better. You know it’s so important. 

Dr. Eric: 

Definitely for overall health. 

Why do so many women have hormone imbalances? I’ll just start with that simple question, but not so simple answer. 

Bria: 

What I have seen in my practice and my own journey, pretty much all hormone imbalances stem from something I like to call health debt. Health debt in my mind is when basically the energy supply of your body is no longer meeting the energy demands of your body. That is when we really start to see the body compensate by pulling energy from different systems, and shut down non-essential personnel in the name of survival of the body. That is when we see shutting down of the reproductive hormones a little bit more. Just close and conserves. 

When we’re in this health debt, we have to look at where we’re coming from, to answer that question of hormone imbalances. It certainly comes from the fact that we’re inundated by stressors more and more in our life these days. Our environmental stressors, food stressors. 

Also, we can get thrown into this health debt if we’re having something going on in the gut. If we’re not breaking down, absorbing our nutrients, suddenly we don’t have the nutrients to make any of the hormones, not just the sex hormones but the thyroid, the adrenals. That really is stressful on the body because it works like that orchestra. If one thing goes off suddenly, that’s where these imbalances start to come from.

I think it’s quite easy and common to fall into them, especially if you’re not paying attention to your body and what it’s saying to you. 

Dr. Eric: 

True. Couldn’t agree more about gut health. We’ll talk more about the importance of the gut, how it affects nutrients. If you don’t have a healthy gut, healthy stomach acid, you’re not going to be able to digest.

Now I did my research. I listened to some episodes of your podcast prior to having you on, just like I do with everybody. You spoke about metabolic typing. Can you talk a little bit about what metabolic typing is for those who are unfamiliar with it? 

Bria: 

Absolutely. One of the most common questions I have always gotten being in the wellness space for women is, “What should I eat? How much should I eat? Give me a nutrition plan.” I get that. “Tell me what to do, and I’ll do it.” Most women are pretty great at that.

I always find the answer to that is so individual and personal. Where metabolic typing comes in is it helps understand the rate that you, as an individual, that your cells turn food into fuel. If you have a faster rate, it’s not about the state of your metabolism being fast or slow. It’s really about the rate that those cells turn things in.

I find that this helps us understand why some people can feel amazing and have mental clarity off of a more ketogenic, lower carbohydrate diet, and other people can feel unwell and sick. Why some people can feel all glowy and wonderful on a plant-based, vegan diet, while other people look sick from that vegan diet. 

When we think about metabolic typing, if you are a fast oxidizer, if your cells turn food into fuel really quickly, then we want to look toward eating slower-burning fuel. That’s more red meats, higher in purine proteins, probably a lower carbohydrate diet, higher fats, higher protein. If you are a slow oxidizer, you will feel a lot better from eating what we call faster-burning fuel, probably more complex carbohydrates, lighter proteins. 

It helps work with the body’s system, and it helps us understand the basic fuel mixture we want to work with, so we can feel full and satisfied and give our body what it needs in between our meals. 

Dr. Eric: 

How do you determine someone’s metabolic type? 

Bria: 

There’s a great book called Metabolic Typing, and the test is right in there. You can pay to have the test done. This is something I do with my clients to get a more elaborate picture. There is a really simple self-test that you can actually do at home to have a rough understanding of whether you’re a fast or slow oxidizer. 

That is simply to, in the afternoon, maybe, when you might be able to have a snack. You don’t want it to be your meal. You would either choose to have something like an orange or a piece of meat. Specifically, the orange I find helpful. If we have an orange, this is a fast-burning fuel. It’s a carbohydrate. 

After you have that as a snack, if you pay attention to your body an hour or two later, if you feel really good, you’re likely what we call a slow oxidizer. It needs that faster-burning fuel, so you don’t get sluggish and bogged down trying to get through it. If you feel jittery or hungry already or a low energy crash, that’s a better indicator that you’re what we call a fast oxidizer. Eating straight up simple carbohydrates or too many carbohydrates can really make you drag your body down and throw off your blood sugar levels. 

Dr. Eric: 

Do you find that more people are one or the other, a slow oxidizer or a fast oxidizer? 

Bria: 

I find it’s pretty in the middle. There is something we call a mixed oxidizer as well. When you think about where this stems from and where the research came from, it was looking at where we come from genetically in the world. 

It helps explain why you think about certain parts of the world, where maybe in the way north, there is not a lot of vegetables available. We are talking rich seal meats and rich fats that way. Genetically, that is what people evolved to work with in their body. Versus parts of Asia, when we see people with diets much higher in rice and vegetables, higher carbohydrates. Proteins are more expensive. They have adapted that way. 

I do find it pretty split. This mixed oxidizer comes into play a lot as well. That is what I am. We see that a lot from people coming from western Europe, in England, Ireland, Scotland, where you’re having a good mix. You have some meat and some fish and some potatoes and some vegetables. We have that mixed combo in there. 

I do find it’s pretty split. If you are a fast oxidizer, and you’re not eating a higher protein diet, it’s a real struggle for you to feel well and therefore to lose weight or feel your best or optimize your hormones. Vice versa for slows. 

Dr. Eric: 

I don’t know if you are familiar with hair testing. Some hair testing looks at slow versus fast oxidizers. 

Bria: 

This is different from that. It’s called the same thing. It is a different theology and a different result. 

Dr. Eric: 

Good to know. It sounds like though ideally you would want to be a mixed oxidizer.  

Bria: 

I find in some ways being a mixed oxidizer is easier because then we have a bit more fluidity and option. However, it’s not as direct. When I am working with my clients, and they are mixed, they don’t know what to eat. It can be more confusing. It’s a little bit more cut and dry if you’re fast or slow. You’re going to need a higher this or a lesser that.

Most importantly, I find it really helpful to give us a starting point for the macronutrient fuel mixture. If you’re a fast oxidizer, we likely want to be having a minimum of 30g of protein in our meals. If you’re a slow oxidizer, we can probably get away with 20g of protein and making it up with more carbohydrates and some fat. If you’re mixed, we can sit in the middle there. You might feel just as well on either side of those. 

That’s where it becomes very bioindividual. We have to pay attention, which I think at the end of the day is the name of the game. Listen to your own body. That’s where your answers are. 

Dr. Eric: 

True. Couldn’t agree more. 

Let’s talk about stress. Stress also is important. We spoke about sleep also. When it comes to stress, how does stress impact the hormones? How important is it to do things to manage stress or at least manage the perception of stress in order to have healthy hormones? 

Bria: 

It’s critically important to try to manage that quickly. Stress is the biggest energy sucker of our body. When we’re coming back to that example of health debt, if we want to reduce the demand on the body, we want to reduce stress to the body for sure. 

At the same time, we want to have capacity for stress. If we have capacity and bandwidth and reserves for cortisol or stress in the body, that’s going to allow us to handle the aging process, the shifting of these hormones that we know are happening in perimenopause and menopause. Lots of things there.

When our cortisol is elevated, that is the body’s alarm system of saying, “Okay, we need to manage this life-altering, life-threatening situation.” As a result, it suppresses the sex hormone production at that time. Our bodies are designed to handle stress not chronically but acutely, like in a short term, so we can survive. 

What we see more and more for women, and this also goes to that question of why so many hormone imbalances, is people under much more chronic stress these days. That significantly depresses the production of our sex hormones, which is also why we’re seeing symptoms of perimenopause earlier and earlier in women than before. We’re seeing the impact of that. 

As you know, the adrenals and thyroid work quite closely together. We’re seeing some major impacts on those. Of course, the sex hormones are really impacted by the thyroid hormones. It massively matters how we manage stress in our lives and also how we reduce it. 

It’s not just our emotional stress; it may be stress from us staring at screens all the time and stress from the fact that social media can tell us all the scary things going on in the world at any given second. It’s also the stress happening in our body from the food we’re eating, from whatever dysbiosis may be in the gut, from the environmental toxins we’re exposed to that may be impacting the liver and all of these pieces.

Long-winded answer. It significantly makes all the difference. My whole process with my clients is how do we reduce the call to cortisol in your body? How do we reduce stress and your brain’s experience of stress? 

Dr. Eric: 

There is that adrenal-thyroid relationship, where there are a number of factors that can affect the conversion of T4 to T3. One of those is having high cortisol. Gut and liver play a big role in that conversion as well. Like you said, it’s not just emotional stressors. That is a big factor, but all these other things are stressors as well. 

Sometimes, I’ll share my story when I was dealing with Graves’. Prior to my diagnosis, I was overtraining. That was also putting a big stressor on my body. I think you do adrenal testing, saliva or DUTCH. Back then, in 2008, it was the adrenal saliva test. My cortisol was in the tank. My DHEA was in the tank. It’s hard to know if it was more due to overtraining or emotional stressors. I’m sure it was a combination. I was working out too hard, and I wasn’t listening to my body.

I agree with everything you said. You mentioned earlier how you weren’t sleeping, and I’m sure that wasn’t helping in your pursuit of having happy hormones at the time. Like you said, things are a lot better. You’re sleeping better, and it’s probably no coincidence that you feel better now in your 40s than you did in your 20s. 

Bria: 

Yeah, I sleep more appropriately now. I can relate to that. That was part of my issue. My cortisol was in the toilet. It felt like, is this perimenopause? Ultimately, I think perimenopause gets a bad rap. Our sex hormones get blamed, but they are just the messenger. Don’t shoot the messenger. Who is throwing off the messenger?

For most women, especially under 48, the sex hormones might be off, but it’s probably not because you can’t produce the amount of sex hormones that you need. It’s likely because something else is causing a problem. Of course, the shifting of hormones into retirement is a stress on the body. I can’t even handle this stress, and you’re throwing another thing at me. It gets challenging. 

Dr. Eric: 

It does. I want to get your opinion on fasting. Going back to diet a little bit. There are so many perspectives on fasting. Obviously, there are some advocates of fasting, and there are some who are against fasting. 

I am bringing this up because we are talking about stressors. Some are concerned that extreme fasting especially might be a stressor on the body. I want to get your perspective. What do you think about fasting? Do you fast? Do you recommend for your clients to fast? 

Bria: 

What I use for myself and what I recommend for my clients is a typical nighttime fast and fasting in between meals. When we are talking about our sex hormones, in a time when we know the body is under more stress than usual, our first line of defense against calling on more cortisol is regulated blood sugar. 

If you wake up in the morning as a woman, when our cortisol should be getting its highest spike, and we don’t eat, that means we don’t have glucose coming in, so the body is calling on more cortisol. Now we have more cortisol. Then you have a coffee, and there is more cortisol. Then you work out, so there is more cortisol. Then you’re not eating again until lunch. You are massively impacting your sex and adrenal hormones in a very negative way. 

In my practice, with myself and my clients, I feel very strongly that we eat within two hours of waking, that we eat enough in that meal to last us 4-5 hours until lunch, and then 4-5 hours until dinner. For whatever reason, if life gets in the way and we need a snack, we have a snack.

Let’s say you wake up at 6am. You have breakfast at 8am. You have dinner at 6pm. That’s a 14-hour fast plus a 4-5-hour fast between those meals. That seems to support the body in a much better way. Sometimes, in order to regulate that blood sugar, depending on what’s going on with the gut and the body, we need a snack at night in order to be able to sleep through the night, which is priority #1.

To answer your question, I see the value of fasting when it’s done appropriately for women, but not during the time of day when we need the most energy. We need to give the body what she needs in order to do this big job that she’s doing in general. 

Dr. Eric: 

Everybody is different. There are some people who might seem to be doing fine with 16-8 fasts or occasional 24-hour fasts. I think a big concern is having such a small eating window. Like you said, during the day, that’s when you want to make sure you get the nutrients and protein. 

Over the years, I’ve had some people I work with who are doing 20-hour fasts on a regular basis. Even an 18-hour fast regularly, that is only a six-hour eating window. It’s difficult to get the nutrients and protein you need. Also, I think it could be a stressor on the body as well. 

Bria: 

Like you said, it’s very individual. If you’re in a place in your body where your health is solid, the foundations are solid, you feel really good, and you want to play with tools and hacks to test it out, it could be something that might be beneficial for you. Only you will know if you try it.

If you’re trying to use it when you’re in a health debt situation, when you are having these symptoms, your PMS is off, you can’t lose weight naturally, and you are feeling exhausted, that is a time to use that more extreme fasting for another time in your life when you’re solid. 

Dr. Eric: 

Makes sense. Let’s talk about building muscle. How can women build muscle mass? 

Bria: 

Obviously as a trainer, I think putting on lean muscle is the gold standard for protecting our hormones, our bodies. It’s like wrapping our body in armor.

We have to make sure we have the energy to handle that stressor. You and I both have already shared how overexercising is actually doing the opposite for us. 

I always like to make sure our basics are in place for women. Do we have enough sleep happening? We need at least seven hours of sleep to be able to repair and create muscle synthesis. Let’s make sure that’s in place. Let’s make sure our nutrition is on. 

Let’s make sure we get functional movement in a day. I’m not sure about you, but for me, I spend a lot of time sitting in front of a computer working with clients, so I need to make sure I am getting up for lymphatic drainage, for my mindset, for walking and moving the body. No matter what, these are things that have to be there first. And stress management and joy. 

Once those pieces are locked in, then I think putting on lean muscle at any age, but definitely in perimenopause and menopause, really comes down to, now, I have this additional energy because my foundations are in place. I’m not in debt. Where do I want to invest this energy? 

What we see is that the best use of your energy is going to be in resistance training. Weightlifting or body weight resistance training. To be specific about it, I find three, four days a week of resistance training complemented by good flexibility and mobility training is enough to make a difference and put on that lean muscle. 

During that process, you can notice, “Am I hungrier now? Maybe I need to support with more protein,” which our body needs to create muscle. It can be staged and simple for women, but it is so critical. 

Once our ovaries retire, our adrenals are going to be producing some of those hormones, and the rest is coming from our tissues. We want to put on that lean muscle as long as we have the energy and capacity to do so. 

Dr. Eric: 

How long personally do you train? When you do resistance exercise, is it 30 minutes? An hour? 

Bria: 

I typically do a 45-minute workout. 15 minutes of that is mobility and stretching, whether it’s on the front end or back end. About a 30-minute lift is what I do. That is enough for most women, unless you are trying to win a competition. Then you will need more. 

Dr. Eric: 

I need more on the flexibility/mobility side. My wife does a pretty good job in that area. She probably didn’t need to do more of that resistance. I won’t say I need less resistance, but incorporate some more flexibility/mobility training. 

Bria: 

It’s an important piece that a lot of us overlook. The strength of our muscle is always going to be limited by the elongation and flexibility and elasticity of it. If you are doing one without the other, you’re going to hit a plateau. 

For me, I like two days of resistance training to one day of solely flexibility and mobility. I find that really helps make all the difference and keeps our body happy and our nervous system calm. 

Dr. Eric: 

For anyone listening, including me, where would you start? Personal trainer? YouTube videos? Probably not on your own. What is some advice? 

Bria: 

It’s hard to know what to do. It’s always good to ask yourself how you feel about this stuff. A lot of people, athletes especially, when I say, “Go do yoga,” they roll their eyes and groan. There is so much beauty and value in doing yoga. For athletes, that quietness doesn’t feel very productive. 

There is a lot of noise that comes up in your head when you are not used to more stillness. If that’s how you’re feeling, looking for workout programs or going to a mobility stability class that is around myofascial release with a roller, or more athletic stretching and mobility can be easier to get into. Or if you haven’t tried yoga, I would recommend doing that.

I have been a long-time user of online workouts. I just work out at home because I find that’s the most efficient thing for me. Some people really love the environment of being somewhere else. 

My suggestions are know thyself a little bit in what you want. If you are not someone who will be motivated on your own, look at the local gyms or community center or classes and find a mobility/stability and stretch class to go to regularly. Or a yoga class. There are hundreds of yoga classes around. I would go to the class because then you would have an instructor to help guide you in the process. 

Dr. Eric: 

Good advice. There are stretch labs everywhere. Yoga. I like working out at home. I don’t do the same workout at home as I do when I go to the gym. That’s why I go to the gym. I do have a personal trainer. If I asked him to focus more on flexibility and mobility training, but I haven’t. 

They have classes at the gym that we go to, too. A few weeks ago, my wife on a Sunday morning asked me to go to yoga with her. “No, I’m good.” Maybe next time, I’ll say yes to the yoga class. 

Bria: 

Two times a week, Dr. Eric. 

Dr. Eric: 

When it comes to losing weight, building muscle mass is also important for weight loss. The metabolic typing you mentioned. Is there anything else you want to add when it comes to women looking to lose weight? 

Bria: 

I think one of the first things that we always want to do when we’re wanting to lose weight is let’s make sure our kindergarten foundations of health are in place. We often skip over these in the pursuit of seeing the changes in the body. In order to create stability in a body that for women in midlife is almost like it’s on a floating bridge. There is no stability here because these hormones are shifting. We want to create a lot of stability.

Before we start getting into workouts, before we start changing into a calorie deficit for example for fat burning, we first need to solidify the foundations of our health. I look at that like a dining table that we eat on that has four legs. We have sleep, nutrition, movement, and joy, which goes hand in hand with stress management. 

We need to hold space for at least 7-8 hours, if not nine, of sleep in a day. If we’re not there, the body is not going to be able to lose weight. We need to be able to sleep. That is when our fat burning happens. That is when our hormones get produced. We want to look at that basic functional movement. Before we start stressing out the body with resistance training, we need to get our basics in, in walking and stretching. 

Look at nutrition. We have to make sure we’re not cutting out the things that are costing the body more energy than they’re providing, so we have the energy to repair and burn stored fat. We’re eating consistently. We talked about those things. 

Then stress and pleasure. Pleasure is a really massive opportunity to bring energy into the body. If you’re stressed, we can’t add pleasure. We need to find ways to manage that. 

If we think about those four pillars of a table, if one of those legs is rickety, it’s not a very good dining experience. If two are rickety, you’re not coming back to that restaurant. If three are rickety, your meal is on the floor. Really starting with those foundations first and foremost, making sure these are as easy for you as brushing your teeth is priority #1 for weight loss. 

Priority #2, especially in this age box, is noticing where the loss of function started to happen in your body. Are you pooping every day? Is that digestion good? is there bloating or gas that we don’t know or understand where it came from? Are we waking up multiple times at night? Then we are looking more at adrenals and liver. Are you waking up in a sweat? Are we having a lot of funky PMS? That will speak more to those sex hormones. 

Pay attention to where those weak spots are. Focus on strategies that work on improving that area first. If function is off in the body, if the thyroid is off, and we start stressing out more but cutting calories and doing more fitness, it will do the opposite. It will start to hold onto more fat and break down the muscles, which can be very confusing for people. 

Dr. Eric:

Let’s talk a little bit more about gut health. You just mentioned the importance of healthy bowel movements. We chatted earlier about gut health. What do you do to help your clients improve the health of their gut, including any functional lab testing? Do you do it on everybody with regard to the gut, or is it more selective? 

Bria: 

I always do a GI Map, which is a functional stool test. You know what it is. For those listening, it’s a wonderful thing. It certainly rules out things like pathogens and parasites and yeast and fungus, which is helpful. I think the greater value in it is looking at the good bacteria and bad bacteria, the commensal and opportunistic, to really understand the state and capabilities and where the weak spots are in the gut, as well as some good intestinal health markers. 

It’s a really great lab. I run it on all of my clients, even if they don’t have digestive issues. I have found over time that for many women, they might not have any digestive issues, but they are not breaking down and absorbing any nutrients. Their gut is almost like a dry garden. It doesn’t have what it needs.

People have genetic weak spots naturally in their body. Some people might have massive GI distress, and that makes it very easy to say, “Okay, let’s start in the gut.” For a lot of women, when we aren’t getting those nutrients or detoxifying those hormones, we’re seeing the downstream effects in the thyroid, in the adrenals, in the sex hormones. They’re experiencing those symptoms but not the GI issues.

I really like to run that as a good understanding of what is going on and what is our customized strategy to make sure we have a really nourished gut. 

Dr. Eric: 

I think it’s important what you mentioned. Just because you don’t have digestive symptoms doesn’t mean you have a healthy gut. 

Bria: 

What I see most in my clients who don’t have digestive issues but are really struggling with sleep, a lot of more common thyroid symptoms. Maybe they have temperature issues in their body; they’re cold all the time. They’re losing hair. We are seeing a very depleted gut at that point in time. We need to renourish that, so we have those minerals and vitamins.

I know you probably speak to this all the time. In those clients, I often see low T3 and an elevated reverse T3, which makes it so challenging to feel good in your body. 

Dr. Eric: 

Yeah, definitely agree. It sounds like you test for reverse T3 in your patients. Do you test thyroid in everybody? 

Bria: 

I do. When I work one on one with a client, I really will always start with the GI Map; a DUTCH, which we have talked about to test adrenals, sex hormones, balance, and detoxification. I like to do a good blood chemistry that has a full thyroid panel, iron, verifies some of the sex hormones and minerals. I like to see Vitamin D, magnesium, zinc, B12, things like that, just to get a better picture of what’s depleted and try to get an understanding of root cause a bit more, so we can focus our efforts. 

Dr. Eric: 

With the DUTCH, when it comes to women in perimenopause, do you recommend a DUTCH Complete? They also have the cycle mapping. In perimenopause, might be challenging. Is it just the DUTCH Complete you typically recommend? 

Bria: 

Most of the time, I do a DUTCH Complete. If I have someone who works a lot of shift work, and we know their cortisol is all over, we can do the Plus, where they also do the saliva. I find the DUTCH Complete is very thorough for women in this age box. To understand what is off and why might it be off, and fingerpoint at some issues. Help us create a strategy that works for them in their life to reestablish calm and balance in the body. 

Dr. Eric: 

HRT. What are your thoughts on specifically bioidentical hormone replacement therapy? Yes, no, depends on the person? 

Bria: 

Yes, and depends on the person, for sure. I think it can be very beneficial for people. I feel very strongly that we need to make sure those detoxification pathways are clear before we start introducing things like that. It’s really a matter of where we are at, why are we there, and would this be a benefit? It is dependent. 

Sometimes, if our progesterone is okay, but our estrogen is way high, because of a detoxification issue, then when we correct that issue, often it just comes back into balance, and we don’t need to add bioidentical hormones. It is very person to person. 

I think we can see that it’s, more often than not, not just the sex hormones. If it was, we could all just take hormones and feel fine. That’s not the case. 

Dr. Eric: 

I’m with you. There is a time and place for HRT, but if someone does a DUTCH test, and if they have high 4 hydroxy and 16 hydroxy metabolites, and you want to focus on improving the estrogen metabolism. If someone has compromised adrenals, that could also affect the sex hormones, so you want to try to optimize the adrenals. Definitely agree with what you said here. 

This has been a great conversation. I did warn you I was going to ask this question, so you’ve had time to prepare as far as some hormone balancing hacks. 

Bria: 

For sure. I do have a few. There are some that I think a lot of us here, we have talked about a few of the basic ones. Holding that space for sleep. The consistency of eating enough that you feel full and satisfied. Functional movement. 

Some of my favorite tools that are very helpful as hacks. I really am a big believer of waking up and having an adrenal cocktail right away: a big flush of water, some lemon, some good sea salt in there. You can google adrenal cocktail recipes. Supporting those adrenals first thing in the morning can be a really powerful thing. 

What I love these days is a good green juice. We are having a nice flush of water. We are fueling that gut, which will help support the adrenals, too. I find this makes a massive difference for most women. Wake up, flush the body with water and some good nutrients. 

Another one that I find super helpful is I run into a lot of women who are drinking all their water, but they are peeing every hour. When the body is going through this added workload of perimenopause, we demand more minerals. Remineralizing with good electrolytes once, even two times a day. If you’re working out, definitely with your workout, and maybe a good one in the afternoon. I find that can make a big difference in mental clarity, the calming of the body, detoxification. 

If you are struggling with sleep, if you are waking up every night between 2-4am, try a snack half an hour before you go to bed. Test out a little snack. Some of my favorites are a spoonful of nut butter. Sometimes, that alone can make a huge difference. 

If our blood sugar is off, whether it’s because of how we’re eating, or because of our gut, it’s hard to say until we test. It’s going to wake you up. Then it becomes very hard to do anything else if we’re not sleeping well. 

Those are three of some of my favorite things to do that are quick, easy, and affordable that really move the needle for women. 

Dr. Eric: 

With the adrenal tonic, is that something someone could do every single day? 

Bria: 

Yeah, that can be done every day first thing in the morning. Without whatever life is going to throw at you, first thing in the morning is when we are having that highest cortisol spike. We just want to give the adrenals some extra love during the time they are working extra hard. 

Dr. Eric: 

Makes sense. Just water, lemon, and sea salt. No harm in taking that on a daily basis first thing in the morning. 

Bria, this was amazing. You shared a lot of information. I loved this conversation. Anything else before we wrap up that I should have asked you, or any last words you want to say before I ask where people can find out more about you? 

Bria: 

The big message I always want to get across to women listening is that perimenopause happens for us, and not to us. It’s like the gift you didn’t want, but you needed. This added workload to your body is going to shake down and point out where the problems are. 

Although it’s frustrating, and you might not feel like you have the capacity right now to handle the symptoms that are coming up, I think this is your opportunity to do the deeper underlying work with Dr. Eric or a practitioner that might specialize in your area to lock in your health, so you have the next 4-5 decades to feel great. Really try to think of this shift as a gift, this opportunity to do the real work, so you can feel your best going forward. 

Dr. Eric: 

Wonderful. AS far as where people can find you, your website is BriaThePeriodWhisperer.com. You have a big following on Instagram. I’ll let you share the details. 

Bria: 

My website is great. @Bria_Period_Whisperer on Instagram. Check out The Period Whisperer podcast, where this is all we talk about. If you’re in it and need some more support, it’s there for you. 

Dr. Eric: 

Thank you again. This was a really good conversation. Just really enjoyed it. I’m sure my listeners did as well. 

Bria: 

Thank you so much for having me, Dr. Eric. 

 

In this episode, I share how trauma may affect thyroid health and why addressing it could open new doors for healing when efforts seem to no avail. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

Did you know that stress from years ago can still affect your body today? Could these unresolved experiences from the past be part of why your thyroid antibodies refuse to decrease? 

Whenever someone joins my 1:1 program, I ask someone to rate their stress levels and their stress handling, which I realize isn’t always easy to do. But the truth is, even if someone currently rates their stress levels as being low, and they feel they do a great job of managing their stress, past stressors and traumas from many years ago can sometimes hold them back from healing. 

This just isn’t related to the impact of stress on adrenals. Yes, without question, this can be a factor. I have spoken about this many times, including my personal experience. Stress and past traumas can also have numerous other consequences, which of course, I’ll discuss in this episode. 

It’s one of the hardest realities of thyroid autoimmunity. Sometimes, the roadblock to healing isn’t what you’re eating or related to high toxic burden or a gut infection, but the body’s memory of traumatic events. Don’t get me wrong, these other factors are important. Many times, it is related to what someone is eating or a high toxic burden or a gut infection. To be honest, you often have multiple triggers, not just one thing. 

The point is, old patterns of stress and trauma can keep the nervous system on high alert. When this happens, the immune system can stay overactive. The challenge is that thyroid antibodies won’t decrease, and most doctors don’t ask about trauma. I have been guilty of this in the past. This can leave you feeling like your story is being reduced to a lab number, just looking at your thyroid panel and the antibodies. As we both know, most medical doctors, including endocrinologists, won’t look at antibodies to begin with. If they do test for antibodies, they are not looking to do things to decrease antibodies.

In this episode, I want to talk about the connection between unresolved stress and trauma and the potential impact they have on thyroid antibodies. 

I also want to add that one of the reasons I am focusing on this topic now is because I have been going through a series of nervous system retraining modules recently, specifically for practitioners, which along with having Dr. Evan Hirsch on the podcast not too long ago, this really has opened up my eyes to the power of nervous system retraining.

This doesn’t mean that everyone needs nervous system retraining. If someone hits a roadblock in their recovery, it’s something to consider. We will talk more about this. 

This is also a time to consider additional functional medicine testing. Sometimes, it’s challenging to know which direction to go in. Should you do more functional medicine testing? Should you do nervous system retraining? 

Let’s start by discussing the stress-immune connection. Chronic fight or flight changes, cortisol patterns can cause inflammation. That can affect immune activity. This is one reason why antibody levels can remain elevated even when diet and, I don’t want to say “basic”, lifestyle changes are in place. Chronic stress can definitely have a big impact. 

If they are eating well, and they are blocking out time for stress management, and seem to be doing a good job there, they are getting sufficient sleep, it could be something else, like gut infections or increased toxic burden. Again, it could also be related to chronic stress and trauma specifically. 

Both chronic stress and trauma can negatively affect the adrenals. Chronic stress and trauma can also negatively affect the gut microbiome. If you have listened to me before, you realize the importance of the gut microbiome in all chronic health conditions, especially if someone has thyroid autoimmunity, any autoimmunity really. You need a healthy gut for a healthy immune system. One of the big reasons is because most of the immune system cells are located in the gut microbiome. Approximately 70-80%. 

Also, chronic stress and trauma can dysregulate the nervous system. The nervous system controls everything in the body. The nervous system controls the thyroid gland, innervates the gastrointestinal tract, the immune system. You really want to have a healthy immune system.

Many listening to this probably have heard of the vagus nerve. The vagus nerve is extremely important. Definitely gets affected in chronic stress. The vagus nerve is also important for gut health. I have spoken many times about chronic stress. I think that many listening to this already are familiar with chronic stress. It’s the difference between chronic stress and trauma. 

Let’s talk about this now. Can trauma truly be the reason why someone with Graves’ or Hashimoto’s isn’t healing? That’s the question behind this episode. I have had numerous people on the podcast. I mentioned Dr. Evan Hirsch, who wasn’t focusing on trauma, but on more complex conditions, like toxic mold and Lyme and bartonella. 

I also had Dr. Aimie Apigian on the podcast a couple years ago. She has a lot of experience when it comes to dealing with stored trauma. When I had her on, and I looked this up, because my memory is not that amazing, and I am quoting her here, “When it comes to these chronic diseases, especially autoimmune, all autoimmune conditions fall under the category of being trauma-related, not stress-related.” That brings up the question: What is the difference between trauma and stress? 

She says that we need to redefine trauma because we may look back, and I may look back and say, ‘Well, I haven’t really had trauma. I relate to being stressed, not traumatized.’ That’s me. I don’t think I was traumatized. There have been some traumas, but I wouldn’t say chronically. If someone dies unexpectedly, that’s traumatic. That could dysregulate your immune system. There are other more long-standing traumas that happen over a period of months and years, abusive situations for example. I don’t think that was my situation in the past. You don’t have to have that type of situation. 

Dr. Aimie Apigian went on to say that many people are being diagnosed with stress and even chronic stress when they should be diagnosed with dealing with trauma. They are in the trauma response. Your body is chronically in a trauma response, not a stress response.

What is the difference? She goes on to explain. You could go back and listen to the episode. She says the stress response is when you don’t want to go to bed because you’re actively having a problem and want to solve it. You’re taking action to solve it. That’s the example she gave. 

For example, we have all had a situation where we go to bed, and we had a stressful event. Maybe it’s not a single event, but something stressful lately. Maybe financially, things have been tough, or your job has been tough. You are having difficulty falling asleep because it’s on your mind, and you’re stressed out.  

The trauma response, according to Dr. Aimie, is when things feel like they have been too much, and all you want to do is go to bed, and you don’t want to get out of bed. 

Like a fight or flight response, where the person is going to fight the stressor, whereas the trauma response is, “I’m done fighting. I don’t have the energy to fight anymore.” 

She goes on to explain that the person may still go through the motions because the person still has responsibilities. They have a job, kids, a partner. They still have things to do. Pretty much they are just going through the motions rather than experiencing aliveness, energy, joy, and feeling like you actually are present and engaged.

I am not going to keep on quoting Dr. Aimie because you can go back and listen to the episode. The point is that many people know that they have past traumas. You might be listening to this and thinking, “You don’t have to tell me the difference between stress and trauma. I have dealt with past traumas.” Maybe that’s a reason why you’re not responding the way you should. 

Then there are some people who, just like me, I look back. We have all had stressors. We have had quick traumas, acute traumas, like someone dying unexpectedly. There is more than that as far as how a traumatic experience affects us. Not everybody is going to feel like, “I can’t get out of bed because of this trauma.” We have to function. Some people certainly feel like that. 

That brings us back to the question: How do you know when to choose between doing additional functional medicine testing and maybe looking into something such as nervous system retraining for those stubborn antibodies that just won’t decrease? Or maybe they decrease, but they’re decreasing very gradually, and it seems like at this rate, they are taking forever to decrease.

The truth is autoimmunity is challenging. Even non-autoimmune conditions, like toxic multinodular goiter, this information can also relate to you as well. Past trauma can also affect your healing, even if you have a non-autoimmune thyroid condition. 

When it comes to functional medicine testing, I have always been one who incorporates functional medicine testing since dealing with Graves’ back in 2008. This doesn’t mean I go overboard with testing. 

As many of you know who have listened to me for a while, when I dealt with Graves’, I didn’t go crazy with testing. I did adrenal saliva tests. I do hair mineral analysis testing. I know that’s controversial, but I find it to have value. Of course, I recommend comprehensive blood testing. That’s what I did. I can’t say I did a lot of testing. 

Let’s say if someone else goes through that, and if they hit a roadblock in their recovery, then we might want to retest. If their adrenals were in the tank, like mine were, I did do a retest of my adrenal saliva test because my cortisol was low, my DHEA was low, my secretory IgA was low. Thankfully, when I retested, almost everything looked good. My secretory IgA was still low, and I had to work to improve that. 

Let’s say if someone retests, and everything looks good. Maybe for whatever reason, retesting isn’t the best option, and we want to do something different. With the person whose antibodies aren’t decreasing, do we recommend additional functional medicine tests, like a comprehensive stool test or organic acids testing or something else, or do we consider nervous system retraining? 

Again, it really does depend on the person. This is why we also want to do a health history, which just about every practitioner does. I wouldn’t say it’s wrong to do either one. Sometimes, you just don’t know because many times over the years, if someone hasn’t been progressing, and I recommend additional testing, and then we find some answers, and then we find something we’re missing, and then the person from that point progresses, and their antibodies decrease and eventually normalize. There are times where that doesn’t happen. 

We do some additional testing, and maybe we don’t find anything significant. Maybe we’ll find something that seems significant, recommend a protocol, and the antibodies don’t improve. That can be very frustrating to the patient and the practitioner. As a practitioner, we want to see people get better. We don’t want to keep doing testing and not seeing the antibodies improve. 

If someone is in a position where maybe they don’t have a lot of money to spend on functional medicine testing, maybe look into nervous system retraining, even if they don’t think it’s a past trauma. Sometimes, we don’t know. Sometimes, we might dismiss past trauma. 

Nervous system retraining, a lot of things can affect the vagus nerve. It is tied into our parasympathetic nervous system, which is our rest and digest system. We want to be in a more parasympathetic state.

To be fair, we could just start out by incorporating some vagus nerve exercises such as vigorous gargling, hot and cold showers, singing loudly. I am pretty sure I have spoken about this previously. If not, if you visit NaturalEndocrineSolutions.com and type in “vagus nerve exercises,” I did write an article related to this. You can do that. 

I am recommending for everyone to block out time for stress management. Incorporating vagus nerve exercises also isn’t a bad idea, and it won’t hurt. It won’t hurt to do nervous system retraining. Sometimes, you will have something holding you back that is not a dysregulated nervous system. It might be something in the gut. It might be something else where you need functional medicine testing, not nervous system retraining. 

I know I am not giving a clear answer, but that is because there isn’t a clear answer. That’s why it’s a good idea to work with someone. Even working with someone, if someone reaches that point where their thyroid antibodies aren’t decreasing, maybe the right answer for one person is to do additional functional medicine tests and find additional answers. For another person, it might be to try some nervous system retraining. 

You could of course start off with some simple practices, not just vagus nerve exercises, but some simple deep breathing, journaling, emphasizing small, safe steps initially. I mentioned nervous system retraining. You could work with someone like Dr. Aimie Apigian if you want to focus on that. There are other programs I will talk more about. 

This episode was about bringing awareness about other factors that can affect thyroid antibodies. If you haven’t noticed, I have been focusing a lot of episodes on thyroid antibodies. Late 2024 into early 2025, I had a six-part podcast series on thyroid antibodies. It was really well received. It’s a big problem with a lot of people. Just about everybody with Graves’ and Hashimoto’s has elevated antibodies. Some people have false negative antibodies. Most people will have elevated thyroid antibodies, and it can be a challenge to decrease them. 

I figured let’s revisit some of the topics that we didn’t talk about as much. I had an episode where I spoke about mercury amalgams and root canals, talking about oral health. I did have an episode in the six-part series that spoke about stress. I didn’t differentiate much between stress and trauma. 

Since then, a few things have happened. I mentioned having Dr. Evan Hirsch on the podcast. I also have been going through nervous system retraining myself with the practitioner program. I will talk about that resource soon. 

Antibodies that stay elevated. They’re not always a judgment on what you’ve done so far. They’re pretty much an invitation to look into places we don’t always think about, like how past experiences still may be shaping your immune system. It may mean the nervous system is carrying old stress and traumas that haven’t been given a chance to be released. 

It might be frustrating to some people, but I also hope that it’s giving you hope. Once those patterns shift, the immune system could start healing again. The nervous system affects everything. 

This isn’t just based on my recent training. Remember, my background is as a doctor of chiropractic. A lot of people think of chiropractors as neck and back pain doctors. We really focus on the nervous system, focusing on spiral vertebral subluxations, which relate to the nervous system. Not going to get into this here.

In any case, most people in this situation who get stuck, especially if it’s been a while. Maybe you have done additional functional medicine testing. You probably don’t need more protocols to follow. What you probably need is a way to step back, connect the dots, see if deeper factors like trauma are still in play. 

Using that understanding when weighing a decision about such things as radioactive iodine, thyroid surgery. When someone’s antibodies aren’t decreasing, especially if they’re still taking antithyroid medication, and it’s been a while, and they are working with an endocrinologist, an endocrinologist often will bring those up and pressure them to receive those types of treatments.

If you want to learn more about brain and nervous system retraining, visit SaveMyThyroid.com/Trauma. That will bring you to the program that I have been doing. It’s a little bit different. The program I have been doing is more for practitioners. It’s taught by the same people, but it’s specifically for practitioners. 

It’s smart of them to do this. They are teaching us because they want to help people. It’s a business, too, so of course they want people’s business. There are a lot of people out there who aren’t healing, where this could benefit them. They are trying to get the word out to practitioners like me.

Before wrapping this up, for those with hyperthyroidism who are considering radioactive iodine or thyroid surgery, I want to let you know that recently I put together a live masterclass that was very well received. I did record it. It’s also now available to those who weren’t able to attend live.

In this masterclass, I guide you through three areas that could bring more clarity. The scenario where permanent thyroid treatment truly makes sense and where it may not be the only option. Second, overlooked triggers, including stress and trauma, that could potentially keep thyroid antibodies high. Third, a practical checklist to take with you to your next endocrinologist appointment, where you walk in prepared rather than pressured. 

I don’t want anyone dealing with hyperthyroidism to feel boxed in or rushed into something permanent. What I want is for you to feel grounded, with a clearer view of your options. Whatever you choose feels like it truly fits you. Hopefully, it’s not radioactive iodine or surgery. If you do end up choosing one of these, then I want you to be comfortable with your decision and have no regrets. 

The recording to this masterclass is available now. You can watch it any time. See if it gives you the perspective you’ve been looking for. I think it will. You can also learn more about the masterclass by visiting SaveMyThyroid.com/MasterClass.

As per usual, thanks for tuning into this episode. Hope you found the information to be valuable. Of course, I look forward to catching you in the next episode. 

Recently, I interviewed Dr. Jen Pfleghaar and she shares insights from her new faith-based book The Perimenopause Reset. We talk about hormonal shifts, environmental toxins, gut health, and stress and how nutrition, and simple lifestyle changes can restore balance. She also explains the correct fasting method according to your menstrual cycle, and how certain peptides may help in easing discomfort and supporting sexual health. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

I am super excited to chat with the return guest, Dr. Jen Pfleghaar. Dr. Jen, welcome back to the Saving My Thyroid podcast.  

Dr. Jen Pfleghaar: 

Thank you! Thanks again for having me back. 

Dr. Eric: 

Let me quickly go through your impressive bio. Dr. Jen Pfleghaar is a double board certified physician in emergency and integrative medicine. She went to medical school at Lake Erie College of Osteopathic Medicine. She completed her training at St. Vincent’s Mercy Hospital, and she did her fellowship at the Andrew Weil Center for Integrative Medicine. 

Dr. Jen brings more than just expertise to the table; she co-authored Eat, Sleep, Move, Breathe: A Guide to Living a Healthier Life and serves on the board of Invisible Disabilities Association. She is part of the American Osteopathic Association’s Bureau of Osteopathic Research and Public Health. 

Her passion for healing isn’t just professional; it’s personal. After being diagnosed with Hashimoto’s, Dr. Jen dove deep into the world of autoimmune conditions, hormone imbalances, and thyroid health. Now, she is on a mission to guide others toward better health. 

Of course, her new book, The Perimenopause Reset: 28 Days to Energize Your Body, Shed Weight, and Find Peace with God is a faith-based guide that helps women restore their health, renew their energy, and reconnect with god during menopause. 

When she is not sharing insights on Instagram or YouTube or running her health hub at HealthyByDrJen.com, you will find her cheering on her four children, spending time on her mini farm in Tennessee, lifting weights, or soaking up wisdom form her favorite book, The Bible. 

Dr. Jen: 

Thank you for that, Dr. Eric. 

Dr. Eric: 

We have to let people know about your background. Very impressive. Very excited to talk about your book.

The first question is: What inspired you to write your new book? Also, how does it differ from other books out there on perimenopause? I know one way is you mentioned it’s a faith-based guide. 

Dr. Jen: 

Actually, to be honest, I was praying last year/two years ago. I always thought I would write a book on thyroid because of my Hashimoto’s and reversing it. “Lord, I have just been doing what I thought you wanted me to do. I never asked.” I heard while I was silent in prayer, a book on perimenopause. I walked out that obedience. 

It was crazy. The last decade, practicing integrative medicine at a brick and mortar in northwest Ohio, the majority of my patients were perimenopausal women. Not only their body feels like it’s being attacked, but they are gaslit when they go to their conventional doctors or even their OB/GYN. They are spiritually attacked. 

We know the enemy waits until we are alone. The sheep that wanders off from the flock, they are alone, so they are the ones the wolves are going to go after. In perimenopause, we feel isolated and alone. We don’t always want to talk to our friends or husbands about how our body is changing and how we just feel crazy at the end of our cycle when we never have before. There are all these big changes that are happening.

I feel like the faith-based part of it is so important because it’s mind, body, and soul/spirit. We need to address all three. I have patients who are on the perfect supplements and hormones, and they still don’t find that peace. That’s what we’re all looking for: peace and purpose. This book ties in that part. 

A teenager could read this and pick up some wisdom from it. Post-menopausal women could read it. It gets you to know your hormones. As you know, “physician” in Latin means “to teach.” That’s what it’s all about. It’s about teaching patients to know more about their bodies, so they can be part of the solution, not just someone to write a scrip pad to or tell what to do. They should be part of the team in their healthcare.  

Dr. Eric: 

I’m glad you mentioned that. Obviously, it’s targeted for women in perimenopause. One day, they could benefit from it. You talk a good amount about the impact of environmental toxins on the hormones. It’s getting worse and worse. I wasn’t going to start out with that, but why not. Let’s talk a little bit about the impact of xenoestrogens and all these other chemicals, how they wreak havoc on our hormones. 

Dr. Jen: 

Thyroid included. 

Dr. Eric: 

Exactly. 

Dr. Jen:

It’s really hard. I will say the book, too. Men should read it also or at least skim through it. If you look at divorce rates, a lot of them are when a woman is between 30-50. They are going through that perimenopause change. Men learning this can be really helpful, too. 

It’s kind of scary. This isn’t to invoke any fear, just facts here. We need faith over fear here. Our environment is really toxic. What filters a lot of those toxins are our liver. Women’s livers are so important for detoxifying estrogen and getting it through there the right way. A lot of these environmental toxins can clog up the liver, and our estrogen is not being broken down and removed correctly.

A good example is mold. I talk a lot about that in the book because mold is a really sneaky environmental toxin. 50% of homes can have mold in them. Recognizing how that can wreak havoc on hormones is important. 

We also have environmental toxins like xenoestrogens, as you mentioned, that actually go in there and can bind to the estrogen receptor and activate it, or inhibit estrogen from binding there. We have all sorts of problems in the environment. 

A lot of this is plastic or BPA. I struggle with this because I like a good Poppi or Olipop in the afternoon. The can is lined with BPA. It’s everywhere.

Did you see that study, how the glass top on the bottles had more BPA than can linings? What can we drink? So frustrating. It can be really difficult. I go through all of those things.

Just being aware of it, so you can make small changes. No one will be perfect. What are you storing your leftovers in? Is it in food-grade silicone or glass? Is it in plastic or Tupperware? This can leach into your food. Simple things. Even heavy metals. Aluminum baking pans. You should be putting down parchment paper or cooking in glass. These really easy swaps can help. 

I talk about in the book a story for myself about how I had this non-stick wok that was so nice for frying. I made chicken nuggets that were gluten-free for my kids. I wouldn’t throw this non-stick wok away. It was the only non-stick pan we had in our kitchen. I had to throw it away. Even though it worked so well, it’s hard to let go of some of these things that are leaching into our body and causing problems with our hormones. 

I share a lot of the stories because even though I had everything non-toxic in my kitchen, it was hard to let go of that thing. I get it. You want your eggs to slide across the pan. It’s not worth having forever chemicals inside of you that are interacting with your thyroid, your hormones, causing inflammation in your body. 

It’s tough. Our environment is toxic. You have to do what you can in your home to make it as non-toxic as possible. 

Dr. Eric: 

Agreed. Like you said, no one is going to be perfect. There is a lot that we can do. Many people, including myself, years ago, also had non-stick pans, things like the George Foreman Grill with the Teflon and stuff like that. 

Dr. Jen: 

Slides right off. It’s toxins. It’s hard. Listeners, don’t get overwhelmed. There are things that are just toxic. I wear contact lenses. Yes, there is some forever chemicals in them. I have tried the ones that are clean, and they don’t work. I can’t function. You have to pick your battles. I know people who travel with their own pans when they go to an Airbnb. It depends on how intense you want to get. 

Is this really causing so much stress for you that then is hurting your adrenals, thyroid, hormones, and blood sugar? It’s definitely balance when we look at some of these environmental toxins. 

Dr. Eric: 

Exactly. Just try your best. You won’t be perfect. Just one of those things where you not only need to minimize your exposure, but also do things to increase the elimination of these toxins. 

You mentioned the metabolism of estrogen and having a healthy gut. Microbiome is important for optimal health and detoxifying. Do you do functional medicine testing to look at the metabolism of hormones and the gut microbiome? 

Dr. Jen: 

I use stool testing to see if you need more support with how you remove estrogen. Beta glucuronidase, if that’s really high, it’s an enzyme that will be recycling estrogen. If people have dysbiosis or an unhealthy gut, they can recycle toxins and estrogens. If you’re not eliminating properly, it will be hanging out there. 

One way to look at how estrogen is broken down in the liver is to do an estrogen metabolite urine testing. That’s really helpful to see how you break it down. Me versus my mom versus my friend, we are all going to break down estrogen a little differently. It’s nice to see where it’s not moving. It’s like a conveyor belt that gets stuck somewhere because something is not working, or someone is not taking the part off right. 

If you go to a Jeep factory and watch how everything moves perfectly, if one person is not doing their job, it will all affect the whole manufacturing system. This is like our hormones. If phase 2 is not working properly, that will back up, and we will have toxic intermediates. That’s important also. You can get that test, or you can support the pathways. 

Dr. Eric: 

If you do the test and see an elevation of those toxic metabolites, like a 4 hydroxy for example, what approach do you take? Do you have the person take DIM or sulforaphane? Or do you have them eat a lot of cruciferous vegetables? A combination? 

Dr. Jen: 

A combination. I have DIM. Sometimes, I have them take that two weeks out of the month. A few studies show that if you take it continuously, it can affect testosterone. I take it every once in a while. 

I try to do a lot of broccoli sprouts. Make my handmade burger patty with an egg on top and bacon. My favorite meal. I will put broccoli sprouts on there. You can get that from food. Broccoli sprouts are really high in sulforaphane. 

Supplements can be helpful. One supplement is called Liver Aid. It has a bunch of herbs that support liver detoxification. Often, our liver is just not functioning as well because of the environmental toxins or alcohol. That’s important.

Also, NAC or glutathione is very important for phase 2 metabolism. Sometimes, that is where women get stuck a lot. They’re not going down the good pathways. 

It’s very important when we look at the urine metabolites that you look at where you’re stuck and why. Like I said before, mold can clog and stress the liver. Alcohol stops estrogen from being metabolized in the liver because alcohol is a toxin. Your body has to get rid of it, so you don’t die. You will do the estrogen later.

That’s why it’s very interesting if you follow the allowed alcohol allowance before it affects your health. For women, it used to be 1-2 glasses a day, and you won’t go over that. Then it was one glass a day, and you’re fine. Now it’s zero. If women have any alcohol, we now know that increases your risk for hormone-driven cancers like breast cancer. Men can have one drink, and it won’t affect anything. 

It’s very interesting because especially during the pandemic, all of these people- We were in Ohio, and our governor is DeWine. People would make it a thing. He’d come on every night at 3 or 4 to give an update on the situation, and everyone was like “Wine down with DeWine.” That is the worst thing you want to do for your health: drinking copious amounts of wine. 

We have to be careful as women. I know women are targeted for advertising for alcohol or making it cool. It’s not. Really watch your alcohol intakes, especially heading into perimenopause. 

Dr. Eric: 

Do you think it’s okay to have an occasional glass of wine? Once a week, let’s say?  

Dr. Jen: 

Alcohol is a poison, right? I am not into the fad of everyone drinking THC because you shouldn’t be driving or operating vehicles with that. There are more natural things like L-theanine or DHHB or peptides or oxytocin that can regulate us. Vagal nerve stimulation, right? 

Tonight, I am going out to dinner with my husband. I will have a smoked old fashioned, right? I am not drinking to escape. I am not drinking to cope. I know it’s a bad decision for my health. Same decision if I would have woken up today and not have lifted weights. It’s all risk and benefits. 

If you have true informed consent of what it’s doing to your body, and you will trade off on that. I don’t like to be legalistic about religion or health. We can’t be so legalistic about it. We need to have informed consent. 

The study is really for women, no. None of it. Wine, yes, there is resveratrol and some positives, but there are sulfites in a lot of them. It’s a balance. 

I’ve had patients come to me who have seen other providers, and they were on really stringent elimination diets. It was stressing them out. They got worse. We need to have a balance.

Do I feel better when I don’t drink alcohol? Yeah, that’s why I usually don’t drink a lot. But I like my smoked old fashioneds. Now that we moved to Tennessee, I fit in. 

Dr. Eric: 

There you go. I’m not a wine drinker, but I have a lot of patients ask if it is okay to have a glass of wine once a week. I’m with you. The less you can drink wine, the better. If that’s the worst thing someone is doing, is having a glass of organic wine once a week, and everything else is pretty good, it’s probably okay. 

Dr. Jen: 

Yeah, it’s the why behind it, too. Why are you doing it? Is it to escape? Is it to feel buzzed? You have to be careful. It’s a slippery slope. If someone is going to have one or two drinks once or twice a week, let’s see what else is going on with their body. It probably will be okay, but they still have to know what it’s doing to their body. 

Dr. Eric: 

It also depends on where they are. If someone is starting with me, the first few months, I will encourage them to take a break from wine completely. Not only is it a toxin, but it can affect gut permeability. I want to do everything we can to optimize healing. It does depend on the person. 

Dr. Jen: 

Personalized medicine. 

Dr. Eric: 

Exactly. Let’s take a step back and talk about the basics. How estrogen and progesterone are affected during perimenopause. Also, if someone is doing a blood test, since you have those fluctuations of hormones, how do you test? What day of the cycle do you test? 

Dr. Jen: 

Perimenopause is defined as before menopause. Menopause is a year without a menstrual cycle. Perimenopause can be five years or 10 years. It’s pre-heating an oven. If you preheat your oven versus your neighbor’s or a friend’s, they will all preheat at different times. We can’t just say it’s a hard and fast rule for everyone. 

I will have some women in their mid-30s have perimenopausal symptoms. This isn’t an overnight, bam, here we are. It’s gradual. Your body is aging. Your progesterone is gradually going down. Your estradiol is going down. Then we have these fun surges in estradiol, and it can be up and down. Some cycles, you have extra estrogen because of how FSH is looking at the follicles that aren’t as robust as when you were younger. We are having this fluctuation of estradiol. 

My mentor, Dr. Pam Smith, she is very conservative—so am I because of her and what I’ve seen with giving hormones and how you do it. Because that estradiol is up and down, we usually don’t replace estradiol during menopause, just progesterone. 

Progesterone, we know it’s declining. Progesterone is what is really shining during that luteal phase of your cycle, that second half. You have bleeding, then the follicular phase up until ovulation, then ovulation, then until the next cycle, the luteal phase. 

The luteal phase is what starts to go wacky for women during perimenopause. They are more irritable. They might have anxiety. They have weight gain. They have heavier cycles, cramps. Some of them have never had these symptoms, and they are changing. What is going on? That is because progesterone is declining, and estradiol is still there. We are just getting a big gap in between them. They are having more estrogen dominant cycles.

When we give a little progesterone or use herbs like chaste tree berry to smooth that up, that can really help. 

When I check hormones on women, I check them on day 19-21 of their cycle. I am most interested in where their progesterone is at its peak, which would be day 19-21. 

You can do serum testing to start with. Sometimes, they want to use their insurance, or we are checking other labs, so we grab a baseline there. If they are going to be on hormones, especially topical hormones, we need to move to saliva testing. Some people are also using blood spot, but I like saliva better. It’s telling you what is actually active in the tissue as opposed to serum testing, where these hormones could be bound. They are not as accurate, especially when you are doing topical, which is going right to tissue replacement. We won’t see that in bloodwork. 

I have had many case studies, where patients have come to me on estradiol. Some on oral estradiol, which is terrifying. They were post-menopausal, and they just kept getting increased and increased dosing because their OB-GYN and practitioner said their serum testing shows it’s still low. It’s not the right way to test. 

Then I get their saliva testing, and they are massively overdosed on estradiol. Then their progesterone is where it should be; it’s fine. That’s a big gap. When we don’t have progesterone to protect our breast tissue, our endometrial tissue, that is a recipe for disaster, for cancer, for DNA damage, and bad things to happen. 

In the hormone world, there is a lot of concern with a lot of things. It’s the wild west out there. It’s terrifying. You have to go to someone. Did they take a weekend course? Did they take a real course? Pam Smith has a personalized medicine course, which is great. Did they do an integrative medicine fellowship? Are they able to prescribe hormones, or are they telling you to order it from their website and rub it all over your body? I had that happen to a patient. It’s scary. 

We want to start low and test, not guess. For perimenopause, progesterone is what we’re doing during the luteal phase. Then we adjust that as they get closer to menopause. 

If you are having saggy skin because you’re getting closer to menopause, and your estrogen really is lower, or your vaginal health is not good, we can do some topical estriol to support that while we transition to menopause. 

Yes, it’s still personalized. There are case areas that we are going to be more sophisticated and might use a little bit of estradiol, if you are getting your period only every nine months. That happens to patients. I’m at nine months, and they get a little cycle. We want first to do no harm. 

With hormones, especially post-Women’s Health Initiative, when they scared women from using hormones because they were studying conjugated equine, synthetic estrogen, and progestin, synthetic progesterone, women are scared of it. Doctors don’t know how to use hormones. This is where I feel like women are just really not taken care of during this time. That goes back to how they feel alone, gaslit. They are just not doing okay. 

Anyway. I’m really passionate about this. I know that women can feel good all the time. They can feel better than they did in their 20s in their 40s. 

Dr. Eric: 

Great to hear. I can definitely tell how passionate you are about this. 

Just to confirm, when someone is in perimenopause, and no estrogen, just progesterone, and they would only take progesterone in the second half of the cycle/the luteal phase. Same thing, if you were to give chaste tree berry? 

Dr. Jen: 

For the most part, progesterone during the luteal phase. Oral extended-release dosing is really helpful because it helps with sleep. A small percentage of women don’t tolerate that, so we go to topical. 

This would be the same recipe for someone in their 20s who is having very irregular periods. They are very estrogen dominant. We put them on a luteal phase progesterone topical if they are younger usually. We work on their estrogen detox. Then they are fine without nasty birth control.

I say “nasty birth control” because it’s awful. We all know that now. I don’t even know how they can still prescribe it honestly. 

The chaste tree berry. If someone is in their 20s or early 30s, that’s great. That works centrally in the brain to support your body making more progesterone. We will give that for at least three months, and then you can recheck labs. That’s given every day. It’s an herb, and it’s working differently. You let your body’s natural secretion take over. That can work really well. 

Some women are really responsive to it that they don’t want to do progesterone. If women are in their late 40s and are just showing perimenopause symptoms that are bothering them, and we test, let’s just go to progesterone. Your body is not going to be really awakened to make a bunch more. It depends on where they’re at. I also try to work with my patients on how their convictions are and how they feel, if they want to wait and try a supplement. 

Dr. Eric: 

Makes sense. Let’s talk about stress. How can chronic stress impact the hormones? Not just emotional stressors but physical stressors, overtraining. 

Dr. Jen: 

We know chronic stress can affect cortisol and the adrenal glands, but it can also affect your thyroid. You can gain weight. It really hurts progesterone. When we look at the hormone cascade, we have progesterone, and progesterone turns into cortisol. I like to say to protect the progesterone, and let’s keep your stress and stressors down. Really keep that progesterone. We see chronic stress can really affect menstrual cycles. Usually, it’s that luteal phase defect of progesterone.

Think about people doing chronic training or cross-country or marathon runners. What happens to them? They skip their periods. They lose their cycles. They become anovulatory. Their body doesn’t feel safe to be able to reproduce. Fertility is a vital sign, and our cycle is a vital sign of our health. Chronic stress and cortisol can affect in perimenopause your cycle and your symptoms.

This could be for a lot of different reasons. We can have stress, like environmental toxins or EBV/mono, stress on our bodies from an illness. We can be chronically fasting in the wrong part of our cycle, and that can cause stress. 

Cycle syncing. I have a whole chapter dedicated to that. It really is important for women to know their cycle and know when they should be fasting. Seeing patients, I’ve noticed that if they do chronic intermittent fasting throughout their whole cycle and just push that more and more, they actually gain weight, and their hormones suffer. It puts stress on their body.

For fasting, or maybe doing carnivore or lower carb, I recommend that during the first half of the cycle. You’re more insulin-sensitive because estrogen is high. You will succeed, and you won’t stress your body out. If I do a longer fast or recommend patients, because I do recommend that they do a 24-hour or 36-hour fast during that follicular phase. 

The luteal phase is when you will just have more calories. Your body will crave more calories. You’re more metabolically unfit. That is when you can lean into some more complex carbs. Make sure you’re not fasting. Eat breakfast. That will take the stress off your body. 

Remember, some stress is good. It’s hormeses. A little bit of stress makes us stronger. Same with lifting weight. You break down your muscle to build stronger muscle. Women are special. We have this great rhythm where our hormones are different each day. We should not be pushing ourselves during that luteal phase. We will just exacerbate the problem we are trying to fix, which for a lot of women is weight loss.

Think about Orange Theory. It’s all about splat points, being competitive, and pushing yourself. Every day, you’re at the gym. No! You’re different during different parts of your cycle. I’ve had patients gain weight doing those HIIT routines chronically. They’re stressing their body out. If you’re stressed, your blood sugar will be affected. Cortisol will be up. You will gain weight where you don’t want it, which is around your belly. 

Dr. Eric: 

Intermittent fasting. First half of your cycle, not second half. You mentioned you will have them do 24-hour or 36-hour fasts. Will you also have them do a regular daily 16-8 fast during their follicular phase? 

Dr. Jen: 

Oh yeah, they definitely can. This is not a hard and fast rule. Today, I’m luteal phase, and I just had a lot of fat in my coffee in the morning. That is sustaining me through. I’m in ketosis, but I’m not technically fasting. There are mornings where I just need to eat. You need to be intuitive and listen to your body and not push through.

I will say I’ve had patients who have done intermittent fasting every day, and they didn’t feel bad doing it. Then we put a continuous glucose monitor on them, and they were spiking when they weren’t eating. We moved her to three balanced meals a day with a lot of protein and fat for breakfast. Then she dropped two pants sizes. She was post-menopausal, but it was very interesting to see that sometimes, we really need that data. We can fool ourselves into thinking what we’re doing is helping. Some people gain weight when they train for marathons, when they do restrictive diets and intermittent fasting.

For women who are frustrated with weight gain or what they’re doing, if you do those 24-hour fasts, great for rebooting gut health. If you were being seen for Hashimoto’s, it’s great to throw one of those in every once in a while to get that gut rested and healing.

If you can push it to a 36-hour fast, that is really good for fat burning. If I have patients struggling with some weight stuff, do a 36-hour fast once a month. Pick it during your follicular phase. Then it takes the guilt off when you know you are going to do more keto, more fat-burning in your follicular phase, and in your luteal phase, you can eat carbs.

I was telling my daughter because our cycles are synced together because we live in the same house. I am eating so many carbs; this was yesterday. It’s always the same part of our cycle. It’s just fun. You’re not restricting. You won’t stress out your body. Then I know my weight will stay balanced because during my follicular phase, I am working with my cycles and my hormones. I can do a 24-hour fast. I can eat lower carb. Wow, I don’t need to be so stressed out all the time about what I’m fueling my body with because I am working with that rhythm. 

Dr. Eric: 

So many women continuously fast throughout their cycles. They are not taking that break during that second half. 

Dr. Jen: 

It’s just so funny. Men, 24 hours, they’re the same. They get the same hormone stuff. For you guys, it’s so different. You’re not emotional about it. You’re just like, okay, it’s food. It’s fun to see the differences. This is why this is helpful for men to know this. Let’s plan stuff around this. You can support your wife to get healthy. 

Dr. Eric: 

Before we wrap up, I want to talk a little bit about peptides. We’ve had you on the podcast in the past talk about peptides. Are there peptides that can specifically benefit those who are in perimenopause? 

Dr. Jen: 

Oh yes. So many peptides always. Depends on what you’re looking for. I know weight is a big one. We know GLP-1s are always on everyone’s mind. I do like these. 

I have non-negotiables with patients with this. As we age and are going through perimenopause and even menopause, you are losing muscle. Every year, you’re losing muscle. It’s harder to keep that muscle. If we are doing one of the GLP1s and we are not eating protein, lifting weights, if we are on too high a dose where we can’t even eat, that is bad news. 

You’re losing muscle. It will be hard to get back, and you might not get it back. You will just be a bunch of flabby skin. We don’t want that. We want strong muscle for longevity and blood glucose control. Building muscle is actually an amazing way to fight insulin resistance and lose weight. If you are getting less insulin resistance, you will lose weight.

I do like GLP-1s because I will have women who are doing everything, and they are stuck in a circle of high insulin. Berberine won’t touch this. Metformin might, but let’s do a lower dose of a GLP-1 because they are already doing all the things, and that will help support them. Like I said, you have to have the right tools.

I will also put them on a peptide called PeptiStrong. That will help maintain that muscle, too, while they are going through GLP-1s. 

Another one that I love is PT141. I pair a little oxytocin with that. I love it as a nasal spray. You can get that as a prescription from a compounding pharmacy from a doctor. 

PT141 helps with sexual arousal. Sometimes, when we are going through perimenopause, we do have more stress. We have kids who are bigger with bigger problems. You are helping them go to college. You have parents who are aging. Plus you have a spouse. Plus you might have a career. There are a lot of things juggling. Everyone thinks it’s low testosterone that is ruining your sex drive. Let’s put you through pellets and damage your heart. That’s another topic, Eric. 

Let’s be honest. Most lack of sex drive is from high cortisol. I like PT141. You shoot it up both nostrils half an hour before you want to be intimate with your spouse. PT141 helps with that arousal, and the oxytocin is our love hormone and bonding. It gives it a nice extra special flare. Men and women can use it. That’s a really nice peptide for perimenopause. 

Of course, I love gut health peptides. If you are stressed in perimenopause and with the changing hormones, your gut can really suffer. I love Larazotide, KPV, and BPC157. The good news is those can all be oral preparations. You can just take them orally as a pill. 

Those can really help support gut health and inflammation if you’re going through an acute, stressful event, or you are working on something. Dr. Eric probably works with a lot of patients with dysbiosis of the gut due to mold or candida or H-pylori. If you don’t have good gut health, that is going to have this downstream effect of your hormones, thyroid, all the things. 

Those are probably some of my top peptides for perimenopausal women. 

Dr. Eric: 

I need to ask you quickly. I don’t have prescribing rights, but you mentioned you’re not a big fan of testosterone replacement. 

Dr. Jen: 

No, I am. This is what happens to perimenopausal women. These med spas prey on them. They don’t know how to dose hormones correctly. I wouldn’t get your hormones from a med spa unless they were trained appropriately. 

Really only a handful of people should be using pellets. They don’t absorb well, or they won’t rub the cream on themselves for five minutes because they’re too busy. I don’t think that’s an excuse. 

What happens is these pellets, they dose women really high on testosterone. Testosterone is a controlled substance. They are overdosed for months. Then they crash. For women, if you overdose testosterone and have low estradiol, that can contribute to hardening of your arteries. We know estradiol is protective. In women, we are not supposed to be on high doses of testosterone. We are supposed to be on just right. I am a big “just right” person, low and slow. We don’t need to overdose anything. 

I argue that that is not functional and integrative medicine. If you are overdosing on supplements, hormones, anything. More is not better.

What I do for perimenopause with women is I have true informed consent with them. I tell them to use supplements to support testosterone because maybe it’s going to DHT or estradiol or estrone. If it’s continuously low, and also building muscle, which can help increase testosterone, we look at DHEA. I have an informed consent discussion with them. I say we can do a topical testosterone, low and slow. We will recheck saliva hormone levels and make sure where we’re at. Like I said, there is no magic pill. A lot of problems are stress and diet. 

I love testosterone. About 20-30% of women need testosterone post or peri. Some women keep making it. Their adrenals. It depends on the patient. I don’t want to say that I have many women on testosterone. 

Dr. Eric: 

Thanks for clarifying. You don’t want to have someone take too much testosterone, which makes perfect sense. 

Dr. Jen: 

But they do it out there. It’s crazy. It’s like a ripple effect. You will feel amazing. If I give someone a shot of testosterone or a pellet, that’s why it’s a controlled drug, you will feel good. Then your body crashes. 

I am sure you get a lot of patients who are overdosed on a lot of things. We have to back up there. Like thyroid medicine? That’s another example. T3. It has consequences. If your T3 is really high, palpitations, increased risk of congestive heart failure. We have to get back to balance and homeostasis. 

Dr. Eric: 

Agreed. I see the opposite, too. Those with Graves’/hyperthyroidism who are on too much antithyroid medication. That makes them hypo. 

Dr. Jen: 

The methimazole. 

Dr. Eric: 

Exactly. 

Dr. Jen: 

That’s one of the hard things. That’s why we’re patient advocates. We’re there for you. It’s personalized. Everyone is different. 

Dr. Eric: 

Agreed. This was an amazing conversation. Check out Dr. Jen’s book. Let’s tell everybody where they can find out more about you, where they can get your book. 

Dr. Jen: 

I’ll keep it really easy: DrJenBook.com. If you go there, you will find out more about the book, the freebies given with the book, and all the fun stuff. 

I have a website, HealthyByDrJen.com. I have a bunch of free information and protocols and blogs on there. 

I hang out more on Instagram, @IntegrativeDrMom. YouTube also. I have videos on there, like our mini farm, lots of education. You can take control of your own health. 

Dr. Eric: 

Awesome. Thanks again for hopping on the podcast, chatting about your book. I know there is a lot more great information in the book. I’m sure listeners are excited to get a copy of that. Again, thank you for joining us. 

Dr. Jen: 

Thank you so much.

This episode explores the real benefits and limitations of LDN for autoimmune conditions like Hashimoto’s and Graves’ disease. I share what the research actually says, why results are mixed, and why LDN should never replace the foundations of thyroid healing. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

Have you ever come across low dose Naltrexone (LDN) as a way to lower thyroid antibodies? Maybe you have even wondered, is this the missing piece for me? LDN gets a lot of attention because it can modulate the immune system in certain cases. 

Here’s the challenge. It doesn’t work for everyone. Some people see their thyroid antibodies drop. Others notice no change at all. A few even struggle with side effects. The real danger comes when LDN is assumed to be the answer. If it doesn’t deliver, you’re left feeling discouraged, questioning your next move. The lack of results might even be the last straw and cause you to choose radioactive iodine or thyroid surgery. Or if you are dealing with Hashimoto’s, the only solution is to stay on thyroid hormone replacement permanently. There is a time and place for this, but the point is, if you take LDN and it doesn’t work, there are other options. 

In this episode, I do want to walk you through what LDN can and can’t do and how to think about it in the bigger picture of thyroid healing, especially if you’re trying to decide whether you’ve truly explored your options before committing to something permanent. 

Let’s briefly talk about what LDN is. I have spoken about this in other episodes. I have had guests also talk about LDN. Naltrexone was originally used for opioid addiction. At lower doses, hence the name LDN, it can modulate immune activity as well as reduce inflammation. Typically, for years, doses like 1mg-4.5mg or 5mg were used. Still to this day, it’s used. I’ve had practitioners on the podcast who mentioned they are using a little bit higher doses, up to 10mg or 12.5mg, which apparently is still considered to be low dose. 

As far as why LDN is considered in autoimmunity, the main reason is because it has the potential to calm the immune overreactivity in autoimmune conditions such as MS, Crohn’s, Hashimoto’s, and Graves’. 

As far as the research goes, it is limited. There is not a lot of studies showing that LDN is successful in lowering thyroid antibodies, or auto antibodies. When it comes to thyroid antibodies, I am pretty sure there is no research I am aware of specifically showing that LDN can lower antibodies in those with Graves’ and Hashimoto’s. 

That being said, over the years, even though most of my patients with Graves’ or Hashimoto’s don’t take LDN, I have had a good amount taking LDN from a different practitioner. Also, I’ve had practitioners on the podcast, like functional medicine practitioner who recommend LDN to pretty much all of their autoimmune patients. The reason they do that is because they see results, maybe not in everybody, and we’ll talk more about that. It’s an option to consider. If you are looking for research in the published journals, specific to Graves’ or Hashimoto’s, you probably won’t find anything.

Let’s talk about the upsides and downsides, starting with the upsides. Overall, LDN is safe. It is a medication, but when compared to, let’s say for those listening to this who have Graves’, and are familiar with antithyroid medication such as methimazole and PTU, those come with a lot of side effects. Some people tolerate them well, but they are known for their side effects. 

For Hashimoto’s, taking thyroid hormone replacement, side effects are minimal. 

With LDN, there are potential side effects such as sleep disturbances, which can be common. Most people do tolerate it. It’s also low cost and easy to get, especially in the United States. If you have a local practitioner who isn’t willing to prescribe LDN, you can visit a website. One of the ones I like is LDNDirect.com, where for about $100, you can speak with a practitioner remotely, and they almost always will prescribe LDN.

If you live overseas, there is LDNScience.org. You can use this in the United States, too. You can also go to your local pharmacy and ask them if they know anybody local who prescribes LDN. 

There is the upside that it can potentially modulate the immune system. Also, side effects are minimal. Low cost. Not too challenging to get a prescription in most cases.

As far as the downsides and limitations, it does not address the root causes. LDN is not a substitute for eating a whole, healthy foods diet; managing your stress; getting sufficient sleep; incorporating regular movement; healing your gut; reducing your toxic burden. Assuming you want to address the cause of the problem, you still want to do that.

Another downside is some people don’t tolerate it. I mentioned sleep disturbances as common. Mood shifts, sometimes headaches. Not as common. Sleep issues are somewhat common. Some people take it at night, and they have issues sleeping. Their prescribing doctor recommends to take it earlier in the day. 

Another downside is the risk of false hope, or should I say unrealistic expectations. Thinking that that will be it. I take LDN, and everything is great. To be fair, there are some people who take LDN, and that’s all they do. Just like some people take thyroid hormone replacement with Hashimoto’s, and that’s all they do. 

The difference is that thyroid hormone replacement is hormone replacement; LDN is modulating the immune system. Either way, neither one are doing anything for the cause of the problem. 

One can argue that LDN is better in a way because thyroid hormone replacement isn’t doing anything for the immune system component of Hashimoto’s. Someone might take thyroid hormone replacement, and the immune system is still damaging the thyroid gland. If LDN is working, it should prevent that from happening. Even if it does work, it doesn’t always work long-term. 

That’s another downside. It is hit or miss. I think moreso with Graves’ than Hashimoto’s, for whatever reason, it’s more miss. It can work with Graves’, but that’s something to keep in mind. It doesn’t work in everyone. Even if it works, and you choose to take it long-term, it might stop working. 

It is an option to consider, especially if your endocrinologist is pressuring you to get radioactive iodine or thyroid surgery with Graves’, and you are not doing well with antithyroid medication. Maybe you have even tried natural agents such as bugleweed or higher doses of L-carnitine, which also didn’t help, so you’re stuck. I really don’t want to get surgery or radioactive iodine. Maybe you are looking into something like LDN.

I mentioned how LDN is hit or miss. Over the years, I’ve had a decent number of people take LDN. I don’t have prescribing rights, so I am not prescribing it. They’re either working with another functional medicine practitioner while working with me who recommends LDN. 

A lot of times, what happens is they took it in the past, or they are working with me now but in the past took LDN. I have had cases where someone took LDN, and it really didn’t work, or maybe had minor improvements. No major antibodies shifted. They came to see me, and we addressed the underlying cause of the problem. 

Admittedly, this is challenging. I am not making out like it’s easy to do that. Again, I have seen cases where the LDN didn’t help, and they saw me and we addressed the cause of the problem, and it did help.

Another challenge is if you are taking LDN and simultaneously trying to address the cause of the problem. If you have antibodies lowering significantly, you don’t know if it’s related to the LDN or the natural approach. You would hope it’s related to the natural approach, but you’re also taking LDN for that purpose. You really wouldn’t know until you stopped taking the LDN under the guidance of the prescribing practitioner. 

Everything comes down to risk versus benefits. If you feel like you’ve tried everything, if you have changed everything diet; blocked out time for stress management; are getting sufficient sleep; are doing things to reduce your toxic burden; maybe even did some functional medicine testing and found some triggers; no matter what you tried, nothing worked. Your antibodies still remain high. 

Even though LDN is not addressing the cause of the problem, if you’ve tried everything, maybe that’s something to look into. I just wanted to remind you that it shouldn’t replace the foundations of healing. There is a time and place for functional medicine testing. 

Sometimes, you may try something like LDN. You might expect clear progress. The thyroid antibodies gradually are improving over time. Remember that healing isn’t linear. It’s not just with LDN, as we are not really healing with LDN, but taking a natural treatment approach. 

Everybody with a natural treatment approach will gradually see their antibodies decrease as they normalize, we hope, but sometimes it’s more of a rollercoaster ride. Sometimes, people hit roadblocks. Keep in mind, if one approach doesn’t deliver, it doesn’t erase the possibility of improving through other avenues. It’s easy to try many different things, whether it’s medications, supplements, protocols. What really makes a difference is clarity, knowing which tools are making an impact and which ones aren’t, and where your focus truly belongs. 

Because this crossroads is so common, I did put together a recorded session that you can go through at your own pace. In it, I walk you through three areas that can make these decisions less overwhelming. 

First, when permanent treatments like radioactive iodine or thyroid surgery are truly necessary, and when they are not the only option. Second, the overlooked triggers that keep thyroid antibodies high, even when things like LDN don’t make a dent. Third, a decision checklist you can use with your doctor, so you can feel more prepared and less pressured in your visit.

Too often, the conversation around medications like LDN becomes black and white. Either take it, or don’t. Most practitioners don’t recommend it at all. There are functional medicine practitioners who recommend it to all their autoimmune patients. 

I want you to feel like you have more than two boxes to check. You can make a decision that reflects your unique situation. If you ever pin your hopes on something like LDN, and you have felt let down, this class can give you the perspective you have been missing. It’s available right now. You can go through it at your own pace. Or you can also visit SaveMyThyroid.com/Masterclass. 

I’d like to thank you for taking the time to listen to this episode. Hope you found it to be valuable. Of course, I look forward to catching you in the next episode. 

Recently, I interviewed VJ Hamilton,  The Autoimmune Nutritionist. We talked about overcoming alopecia areata and other forms of hair loss by addressing root causes. We dive into nutrient deficiencies, gut health, thyroid imbalances, and inflammation and how functional medicine can help hair grow back naturally. If you would prefer to listen to the interview you can access it by Clicking Here.

Dr. Eric Osansky: 

I am super excited to chat with VJ Hamilton. We are going to have a conversation on hair loss and alopecia. Let me go ahead and dive into VJ’s impressive bio here. Then we’ll start chatting about hair loss. 

VJ Hamilton, also known as the Autoimmune Nutritionist, is the founder of the Autoimmune Nutrition Clinic and a registered nutritionist specializing in reversing hair loss, particularly alopecia areata and other autoimmune conditions. 

With a medical science degree in biochemistry and immunology and certification from the Institute for Functional Medicine, VJ combines scientific expertise with lived experience to deliver evidence-based personalized therapy. Thank you so much for joining us, VJ. 

VJ Hamilton: 

Thank you. I’m excited to be here, Eric. 

Dr. Eric: 

This will be a great conversation. Unfortunately, a common problem. A lot of people experience hair loss. Definitely a lot of women with hyperthyroidism and hypothyroidism, thyroid hormone imbalances, a lot of people have alopecia areata, which is autoimmune. 

Let’s talk more about your background. How did you become interested in hair loss? You work with other types of autoimmune conditions. There is a personal story when it comes to hair loss, correct? 

VJ: 

Yeah. When I was seven years old, my parents discovered a circular patch of hair loss at the back of my head. I went to a dermatologist and was diagnosed with alopecia areata. We didn’t really explore any root causes back then in the late ’80s. I was asked about stress. As a seven-year-old, I liked school and took it quite seriously. I had a few unsettling things happening at home with my parents splitting up. That was probably a factor. We didn’t think any more of it. 

My mom was training as a nurse at the time. She switched my breakfast from cereal to eggs, which was quite forward-thinking. They gave me a steroid cream. My dad applied it every night, and my hair grew back. 

Unfortunately, my hair kept coming out in cycles, especially after stressful events or being ill. This went on and on for many years, 25 years. I had some success with different protocols I followed. I did develop other conditions like psoriasis and chronic fatigue syndrome (CFS). 

I discovered functional medicine. I’d been to university to do my science degree. I discovered functional medicine and nutritional therapy in my early 30s. I was living with chronic fatigue syndrome at the time and thought I couldn’t live with it any longer. The alopecia was something I was used to managing. The psoriasis, I was managing. The CFS, I needed to do something about because I couldn’t live a normal life. 

By working on my gut, nutrient deficiencies, thyroid health, all these different aspects, my hair grew back. I was thinking, if it grows back for a year, that’s the best it’s ever been. It grew back for a year. I was thinking, how long has it been now? From there, it has grown back, and it has not fallen out again, which was over nine years ago now. My fatigue reversed. My psoriasis went away. I had niggly things going on with joint health and other skin issues. Everything reversed by taking that root cause approach. 

That is how I work with clients now. We really work on the underlying imbalances, any triggers that might have caused the hair loss. I work with all different autoimmune diseases, but I work with a large amount of clients who have hair loss. People hear my story. When you are working with anybody who has been through something yourselves. That’s why you work in the area that you work in as well. People like that you’ve lived it. 

I find that everybody’s root cause is different. I am very passionate about helping people with hair loss. How it can affect you, especially when I was a child. It can make you feel self-conscious. It can affect your self-confidence. Because it is showing that there is an underlying imbalance that needs to be worked on as well. 

I work with children and adults with alopecia. It is really rewarding when you see somebody grow their hair back and get their life back. It’s not to say that if you haven’t experienced that- We should accept everybody as they are. There can be that sign if you are losing your hair that there needs to be a health issue that needs to be worked on. That’s what I find with my clients. Once we work on that, their hair grows back like it did for me. 

Dr. Eric: 

You said that you had severe fatigue, which is no longer a problem. You also said you had psoriasis, so I assume that is also resolved? 

VJ: 

Yes. Everything resolved once the fatigue resolved. The fatigue was the first thing to reverse, if you want to call it that. I had a realization one day that I wasn’t fatigued anymore. I just lived with it for such a long time. I thought, actually, I can exercise, and I am not feeling tired for five days. I can wake up in the morning and not drag myself out of bed. I am not falling asleep on the tube anymore. I am able to work through the afternoon without feeling like all I can focus on is staying awake. There were subtle changes. One day, I realized the fatigue is gone. 

Then the hair started growing back. The psoriasis took a little longer. Once I was getting better and making changes with my gut health, I had a few flares. I got hives at one point. I had different outbreaks as part of getting better. All the skin issues then resolved as well. I rarely react to insect bites anymore, and that was something I was really reacting to at one point as well. It just shows that by working on the nutrient deficiencies, the gut health, the energy system in the body, it has an effect on so many areas. 

Dr. Eric: 

Agreed. With alopecia areata, that is autoimmune, just like Graves’, Hashimoto’s, MS, etc. There are also non-autoimmune causes of hair loss. When you deal with someone who doesn’t have alopecia areata but a different autoimmune condition that has hair loss, what are some of those potential causes? 

VJ: 

Sometimes, it can all go down to the same root causes. It’s all about the hair growth cycle for the most part. Alopecia areata is an immune condition rather than a hair issue. Sometimes, it can be that somebody doesn’t have the nutrients to grow their hair. Or they go through a stressful event and have telogen effluvium, so that’s a factor for somebody. 

The cycle of hair growth. Most of the time, you want your hair to be in the growth phase. It will detach from the hair follicle. Even when it’s detached from the hair follicle, it hasn’t come out of the hair follicle yet. 

When I am working with clients who have alopecia or hair loss, it sometimes is something that happened a couple months ago, and then they are seeing the shedding. What happens when you’re stressed or have a thyroid condition or toxicity or stress around the hair follicle or nutrient deficiencies like ferritin or iron, it pushes the hair into the telogen phase, which is where you start losing your hair and get shedding of hair. That’s what’s happening with some other forms of hair loss. 

That can be to do with gut health. If you’re not digesting your food and absorbing your nutrients, you might not be getting enough protein or iron in your diet. You might not be absorbing it in your gut. You might be low on B vitamins or zinc. All of those things can affect hair loss.

Stress in and of itself could be the trigger for hair loss. It could be the cause of something like alopecia areata or telogen effluvium. When someone comes to me with stress-related hair loss, I am always 90% if not higher confident they will get their hair to grow back, once we get the nervous system calmer, and they have been through that stressful event. 

I don’t think I have ever worked with someone who hasn’t gotten their hair to grow back after telogen effluvium. Sometimes, it can happen after a virus or infection as well. Alopecia areata, there is a bit more to think about because it is an autoimmune condition.

There is female pattern hair loss, male pattern hair loss. The hair follicle gets smaller and smaller. That is a different type of hair loss altogether. In some respects, it’s just a normal process that we go through in life. There are things you can do and nutrients you can think about using that can help with that type of hair loss. 

For the most part, I am working with alopecia areata and telogen effluvium. There are certain autoimmune conditions that in and of themselves can cause hair loss, like Hashimoto’s. It’s one of the symptoms of Hashimoto’s. You could have different types of systemic lupus, where hair loss is a symptom. Certain autoimmune conditions, some of the symptoms can be hair loss. 

Alopecia areata is specifically a circular patchy hair loss. Some people will develop alopecia totalis or alopecia universalis. Totalis is full hair loss of the head. Universalis is full hair loss all over the body and head. Some people will develop that as well, and that is the autoimmune type of hair loss. 

I am assessing the type of hair loss. For the most part, I am working with people with alopecia areata or possibly lupus. 

Dr. Eric:

It sounds like there are multiple causes and factors. You said that the shedding of the hair can happen. It can take time for that to happen. Even if there is a triggering event, it’s not like the person will necessarily notice a loss of hair right away. 

I know the reverse is true, too. When you start correcting the problem, it can also take time to see the hair loss stopping and growing back. 

VJ: 

Yeah, it does take time. I will normally work with clients over a 3-6-month period, especially with alopecia areata. I’d like them to be seeing results by the time we stop working together. Realistically, it can take time. It depends where you are catching the hair growth cycle as well. You want to be in that halogen growth phase. That can take time. 

Part of it is calming down the immune system when I am first working with a client. Stabilizing all of their systems. Bringing down the inflammatory response. Then you think about how you stimulate the hair growth after that and energize the hair follicles. Before that, you want to stabilize everything in the body. That might mean you won’t see any hair growth in that phase. You have to be patient with it and have faith in the process. 

When I am working with clients who are experiencing alopecia, we note other symptoms as well, like monitoring gut health, fatigue, other skin conditions. If we are seeing progress with those, and we know things are changing for the better, ordinarily by the second appointment, they will see growth around that phase. It can be fair hairs to start with, and you do want those darker hairs coming through. This is where we are seeing good growth now. That can take time. Normally, by the second appointment. 

By the third appointment, when clients can see that hair growth coming back, they maintain that because they know what is working for them. They have the right nutrients. Hopefully by the six-month or nine-month mark, they have a good covering of hair. 

That happens with 80% of my clients. I have more complex cases where it is harder to get their hair to grow. There is more going on in the body that can take a long time, a year, 18 months, sometimes two years. Sometimes, honestly, we can’t get it to grow back. That’s just what happens. As long as you’re healthy and feeling good, you can still live a good life without hair. 

The truth is, you can be healthy and have alopecia because it’s normally what happens. Years ago, when you first lost the hair, when there was the inflammation and issues with hair growth, sometimes, and I don’t think there is any evidence of why this is the case, some people find it very hard to get their hair to grow back. If you have left it for a longer period of time to try to do anything about it. I find most success when people notice their hair loss and come to me, and we are almost proactive around it. That’s when I see the best results. 

Dr. Eric: 

When you say inflammation, do you mean specifically gut inflammation or overall systemic inflammation? Or does it vary depending on the person? 

VJ: 

It can vary. A lot of people will say they can feel the inflammation in their scalp. This goes for other autoimmune conditions as well, like lupus. Clients will say their scalp feels like it’s burning, or just before they lost the patch of hair, they felt some tingling sensations on the scalp. That is often a sign of localized inflammation. 

It’s not just about the scalp. It’s probably coming from other areas in the body. It is more likely to be systemic inflammation or gut inflammation driving that. It can be localized and systemic. 

Some people might not have those obvious markers of inflammation either. It could be something going on in the gut. You can do high sensitivity C reactive protein and look more at systemic inflammation that would be caused by an infection, toxicity, or something else going on in the body. It’s not always inflammation. Sometimes, people’s inflammation markers will be really low, and they are still experiencing hair loss. 

Dr. Eric: 

Makes sense. Just because someone has a positive CRP, chances are they have inflammation. If it’s negative, it doesn’t completely rule out inflammation. Same thing, if you do a comprehensive stool test, a lot of people have calprotectins that look good, which is a marker of inflammation. If calprotectin is elevated, you can assume the person has gut inflammation. Just because it’s normal doesn’t mean there is absolutely no inflammation in the gut.  

VJ: 

Exactly. 

Dr. Eric:

I listened to some of your podcast episodes. I know there was at least one where you spoke about hair loss. I think there were a few that I grabbed some questions from. One was the five markers that you recommend for those experiencing hair loss. Can you talk about those? 

VJ: 

The first one, you may have heard of this, especially if you are experiencing hair loss: ferritin. Ferritin is our iron store. It is good to get the full iron panel if you aren’t getting this tested, so you can get a bit of a better sense of why your ferritin levels might be high or low. If you have inflammation, your ferritin levels can be high because of the inflammation. You just need to take it in the context of the markers. 

When your iron stores are very low, it just means that you’re not able to circulate oxygen and nutrients to the hair follicle. It can cause an issue with the immune system as well. Our mitochondria, our energy organelle in the cell, isn’t able to work effectively when you have low iron. 

Your hair follicles need lots of energy to grow that hair. When iron is low, it will be harder to get hair to grow back. It’s like with anything. Growing hair, while it’s growing, still needs all these nutrients. When you’re boosting it to regrow again and get everything calm around the hair follicle, you need to make sure you have enough. 

This can come from diet. If you are following a vegan or vegetarian diet, you might not be getting enough iron in your diet. I was vegetarian for 11 years and didn’t think about that. Red meat and more animal-based products have that active form of iron that is far easier for our bodies to use. It can get more complicated when we are trying to get iron from spinach and combining it with certain nutrients. That is something to think about.

When there are issues with the gut, for example with Celiac, low iron would be a symptom. If you have low iron, but you are eating quite an iron-rich diet, it’s worth looking at what’s happening in the gut. If there is damage in the gut lining, you won’t be absorbing as much. It gives you some information, which is good.

The other markers are of course the thyroid markers. If you can get a full thyroid panel, in the UK, there aren’t normally tests here that give you the full picture. When clients come to me, we often do a full panel. We need our metabolism for that hair growth cycle. 

When our thyroid hormones are low, it’s far more likely to push into that telogen phase. It can also affect the immune system as well. I know when I was younger, my parents were claiming on the health insurance. They came back to me after we claimed a few times. They said I wouldn’t be insured for any thyroid issues. They know there is a link with your thyroid. 

Certain immune conditions like Hashimoto’s, there will be hair loss, and there is a link with alopecia areata. My TSH was all over the place at one point. I know I had been diagnosed with a certain thyroid condition. There was a lot going on. My T3 was really low at one point. That is what I will see. Even if they don’t have Hashimoto’s, they can have very low thyroid hormones.

Next is Vitamin D. The hair follicle is what we call an immune-privileged site. The immune system shouldn’t be able to penetrate it. At the minute, I am pretty obsessed with this barrier function, which I know we have heard so much about the leaky gut. The barriers in our body protect certain molecules or systems or organs from the immune system attack. When that barrier is broken down, that is when the immune system can get to it and cause an issue. 

Vitamin D is really important for modulating the immune system and keeping that hair follicle protected from it. Checking your Vitamin D levels is vital. I would say anybody with an autoimmune condition, if you aren’t checking Vitamin D levels regularly, you really should be. There are so many studies which show that low Vitamin D can cause an issue if it’s related to so many autoimmune conditions, including alopecia areata. There is a study that showed people with alopecia areata were 2-3 times more likely to have low Vitamin D than the average person. That is certainly worth testing.

Your zinc levels are important. Zinc has to be balanced with copper. It’s worth bearing that in mind. With Vitamin D as well, you need to be balanced with Vitamin K and magnesium. Your zinc levels are important for your immune function, hair growth. Zinc needs to be balanced with copper. I find a lot of my clients have a zinc deficiency as well, which can affect the immune response. 

The four main markers are there. Then, from my perspective, I am a bit obsessed with Vitamin B12. Folate is also really important. It’s important for our cells and cellular health and energy production. Our red blood cells as well. They are what help transport these nutrients around the body. They are important for the immune system as well. 

I was always deficient in Vitamin B12, so that’s why I am obsessed. When you are deficient in Vitamin B12, you have enlarged red blood cells. You need B12 to help those red blood cells mature. 

When they are premature, they are large. You can think about the capillaries up to the hair follicle are tiny. If you have enlarged red blood cells, you probably can’t get oxygen to the right place. 

You see this in MS as well. My brother has MS. He also has this issue with Vitamin B12. You can see how that can create a problem. He has hypoxia. You can’t get oxygen to certain parts of the brain, hair follicles, spine. 

For me, checking B12 and folate, because they work synergistically together, is another key marker. That is more a personal one. It’s probably not an obvious one for everyone. I do find a lot of clients are deficient in B12 or folate as well. 

Dr. Eric: 

B12, folate, iron, Vitamin D, zinc. 

There is a lot of talk about: Is biotin overrated when it comes to hair loss? Is it important in your opinion? Can a biotin deficiency cause hair loss commonly? 

VJ: 

I think if you have a deficiency, most studies are around nail health rather than hair health. Studies do prove that biotin deficiency can cause an issue with nails. I don’t think it’s as conclusive around hair growth, even though I know every supplement out there has high biotin in it. 

There is an interesting study relating to biotin in MS. Maybe it’s just a personal thing for me. They have shown now that biotin can be helpful for MS as well. 

I think any deficiency can cause an imbalance in some system, and if you have a certain genetic susceptibility to one of those nutrients, that can create a problem for you. When we’re taking excess biotin, it probably isn’t going to be helpful. 

The truth is, what biotin does is it helps with protein synthesis. This isn’t based on science. When I was doing a trichology qualification, they mentioned it. I thought from a hypothesis perspective it made some sense. They said if you take high-strength biotin, it helps to make proteins in the body. If you are protein deficient, where does it get the protein from? It could probably cause more harm than good if you have it in excess amounts. I would be conscious of that.

The B vitamins work together. If you are taking one at really high strength, and you don’t know whether you need it or not, I personally don’t use that approach with my clients unless I think there is a requirement for it. 

Dr. Eric: 

Also, biotin can affect the thyroid values. You want to be careful if you are doing blood testing if you are taking anything with biotin, especially higher doses. Take a break from it for at least a few days before doing a blood draw. 

You mentioned zinc. Any other nutrients like selenium, Vitamin A? They’re all important obviously when it comes for hair loss specifically. 

VJ: 

If there is a thyroid component to it, and you think selenium could be one of the underlying root causes, selenium may be helpful. 

Vitamin A is generally important for skin health, the immune system, and fighting off infections, which could be at the root of someone’s hair loss. Vitamin A is where genetics plays a part. Some people will not be able to convert beta carotene to the active form of Vitamin A, which is most important when it comes to hair growth, skin health, and immune health. 

You find a lot of these supplements that you will buy for hair growth will have beta carotene in it. It’s an amazing antioxidant, but it’s not giving you the nutrient that you need. I would recommend taking cod liver oil over an expensive hair product that has beta carotene in it and doesn’t have active Vitamin A. 

What happens in the body is you will absorb the beta carotene, and your body converts it to Vitamin A. Some people can’t do that conversion. You are building up a lot of beta carotene and not processing the Vitamin A you need to use. It almost creates a deficiency in that way. I have seen that be an issue. That’s something to look for. 

When it comes to nutrients, I am working with my clients. There are certain things I would recommend for everyone who is experiencing hair loss. Some things that are more natural, and certain nutrients that will work for particular people, depending on what their underlying root cause is. It’s not always the same.

When I am working with children, they often have an issue in their gut, which has happened for various reasons. We deal with the issue in the gut. It might be a parasite, dysbiosis, inflammation. Then they start absorbing nutrients again. Ordinarily, their hair grows back. I see that so much with children. It is often to do with the gut. 

That could have been for me as well. Even when I was six weeks old, I was diagnosed with a milk allergy. I have done all the tests in the world, and I don’t have a milk allergy. I did come off milk. It was probably that my gut didn’t have the right gut bacteria, and I wasn’t able to digest the milk. I didn’t have the right bacteria at the time. That is what I see with children. 

It’s hard to say all of the nutrients. It just depends on what you’re deficient in. That can be dependent on your genetics, your gut health, your cellular health. Your cell membranes working appropriately, so you can utilize these vitamins. I’ll use things like organic acid tests to look at functional deficiencies as well. Some people can have very high levels of Vitamin B12 but at a functional level aren’t able to use it, so we need to explain why that’s the case.

Nutrient density is absolutely key when it comes to hair growth, whether it’s alopecia areata, telogen effluvium, or a different type of hair loss. You need to be eating nutrient-dense foods. When people are not eating as much nutrient-dense food, they start experiencing hair loss for that reason. I am always educating the children I work with and clients about how they can have hearty meals again rather than just salads. Let’s get hearty, good, healthy food that will nourish your body and hair follicles. 

Dr. Eric: 

Couldn’t agree more. Definitely want to eat whole, healthy foods in a nutrient-dense diet. If you are doing that and still experiencing hair loss, there could be other factors. 

You mentioned gut health being a big factor. How about stomach acid? If someone has low stomach acid, you need that to break down minerals and nutrients. Vitamin B12 is important for having healthy stomach acid. 

VJ: 

That’s huge. There are so many studies to support that as well. I’ll definitely be looking at that as a starter as well. If your stomach acid is low, it will affect the rest of the gut. That is normally stage one or two of the protocol. 

If I am working with someone whose stomach acid is low, you need to get that up as soon as possible to help with all the other aspects. That’s something that comes up as well. That can create dysbiosis and growth of different bacteria in the gut and other things getting through. Undigested food particles, which haven’t been broken down properly. You see that on stool test results, which is helpful. 

Dr. Eric: 

Hair growth supplements. You gave an example of beta carotene. A lot of these supplements have other things, too. I don’t know if you’re familiar with Nutrafol? It’s pretty popular here in the US. A lot of patients ask me about it. If you could talk about whether you recommend any hair growth supplements, or if you just focus on individual nutrients, healing the gut, saving your money and staying away from those. 

VJ: 

It’s hard, isn’t it. Not everyone will be working with a nutritional therapist. That’s what I would recommend you do. Learn about how to include these nutrients in your diet naturally. If there are some key vitamins you need, just taking those rather than taking a supplement which has a lot of different herbs in it, a lot of different vitamins, minerals that can create imbalances in the body. 

Especially when you have an autoimmune condition, you are so reactive. When you take anything with loads of ingredients in it, I find clients don’t know what they are reacting to anymore. They might be taking a powder. This has 50 different ingredients in it. Then they are taking a supplement. It’s hard to keep track of what’s working, what’s not working, what the client actually needs.

In the past, I took different supplements, which were specifically out there about hair growth. They’ve all had patterns and certain things in them like marine collagen or certain marine aspects to them. I took them. When I look back, at points, I felt like they might have helped to get my hair to grow back. This was when I was going through the cycles of hair growth and then loss. 

That’s why I took this other approach in my early 30s. I have gotten my hair to grow back, and I felt a massive shift in my own health. Taking a pill to help, it sometimes makes you feel better, so I do understand why people do it. It’s not going to help in the long run. If you want to take it and feel okay taking it, go for it. It’s not something I would particularly recommend. 

Dr. Eric: 

Okay. For those listening who are dealing with alopecia areata or another autoimmune condition with associated hair loss, what are some steps they could take to get started? 

VJ: 

If they are experiencing it in the moment or just have been diagnosed? 

Dr. Eric: 

The audience here, not to say there can’t be people with Graves’ or Hashimoto’s experiencing alopecia areata. As you know, you have one autoimmune condition, and you may develop others. Let’s say someone listening who has Graves’ or Hashimoto’s or a non-autoimmune thyroid condition are currently experiencing hair loss. 

Let’s take it a step further. I talk about hair loss. Of course, I’ll say balancing thyroid hormones and healing the gut. At the very least, let’s address the thyroid. The thyroid seems to be in balance. They are doing some of the foundational work, like eating nutrient-dense, managing stress. 

One of the more challenging cases, what would you recommend in that situation? They have done some of the basics. I am eating pretty healthy. I am doing things for my thyroid. What other steps should I take? 

VJ: 

When clients come to me, and they are in that position, they have tried lots of things, and for whatever reason it’s not working, that’s when I can work with them as a practitioner and go through all the timeline health history. See if I can get more ideas about what might be causing it. 

You can also do functional testing. However, I know not everyone can do that. You can do it yourself as well. Just work through how things have developed over time. That will give you more ideas as to whether it was triggered by infection or your gut. I do think at that point, you need to take more of a focused protocol of working on a specific area and potentially a specific issue. 

If you feel like you have been doing everything right, exploring your environment as well. When I am working with more complex cases, there can be mold toxicity or chemical toxicity that can be contributing to it. That’s when I’m working with my more complex cases. 

If someone has tried everything and is not seeing results, the ferritin isn’t getting higher, you have tried iron supplements and it’s not moving, then we’re thinking there is something going on with the gut. 

If you have bacteria that have been there for a long period of time, or a parasite, or any kind of inflammation, like food reactivity to some degree, you have to take a focused protocol to work on that. Then once you have dealt with that, you will get the benefits of all the great things you’ve been doing. You need to deal with that aspect. I think that’s why I kept having these cycles of hair loss. 

Outside of that, the nervous system is key. I don’t know if this individual had already sorted out their nervous system. A lot of people come to me and are still living in fight or flight. Even though they are doing meditation or yoga or are doing things to help with that, they are still living in a stressed state. Meditation and yoga and those types of things can be helpful. 

It’s actually getting comfortable with yourself and having little intervals throughout the day when you can do deep breathing or journaling, really working on yourself and calming your nervous system down. 

I find particularly with hair loss, while that is still happening in your body, it’s harder to get everything back into balance, so your body feels safe again to grow hair. It’s that safety aspect, feeling calm and safe. Anxiety is definitely a symptom I experienced. I see clients experience it as well. 

Unfortunately, it’s not always straightforward. I do think nourishing food, working on your gut health, calming the immune system, doing all the things you love in life, all these things can benefit you. Sometimes, that’s enough. 

If you have tried that, I do think you need to be a bit more specific about the areas you focus on and really do a set protocol around something. See those meaningful changes. 

Dr. Eric:

Sounds great. This was a great conversation. Thank you so much for sharing all that you shared. Where can people who might be interested in working with you or learning more about you visit? 

VJ: 

They can go to my website, www.TheAutoimmunityNutritionist.com. You can go to TheAutoimmuneNutritionClinic.com, too. Over there, you will find a free guide, “The Autoimmunity Recovery Plan.” If you are looking to take your first steps when it comes to improving your autoimmune condition, you can download that. It gives you things you can start including in your life straightaway, things like journaling. There is a green juice on there. There is advice around sleep. There is a food plan you can follow. If you want to get started today, that is a good guide to download and get started with. 

Dr. Eric: 

Also listening to your podcast as well. 

VJ: 

I have a podcast called The Autoimmune Reset. I also have a free group called The Autoimmune Forum, which you can find on Facebook. We have an amazing community over there of people living with autoimmunities and sharing experience and advice. I’d love to have everyone here in that group as well. 

Dr. Eric: 

Thank you so much, VJ. This was a really good conversation. Appreciate you sharing your experience and showing others what they can do to help overcome hair loss. 

VJ: 

Thanks so much for having me.