Perimenopause Q & A with Ann Louise Gittleman
December 18, 2017
Do you suffer from insomnia, hormone fluctuations, irritability, or thyroid issues? These symptoms, and more, can be related to perimenopause, the stage before menopause.
Ann Louise Gittleman, First Lady of Nutrition, answers questions about how to handle some of your body’s perimenopause symptoms with good nutrition. Listen in!
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Transcript
DAR: Welcome to Dishing Up Nutrition, brought to you by Nutritional Weight & Wellness. I'm Darlene Kvist, certified nutritio specialist and licensed nutritionist. I believe many of you will want to stay tuned today because this morning we have a very special guest on Dishing Up Nutrition who will be happy to answer your questions about perimenopause and even about menopause. So, start thinking about your symptoms and your personal questions about hormones because Ann Louise Gittleman, author of Before the Change, nutrition for menopause, will be joining us really in a few minutes by phone.
MARCIE: That's right. Good morning and thank you for tuning in today. I am Marcie Vaske and I'm also a licensed nutritionist who really wears a lot of hats for Nutritional Weight & Wellness. I'm usually out counseling clients individually at one of our seven locations many times a week. I work with clients either by phone or even Skype and on some days I'm teaching our lunch and learn classes at a variety of businesses and social organizations around the metro area. And I even represent Nutritional Weight & Wellness at many of our health fairs. And I really do enjoy it. I love getting out there and meeting people and spreading our word about just eating real food. So, every day I have the pleasure of helping people understand the benefits of good nutrition. I love it. It’s a passion.
DAR: Yes, it is. So today we’re with author Ann Louise Gittleman. We're going to talk about how you could take charge of your perimenopause and take charge of your symptoms. Personally, I've followed Ann Louise’s teachings for over 20 years.
MARCIE: Yes. I remember when I first started and you were talking about her. And I thought I’ve got to figure this Ann Louise out.
DAR: So, I've been learning from her. And today, you can learn from her because, although Ann Louise is a well-known expert in the field of nutrition, she's always willing and ready to answer your questions.
MARCIE: Yes, and we are so happy to have her with us today. I'd like to share a little more about Ann Louise to our audience. She is considered the first lady of nutrition and is a New York Times best-selling author of over 30 books on diet, detox, the environment, and women's health. And they are full of valuable information. Such good stuff. Ann Louise has been recognized as one of the top 10 nutritionists in the country by Self magazine. So, let's welcome Ann Louise Gittleman.
DAR: Yes. Ann Louise, welcome to the show. It's really an honor to have you join us today. So, let's start with a couple of just basic questions. What is perimenopause and how long can it last?
ANN LOUISE: Hi There. Thank you for your lovely introduction and it's a pleasure to be with you on Dishing Up Nutrition, as always. So, let's just dive into it because Perimenopause is a very interesting time of life and it's really the period of time, sometimes lasting up to 10 years believe it or not, before the actual onset of menopause itself, which is the cessation of your monthly cycle.
DAR: Think about this, Marcie, 10 years. It could be.
ANN LOUISE: Many of the symptoms which we can also dive right into are very kind of mystifying because they seem to masquerade as other diseases. So, when you look at what you can expect during this time of life then we're looking at sometimes times of anxiety, of more irritability, of the inability to sleep through the night, very often times the period itself starts to get irregular, there are fluctuating hormones, and this traditionally is the time when two specific hormones do a kind of seesaw job and that is your estrogen and progesterone. But typically, what we're finding is a time when progesterone production starts to plummet. So, typically, we used to think that this was a time of life when women needed estrogen. What we're finding from the newest research, which I talk about in great detail in Before the Change, is that it's more progesterone related where you're holding water, where you're irritable, where you're weepy. Sometimes women start to sprout hair on their chin. It's that time of life. And if you've never been through it, what a treat you have in front of you.
DAR: So, I think we know this when we're working with clients. People come in and they'll talk about their hair is thinning. That's another one of those symptoms, isn't it?
ANN LOUISE: Yeah, the thinning hair. It's really seeing your system, at all levels, getting older. And many women also start to get some weight around the middle. So, it's that middle age spread that starts to rear its ugly head. And even though you've been doing everything right up to this point, whether it's exercise or diet or even willpower, there's all kinds of biological changes that are prompting the excessive amount of weight around your middle. So, it's a time of life when you see you see all kinds of changes and you may also be juggling situations on the home front which are adding stress, whether that's empty nest syndrome, whether that's parents that are aging that you need now to take care of. So, it's not an easy time of life. It truly isn't. And it's one of the reasons that I wish I had a book like Before the Change when I was going through this period of life. I really would have liked to have gotten to the root causes of my mood swings, of my sleep, and my energy loss. And I'm hopeful that women will be able to benefit now that we've got something like Before the Change.
DAR: Ann Louise, one of the things that you kind of alluded to is that we actually have a deficiency of progesterone, but we have a little bit too much estrogen. Would you talk a little bit more about that, because that is kind of a new concept for a lot of people, because I think a lot of times women will go into the visits or their general practitioner and they'll be prescribed estrogen and actually that's not the hormone that you need.
ANN LOUISE: Not during this time of life, it's certainly not. And progesterone is really the counter hormones to estrogen. And, you're right, most people don't know about it. We didn't know about it until we got into this time of life. What we find is that adequate progesterone really starts to help your sex drive, depression, it also moderates blood sugar levels that helps with your thinking because there's a certain amount of progesterone, believe it or not, in your brain. It also figures into thyroid dysfunction and bone loss and fat gain and low adrenal function. So, many of the symptoms that women start to experience, and I know that you're very aware of this, as I am, because we're a little bit past the perimenopausal stage. We've been there, done that, and we know that progesterone at least in the form of maybe a natural progesterone cream is really very helpful to mitigate and navigate these symptoms safely and healthfully.
DAR: So, why might a woman suddenly have less progesterone and excess estrogen? What's going on with their body at this time? Maybe you could explain that to people a little bit.
ANN LOUISE: Yeah. And it's very interesting because I don't think that this situation was something that our mothers or grandmothers might have gone through. It's very new to the current generation and people of our age and stage of life. Those of us in our 50s and 60s. I think a lot of it has to do with the fact that we may still have a period, but we're not ovulating, and that's because of that estrogen dominance that you spoke about, whereby estrogen may also be fluctuating, but at least you've got more of it than you do with a dwindling progesterone. So, it's a really interesting type of relationship that starts to form. Also, there are not a lot of nutrients in the diet that are precursors anymore for progesterone, so you're not making it natively. And the mineral that we think of which is so key and so many people forget is the mineral zinc, which is very much related to the progesterone production. So, if you're deficient in zinc, as many of us are, based upon clinical studies, then you're simply not making enough of this balancing hormone. So, there's an awful lot that goes into play at this time of life.
DAR: I think I read some research where it's like 73 percent of us are deficient in zinc and so that's a lot of people. And that's actually influencing how our hormones are functioning or not functioning well. That's interesting.
ANN LOUISE: Yeah. And it's amazing because we don't always tell people to think zinc, and you've got to think zinc at this time of life, not just because it's a lovely anti-viral, it's also very helpful for your skin, for adult acne, for your hair. But again, because it is a precursor of this particular hormone, just the way copper may be related to estrogen, we find zinc related to progesterone and that's the seesaw of minerals. To me it’s the real key behind the estrogen dominance syndrome that's so popular today.
DAR: Oh, that's a good insight.
MARCIE: Yeah, I like that a lot. May we get into that after our break here? You are listening to Dishing Up Nutrition brought to you by Nutritional Weight & Wellness. We are pleased to have nutritionist and best-selling author, Ann-Louise Gittleman join us by phone to discuss her new and revised book, Before the Change: Taking Charge of Your Perimenopause and we'll be back in a minute.
BREAK
DAR: Welcome back to Dishing Up Nutrition. I’d like to get right back to our discussion about perimenopause with author and certified nutrition specialist, Ann Louise Gittleman. So, Ann Louise, how can people find you? Because I know they're going to want to know how can they find you and how can they find your books.
ANN LOUISE: Well, if they go to annlouise.com they can find me on my website, they can go to my Facebook page, they can join my special Facebook group, which is called The Fat Flush Nation, that's my weight loss program. But we also discuss many perimenopause and menopause and beyond menopausal issues on that particular Facebook group. So there are lots of different ways to connect. And I'm very happy to answer personal questions when I can on either of those sites.
DAR: That's fantastic. About 20 years ago you were in Minneapolis and you did a lecture on minerals and it was just absolutely fantastic. And you talked about zinc then and you talked about magnesium. And it's something that I really took notes and I've learned from that. And we use a lot of magnesium now for people that are having sleep issues. So, what else do you do, Ann Louise, for people that are just struggling with insomnia, struggling with their sleep?
ANN LOUISE: Oh, that's the toughest one of all. And it was my first symptom of perimenopause. I never had a hot flash. And I'm beyond perimenopause and beyond regular menopause at this point. Never had a hot flash. So, the symptoms are very atypical, but the inability to sleep or the ability to get to sleep and wake up intermittently at 2 and 3 and 4 and being ready to go is just part of the situation. A lot of it has to do with cortisol, the ups and downs from the adrenal at that time of life. And I also find that many women are very acidic before they go to bed because they've been on the computer, they've been secreting a lot of dopamine, maybe a lot of cortisol, they're high strung, they're anxious, they've got a lot going on. So, I tell people to take a quarter teaspoon of a good sea salt and warm water, maybe 4-6 ounces and go to bed because it will take the edge off and it will make them more alkaline on a cellular level. Very important to sleep through the night. That's one of my tricks of the trade.
MARCIE: What type of sea salt?
ANN LOUISE: Well I like Selina salt very much. I love that Celtic salt that's out there. I love Real Salt which is from Utah and then a really good type of Himalayan salt. It’s a quarter teaspoon. It's a small amount, and that amount certainly shouldn't raise high blood pressure if there's an issue with that. But most of us need good salt because, as you mentioned, minerals, especially trace minerals, are very important and very deficient in this day and age.
DAR: So, are there other tricks to do besides that for sleep issues? Because I know we talk about sleep so often and Dishing Up Nutrition because it is such a problem for so many people. You have any other little tricks that you do?
ANN LOUISE: I do have a lot of tricks up my sleeve. We’ll spill all the tricks. Well the quarter teaspoon of salt. Very important. I also find that you have to remove all electronics from the bedroom, which means you unplug anything that is electronic. That's usually, perhaps a lamp, number one, you make sure that if you have a router that's in your bedroom you disable the wireless components so that you disable your wireless router. Actually, it's a darn good idea to do that regardless of where the wireless router is stationed. You've got to make sure that you're not having all of those radio frequencies being emitted and received in the house. So, we've got to make sure that you're living in an area or you're sleeping in an area which becomes a real sanctuary, so nothing electronic, nothing digital in the room. Shut off, disable the router. That's number two or three at this point. And I take a handful of supplements before I go to bed which helps.
I take extra zinc, number one. I do the salt myself. I also take a time-release melatonin so that I'm getting a certain amount of melatonin, not all at once, because less is more when it comes to melatonin, which is a very important kind of anti-oxidant that will fight off breast cancer and any other kind of disease you may be concerned about.
And I also take something which is an amino acid, which is the big guns, which is called glycine. I take 2 grams of glycine because there are a lot of studies which suggest that this sugar-like amino, it's not quite a sugar, but your body regards it as such. It's very important for sleeping throughout the night.
MARCIE: Wow, those are great tips.
DAR: Yeah. Are you also using any progesterone cream at that time?
ANN LOUISE: Oh yes. That goes without saying no time. It's so much a part of my life, it's like brushing your teeth that I forget about that. But I am always using progesterone. Let me tell you that a good progesterone cream, I created my own because when I first wrote the book, which was over ten years ago, there was nothing on the market. So, I still use the Progestakey.
DAR: We still do too.
ANN LOUISE: Yeah, I love that progesterone. So, I use that and I am out of the perimenopausal cycle. So, this is what you do if you’re not having a period. So, this is good for women that are perimenopause, menopause, and beyond. And even PMS. I use this for the days one to twelve of the calendar month. I take one pump, which is 20 milligrams. It’s the physiological dosage that your body would normally be secreting, then on days 12 to 25 I try to match what your body would normally be doing, which is more than 20 grams and I take a pump in the morning at a pump at night. And before I go to bed I use that second pump and I put that on the thyroid because it helps with thyroid function. So that's probably my secret. So, thanks for reminding me.
DAR: No, that's perfect. So you actually are using two pumps a day. That's great to know. So, Marcie, do you want to talk a little bit about thyroid stuff?
MARCIE: Yeah, let's just dig right into the thyroid since you kind of brought it up, but in your book, Before the Change, you have really dedicated an entire chapter to the thyroid, which is so important. So, just to give a background, here in the book you've said this tiny butterfly gland in your neck has a huge impact on absolutely every aspect of your health. You also said that the thyroid regulates body temperature, it drives metabolism, supports that immune system, the nervous system, and even the intestines. It influences the brain, muscles, heart, gallbladder, and liver. So, I know all of our clients want to know more about their thyroid, their thyroid function, or even dysfunction. There's so much of that going on right now, so maybe we can share a little bit about what are some of those symptoms of low thyroid function or what is commonly called as hypothyroidism.
ANN LOUISE: Yeah, and that's such a great question because quite honestly, it's so important at this time of life to tame the thyroid. And I have a whole chapter called “Taming the Thyroid.” This is the time of life when women start to exhibit thyroid symptoms, or sometimes out of the blue you've got symptoms that seem to be very disconnected and unrelated, but in truth they are. They're all a reflection of thyroid function. You've got constipation, you've got sometimes depression, dry, scaly skin, coldness of the arms, of the legs, of the feet, of the hands, swelling around the eyes, muscle weakness, premature greying of the hair, I can go on, and insomnia. This can also be related to the thyroid, which is so connected to adrenal function. Sometimes women have a lot of fluid retention. They have hair that’s thinning, they've got difficulty swallowing pills, they've got menstrual irregularities, muscle stiffness. It's all related to the good old-fashioned thyroid. It really takes a hit at this time of life. And because of the environment, we cannot forget the environment, which has become quite toxic in this day and age.
DAR: So, Ann Louise, hold that thought because it's that break time again. But we want to talk more about the environment and the thyroid. Our clients have a lot of questions about their thyroid.
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BREAK
MARCIE: Before we went to break we were discussing the thyroid and how important it is to our health. So, Ann Louise, can you share with us and our listeners about some good supplements that you think are really important for the thyroid or minerals or nutrients that they really need?
DAR: I mean they could get it from food.
ANN LOUISE: You could. There's a little perhaps there. Because of the environment you have to be very cognizant of the environment and in that regard, I was thinking of iodine which is so important for most thyroid issues. You have to be careful with Hashimoto's of course, but iodine is notoriously deficient for most people and that's anywhere from 50 to 150 micrograms and sometimes more. There's a new spade of doc out there that really believes we need anywhere up to 12 grams, sometimes even more because we're so exposed to other chemicals that you need the iodine to displace some of the toxic chemicals in the environment; the chlorine, the bromide, and the fluoride. So, iodine is really important. Selenium is another one which can even be used for individuals that have any kind of auto immune issue. So, selenium is a biggie. It helps the transfer of the inactive T4 to T3. The vitamin B6, which is a woman's godsend, which I hope we'll discuss, sometimes up to 50-100 milligrams a day. Vitamin A is important. There's your good old-fashioned zinc and iron. If you're anemic you've got an issue with your thyroid. So, everything really connects, especially when it comes to the mineral component.
MARCIE: And you would say starting now with all of those would be beneficial? Or should you kind of start with the one and see what's helping you?
ANN LOUISE: What I would do is probably get a female multi that has most of these added to it. You might need a little extra selenium. Sometimes you don't have enough, like the 250 micrograms that I recommend in terms of selenium. That probably would be helpful, and chances are you're not getting a supplement that has enough iodine. I mean that's where sea salt might come in handy if it's enhanced with iodine, or even some of the sea vegetables like nori. So, just make sure that your sea veggies are coming from the Atlantic, not the Pacific because of the Fukushima disaster.
DAR: So, let's talk about other things that people are getting in their environment, and you kind of talked a little bit about fluoride. You want to talk a little bit more about that because I think that's going to be new information for a lot of people.
ANN LOUISE: Well, it competes with iodine, which is probably one of the most important trace minerals for the thyroid. So, you've got to get rid of the fluoride and fluoride is just about everywhere. It's in your toothpaste, although you can now find toothpaste which is fluoride-free so you have to take a really good look. There are multiple studies that really question the true efficacy of fluoride in the water supply in so many areas in our country. You have to be very wary even of tea, which will come as a surprise, because tea is a bio-accumulator. The tea plant is a bioaccumulate of fluoride. So herbal teas are great. I'm a real big believer in the herbal teas if you want to be concerned. And something else that I learned in my research for Before the Change and that is that we find a lot of women that come down with an adult type of acne actually have a real sensitivity to fluoride. You get rid of fluoride in their toothpaste, get rid of it in the tea because everybody thinks that all this tea is good. They're not recognizing that fluoride can be an issue, especially because of our thyroids in this day and time. So, you get rid of the tea, you just use herbal tea, and you'd be surprised some of these bone broths that are on the market are very high in fluoride because they use fluoride as a type of pesticide to spray the feed given to the animals, which then stores some of these heavy metals and chemicals in their bones.
MARCIE: Wow, that's really good.
DAR: So, I know this is kind of off topic a little bit, but as long as you are talking about bone broth and fluoride, how about some of these collagen products that are on the market now? Have you looked into any of those? Because my intuition says no.
ANN LOUISE: Your intuition I think is pretty right on. I started testing them. We have a lab that I use. It just got exceedingly expensive to test for the fluoride, but I'm not a big believer in the collagen products that are on the market. I mean, it's a big issue, but the most important things for collagen are actually Vitamin C and lysine. And nobody's talking about lysine. Well, you have talk about lysine because we're going to tell you all about it. It's important to fight viruses as we well know and it's important for your bones and it also helps with collagen production as well as hyaluronic acid. If you get a good hyaluronic acid product, you'll find that you don't look as if you're sagging or dragging in the face and the arms and the legs all over the place. As women, we do because of gravity and age but those are really the important things to be concerned about. Not a lot of these products they're talking about out there. I'm very suspect of them as well.
DAR:They are. So, Ann Louise, you have to go over that one more time because everybody's sitting there taking notes because this is such a big topic for people. Start back with the vitamin C. Just go through that one more time. You just said a lot.
ANN LOUISE: Yeah, I probably did because I get on a soapbox. I'm so concerned because I see people. Everybody’s out there and they all have a gimmick in this day and age. Everybody wants to look good and remain young. And I'm all for that. But you have to use the right ammunition and when it comes to collagen, vitamin C is really the precursor for collagen to the body.
DAR: And why do we need collagen, first of all?
ANN LOUISE: Well, it glues together your whole system. You need collagen for the strength of your bones, your tissues, your teeth to keep you looking good. The sagging, the dragging, we all need good collagen, and all of this, because of gravity and because of age and because of the electrical pollution and the radio frequencies and what were exposed to can all take a hit. It’s really something out there. But with sufficient vitamin C, and it's usually more than 500 milligrams a day, I mean some people take three to five to seven grams a day. That's seven thousand milligrams a day vitamin C, which will make your collagen. And then you need an amino acid, that's where I love the Lysine. Looking good, love lysine. It’s an “L.” Very important. Sometimes up to 3000 milligrams a day of lysine. That's very important, and then there's another one, which I neglected to mention, which is proline, very important for collagen. And the other thing to just let you know, which is definitely on a side here, is that there are some very avant-garde researchers that feel that cancer is a collagen disease. If you can protect your collagen, you have a very good chance of protecting yourself against any of the degenerative illnesses of our day and age.
MARCIE: Wow that’s fantastic. Let's maybe talk more about that after this third break.
DAR: We’re going to need a longer show today.
MARCIE: I think so! You're listening to Dishing Up Nutrition. Today we are all learning from author Ann Louise Gittleman. So much great information about how you can take charge of your perimenopause. And as we discuss some of the key information in her updated and revised book, Before the Change. If you enjoy today's show and you want to share it with a friend a sister or a daughter, have them listen to this on podcast. The goal of our show and of our podcast is to give you the information you need to change your nutrition to change your life. We'll be right back.
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DAR: So, Ann Louise, we have so many things we want to talk about yet. So, let's talk about that irritability that a lot of women have during this perimenopause time.
ANN LOUISE: Yes, irritability was another one of my atypical symptoms during this time. A lot of it has to do with this progesterone/estrogen situation that's going on and also because we seem to use more of the stress mineral, which is none other than magnesium, which we now find is more important than calcium for building strong bones and for settling the nerves and for brain power. It's really a hormone rescuer. So, I think this is a great time of life to start integrating a good magnesium supplement, which we find is also very important because it helps with energy. So, magnesium is my go-to when it comes to irritability and even anxiety. And I find that if you weigh a certain amount, let's say you weigh 120 pounds, that if you simply use five milligrams of magnesium for every pound of body weight you can get to the saturation point. And that's the point in which you're no longer constipated, you're no longer anxious, it's really good for everything that ails you. And because we're under so much stress, we seem to lose the vitamin and I don't think that foods can really supply what we're losing on a daily basis.
DAR: That's amazing. Yes, that's a good guideline. So, the other thing that we always hear about Ann Louise is calcium, calcium, calcium, calcium. And I think every woman that goes in to have their bone density taken are told that they should be at probably 1200-1300 milligrams of calcium. Talk to our listeners about that.
ANN LOUISE: Yeah, I think it's magnesium, not calcium, and I think the new research, which is really all over the place, was started by Dr. Mildred Seelig and I remember attending a lecture 25 years ago with Dr. Mildred. You need twice as much magnesium as calcium and it used to be the other way around. But now we know it's twice as much and we now believe that you can just get calcium from foods. You need maybe 500 milligrams let's suggest. So, calcium from good quality, unpasteurized raw dairy perhaps would be good. Lots of greens would be another alternative. So, I truly believe that if you're feeling that you're very viral or you're constipated, reduce that calcium and you'd be surprised that your symptoms will go away.
DAR: So, one of the other topics that you wanted to talk a little bit about was vitamin B6. You mentioned that earlier in the show. So, talk a little bit about why people need B6.
ANN LOUISE: Vitamin B6 is important because it's a cofactor for amino acids in your body, which are important for neuro transmitters. So, vitamin B6 is a woman's guardian angel. I feel that whenever you need more protein, you also need more vitamin B6. It's also a cofactor for the proper use of magnesium, which is so important. The hormone rescuer. And B6 is good if you're retaining a lot of fluid. B6 is very good also if you're irritable or anxious. It's kind of like the vitamin cofactor. The vitamin component of the magnesium connection. So, I love vitamin B6 because so many of us are deficient again because of stress and because, if in fact you're retaining fluid, which is a real problem as we get older, this will do the trick. It's a natural diuretic without detrimental side effects.
DAR: And a lot of times I have people take maybe 50 milligrams to 100 milligrams of B6 along with their magnesium at bedtime and it helps with that fluid retention. But I think you could probably take it any time during the day would be fine.
ANN LOUISE: Yeah, I don't disagree. I think it's really important, and people know about this. This was so big when we were coming up in the 70’s and early 80’s, but they've forgotten how important this is. There used to be a doctor that looked at women's hands and if you saw puffiness, immediately vitamin B6. They also used to use it in those days for carpal tunnel which was very, very rare and so prevalent right now because of the computers.
DAR: I know we've only got maybe a minute or two left. Anything that you want to share that we haven't? I mean there's so much in your book.
ANN LOUISE: Well, here's what I would suggest: I think that what women have to know is they have to feel empowered, that you can actually take charge of your perimenopause, take charge of your symptoms. In the book, you're going to find a quiz to see what throws of perimenopause you're in. You have to understand that there are safe and natural alternatives to hormone therapy, whether it's synthetic or bio identical, which I'm also not crazy about. Because regardless of what hormone therapy you're taking, you need to be monitored. So, I mean let's just get real about that. And the other thing is you have to look at your thyroid. It's connected to anything that ails you. And it's really under the gun these days because of all the cell phone radiation we're exposed to. People are taking x-rays and CAT scans and MRI’s. So, you've got to really be very kind to your thyroid, so I'm hopeful that your listeners will pick up a copy of the book, contact me, or come and see you for a personal consultation.
DAR: You’re great, Ann Louise, we love you. It was fun having you on today.
MARCIE: Yes. Thank you so much, Ann Louise. Thank you for listening to Dishing Up Nutrition. We encourage you to share today's show with your friends and family. It's always a pleasure to have Ann Louise Gittleman, the best-selling author of over 30 nutrition books, join us and share her wonderful, vast knowledge. We thank you, Ann Louise Gittleman, for writing her books in a way that will help each of you change your nutrition to change your life.
ANN LOUISE: Thank you both so much. Bye bye.
