Experiencing Anxiety & Sleep Problems in Perimenopause?

Transcript:

MELANIE: Welcome to Dishing Up Nutrition. Our podcast today is brought to you by Nutritional Weight & Wellness. We're a company in Minnesota that specializes in nutrition education and counseling. I'm Melanie Beasley, a Licensed and Registered Dietitian, and here with me today is Kara Carper, who is a Licensed Nutritionist and board Certified Nutrition Specialist. And I believe our topic today is going to resonate with a lot of women.

Common symptoms women experience in perimenopause

We're going to be discussing two of the most common symptoms that women experience when their hormones start to change. And this stage is called perimenopause, which is the transition to menopause.

KARA: That's right. And perimenopause usually starts in a woman's mid to late forties, but it can begin as early as her thirties. And research shows that on average, women are in the perimenopause stage for about four years before they stop having menstrual cycles. But you know, it can last longer, even up to 10 years. So if you're listening and you're in your thirties, your forties or your fifties, you very well may be in perimenopause.

MELANIE: Yep. And if you're in the age range Kara mentioned, you may be experiencing irregular menstrual cycles. They may be longer or shorter than usual. You might also have different menstrual flow. It might be lighter or heavier than your normal flow and you think something's up here.

KARA: Something's changing. There could be breast tenderness or changes in breast size or shape. Also changes in urination are quite common. Usually it's more frequent urination.

MELANIE: Yeah.

KARA: And hair thinning or hair loss, that's another sign of perimenopause.

MELANIE: Your body's thermostat really starts to change and hot flashes and night sweats can begin and that's pretty common.

This podcast’s focus: problems with sleep & anxiety in perimenopause

KARA: And of course, night sweats will often disrupt sleep. Today we're going to focus on two specific symptoms of perimenopause that are closely related. It's problems with sleep and increased anxiety. Sort of the chicken and egg scenario. Is your increased anxiety preventing you from getting a good night's sleep? Or is your insomnia leading to more anxiety the next day? If you were tossing and turning all night long, chances are you're not going to wake up feeling fresh and calm.

MELANIE: Yeah. And many of my clients tell me they are miserable during these perimenopause years, and they just want to wake up feeling rested and calm, get back to feeling like themselves. Well, we have some natural solutions for you in our show today. So get a pencil, take some notes.

What is perimenopause & menopause?

KARA: Before we get into the solutions, I do want to take a moment to define perimenopause and menopause. A woman is considered being in menopause when she hasn't had a menstrual cycle for 12 consecutive months. The changes that are happening hormonally up until that point are referred to as perimenopause.

MELANIE: And the average woman will go through menopause around 51, but really this varies.

KARA: I actually have a relative and a friend, so two, two females in my life who went into menopause in their early forties and that is pretty young, but that can happen. On average, menopause occurs anywhere from ages 45-55.

MELANIE: Well, I'm really glad our topic today is focusing on anxiety and sleep problems during perimenopause because when I meet with clients, they're often surprised when I explain that increased anxiety and difficulty sleeping are common symptoms of those changing hormones. And everybody has heard about hot flashes. I feel comfortable saying that. But some of the other perimenopause symptoms are not as well known.

KARA: A recent survey, this was conducted by the American Association of Retired Persons. You probably have received mail. I know I started receiving mail in my forties from ARP.

MELANIE: Yeah. Isn't that fun?

KARA: It's a blast. So, ARP found that only 18 percent of women over the age of 35 felt that they were well informed about the impact hormonal changes can have on the body as they're aging. So really, that's only one out of five women who feels comfortable and prepared for perimenopause or menopause.

MELANIE: Yeah.

KARA: It's not a big number.

MELANIE: It's not. And I hope that some of our listeners are tuning in prior to experiencing midlife hormone changes because half the battle is knowing what is going on with your body and why it's happening.

KARA: And that way it's just, it's not a surprise and you don't feel like, oh, is something wrong with me? You realize that it's related to these hormonal changes. When it comes to anxiety during perimenopause, this anxiety can present differently. Some women describe that they just kind of feel on edge. There's often more irritability, being short tempered, less patient. Perhaps you're snapping more at your kids or your partner.

MELANIE: Yeah. And for some women, they notice an increase in social anxiety, or they may feel more anxious in certain settings like work. There can also be physical symptoms as well, such as increased heart rate, feeling flushed or hot or shaking. You're thinking, what is going on?

KARA: Anxiety can happen throughout the day, but a lot of times it does get worse at night. Picture yourself, you're trying to go to sleep. Do you find yourself lying awake thinking about what you said during your work meeting? Or are you planning out your kid's schedules in your head for the next day when your brain should be shutting off to allow a good night's sleep? When the mind is racing, it's very hard to get to sleep. I've experienced that many times. It's just really frustrating.

Hormone fluctuations can cause symptoms during perimenopause

MELANIE: I experienced it too and I blame two hormones that change the most in perimenopause and they are progesterone and estrogen. The change in estrogen looks much different than the change in progesterone. During the reproductive years, your ovaries make most of the estrogen. So it makes sense that as women get older, ovaries will make less and less estrogen. Essentially, they're starting to get tapped out.

KARA: In the perimenopause years, estrogen rises and falls unevenly though. So sometimes there will be spikes in estrogen and then dips. But with the hormone, progesterone, it's more of a steady decline. And eventually when a woman stops ovulating, the ovaries stop producing progesterone. And our bodies make more progesterone compared to estrogen. That might be new information. So when progesterone starts to decline in those midlife years, the effects are often much more noticeable. Declining progesterone is a really big reason for that increased anxiety.

MELANIE: Yeah. And progesterone is so important because it stimulates the GABA receptors, which like you love to say:

KARA: GABA is like our nature's Valium.

MELANIE: Yeah.

KARA: I know. I swear by GABA. I really do. It's really, it's the main calming neurotransmitter in the body. GABA has an antidepressant effect, stress reducing effect, and it's slightly sedative. So think about that. As progesterone is declining, so does GABA. And this can lead to mood changes, sleep problems, less stress resilience. So women are more likely to get easily stressed or easily anxious.

Balance blood sugar to reduce anxiety & increase stress resilience

MELANIE: Yeah. And we have a few tips on how to reduce anxiety and increase stress resilience. You know, balancing blood sugar levels throughout the day is going to be very important. And how do we do that? Well, it's by eating several times per day and balancing out those meals and snacks. Each one, each meal, each snack should have a good source of protein, some complex carbohydrates in the form of vegetables, and healthy fat.

KARA: And I thought Melanie and I could just give some examples of some balanced meals and snacks, maybe that we eat, or Melanie, maybe something your clients are really enjoying that's balanced. Just an example, I do like eggs. And so for breakfast, that is often my source of protein. I will frequently have three eggs, pasture raised with a nice deep yellow yolk full of nutrients.

Cook that up in some healthy butter. That's my fat. And I will often just kind of sauté some spinach. I do like to have like a small apple or a piece of fruit on the side, maybe a half a cup of berries instead, just to get a little bit more carbohydrate. And to me, I mean, that will give long lasting energy and good moods for several hours.

MELANIE: A hundred percent. And I love a big salad at lunch, especially in the summer. So I'm really into snipping herbs from my garden. So I will make, I did some black beans, about half cup of black beans. And then I do mint and parsley and cucumber, some pumpkin seeds in there and about four to five ounces of chicken and just lemon juice and olive oil. And I love that. That's one of my favorite salads.

KARA: Sure. So for you that, I mean for anybody, that would be a fantastic balanced lunch or dinner.

MELANIE: Yep. Any type of meal. And what we mean by balance is it's not giving your blood sugar a big spike and it's not going to crash later, which in turn affects those hot flashes and anxiety.

KARA: Absolutely. Yeah. The spike comes down in the dip leading to more night sweats, hot flashes, anxious feelings, lower stress resilience, everything we just talked about.

MELANIE: If you think of a rollercoaster blood sugar, it's real, it equates to rollercoaster emotions.

KARA: Yes, it certainly does.

MELANIE: Well, when we eat carbohydrates, insulin is an important hormone that helps control the amount of sugar or glucose in the blood.

KARA: I'm glad you brought up insulin because all hormones are interconnected, which means when one hormone changes or shifts, others are affected as well.

MELANIE: And I think it's important that our listeners know that insulin is your master hormone.

KARA: It is absolutely the master hormone. So everything is related to insulin. And when a woman's estrogen and progesterone are fluctuating during perimenopause, this also creates more fluctuations in blood sugar or glucose levels.

So women are more vulnerable to high and low blood sugars. So it's even more important during these hormonal changes of midlife to focus on stabilizing blood sugar levels. And so we're not having the rollercoaster that Melanie referred to.

MELANIE: Yeah, I agree. And then estrogen plays a role in insulin sensitivity. So when estrogen is declining, it becomes easier and easier to develop insulin resistance.

KARA: So although our topic today is not focused on weight gain that can sometimes come with perimenopause or menopause, this is still a good time to point out that there is a connection because many women in perimenopause and menopause complain I haven't changed anything with my eating or my activity levels, but I seem to be gaining weight.

Well, that's because it is easier to become insulin resistant when hormones decline. There's not as much wiggle room when it comes to overeating carbohydrates, processed carbohydrates, or sweet treats.

MELANIE: Or that glass of wine in the evening that you've always had. Suddenly you're developing you know, a little excess weight, a belly pooch, and it's frustrating, which in turn leads to some anxiety. So you may be wondering how and why balancing blood sugar and avoiding insulin resistance can help reduce anxiety.  

Well, we touched on you just feel better about yourself. But can you think of a time when you skipped breakfast and by late morning you started to get a little hangry? This is when your husband doesn't breathe properly. That's when your children chew too loudly. So when the body experiences low blood sugar, it attempts to correct this by producing adrenaline. And adrenaline is a hormone that causes the fight or flight response.

KARA: Again, women are in a much more vulnerable state during perimenopause when it comes to feeling anxious and feeling on edge. So that's why focusing on what you can control. is really important. And what you can control, ladies, is what you're eating and how frequently you're eating and whether it's balanced or not. Like we talked about that protein, veggie, carbohydrates, and healthy fat, the proper balance of those three macronutrients.

Eliminate or decrease processed food & caffeine to decrease anxiety

MELANIE: And I would say if you were feeling anxious, a lot of times, what do we reach for? Comfort foods like mashed potatoes and potato chips or crackers. But if anxiety is a real issue for you, it's best to either eliminate or really decrease processed foods as well as caffeine. We should talk about caffeine.

Caffeine on an empty stomach can spike blood sugar even more. And the crash that comes afterward can lead to anxiety. And I can remember being in perimenopause and I had a great big cup of chai every morning. Not the sugary chai, but the tea bags. And that caffeine, I would just feel anxious and irritable afterwards. So it had to go.

KARA: Yeah. Yeah. It's really important to pay attention to those body signs like you did Melanie. I'm also sensitive to caffeine and if I do have a cup of coffee and an empty stomach before breakfast, I tend to get shaky, hot. I feel my heart racing. I'm more reactive to stressors.

MELANIE: Oh my goodness.

KARA: So even just if I pair my morning coffee with some breakfast, it helps to blunt the effect of the caffeine. So that's personally what works for me. Some women are more sensitive than I am and would do better by switching to something like herbal tea that does not contain caffeine or maybe green tea that has less caffeine than coffee.

MELANIE: Still has some, but yeah, I can't even do green tea. I'm that big of a weak link when it comes to caffeine. So I'm an herbal tea girl.

KARA: It's important for people to hear that though.

MELANIE: Yep. There's some great, delicious herbals out there. So I want to circle back to some of the hormonal changes that happened during perimenopause. And you had mentioned, Kara, that the progesterone really production really starts dropping at this time. And I want to mention that progesterone is available in a tube form and that you can get over the counter.

And if you're already eating in balance and not skipping meals and watching your caffeine intake, but you are still struggling with anxiety, I would suggest trying out one of these progesterone creams that are made from yams. It's completely natural. You could try that.

Symptoms of low progesterone

KARA: And if you're wondering, you know, is my anxiety coming from declining progesterone, I'm just going to give some other examples of what symptoms would be from having low progesterone. So in addition to mood swings and feeling heightened anxiety, if you've also noticed spotting or bleeding between menstrual cycles, or maybe a shorter menstrual cycle, if you have noticed prolonged heavy bleeding or just in general, more heavy periods, premenstrual syndrome, headaches and migraines, having issues with fertility and trouble sleeping. Those are all signs of having low progesterone.

MELANIE: And the Journal of Clinical Pharmacology published a research study in 2018 that showed when progesterone cream was applied for 12 days, twice per day in the amount we mentioned, a fourth to a half teaspoon, that hormone levels in the bloodstream were restored to their same level as progesterone during menstruation years.

KARA: You are listening to Dishing Up Nutrition and our topic today is, are you experiencing anxiety and sleep problems in perimenopause? Most women understand that hot flashes are a common symptom of perimenopause and menopause, but other symptoms such as anxiety and insomnia are not as well known. If you have female friends, family members, or colleagues who are in perimenopause, it's important for women to know that hormonal changes can affect moods and the brain just as much as our bodies. So we'll be back after a short break.

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Sleep problems are a common symptom of perimenopause & menopause

MELANIE: Welcome back. You're listening to the Dishing Up Nutrition podcast. Are you in your thirties, forties or fifties and have noticed increased anxiety or problems falling or staying asleep? Well, these are normal part of hormones changing during midlife. And today we are giving natural solutions on how to lessen those. So, I want to move into the information that we've covered on anxiety is very similar to nutritional solutions we'll be giving to get a better night's sleep. And I would say sleep problems are one of the most common issues that I hear in clinic. But especially during the perimenopausal or menopausal years.

KARA: So, listeners, have you noticed this? Maybe you're in your 30s, your 40s, or your 50s, and you feel like as soon as your hormones started shifting and changing, that either the quality or quantity of your sleep has declined. Maybe you can relate to that.

MELANIE: Yeah. One of the biggest complaints I hear is something that we refer to as, you know, surface sleeping. You might be sleeping, but you're not getting into that deep restorative sleep that we neem for rest and repair. And if you're surface sleeping most of the night, most likely, you're tossing and turning even after being in bed for 7 to 8 hours. You might wake up feeling tired and groggy. You just feel like you didn't get enough rest, or it feels like every little sound wakes you up.

KARA: Oh, that light sleeping.

MELANIE: That was me.

KARA: Oh. Yeah. Yep. I can relate to that. The National Sleep Foundation gave a poll in 2022. 60 percent of women in America said they only get a good night's sleep less than half the time. And almost 70 percent said they frequently experienced sleep problems. Those in perimenopause or menopause were the ones who reported the most problems with sleeping. And so that's not really a surprise after we've been talking about why that happens.

MELANIE: Yes. And surface sleeping or sleeping lightly, it's definitely an issue during perimenopause, but are there other things keeping you awake at night? What about night sweats? Is that happening to any of you? Oh, I had the worst.

KARA: I know. I remember you talking about that. I felt so bad.

MELANIE: I might have a little PTSD whenever we do this. Okay. Sometimes hot flashes and night sweats are one of the first signs of going into perimenopause and these can really disrupt sleep. My clients have told me that they have to get up out of bed and sometimes more than once. They change their clothes or even have to change their sheets because they soak right through them.

I remember I was in a small group Bible study and there were three of us that were going through perimenopause/menopause and we all had rubber hair binders on our wrists and you could tell when one of us was flashing because you would grab your hair and throw it up in a ponytail at any given time.

KARA: Oh goodness.

MELANIE: Yeah. It was just, we were all hot. We probably all had layers on as well. Oh, and you never put anything on that you can’t rip off really quick.

KARA: Oh my gosh.

MELANIE: I wish I would have known what I know now.

KARA: Yeah. Yep. Well, we're help, hopefully we're helping to educate people so they don't have to go through that. I've heard about women sleeping with a fan pointed directly at them. Depending on your sleeping situation, you know, some of these things can disrupt your partner's sleep as well. So nobody wants that. In addition to light surface sleeping and night sweats, the increased anxiety and brain shatter can keep you from being able to fall asleep as well.

MELANIE: Yeah. I've heard it called monkey mind, and let's talk about what causes light surface sleeping. Or maybe it's more noticeable than just light sleep. Have you ever woken up in the middle of the night and felt wide awake like you had a rush of adrenaline? Or do you wake up several times during the night?

That's the most frustrating thing in the world when you can't get back to sleep right away. Maybe your spouse is sleeping soundly beside you. You almost want to poke him with a sharp stick. I mean, they're sleeping and you're wide awake having to be quiet.

Tip for getting better sleep: include a balanced bedtime snack

KARA: Fortunately, there's usually a simple solution for that particular issue and it's having a small bedtime snack. Now, the snack can't just be anything because some snacks or meals close to bedtime will actually cause you to wake up more frequently during the night. What we're talking about is a snack with a serving of healthy fat paired with about a half cup of carbohydrates. So if you're someone who likes to measure using grams, you know, what I'm talking about is 15 grams of a healthy fat and 15 grams of a healthy carbohydrate.

MELANIE: That's going to anchor that blood sugar from dipping. We often talk about the bedtime snack that has two tablespoons of heavy whipping cream and not the kind that you spray out of the can with sugar and propellant. But the kind that you whip up into whipping cream. And then add a half a cup of berries, fresh or frozen. Berries are a lower sugar fruit. So it's kind of nice. You can actually pop that to like three fourths of a cup.

And if you whip up the cream to make it more decadent, it's delicious. If you whip it together with frozen berries, also delicious, but it tastes great if you just drizzle it over your berries.

KARA: Yeah. And really the heavy cream that you're referring to Melanie, that's the healthy fat that will anchor the blood sugar and the small amount of carbohydrate pairs well with that to stabilize blood sugar.

MELANIE: And it anchors because fat is broken down slowly. And so it's kind of buffers the reaction of the sugar from the fruit.

KARA: Yeah. Great explanation. And also fat does not raise our glucose; like carbohydrates we know raises glucose, but the fat does not. Another quick and easy bedtime snack that we like at our house, and this will stabilize glucose levels as well;

Two tablespoons of a nut butter and a small apple, maybe half of a larger apple. If you don't like apples or you can't tolerate them, you can replace that with something like a small banana or half of a large banana.

MELANIE: Yeah. Yeah. That's a good point. One of the things that is super delicious is if you get a banana, a firm one, half a banana, slice it, or a whole banana. You can slice them and make little peanut butter sandwiches. Put them on wax paper and freeze them. And then you just want to take the half of that amount and that would be your snack or split it with someone.

KARA: I'm definitely going to do that. My daughter will love that. So little banana slices and then you put a nut butter in between the two little slices and freeze that.

MELANIE: Yes. It tastes like banana peanut butter ice cream.

KARA: Great. Great.

MELANIE: So, one of our nutritionists who's in perimenopause says that when she eats a half an avocado and a half a cup of berries before bed, that her sleep is greatly improved. One of the things I suggest to my clients is a half of an avocado, half of a banana whipped together with some cocoa powder, tastes like chocolate pudding.

KARA: Oh, that's another great one.

MELANIE: So it feels like you're getting away with something

KARA: And it's good for you; helps you sleep better. But that makes a lot of sense that avocados would be a good choice, especially before bed. Avocados have several nutrients that support good sleep. First of all, they do contain the healthy fat to stabilize glucose; fiber also, and that's going to help stabilize glucose. They're also high in magnesium. Magnesium is a calming mineral.

MELANIE: I do want to mention you want to avoid processed carbohydrates made from grains and these will spike the blood sugar. So if you're used to having popcorn, which we all think it's the healthiest whole grain snack, no popcorn or chips or crackers. Or another sweet treat before bed. That's probably making your sleep issues worse, spiking your blood sugar, causing a rush that gives you a hot flash. So that's not one that we recommend. Plus it's, we want real food to nourish the body.

KARA: So I do have a quick example of something that pops into my mind whenever I think about eating certain foods before bed that cause us to wake up in the middle of the night, like an adrenaline rush. I remember having sushi on Valentine's day, several years ago, and we made it; homemade sushi, so we were eating kind of late. It takes a very long time to make homemade sushi, but it had quite a bit of rice as sushi often does. And I ate a lot of it and I went to bed at my normal time. And I remember about two o'clock in the morning, I popped right awake.2

MELANIE: Oh.

KARA: Like I was up for the day and I thought, what is happening? And then it occurred to me, I had had so much rice, which is a very starchy carbohydrate

MELANIE: That converts rapidly to sugar.

KARA: Yup. And it raised my glucose, which came crashing down at 2 a.m. and I was awake for a couple of hours.

MELANIE: Oh my goodness. So that's just an example of how specific foods, especially those carbohydrates can cause the middle of the night wake ups. And sushi has gotten such an unwarranted rap for being a healthy food. Not so. It's loaded with rice. A lot of the raw fish, tuna, high in mercury, I mean, it's just, it's not the best. It's a sometimes treat. Right?

Beverages that can affect sleep negatively

KARA: Exactly. Exactly. Well, since we're talking about foods that are not going to support sleep before bed, I do also want to bring up beverages, drinks that can affect sleep negatively during perimenopause. So have you started noticing that the wine that you used to be able to drink before, during or after dinner has started causing night sweats to be more frequent? So that is a connection that we hear a lot.

MELANIE: Yes. And sometimes you don't even have to wait. It can be within 30 minutes of having that glass of wine. You get that flush and it's plain havoc. So that is a biggie. And we hear it all the time. For some women, it doesn't serve them well anymore.

So, put some bubbly LaCroix or bubbly or something like that in a drink, maybe a Perrier in a, your wine glass and you're not going to hot flash as much. So just like the processed carbohydrates, we talk about alcohol, it does the same thing causing that blood sugar spike and dive. It could be in the middle of the night, could be when you're trying to socialize and suddenly you're dripping in sweat.

KARA: And if sleep is an issue for you, we suggest that you consider stopping your caffeine by around noon. Avoid caffeine in the afternoon and evening if you want to improve your quality and quantity of sleep.

MELANIE: Yep. And I do want to revisit caffeine. So caffeine stays full strength from the time you drink it for seven hours. Then it goes to a half strength for seven hours and then it goes to a quarter strength for seven hours. So if you were really struggling with sleep slowly so that you don't want to write us a bad review, get a headache, slowly decaffeinate and see if your sleep improves. It did for a lot of my clients that really improved.

KARA: And for you as well.

More on natural progesterone cream for perimenopause/menopause symptoms

MELANIE: And for me. Yeah. I can't even have like a decaf after three o'clock or it bothers me. There's just enough caffeine. So early in the show, we discussed using natural progesterone cream for anxiety. And Kara, you mentioned that you like to use it both during the day for anxiety and at bedtime. Tell us more about that.

KARA: Yeah. Yeah. So the progesterone cream, the natural progesterone cream that I use, helps with a lot of different perimenopause symptoms when it comes to sleep. So remember, progesterone is helping our bodies to produce the calming neurotransmitter that's called GABA. Many women report that by just using a small dab of natural progesterone cream before bed, they start sleeping more soundly.

KARA: And I know that is the case for me.

MELANIE: And me.

KARA: And for you. For me, you know, my brain chatter subsides. I am not getting night sweats, and I can really relax and just get into a deeper sleep.

Magnesium is helpful for anxiety & sleep

MELANIE: Yeah. And as you can see, there is, it's quite a bit of a crossover when it comes to natural solutions for anxiety and sleep problems during perimenopause. So it's kind of a blend. It all works together for your body's good. And a mineral that is beneficial for both anxiety and sleep issues is called magnesium. And magnesium is a mineral that's calming and relaxing. And according to the World Health Organization, three out of four Americans do not get enough magnesium from their food sources.

KARA: If you're wondering, how do I know if I'm deficient in magnesium? Here are some common symptoms of a magnesium deficiency: trouble falling asleep or staying asleep, increased anxiety, muscle cramps, charley horses, muscle twitches, and including the eyes as well. If you have twitchy eyes, that can be a sign of low magnesium.

MELANIE: Yes.

KARA: And in general, just muscle tightness.

MELANIE: Yeah, I think of traps. A lot of people will complain of their traps, their, between their, your shoulder and your ears is, it's so tight. And typically all the signs of low magnesium end up with some sort of tightness or constriction anywhere, and even high blood pressure, which is a constriction of the blood vessels. Headaches and migraines are another one, and constipation as well. So if you don't have enough magnesium, your system is off in so many areas.

KARA: And that's because the mineral magnesium plays a role in more than 300 different processes in the body. So no wonder there are so many signs.

MELANIE: 300.

KARA: There are so many signs of low magnesium. We do like the food first approach at Nutritional Weight & Wellness. So we want to talk about foods that are going to be high in magnesium: things like the dark leafy greens, meat, especially grass fed pasture raised, nuts and seeds. And I had mentioned avocados are also high in magnesium.

MELANIE: Great sources of magnesium. And we encourage you to eat as many magnesium rich foods as you can throughout the day. But sadly, the soil our crops grow in today, as well as the crops our cattle feed on, are not nearly as rich in nutrients and minerals as they used to be. And this includes minerals like magnesium. So we may not be getting a lot of magnesium from food.

KARA: And on top of what you just talked about with our soil being more depleted these days, there are certain foods and certain drinks and other factors that can cause our bodies to excrete and lose magnesium on a daily basis. So eating sugar and processed carbohydrates will cause us to lose magnesium.

Soda and alcohol and caffeine do the same thing. I also want to mention that exercise lowers magnesium. Movement is very important, but it's important to know that sweating and exercising will naturally deplete some of the minerals in our body.

MELANIE: Or if you're someone who struggles with diarrhea, you're losing magnesium or stress burns through magnesium. So if you're in a stressful period of your life, that magnesium can be burned through. And the good news is, there are other ways to get magnesium. Women often need 400 to 600 milligrams of magnesium to be effective for sleep.

On the average, I would say I get 6 to 8. And the bonus is, if you have other signs of magnesium deficiency, you'll notice fewer leg cramps, more relaxed muscles, fewer headaches just to name a few. Your blood pressure may come down when you get that optimal range. And Magnesium Glycinate is the form we typically recommend for the best sleep support. Don't run out and get a citrate or an oxide.

KARA: Oxide is not absorbable. It's a low quality, cheap form. Citrate can be used in some situations, but it can act as a stool softener. So if you're someone that struggles with loose stool already, you're definitely going to want to avoid the citrate.

MELANIE: Yeah, and because the oxide is not absorbed well, it causes diarrhea, too. So nobody wants that on top of being hot and sweaty.

KARA: Yeah. So I would just say, you know, really stick to that magnesium glycinate. It's very absorbable. It's high quality. And if you do have issues with sleep, take all of them at night. I mean, that's what I do, and it greatly improves my sleep. I take 400 to 600 milligrams personally.

MELANIE: And I like a chelated form of Magnesium Glycinate, so it should say chelated. If you roll it over on the back, it should say chelated or from Albion labs, then you know, you've got a good one.

Recap

Well, just to circle back to some of the main points to get you some relief is first look at blood sugar. Are you eating a balanced protein, carb, and fat at every meal; so you don't have those rollercoaster blood sugars, which end up with rollercoaster hot flashing, moods and anxiety.

KARA: And if you do struggle with sleep, whether that is just brain chatter, or maybe you're waking up from night sweats, just add in a nice, healthy, balanced bedtime snack that contains a serving of healthy fat and a serving of healthy vegetable or fruit carbohydrates.

MELANIE: Great, that's a really great point. And then finally one of the things that we talked about was adding in a few things and one of those things was possibly a progesterone cream. You can get it over the counter, a natural one and apply it on your thin skin and see if that doesn't help, but you have to give that a little while. You know, don't give up after a week. I would go through a full tube of it, follow the directions on the package and see if that helps with mood and sleep as well.

KARA: And because so many in our country are deficient in the mineral, magnesium, do consider, incorporating more foods that we discussed that contain magnesium and also consider taking a Magnesium Glycinate supplement before bed just to improve your quality and quantity of sleep.

MELANIE: We utilize our minerals best when we're sleeping. So we want to get sleeping and we want to make sure you get enough minerals, especially if you're having leg cramps or any of the signs that we talked about where you could be deficient. So our goal at Nutritional Weight & Wellness is to help each person experience better health through eating real food. It's a simple yet powerful message. Eating real food is life changing. Thanks for listening and have a great day.