How Hormonal Imbalances Can Affect Your Mental Health And How To Reverse It

Deb Matthew, MD

Well, I used to be exhausted all the time, napping was my favorite hobby and I was freezing cold all the time. I took a sweater with me everywhere I went, even in North Carolina in the summer because the air conditioned restaurants and movie theaters, I would just shiver uncontrollably. And I also got really irritable like I would fly up the handle at my kids way too often. And then I felt like the worst monster mom ever because that’s not how I wanted to behave for my kids. And my poor husband is the one that put up with my wicked witch of the West impersonation. He didn’t know what the heck to do with me and the reality is, I didn’t know what to do with me either because nothing in my medical training helped me understand what was happening to me. I was waking up in the middle of the night with panic attacks and I’d never been an anxious person before and there was nothing worth being anxious about. It was really for no reason and my medical training didn’t understand it, but my husband one day actually gave me a book that he thought I ought to read. 

And it was a book written by Suzanne Somers and I just looked at that book with Chrissy Snow, staring back at me right from three’s company. And like, you know, as medical professionals, we don’t want to get our medical information from celebrities. And I just looked at the book and I said you have got to be kidding me. And he looked at me and said, honey, we have got to do something. And I knew he was right and I read the book and I gotta tell you the book changed my entire life because once I read about the women who were just like me and how much better they felt when they got their hormones back in balance, it suddenly opened my mind and everything made sense what was happening to me because I was hypothesize I was on Synthroid that’s the medicine we give to everybody, right? I felt no different. I had all the symptoms of low thyroid still and I was in my late thirties. So I wasn’t thinking about menopause, but my female hormones were shifting and that’s what was making me anxious and irritable. And once I understood I could get myself the help that I needed and I was able to get my hormones back in balance. I got my Energy back. My kids got their mom back. My husband got his wife back and I got my life back. But then I couldn’t go back to just writing prescriptions all day long because I didn’t make any sense anymore. So for the last over 15 years I’ve helped men and women get their hormones back in balance so they can get well, get off prescription drugs and love the way they feel.

Diane Mueller​, ND, DAOM, LAc

I love it. It’s so, so true. So many of us get into this health profession through our own our own struggles, right? It’s such a great story. And I think it’s a great lead into our next question, really. Which is how do people feel when they have hormonal imbalances? Like you just listed off a ton of different symptoms that I think a lot of times people are not really considering. So let’s talk about that a little bit more. How are people going to even go down that road?

Deb Matthew, MD

Yeah, and that’s what’s tricky about it is like if you’re having hot flashes, if you’re 50 years old and you have hot flashes, you probably have a clue that maybe that has something to do with menopause. But a lot of, a lot of hormone symptoms, they can happen at any age. I mean, you can be a teenager and have hormone symptoms, but especially once we hit 35 and up, we can have hormone symptoms that aren’t obvious. And if you don’t know, you don’t get the right treatment. So if we may, we start with when you’re over 35 some of the first things that change is our progesterone level starts to drop. And progesterone is one of the hormones that goes up and down with the menstrual cycle and when progesterone levels start to drop, our menstrual cycles can change. So heavier periods more PMS it can last longer and longer. 

So instead of like one or two days of maybe being a little, you know, grouchy or whatever, we can have like a whole week or 10 days or even to old weeks of just not really feeling like ourselves. We can have night sweats and interrupted sleep so that instead of sleeping soundly through the night, we’re waking up at two am and at four am and one of the clues is that it gets worse before your period. So if you sleep soundly the week after your period, but you’re not sleeping the week before your period, it could be your hormones and the night sweats tend to be worse before a period too. Another hormone that often changes when we’re in our thirties and forties is testosterone and we think of testosterone as the male hormone and of course men have 10 times more testosterone than women do, but women actually have 10 times more testosterone than estrogen. So it’s really important for women as well and testosterone is really important for our strength, that, you know, muscle strength and bone strength. So we don’t become frail little old ladies, it’s also really important for everything to do with sex. So thinking about it in the first place, you know, caring about it the desire, but also arousal, vaginal lubrication, all of that. And really importantly these hormones affect our mood and that’s kind of a lot of what we’re talking about here, right? So estrogen is like a natural antidepressant and it doesn’t change until you get to around menopause. So usually you’re closer to around 50 and when estrogen starts to change, that’s when your period gets more scanty and you know, eventually you skip periods and starts to, you know stops. We estrogen keeps moisture in our body so that we’re less dry. 

So when estrogen goes down, dry eyes, dry hair, dry skin, dry virgin, everything gets dried out. Also estrogen is really, really important for brain health. So remembering why you walked in the room and where you left your car keys and that word that you want to say that you just can’t find in the moment that you need it. It affects our quality of sleep, it affects our energy during the day. It affects everything about our brain and of course it protects our bones and it also protects our heart. But the thing that I really think it’s important for us to talk about here is how these hormones impact our mood because they are so critical to who we are on the inside, how we relate to other people, how we react to the world around us. Progesterone is like a natural anti anxiety. it helps us feel calm and chilled out and relaxed, it’s kind of like nature’s version of a Valium or a glass of red wine. And so when you lose progesterone, you end up like me where you’re anxious and irritable and impatient and negative and critical and every little thing just makes you nuts. 

And I have a theory which is 100% non scientific and unproven, but you know how we have all these karens out there and they have bad behavior and they say stupid things, I think that they need more progesterone. They tend to be women in their forties, right? Like they’re going through perimenopause, that’s my theory. But progesterone helps us feel calm and and helps with anxiety. Testosterone is a mood stabilizer, it gives us confidence and motivation and self esteem and get up and go and so when testosterone levels go down we tend to feel flat blah, you know, you put one ft in front of the other and you make your way through your day and if you really have to get something accomplished today, you’ll make it happen. But if it doesn’t really have to happen today, you know sometimes we just kind of leave it by the side because we’re not really feeling it and then estrogen is a natural antidepressant. So again, when women go through menopause we just tend to feel more flat, we sort of lose joy. And a lot of times all of these hormones are changing together. And so we kind of have a mix of all these things. And so for me, as my, you know, in my late thirties, who’s thinking about menopause in your late thirties, my progesterone level was changing my testosterone levels low. I didn’t feel like myself and this is so, so common, but just think about what happens right when women go to their doctor and they say I’m not sleeping, I’m moody, I’m kind of depressed. I don’t know, I’m sort of anxious. What do they get? They get antidepressants, they get anxiety pills, they get sleeping pills, like that’s what we’re trained to do at medical schools, write you a prescription for something and the problem is it’s not fixing the right problem if the problem is your hormones, you know, sometimes the pills help somewhat, but they’re not really going to get you all the way back to feeling well, they’re not gonna give you joy.

Diane Mueller​, ND, DAOM, LAc

Yeah, it’s so there’s so much in there to unpack, you know, it’s like, I think so many times we talk in medicine about these great mimic ear’s right, and like, oh, certain imbalances can mimic so many disease processes and you just name so many things in there. So we can really, so many ways say that hormonal imbalances are like the great mimic occurs in many ways of a lot of other symptoms and, you know, in brain health and mood and all that being wrapped up in there. So let’s take it a step further now and now to go back to your story, you had even mentioned that Synthroid. You try, that didn’t work for you. So let’s now talk if you can a little bit about how hormones are interrelated to other things, about like how hormones are interrelated to gut health and to microbes and the thyroid. So, can you kind of tie together some of those other inter plays of hormone and these other organ systems in the body together for us?

Deb Matthew, MD

Yes, I think this is so important because what I really want women to understand is if your hormones are out of whack. The very first question we need to ask is why are your hormones out of whack? It’s you know, it’s not just a matter that all of a sudden you need some kind of hormone replacement therapy. What we need to do is we need to address the factors that are knocking your hormones out of whack. So hormones affect a lot of other parts of your body and a lot of things that are going on in your body, affect your hormones. So maybe if I can start the opposite way first, how do hormones affect other things. So, if your hormones are out of whack that can affect how your gut works because a lot of women will notice that they have changes in their bowel movements right before their period. Sometimes they get a little bit of loose stools and things like that and it’s just a sign of how our hormones are impacting our gut health and our hormones also our female hormones also impact thyroid. 

So we have two different really important thyroid hormones, T. Four and T. Three. And for women who are low in thyroid, like if your if your thyroid gland is hypo thyroid, you’re not making enough thyroid then What we replace that with, we give them the Synthroid which is T4, which is a standard one, but what our body really needs is T. three. So then what has to happen is you have to take the Synthroid that you’re swallowing or that I was swallowing and then your body has to convert it into the active one that you need. And sometimes we’re not so good at that and and when you are stressed, your body makes more cortisol, which is our stress hormone. And that cortisol gets in the way of you being able to activate your thyroid. So that was my problem is I was swallowing the pill, it was making my lab tests look normal, but it wasn’t making me feel normal. And so you know, I thought I was fine because my lab test was normal and that’s what I was taught is if your lab test is normal then your thyroid is fine and it must be that you’re depressed or lazy or whatever. 

But also if you have if you’re in your thirties or forties the way I was and your estrogen should still be okay until you get closer to menopause. But your progesterone may be going downhill. And if you have what we call estrogen dominance that causes your thyroid hormone to not work as well. So even if you’ve got some thyroid hormone, you may not be feeling the effect of the thyroid hormone as well as you should. And if we can help balance out these hormones now your thyroid works better and you feel a whole lot better. So there’s lots of examples of how it goes back and forth. So if we look at your gut now it’s so important to have the right microbes in your gut, right? You need all the good healthy probiotic, the healthy good bacteria and a really important there’s a couple of really important ways that gut affects your hormones. But these bacteria make different compounds in our body that actually impact how we process our hormones. So one in particular is called beta glue your own needs. And if you don’t have the right healthy kind of bacteria in your gut, then you can end up making too much of this beta glue your own needs and what it does is it re absorbs estrogen in your system so that it lasts longer. 

So what happens every day is your body makes some estrogen, your liver flushes it away and dumps it in your gut so that you can poop it out and make way for tomorrow’s estrogen. But if you have too much beta glue corona days, then what ends up happening is that ends up re absorbing estrogen back out of your gut into your bloodstream. So now your estrogen level can build up so now you can have too much estrogen, not enough progesterone and that makes your thyroid hormone network as well. And when you don’t have enough thyroid, you end up constipated. If you’re constipated then the stool is sitting in your gut longer, gives it a lot more opportunity to just reabsorb estrogen back in your system and you get caught in this cycle where your estrogen is going up, your thyroids working worse, you’re getting more constipated, makes your estrogen go up more because it’s being re absorbed. So that’s one of the examples of why it’s just so important for us to be looking at the whole person and not only looking at hormone levels,

Diane Mueller​, ND, DAOM, LAc

There’s so much in there around like the web of the vicious cycles. I think we get into, you know, and that we see in patient care, right, where it’s like, like you’re saying it’s gut and thyroid and estrogen dominance and it just goes into this repetition and this crazy cycle. So let’s talk about that a little bit more, let’s break that down. So if somebody has this cycle happening, they have low thyroid there’s, there’s cortisol component, there’s this estrogen dominance, there’s this beta glue grenades issue and they’re just stuck in the cycle. What do they do? What do they do lab testing wise? Where do they start? How do people even begin to wrap their brains around how to break this apart? 

Deb Matthew, MD

And it sounds so complicated when we talk about it. But really, so when I sit down and talk to people, usually when I want to hear their whole story right, I want to hear all their symptoms. It’s so common nowadays when people go to their doctors office there, doctor just wants to hear about one thing. If you got headaches, just talk about your headaches today, we’ll save your constipation for another office visit. But that’s not how your body works, it’s all interconnected. So when we hear the pattern of your symptoms very commonly we can figure out which of your hormones is probably out of whack. And so it sounds complicated when we’re talking about it. But in reality it’s often kind of obvious once you kind of go through a little checklist to figure it out which hormones are out of balance. 

But then the way that we really know for sure is we can measure the hormones in order to understand what your unique hormone pattern is and I think that’s an important thing to say is we all have very unique hormone patterns and what feels normal for me might not feel right for you. So we and the name of the game here is really balanced. So sometimes what happens is one hormone is a little high normal, but the other hormone is a little low normal. And so there’s out of balance and you don’t feel right. But if you go to your regular doctor, you know, your gynecologist or your family doctor and say, hey, would you mind testing my hormones? I listen to the summit. I think maybe my hormones are out of whack. Could you check my hormones just be ready? Because here’s what’s likely gonna happen. They might say we don’t do that. They might say you’re too young to have a hormone problem. 

And at best what they do is they measure one called FSH follicle stimulating hormone FSH And that kind of tells them whether you’re still likely to be able to get pregnant or whether you’re starting to go into perimenopause and fertility might be an issue. So that’s really helpful if you want to get pregnant and you know, you want to know. But if fertility is not really what you’re thinking about the FSH isn’t nearly so helpful. It’s unusual for sort of sort of standard conventional practitioners to do a hormone panel, but there are a lot of different ways that it can be done. So we can do a blood test but we can also do saliva testing and we can even do urine testing in order to really see what’s going on. So one of the ways that I really like to do hormone testing is called the dutch test. And this is where we get you to pee on little strips and we get you to do it multiple different times over the day so that we can because your hormones change a little bit over the day. So we can kind of see over a whole day what’s happening with your hormones. And that is most important for cortisol, the stress hormone because it’s supposed to go up in the early hours of the morning. 

So you wake up it’s kind of like long acting adrenaline. So you get this little adrenaline burst in the morning and your eyes pop open and you leap from your bed ready to start your day and then it goes down over the day so that at bedtime you’re relaxed and you sound you know fall asleep easily. You sleep soundly through the night. But for a lot of people to get turned around backwards, they don’t get that cortisol burst in the morning. So now they gotta press the snooze button and have some coffee to get going and then by the time they get to the end of the day they’re wired and they can’t fall asleep and they need melatonin or a sleeping pill or something. So knowing that pattern is really important and we can’t see that in a blood test but hormone testing is available. We can look at estrogen progesterone and testosterone. We can look at cortisol levels. We can look at another one called D. H. E. A. Which is a stress hormone from your adrenal gland which is an anti aging hormone. 

We like this one we can look at lots of different thyroid tests, not just the standard scree panel which is a TSH there’s more thyroid hormones to look at. So having a comprehensive hormone panel is really really useful in order to figure out what’s going on. And one more thing that I want to say about testing hormones is if you march into your doctor’s office on any random Thursday afternoon and you’re still having menstrual cycles a lot of times they don’t really want to draw your blood. Or they’re certainly not going to do a urine test or a saliva test. But they’re not gonna want to draw your blood because it really makes a big difference what day in your cycle? You know we’re looking at because when you’re on your period your hormone levels are supposed to be low they drop and that’s what triggers the bleeding. And then the week after your period they’re still fairly low and then mid cycle you ovulate and your estrogen level shoots up super high and then the last two weeks between ovulation and your period your estrogen and your progesterone are both fairly high. So that’s when we want to measure it. If you get your test done and you don’t even know where you were in your menstrual cycle. It’s not very helpful and it’s especially tricky if you’ve had a partial hysterectomy where they took your uterus but you still have your ovaries so they’re still cycling. We just don’t really know when you would be having a period. Or sometimes when women have an I. U. D. They stop having a period. Or sometimes they can have a procedure called an ablation where the uterine lining gets treated so that you don’t bleed anymore. But your ovaries are still doing something we just don’t know what. So measuring hormones can be a little bit tricky and it certainly can be done and it should be done. You know if you want to know but sometimes you have to find the right practitioner to help you because it’s not a typical thing that your regular doctor does awesome.

Diane Mueller​, ND, DAOM, LAc

And I love that. Use the dutch. I want to ask a couple questions to you about that because the dutch measures E. One E. Two E. Three. So it measures both these three types of estrogen as well as the estrogen metabolites. So can you talk a little bit too that in the importance of E. One E. Two E. Three as well as those estrogen metabolites and what that all means. 

Deb Matthew, MD

Three different kinds of estrogen that we measure. So s trone is mainly made from hormones from your adrenal gland as opposed to coming from your ovary estradiol which is easy to that’s the one that comes from your ovaries. That’s a strong estrogen that you make a lot of before menopause. And then E. Three is called estradiol. And that one is highest when you are pregnant and when there are some reasons why we end up converting more estradiol E. Two into E. One which is S. Trone. And that the one is the one that is more closely related to breast cancer. So we don’t really want you to have an excess amount of E. One. And so on this test we can kind of see what your balance is between those three different hormones. And then even more importantly when you have these hormones then your body has to convert them into different byproducts in order to flush them out of your system. And there are three different pathways that the estrogen can go down. There’s one pathway on the test it’s the green pathway because it’s the good pathway down to two oh. H. Est alone. And this one is breast protective. We want you to have plenty of this one. 

There’s a second pathway that it’s blue on the test it’s called 16 0. H. And so this one is it’s a little bit neutral. It doesn’t really protect you from breast cancer but it actually does protect your bone. So we want a little bit of that one. But the third pathway is the red pathway. It’s the bad pathway. We don’t want this one. It’s called 40. H. S. Trone. And this is one that if it gets oxidized like if it keeps going on down on that pathway it actually can damage your D. N. A. And it could trigger breast cancer. So when we look at your unique pattern of how your body processes estrogen we can have some better understanding about your personal risks for breast cancer. And there are things that we can do about it because I know that there are tests out there now that are being developed that kind of tell you genetically like what your risk of breast cancer is. But then all you can do with that is like sit around and wait and keep going for mammograms until they find something here. This is actionable. So if we know that you’re not going enough down the good green pathway and you’re going too much on the red pathway. There are genes that may be involved and we can measure them. 

But there are lifestyle things that we can do to compensate. So if we need to shift you over more to to the green pathway we can give you things like ground flaxseed and omega three fatty acids. We can help normalize your cortisol level. We can help you avoid toxins. There’s that we can give you dim which is a nutrient that’s found in broccoli and other cruciferous vegetables. And then we can redo the test and see if we’ve shifted you over to the better pathway and we know what happens. So we can see this these pathways. But we also know that the next step in the pathway is called methylation. And so wherever your estrogen lands then it has to get methylated. And methylation is a chemical process where this little molecule called um ethel gets stuck on and then your body can flush it out of your system. If you’re really good at doing that, that helps to flush even the bad kind of estrogen out of the way. But if you’re not very good at that, then we can help you. 

So genetically some people aren’t good at that. Sometimes you’re not digesting and absorbing nutrients well. You might not be eating the right foods. So either using nutrition and sometimes using nutritional supplements, we can measure for the genes that are important for that particular methylation pathway. We can do something about it to compensate for your genetic weakness and there’s more to the story because glutathione is a really important antioxidant that also helps with detail classification. And we can measure whether your glutathione seems to be working well or not. And maybe genetically you don’t make it as much, Maybe you’ve got lots of inflammation and things going on where you’re using it all up and there’s none left or not enough left. And so then we can help to compensate for that. So it’s really fascinating. It’s really exciting. It gives us so much information much, much more than just what is your estrogen level. And it gives us a lot of tools that we can work with.

Diane Mueller​, ND, DAOM, LAc

Yeah. So much there and I really hope everybody that’s listening is really hearing this in the advantage of using a test like the dutch and how much information we can get out of this versus just running say a blood level of some of these hormones right? So much deeper than this. And you brought up a lot of, you know when we’re talking overall in this whole whole conversation you’ve brought up a lot of different root causes, right? So it’s like we have our G. I. Root cause we have a thyroid root cause we have a cortisol root cause now you brought even in toxins. So what other from a root cause standpoint? As far as hormonal imbalances are concerned, what other root causes should we be thinking about?

Deb Matthew, MD

Okay, so just generally bad lifestyle habits, not being physically active, eating, you know, not getting enough of the good healthy nutrients in your body, you need the right nutrients in order to be able to make your hormones and interestingly these estrogen progesterone, testosterone cortisol, they’re all made out of cholesterol and so if you are on like a vegan diet or if you are on a really low fat diet you might not be getting all the building block nutrients that you need in order to make your hormones. So or if you’re just, you know, eating like most people out there and you know, lots of fast food and you know, just the processed foods and and honestly, I see a lot of women who are trying their best, like they’re not they’re not eating at the drive through three times a day, they’re not chug a lugging on sodas all day long, but they’re eating a lot of processed foods that look like they’re healthy foods, like fruit, yogurt and granola bars and things that look like they should be healthy, but they’re actually pretty devoid of nutrients. So healthy proper nutrition is so, so important to be able to make your hormones. And that’s a common thing that I see.

Diane Mueller​, ND, DAOM, LAc

What about so you brought up cholesterol, Right, so where do you see that we obviously have so many people on statins in this world, So that I imagine some of our listeners are thinking about, where do you see people that are on statins, do they need to be worried about their hormonal health? And what sort of advice would you give them?

Deb Matthew, MD

Okay, because statins reduce cholesterol and cholesterol is the building block for your hormones. The main thing that I look for is we don’t want your cholesterol to be driven down into the dirt. So the number that where I sort of would really draw the line is a colette A total cholesterol of less than 1.20. So you know we don’t want your cholesterol necessarily to be sky high. But there’s so much more to the whole cholesterol story. And heart disease. And cholesterol is really not the main culprit. But if you’re a doctor wants to drive your cholesterol down into the dirt then that starts to impact your hormones and your hormones are really really really really important for heart health. 

Estrogen is so important. So when women are pre menopausal we have much lower rates of heart disease than men do because estrogen is protecting our heart after menopause. When estrogen level drops the risk of heart disease becomes equal between men and women. So estrogen is so so important. And We want to make sure that we’re doing healthy things for your heart because the reality is 50% of us women are going to die from heart disease not breast cancer. It’s just that we worry a whole heck of a lot more about breast cancer than we do heart disease. So we want you to be heart healthy. But we don’t need your cholesterol driven down into the dark.

Diane Mueller​, ND, DAOM, LAc

Perfect. And then what about another thing we haven’t talked about yet is blood sugar. So I know you talked a little bit about diet and the importance of you know lifestyle and that sort of thing. But one of the things I know I’ve seen with like with measuring people’s blood sugar using a C. G. M. Is sometimes it’s really surprising like one food that’s actually not classically a food that we would think of driving blood sugar up and it can drive blood sugar up for a uniqueness of somebody. So where does stuff like that in your opinion play into this whole picture?

Deb Matthew, MD

Yeah. So sugar drives inflammation and inflammation drives your hormones right out of whack. So when we are eating when we are eating diets that are high in sugar consciously or unconsciously because if you’re you know if you’re snacking on candies like if you’re really going to town on the sugar you kind of know right but sometimes you don’t know like all the hidden sugar in the ketchup and the salad dressing like you really need to read labels to really be conscious of it. But when we’re consuming a lot of sugar that impacts insulin. So insulin is the hormone that regulates our blood sugar so we eat something, our blood sugar goes up, our body releases insulin and that brings our blood sugar back down again. But over time our cells get tired of all this blood sugar and insulin they stop responding. So we have to make more and more and more insulin in order to get our blood sugar down and at this stage in the game your blood sugar will look normal. But it took all this extra insulin to get it there. And insulin is the fat storing hormone and it’s going to store fat right around your midsection. And insulin causes problems with cortisol, which also causes you to gain fat around your midsection and cortisol problems causes insulin problems. 

So they kind of ping pong back and forth. But insulin is also very inflammatory and inflammation is really is really harmful for our hormones. It impacts cortisol in particular because core it regulates our immune system and cortisol regulates all our other hormones. So when you have chronic stress, whether it’s from a low grade chronic infection, whether it’s from blood sugars going up and down all day long, whether it’s from burning the candle at both ends and you know just being stressed out in life. So whether it’s from a hormone imbalance in nutrient deficiency, all of these things are the same whether you’re aware that they’re present or you have no idea your body responds the same way to those stressors by boosting up cortisol and that cortisol knocks the other hormones out of whack. And so now you might present with heavy periods or more P. M. S. Or more hot flashes or low libido or whatever it might be. And you’re thinking there’s something wrong with your hormones over here. But what really started the ball rolling was what was going on with the stress over here. And many of these stress factors have to do with our lifestyle habits, The food that we eat, how we live our life. What we worry about all day long. So the good news in all of this stuff is there so much that we can do to fix it?

Diane Mueller​, ND, DAOM, LAc

Yeah and so many different lab tests we can actually run to get to the root and that sort of thing. So let’s talk about fixing it now. So obviously there’s a lot we can do from a natural perspective, from a pharmaceutical perspective. So let’s talk both about the those you know kind of areas, both the natural and the pharmaceutical as well as some of the overarching picture of from the root cause perspective what people can do for that as well.

Deb Matthew, MD

Okay, so we got lots to talk about if we start with kind of the basics, right lifestyle habits. So we want healthy nutrition and what that means to me is a whole food diet. So I know vegan paleo carnivore, like you can go to the ends, but whole foods as opposed to processed and packaged foods, eating the rainbow. Lots of different, you know colored fruits and vegetables specifically for hormones, we want cruciferous vegetables, so that’s broccoli, cabbage, cauliflower, kale, brussels, sprouts. So I generally recommend a serving a day of one, something in that category. We want to make sure that you are getting enough fiber in your diet because fiber helps to flush excess estrogen out of your system, flax seeds, ground flax seeds are actually something really really good for hormone health because they have lots of fiber which is good for flushing the excess estrogen, The kinds of fiber feed the good healthy gut bacteria. So that’s helping with gut health. They also have omega threes and we want lots of nice healthy omega threes which are the anti inflammatory fats that are good for hormones. And they even have ligaments that are good for your heart. 

So that’s just an extra bonus. So ground flax seed one or two tablespoons a day in the beginning, you might have to watch for a little bit of gloating while you get used to it. But healthy fats are a really critical piece of nutrition when we’re talking about hormones. So we want extra virgin olive oil, avocado oil, or eating avocados. Like who doesn’t like guacamole. We want nuts and seeds. Wild caught fish has to be wild caught because the farm raised fish, they feed it fish chow. So those fish don’t have any more omega threes than we do. So not a good option has to be wild caught. And it’ll tell you what the grocery store whether it’s farm raised or wild caught. When you’re choosing animal products like chicken and beef and things like that. This is where it is the most important of all to look for the healthiest version. So organic grass fed  it’s a little bit more. You might have to go to a different grocery store to find it, but but when you’re thinking of where to put your grocery store dollars, the most important place to look for organic and healthy is the animal products. So those are some of the really important parts about what we want you to eat and then we want you to minimize the sugar, the processed foods. And alcohol, alcohol is a toxin really, if you think about it and it’s really hard on your liver and your liver is the organ that’s gonna be processing your hormones. 

And so if you’re drinking a lot of alcohol, your body has to spend all its resources trying to flush away the alcohol and then it’s not doing a good job of managing your hormones and so you’re more likely to have hormonal symptoms. And in fact, men who are alcoholic often have quite high estrogen levels and lots of side effects from too much estrogen. So that’s just kind of an extreme example. So typically what I would tell, I mean, I would say no alcohol is the healthiest, but not that many of us love that answer. So really realistically, what I would say is try to limit it to four glasses of wine or whatever you’re gonna have per week and it doesn’t count if you save them all up for friday night. And another reason that this is important is because we know that for women every one glass of alcohol or one glass of wine that they have per day increases the risk of breast cancer by 10 per se, two alcoholic beverages per day increases of breast cancer risk 20% 3 30% for 40%. So it’s kind of a big deal. So watch the sugar, watch the alcohol, watch the empty calories. Can you think of anything I forgot about nutrition that we should mention here.

Diane Mueller​, ND, DAOM, LAc

That seems pretty good. The only other thing I’m thinking is just hydration, some of those basics around.

Deb Matthew, MD

Yeah, moving your body is important for hormone balance. So walking yoga yoga is great for reducing cortisol levels. So it doesn’t have to be like a marathon or triathlon and in fact over exercising isn’t good for your gut, it’s not good for your hormone. So, so moderation is good here. And then let’s talk about stress because stress is an enormous cause of hormone imbalances and of course all the mood issues that go along with it. There is a lot that we can do to help manage your own stress. And a lot of times the stress itself it’s not so much how much stress you have and it is so much more how you allow the stress to affect you. So if you are in a stressful situation and you’re a worrier and you catastrophizing and you you know, imagine the worst case scenario or if you keep ruminating over and over again of that same thought pattern in your head. You know, I can’t believe she said that too, but or whatever you take that, you know that stressful situation and you just make it a lot worse. On the other hand, if you can catch yourself in these negative thoughts and if you can change your thinking, if you can think positively think of things that you’re grateful for, you know, if you can be a glass half full person instead of the glass half empty person, you actually protect yourself from a lot of the harmful effects of stress. So simple but not always so easy. So a couple of tips that I would say is if you can catch yourself in this negative thinking, that’s the important, the hardest part you have to catch yourself doing it. But if you can catch yourself doing it, put your hand out like stop and say it out loud, stop. And it kind of breaks the thought pattern and then think of three things that you’re grateful for because your body can’t feel like fear and stressed out and grateful at the same time. So that’s a really important one. Some simpler ones are go for a walk, breathe, you know, all the things that we know to do, but taking care of yourself and helping to to manage your stress if you can reduce stress, that’s great. If you’ve got stresses that aren’t going away, you need to help balance the stress in order to protect yourself from the harmful effects of the stress.

Diane Mueller​, ND, DAOM, LAc

Yeah, I really appreciate that. I just want to emphasize that a little bit too for everybody which is stresses is now in the research we’re seeing more and more like what Dr. Deb’s saying here that it’s not just the stress, it’s like how we react to the stress that is really more problematic and your whole handle it like handouts, stop gratitude. It’s so, so good and we can do it on the go. Right. So what about one lifestyle thing I feel like we haven’t gone deep enough into before we move on to some of these other treatments is sleep. Can you talk a little bit more about sleep and sleep hygiene and that. 

Deb Matthew, MD

Most of these hormones that we’re talking about are produced at night when you are in a nice deep restorative sleep. If you are not getting into a nice deep restorative sleep, then you don’t make your hormones properly. And a lot of these hormones help you sleep. So now you sleep worse and then you make less hormones. And then here once again we’re in this cycle. So the things that you can do about it is make sure that you’re giving yourself the opportunity to get a nice deep sleep. So going to bed at a reasonable time you know, not burning the candle at both ends. This sleep hygiene things like we sleep better in a cooler room as opposed to a hot room. Sometimes having like white noise, like a fan or a white noise machine can help for some people avoiding screens in the evening, because that blue light from our screens turns off melatonin, which is the hormone that helps us get into a nice deep sleep at night. So taking, making sleep a priority and doing all the things that you can in order to get a good night’s sleep is, so important for hormones, but hormone imbalances are an enormous cause of insomnia and especially for women over 35 that’s when our progesterone level goes down. Progesterone is the calming hormone and then we don’t sleep so well, tends to get worse before a period better after our period. And then, you know, with menopause, everything is worse because estrogen goes down to, and estrogen also helps with sleep. High cortisol interrupts your sleep lack of thyroid affects your sleep. Every single one of these hormones can mess up your sleep.

Diane Mueller​, ND, DAOM, LAc

And then what about movement? So I know you mentioned movement, but can you delineate between say weight training and hit training and cardio and how much of a hormonal health perspective we should be doing in all of these areas.

Deb Matthew, MD

Okay, so what we tend to do as women is, we tend to walk and we get on the treadmill and we walk and that’s better than nothing and that’s actually good for stress relief, but it’s not so perfect. If what we’re really trying to do is get healthy, feel great and balance our hormones. What’s really, really important is strength training. So we want to do the resistance exercise where we’re doing some muscle building and hit training. So we were doing bursts of exercise, you will get so much more bang for your buck if you are doing the resistance exercise combined with some hit training than if you’re just, you know, walking for 45 minutes. In fact it’s super depressing, right? Like you walk on the treadmill for 45 minutes and then you get off and you know, the little thing tells you how many calories you burned and it’s like enough for one half of an oreo or something like that. Whereas if you can build your muscle, that muscle is very metabolically active. So it’s burning calories 24 7. And so it actually helps to give your metabolism a little bit of a boost. So that’s what we would recommend for balancing hormones, reducing stress, getting your weight back under control your metabolism etcetera.

Diane Mueller​, ND, DAOM, LAc

Perfect. And then let’s move on to more targeted treatments from a pharmaceutical perspective and natural perspective, what do we use, when do we use them? How do we choose between the one versus the other route.

Deb Matthew, MD

Okay, so if we talk about nutritional supplements. There are some that you know we could sort of recommend for anybody without necessarily knowing all the details of their history. So a month a multivitamin is a good idea because it’s hard to get enough nutrients from the food that’s available at the grocery store just because of how we grow the food in the soil etcetera. But it has to be a pharmaceutical grade multivitamin. If you march into one of the you know big box stores or the pharmacy and you grab something off the shelf, it tends to be made with synthetic forms of the vitamins and you don’t you would need a synthetic tomato. So why would you want to synthetic form of vitamin. And often it has food colors and you know food dyes and and sugar and all sorts of garbage in it. So I really want a good quality multivitamin. If you’re gonna bother to take one, take a good one to get the vitamins and minerals that your body needs to be able to make hormones, they’re so important for mood for God health etcetera. Another one that is good for you know most people would be some kind of official supplements Omega three fatty acids, They are very anti inflammatory. Really really important for hormone health because our cell membranes are made out of fatty acids. Omega three’s help our cell membranes to be nice and flexible so nutrients can get into your cells waste products can get out of your cells and all of your hormone receptors are embedded in the surface of your cells. 

So the hormones have to come through your bloodstream attached to these cell receptors and that’s what tells your cells what to do. If your cell membranes don’t have enough omega threes they get stiff. Especially if you’re eating trans fat like deep fried food they get stiff. So now the nutrients don’t get in the waste products don’t get out and your hormone receptors don’t work properly. So omega three is some kind of a good pharmaceutical grade fish oil is another really good one. A probiotic is a good one for a lot of people. If you really have a lot of digestive problems you might need a little bit more help and just grabbing a probiotic might not fix everything. But if you’re generally healthy taking a good quality probiotic can just help to keep your gut healthier because God health is so so important for hormone health. And then vitamin D. It’s best to get your vitamin D. Level tested and we want your vitamin D. Level to be optimal. But the vast vast majority of people are low in vitamin D. And so for most of us we need to take additional vitamin D. In order to really get our level to where it needs to be. So those are kind of the four things that I find most people really benefit from. But of course there are very targeted things that we can do based on how people are feeling. So one of the herbs that we use a lot is Ash Lagonda and Ash Lagonda is an herb from India. It’s been used in ayurvedic medicine for you know thousands of years. It helps adrenal health. 

So for cortisol levels and thyroid health It is great for mood. So there are studies that look at symptoms of anxiety, depression feeling stressed and tired and show that when people take Ash Lagonda those mood symptoms get much better because the hormones impact our mood. So Ash Lagonda is something that we use a lot of. And there are many many other herbs that kind of do similar things and they’re often sold in blends. So there’s lots of different sort of stress relief supplements out there that have herbs. Another supplement that we use specifically for women who have signs of estrogen dominance when their estrogen is a little too high would be dim die indoor methanol and that helps to flush estrogen healthier way. So these other ones are things that we would be more likely to test people figure out exactly what’s going on and then recommend the supplements after the fact. 

Diane Mueller​, ND, DAOM, LAc

And then how often are you actually doing H. R. T. Can you talk about the different types of H. R. T. When it’s safe when it’s not those types of things.

Deb Matthew, MD

Okay so hormone replacement therapy got a bad name about 20 years ago when I was in medical school in the nineties I was taught that all women should go on hormone replacement therapy for their own good because it was going to protect our heart, brain and bones. And then the study that came out and said oh wasn’t really protecting the heart and it was causing breast cancer. So overnight hormones went from the greatest thing since sliced spread too bad dangerous you’re gonna die. And it’s taken 20 years to really kind of help reverse that. But today what we understand is that we made a mistake just like we used to tell you the eggs are bad and now we tell you the eggs are good, we told you hormones were bad and now we’re saying we were wrong hormones are good. So the studies that are coming out now are showing that women on hormone replacement therapy live longer have less breast cancer, not more breast cancer. They have less dementia, less osteoporosis, less hip fractures etcetera. They live longer. But it matters what kind of hormone therapy we’re giving women. So where we went wrong in the study 20 years ago is we were giving women synthetic hormones. So they were drugs man made drugs, chemicals that were never found in a woman’s body but we were assuming that they worked the same and the reality is they didn’t. So in this pill that we were giving women, there was estrogen and there was a drug form of progesterone, it wasn’t even the estrogen that was the problem. It was the drug form of progesterone, it was called. It was called hydroxy progesterone acetate. 

But we have many, many, many drug forms of progesterone, they’re all called progestin. And this drug form of progesterone is the one that was increasing the risk for breast cancer. If we use bio identical hormones, that means hormones that are an exact match for what our ovaries used to make. Then at least in theory, your body can’t tell the difference between whether it came from your ovary or came from the pharmacy and women on these hormones do not have an increase in the risk for breast cancer. So This has been a really big myth for us to bust. Over the last 20 years, generations of women have missed out on the really, really beneficial effects of hormones. They affect our mood. Our energy are really to me, I think it’s our brain, right? If it was just hot flashes, we get over it, but it’s how it affects our brain, our mood, our memory, how we get along with our husband or our partner, you know, so what we use in our practice our bio identical hormones when women are in their thirties and forties, often what they need is progesterone and really of all of them, this is the one that is the most important one to be bio identical, but often women will also can sometimes benefit from some progesterone. 

So we have ways that we can try to boost these up naturally without using the hormone replacement. But if that doesn’t work or if the symptoms are severe, sometimes giving the hormones back feels a lot better and then eventually we hit menopause and estrogen drops and then we can add in some estrogen. So the important things to me about hormone replacement therapy is we need to measure your hormones first because we only want to be giving you hormones you’re deficient in. We want to be using moderate doses, like we don’t need to be giving you a bath in these hormones, it’s not like more is better and you need to be like you’re 18. Again, we wanna monitor for side effects, you should simply feel normal, you shouldn’t have side effects from the hormones, but just like everything else. If you have too much or too low, you might have some side effects. It’s just a matter of adjusting the dose and then we want to repeat the test to sort of make sure that we kind of got you in the right range. And when we do that, we can transform people’s lives and just you just get back to feeling like you, again, I had a patient the other day and I really think she summed it up because the most common thing that I hear women say when they come to see me is I still feel like myself, like this doesn’t feel normal, Something’s not right. I just want to feel normal again. And so this patient, she basically just said, I just want Kathy back.

Diane Mueller​, ND, DAOM, LAc

Yeah. Yeah. That’s a great story and I think it’s super important what you’re saying the comparison to eggs and the myths and that sort of thing, because I just see so many people, especially women that are super afraid of taking hormones and everything is in the garbage, right? The hormone levels are like practically flatlined, but they’re scared to death. So really, really appreciate you clearing up that myth, anything you feel like we’ve missed in this discussion. That’s really important to talk about today.

Deb Matthew, MD

I can’t think of anything big, but but here’s what I’d like to maybe leave with is I feel like all of us need to take charge of our own wellness and you know, people are here listening because they want that, right, They wanna know, they wanna learn, they want to take charge. But I feel so bad for people out there who think that they’re going to go to their doctor and their doctor is going to give them the pill that’s gonna fix them and the reality is the human body is so complex and so fascinating. We don’t have a pill that’s gonna fix everything. Your doctor can’t fix you with the still, The best they can do with pills is they can do some damage control. They can maybe dampen down some symptoms sometimes, but the pills don’t make you well. Like if you’ve got strep throat and give you some penicillin, Ok. 

That can make you well. But other than acute infections, these you know, how long do you have to be on your cholesterol medicine, Your sleeping pill, your blood pressure medicine. So taking charge of our own health, doing some of the simple things and you know, let me can I just maybe leave with one thing. Like if you do one thing after listening to this today, an easy thing because some of these things we said, we’re kind of hard and complicated. An easy thing is just change your veg to change the cooking oil in your house, throw out the vegetable oil, the safflower oil, canola oil, whatever you got and replace it with extra virgin olive oil or avocado oil. Get the organic kind. That’s easy. That’s a two second decision at the grocery store. It’s gonna cost you, I don’t know, an extra dollar a little bit extra. And then you just use it, right? It’s easy after that. So that’s like the easiest thing that you can do that will actually have an important impact on your hormones.

Diane Mueller​, ND, DAOM, LAc

I love it. I love the simplicity of it and I know you have a giveaway for our listeners? I want to make sure everybody knows how to get ahold of you. So how do people find you and what are you giving away to our audience today?

Deb Matthew, MD

Okay, so my practice website is signaturewellness.org and there’s lots of information on the website. The giveaway that I have is my book, it’s called. This is not normal. A busy woman’s guide to symptoms of hormone imbalance. And I wrote the book to help women figure out like could how I’m feeling be because of a hormone imbalance. So it’s got lots of checklists, like quizzes you can go through and do the quizzes and see like could it be low testosterone, could it be high cortisol? And then it’s got some tips for what you can do to start getting your hormones and and really importantly, it has information about how to talk to your doctor, what to ask for, what to say, how to know if your doctor is maybe not the right one, and if you do need to find a different kind of doctor to help you with this, where can you look for a doctor? So it’s got some resources for where you can find a doctor who can really help you get your hormones about.

Diane Mueller​, ND, DAOM, LAc

Super great, thank you so much for being with us today. Dr. Deb I really appreciate your time.

Deb Matthew, MD

Thanks for having me.