Dr. Phil Shares: Menopause Belly: Why Fat Accumulates & How to Tackle It?

 

Many women notice after age 45 that fat seems to accumulate readily at the waist. There are even terms for it, like menopause belly, muffin top, or “meno-pot.” What does the science tell us about menopausal belly fat and how to get rid of it? What are the hormonal drivers and are they amenable to change with personalized lifestyle medicine? Certainly belly fat, specifically subcutaneous and visceral abdominal fat, increases during menopause,1-3 when the changing hormonal environment can bring with it a remodeling of fat storage patterns. Abdominal fat, especially visceral fat, is biochemically different and more metabolically active than fat stored in other areas, secreting more pro-inflammatory cytokines and adipokines.4 That means preventing or reversing belly fat is not just a vanity project, it’s a meaningful step in managing a woman’s overall health, as abdominal fat has been consistently linked with insulin resistance, impaired glucose control, and overall higher cardiometabolic and breast cancer risk. Practitioners are often asked ‘How can I get rid of menopausal belly fat?’, and it is important to remember that effective management is multifaceted – encompassing an understanding how changes in sex steroids interact with other endocrine systems and also with lifestyle choices, and recognizing the best time to implement a lifestyle medicine approach is in the years before a woman’s final menstrual period.

The changing hormonal environment

A robust understanding of the hormonal changes associated with perimenopause and menopause can guide women toward effective intervention. Here are the top five hormonal changes associated with the menopausal transition.

  • Changes in estrogen and estrogen dominance: Menopause is often framed simply as the loss of estrogen, but the road from pre- to post-menopausal estrogen levels is not necessarily smooth. Although loss of estrogen itself is linked with increasing abdominal fat,2,3 paradoxically the estrogen dominance that occurs in perimenopause and that may continue into menopause is seen clinically as a culprit in expanding abdominal fat mass.5 Between age 35 and 45, most women are beginning to run low on ripe eggs and experience hormonal changes linked with advancing reproductive age.6 During this time reduced progesterone coupled with high and erratic estrogen occurs.6,7 Estrogen declines but is in relative excess to progesterone. This is the definition of estrogen dominance: having a progesterone level that’s less than 100X the level of estrogen, creating an imbalance in the estrogen-progesterone partnership and essentially an inadequate level of progesterone to keep estrogen in check. Local estrogen production in adipose tissue can also contribute to estrogen dominance during this time. For example, aromatase enzymes, responsible for converting androgens to estrogens, are more active in visceral adipose tissue of post-menopausal women in response to cortisol.8

 

  • Cortisol: Dysregulation of the HPA axis and cortisol excess can manifest as increased central and visceral fat mass and metabolic disturbances such as insulin resistance.9,10 Increased production of cortisol,11 and conversion of cortisone (inactive) to cortisol (active) has been described in post-menopausal women,12 indicating that increased cortisol synthesis and conversion could contribute to metabolic dysfunction in these women. Cortisol is regulated in part by sex steroids, and estrogen down-regulates the expression and activity 11β-HSD1, the enzyme involved in converting inactive cortisone to active cortisol13 – so higher estrogen, lower 11β-HSD1 and less active cortisol formed. Declining estrogen levels during menopause can have a knock-on effect on cortisol formation, and 11β-HSD1 has been shown to be upregulated particularly in visceral fat in post-menopausal compared with pre-menopausal women. 1,11,12 As well as contributing directly metabolic dysfunction, higher cortisol can feed back to hormonal environment and contribute to estrogen dominance occurring at this time through cortisol-induced aromatase activity.8,14

 

  • Insulin: Fat cells accumulating in the abdomen is linked with insulin resistance. The pro-inflammatory cytokines produced by abdominal fat interferes with insulin signaling.15 This results in insulin resistance where cell response to insulin is lost, which creates a cycle where greater production of insulin is required to manage blood glucose levels. Insulin is a gatekeeper of metabolism, and rising insulin levels can set off a chain reaction that ultimately leads to a cycle of weight and abdominal fat gain. Insulin can lower production of sex hormone binding globulin (SHBG) in the liver.16,17 Lower SHBG results in greater free androgens and estrogens in circulation, and is linked with visceral fat and insulin resistance in menopausal women.18,19 In addition, insulin resistance can have a knock-on effect on leptin, insulin’s cousin.

 

  • Leptin: Leptin is the put-down-your-fork hormone, the one that tells you when you are full.20 Elevated insulin levels eventually lead to elevated leptin, which despite what you may think, does not mean you are more likely to put down your fork and stop eating. Instead, consistently elevated leptin levels lead to a dysfunction of leptin receptors and they stop sending signals to the brain to tell you to stop eating – this is called leptin resistance.21 The mechanisms driving leptin-resistance are complex, but high intakes of refined carbohydrates have linked with its development.22

 

  • Thyroid hormones: Thyroid hormones, which regulate how quickly we burn calories and maintains our metabolism, can becomes unbalanced with age, a trend that has been labeled ‘thyropause’. If the thyroid becomes underactive, this can lead to symptoms including weakness, fatigue, and weight gain.23

What can be done?

One of the biggest myths in women’s health is that once hormones change with menopause, abdominal adiposity is immovable – however addressing modifiable hormones such as cortisol and insulin in the following ways can have an impact.

  • Make foundational changes to dietary intake. When evaluating diet, consider factors that influence insulin levels, such as high carbohydrate intakes or intake of refined carbohydrates which require greater insulin response to manage spikes in plasma glucose. Remove inflammatory or trigger foods, as inflammation can contribute to insulin resistance.31 Add in foods rich in antioxidants which promote detoxification. Eliminate alcohol which robs you of deep sleep and lowers metabolism by more than 70% for 24 hours. Choosing when to eat during the day can also make a positive impact to insulin levels and insulin sensitivity. Time-restricted feeding (TRF) protocols, a type of intermittent fasting, where food is consumed during a limited number of hours per day (often 6 or 8) has been shown to reduce body weight and abdominal fat32 and improve insulin sensitivity even without weight loss.33

 

  • Add more movement to the day. Sitting is like the new smoking. Approximately 35 chronic diseases and conditions are associated with sedentariness, and sedentary behavior makes people more prone to gain body fat.24 High intensity interval training (HIIT) is effective at reducing abdominal and visceral adiposity, as well as improving insulin sensitivity and building muscle.25,26 Studies in post-menopausal women show that HIIT training results in greater abdominal and visceral fat mass loss compared to continuous exercise programs (where heart rate was maintained at a constant level)27,28 showing that HIIT is a time-efficient strategy for improving central obesity in this population. In addition to HIIT programs, practicing yoga can be recommended for menopausal women, showing significant reductions in menopausal symptoms.29 In broader populations, interventions that included yoga asanas were associated with reduced evening and waking cortisol levels, as well as improved metabolic symptoms.30

 

  • Support reparative sleep. A primary step to losing belly fat is to get enough sleep and to make it quality sleep. Epidemiological studies have repeatedly shown links between sleep duration and the risk of obesity and central adiposity.34 People sleeping 7-8 hours/night night have been shown to accumulate less visceral fat mass than those sleeping for ≤6 hours/night.35 Sleep debt leads to changes in leptin and other hormones related to satiety, greater feelings of hunger, dietary indiscretion and poor food choices, as well as reduced physical activity and insulin resistance.34 In other words, getting that solid sleep needs to be a priority. As well as sleep quantity, sleep quality has to be considered, as poorer sleep quality is associated with higher visceral fat mass.36 Subjective poor sleep quality is linked with altered cortisol response37 and insulin resistance in postmenopausal women.38

by Sara Gottfried, MD and Annalouise O’Connor, PhD

Shared by Dr. Phil McAllister @ Forward Health Guelph

Citations

  1. Yamatani H et al. Association of estrogen with glucocorticoid levels in visceral fat in postmenopausal women. Menopause. 2013;20(4):437-442.
  2. Shen W et al. Sexual dimorphism of adipose tissue distribution across the lifespan: a cross-sectional whole-body magnetic resonance imaging study. Nutr Metab (Lond). 2009;6:17.
  3. Lovejoy JC et al. Increased visceral fat and decreased energy expenditure during the menopausal transition. Int J Obes (Lond). 2008;32(6):949-958.
  4. de Heredia FP et al. Obesity, inflammation and the immune system. Proc Nutr Soc. 2012;71(2):332-338.
  5. Prior JC. Progesterone for symptomatic perimenopause treatment – progesterone politics, physiology and potential for perimenopause. Facts Views Vis Obgyn. 2011;3(2):109-120.
  6. Hale GE et al. Hormonal changes and biomarkers in late reproductive age, menopausal transition and menopause. Best Pract Res Clin Obstet Gynaecol. 2009;23(1):7-23.
  7. Hale GE et al. Endocrine features of menstrual cycles in middle and late reproductive age and the menopausal transition classified according to the Staging of Reproductive Aging Workshop (STRAW) staging system. J Clin Endocrinol Metab. 2007;92(8):3060-3067.
  8. McTernan PG et al. Glucocorticoid regulation of p450 aromatase acitivty in human adipose tissue: gender and site differences. J Clin Endocrinol Metab. 2002;87(3):1327-1336.
  9. Paredes S et al. Cortisol: the villain in metabolic syndrome? Rev Assoc Med Bras (1992). 2014;60(1):84-92.
  10. Incollingo Rodriguez AC et al. Hypothalamic-pituitary-adrenal axis dysregulation and cortisol activity in obesity: a systematic review. Psychoneuroendocrinology. 2015;62:301-318.
  11. Li S et al. Effects of menopause on hepatic 11β-hydroxysteroid dehydrogenase type 1 actvity and adrenal sensitivity to adrenocorticotropin in healthy non-obese women. Gynecol Endocrinol. 2011;27(10):794-799.
  12. Andersson T et al. Tissue-specific increases in 11β-hydroxysteroid dehydrogenase type 1 in normal weight postmenopausal women. PLoS One. 2009;4(12):e8475.
  13. Andersson T et al. Estrogen reduces 11β-hydroxysteroid dehydrogenase type 1 in liver and visceral, but not subcutaneous, adipose tissue in rats. Obesity (Silver Spring). 2010;18(3):470-475.
  14. McTernan PG et al. Gender differences in the regulation of P450 aromatase expression and activity in human adipose tissue. Int J Obes Relat Metab Disord. 2000;24(7):875-881.
  15. Castro AV et al. Obesity, insulin resistance and comorbidities? Mechanisms of association. Arq Bras Endocrinol Metabol. 2014;58(6):600-609.
  16. Plymate SR et al. Inhibition of sex hormone-binding globulin production in the human hepatoma (Hep G2) cell line by insulin and prolactin. J Clin Endocrinol Metab. 1988;67(3):460-464.
  17. Loukovaara M et al. Regulation of production and secretion of sex hormone-binding globulin in HepG2 cell cultures by hormones and growth factors. J Clin Endocrinol Metab. 1995;80(1):160-164.
  18. Davis SR et al. The contribution of SHBG to the variation in HOMA-IR is not dependent on endogenous oestrogen or androgen levels in postmenopausal women. Clin Endocrinol (Oxf). 2012;77(4):541-547.
  19. Janssen I et al. Testosterone and visceral fat in midlife women: the Study of Women’s Health Across the Nation (SWAN) fat patterning study. Obesity (Silver Spring). 2010;18(3):604-610.
  20. Klok MD et al. The role of leptin and ghrelin in the regulation of food intake and body weight in humans: a review. Obes Rev. 2007;8(1):21-34.
  21. Engin A. Diet-induced obesity and the mechanism of leptin resistance. Adv Exp Med Biol. 2017;960:381-397.
  22. Harris RBS. Development of leptin resistance in sucrose drinking rats is assocated with consuming carbohydrate-containing solutions and not calorie-free sweet solution. Appetite. 2018;132:114-121.
  23. Diamanti-Kandarakis E et al. Mechanisms in endocrinology: aging and anti-aging: a combo-endocrinology overview Eur J Endocrinol. 2017;176(6):R283-R308.
  24. Levine JA. Sick of sitting. Diabetologia. 2015;58(8):1751-1758.
  25. Boutcher SH. High-intensity intermittent exercise and fat loss. J Obes. 2011;2011:868305.
  26. Maillard F et al. Effect of high-intensity interval training on total, abdominal and visceral fat mass: a meta-analysis. Sports Med. 2018;48(2):269-288.
  27. Maillard F et al. High-intensity interval training reduces abdominal fat mass in postmenopausal women with type 2 diabetes. Diabetes Metab. 2016;42(6):433-441.
  28. Nunes PRP et al. Effect of high-intensity interval training on body composition and inflammatory markers in obese postmenopausal women: a randomized controlled trial. Menopause. 2018;Oct 1.
  29. Cramer H et al. Yoga for menopausal symptoms-a systematic review and meta-analysis. Maturitas. 2018;109:13-25.
  30. Pascoe MC et al. Yoga, mindfulness-based stress reduction and stress-related physiological measures: a meta-analysis. Psychoneuroendocrinology. 2017;86:152-168.
  31. Caputo T et al. From chronic overnutrition to metainflammation and insulin resistance: adipose tissue and liver contributions. FEBS Lett. 2017;591(19):3061-3088.
  32. Gabel K et al. Effects of 8-hour time restricted feeding on body weight and metabolic disease risk factors in obese adults: a pilot study. Nutr Healthy Aging. 2018;4(4):345-353.
  33. Sutton EF et al. Early time-restricted feeding improves insulin sensitivity, blood pressure, and oxidative stress even without weight loss in men with prediabetes. Cell Metab. 2018;27(6):1212-1221.e3.
  34. Koren D et al. Role of sleep quality in the metabolic syndrome. Diabetes Metab Syndr Obes. 2016;9:281-310.
  35. Chaput JP et al. Change in sleep duration and visceral fat accumulation over 6 years in adults. Obesity (Silver Spring). 2014;22(5):E9-12.
  36. Sweatt SK et al. Sleep quality is differentially related to adiposity in adults. Psychoneuroendocrinology. 2018;98:46-51.
  37. Huang T et al. Habitual sleep quality and diurnal rhythms of salivary cortisol and dehydroepiandrosterone in postmenopausal women. Psychoneuroendocrinology. 2017;84:172-180.
  38. Kline CE et al. Poor sleep quality is associated with insulin resistance in postmenopausal women with and without metabolic syndrome. Metab Syndr Relat Disord. 2018;16(4):183-189.

 

Sara Gottfried, MD

Sara Gottfried, MD is a board-certified gynecologist and physician scientist. She graduated from Harvard Medical School and the Massachusetts Institute of Technology and completed residency at the University of California at San Francisco. Over the past two decades, Dr. Gottfried has seen more than 25,000 patients and specializes in identifying the underlying cause of her patients’ conditions to achieve true and lasting health transformations, not just symptom management.

Dr. Gottfried is the President of Metagenics Institute, which is dedicated to transforming healthcare by educating, inspiring, and mobilizing practitioners and patients to learn about and adopt personalized lifestyle medicine. Dr. Gottfried is a global keynote speaker who practices evidence-based integrative, precision, and Functional Medicine. She has written three New York Times bestselling books: The Hormone Cure, The Hormone Reset Diet, and her latest, Younger: A Breakthrough Program to Reset Your Genes, Reverse Aging, and Turn Back the Clock 10 Years.

Annalouise O’Connor, PhD, RD

Dr. Annalouise O’Connor is the R&D Manager for Therapeutic Platforms and Lead for Cardiometabolic and Obesity platforms at Metagenics. Her role involves research coordination, as well as developing formulas for targeted nutrition solutions and programs to assist practitioners in the optimal management of their patients’ health. Annalouise trained as an RD and worked in clinical and public health settings. Dr. O’Connor completed her PhD in the Nutrigenomics Research Group at University College Dublin (Ireland) and postdoctoral work at the UNC Chapel Hill Nutrition Research Institute.

 

Dr. Laura: How does your thyroid function?

Feeling tired, loosing hair, bring fog, brittle nails, constipated,  periods heavy and cholesterol rising? Perhaps your thyroid is to blame.

What does thyroid hormone do?

Thyroid hormone keeps:

  • our metabolism humming
  • hair and skin smooth and silky
  • muscles and tendons well lubricated
  • mood bright
  • digestion moving along
  • brain firing on al cylinders
  • LDL cholesterol at healthy levels

How do you measure thyroid function?

General practitioners assess Thyroid Stimulating Hormone (TSH), and if it is out of range, T4 and T3 is measured. Sometimes an ultrasound is done to visualize the size and health of the gland, to assess nodules or help diagnose thyroid cancer.  Naturopathic doctors, functional medicine doctors and endocrinologists will be more likely the ones to run a full thyroid panel (freeT4, freeT3, TSH, TPO, Anti-Thyroglobulin and reverse T3).

How does the body naturally balance thyroid hormone?

T3 is the active hormone in the body and is made from T4. Although the T4 is made in the thyroid, conversion to T3 happens mostly in the liver and the gastrointestinal tract.   A normal functioning thyroid gland works with the hypothalamus in the brain using a negative feedback system to indicate when there is enough active thyroid hormone in the system.

How does the medical doctor balance thyroid?

Traditionally synthroid or levothyroxine is prescribed to treat inadequate levels of thyroid hormone and treatment is geared to reach a desired TSH level. Direct T3 therapy (Cytomel) is rarely prescribed due to lack of research and clinical experience. Typically the family doctor will  treat to normalize the TSH, but recent research, and numerous patient complaints may indicate that this is not enough.

More research is required to support T4 and T3 combination therapy, whether it is levothyroxine plus cytomel or natural desiccated thyroid, alone or in combination.

Research finds TSH monitoring is not enough to determine adequate thyroid functioning and some medical doctors agree a 4:1 ratio of T4:T3 predicts patient satisfaction and better health.

What does the naturopathic doctor do to balance the thyroid?

Naturopathic doctors seek to support the thyroid in making T4 and the body’s ability to convert the T4 to the active form of thyroid known as T3.   A naturopathic doctor offers support to people on pharmaceuticals like synthroid or levothyroxine, and is also able to additionally or solely prescribe advice for nutraceutical  support and natural desiccated thyroid.

A naturopathic doctor will:

  • look at the full thyroid panel
  • adrenal health
  • cholesterol panel
  • sex hormone health
  • the function of the liver
  • health of gastrointestinal tract,
  • nutrient balance of things like selenium, zinc, iron and iodine

How is cholesterol linked to thyroid function?

T3 levels are also inversely linked to LDL Cholesterol. When thyroid levels are low, LDL cellular reception is reduced, leaving more LDL in the blood stream.  Emerging research finds treatment with T4 alone (synthroid, levothyroxine) does not always correct the high levels of cholesterol induced by poor thyroid function. Rising levels of LDL cholesterol in peri-menopausal women with symptoms of fatigue should trigger an investigation into the balance of T4 and T3, not just TSH.

What drives T3 levels down?

  • Body shuttles T3 to reverse T3 in times of starvation and stress
  • Poor feedback function in the hypothalamus
  • Thyroiditis
  • High levels of natural and environmental estrogens
  • Epstein Barr Virus

T3 levels are increasingly challenged as xenoestrogens (environmental contaminants) rise in developed countries.  Peri-menopausal women also experience challenges. This is because estrogen (unopposed by progesterone as ovulation slows down), or estrogen mimickers like xenoestrogens (from plastics, pesticides and insecticides) have the ability to bind up Thyroid Binding Globulin and somehow affect the T4 to T3 conversion ratio. Some research points to Epstein Barr Virus impacting the genome and ultimately the function of the thyroid.

For more help optimizing your thyroid function, book an appointment with Dr. Laura M. Brown, ND.

 

Dr. Laura: 21 Reasons You Might be Constipated

Bowels that move slow or are difficult to pass are not only uncomfortable, they are unhealthy. It is important we eliminate from our bowels at least once, and up to three times per day. Constipation is an issue affecting up to 20% of the population(1).

When the stool stays in the colon for extending lengths of time, toxins and hormones that have been packaged and processed for elimination are at risk for re-absorption back into the body. Not passing stool frequently enough will lead to a feeling of toxic overload.

What is constipation?

  1. Irregular bowel movements
    1. Pass less than 3-5 stools per week.
  2. Difficulty passing stool.
    1. Hard stool, requires straining,
    2. Insufficient, unsatisfactory, incomplete stool

21 Reasons You Might be Constipated

  1. Diet lacks fibre and vegetables
  2. Diet too high in proteins and carbs, especially in sugar & starch
  3. Dairy or wheat sensitivity
  4. Too much dairy (cheese)
  5. Other food sensitivities
  6. Insufficient microflora
  7. Dysbiosis (overgrowth of the wrong kinds of bacteria in the intestines)
  8. Small Intestinal Bacterial Overgrowth (SIBO) (root cause may be hypothyroid and migrating motor complex)
  9. Hypothyroid affecting the migrating motor complex
  10. Lack of regular daily exercise
  11. Insufficient water intake
  12. Supplements such as iron, calcium
  13. Overuse of laxatives
  14. Side effects of prescription drugs- painkillers (opioids), anti-depressants
  15. Irritable bowel syndrome or diseases
  16. Colon cancer
  17. Stress
  18. Pregnancy
  19. Diabetes mellitus
  20. Hemorrhoids
  21. Nervous system disruption as in spinal cord lesions, MS & Parkinson’s.

Best ways to “get moving” –> relieve your constipation

Laxatives are okay occasionally. Too much use will lead to dependence, which is not how nature intended and don’t fix what’s really happening. Have a look at some of the possibilities of what may cause constipation and see what you can correct. Dr. Laura M. Brown, ND can help you access and interpret many different types of testing.

References:

  1. Portalatin M, Winstead N. Medical Management of Constipation. Clinics in Colon and Rectal Surgery. 2012;25(1):12-19. doi:10.1055/s-0032-1301754.

Dr. Laura: 5 Major Factors in Menopausal Weight Gain

Menopausal weight gain is troublesome and annoying.

Menopausal weight gain can increase risks for cardiac events and insulin dysregulation.

5 Major factors in menopausal weight gain:

  • Genetics
  • Sex hormone changes
  • Sleep
  • Depression
  • Stress
  • Diet

Figure out what’s going on in your body!  Learn how hormone levels, including the thyroid estrogen and progesterone, sleep hygiene, physical activity, diet and stress play a role in menopausal weight gain.

Sex hormone changes trigger menopausal weight gain

  • When the years leading to menopause set in, ovulation slows down before it stops. Ovulation is required before progesterone can be released. If you don’t ovulate, it creates irregular balances of estrogen and progesterone in the body.
  • Chemicals like BPA (plastics), cadmium, phthalates (soaps, detergents), and pesticides contribute to estrogen dominance.
  • Low progesterone against pre-declining estrogen makes for relative estrogen excess compared to progesterone. This means estrogen dominance for a time.
  • Estrogen dominance leads to poor thyroid hormone availability, reducing metabolism
  • If thyroid function is sluggish, this leads to poor estrogen clearance, more estrogen builds up in the body
  • Poor thyroid function can lead to weight gain and increase in LDL cholesterol. Elevated LDL cholesterol is linked to increase risk in cardiovascular disease.
  • As menopause progresses, estrogen declines. Estrogen decline leads to deposition of fat around the mid section.

Contributing factors to thyroid dysfunction:

  • Sagging adrenals (chronic stress)
  • Estrogen dominance
  • Low iron, selenium, iodine or zinc
  • Poor liver function
  • Poor intestinal flora.

Factors in sleep disturbance that contribute to menopausal weight gain

Poor sleep leads to disruption in balance of hormones and time for healing in the body. Lack of sleep itself can contribute to weight gain. The years of menopause are riddled with hurdles to a good night sleep:

  • decline in estrogen can disrupt sleep due to hot flushes
  • Hormone rhythm imbalance from changes in LH, FSH, estrogen and progesterone are thought to contribute to disrupted sleep patterns.
  • From a Chinese Medicine point of view, the Liver Yang rises in menopause, which explains why the sleep is typically disrupted between the hours of 1-3 am. This is why, naturopathically, we look to calm the liver, cool the body and build Yin. Acupuncture and specially blended plant medicines can be very helpful.
  • sleep apnea (in you or your partner) more prevalent in those who are overweight
  • too much technology before bed, or worse yet, in the bedroom inhibits natural melatonin let down. Relative excess of cortisol as it is unopposed by melatonin disrupts sleep and contributes to midsection weight gain

Factors in depression that contribute to menopausal weight gain

Low mood and lethargy generally lend to poor motivation for exercise and healthy habits, which leads often to weight gain.

Here are some common factors in depression and menopause:

  • declining estrogen
  • sluggish thyroid
  • poor nutrient intake
  • imbalance in the intestinal bacteria
  • inflammation in the brain (usually as a result of imbalance in the intestinal bacteria)

How  Stress Relates to Menopausal Weight Gain

In menopause, the ovaries retire and  hand over their hormone duties to the adrenal gland. This is why it is important to support the adrenals at this time. How healthy the adrenals are will dictate how well our bodies will manage the stress and the change in hormone levels. Areas we may not think about in stress that could contribute to adrenal fatigue:

  • sleep disruption
  • inflammation from infections, intestinal dysbiosis, autoimmune conditions
  • too much or too little exercise
  • poor eating habits
  • conditioned stress response (post traumic stress disorder)
  • relationships with others
  • alcohol intake
  • medications and drugs
  • overwork
  • not enough fun & play time

How diet affects menopausal weight gain

  • Generally with age, metabolism slows down and less caloric intake is required. If activity slows or stays the same and intake is not adjusted, subsequent weight gain is likely.
  • Our intestinal tract flora changes as we age, and this changes how estrogen is metabolized.

It is evident that menopausal weight can happen for a lot of reasons. Some of it is a bit of a chickened an egg, like the estrogen dominance and poor thyroid function. It doesn’t matter what comes first, but if not corrected, they build on one another.  A naturopathic doctor’s role is to look at the individual as a whole, remove obstacles, rebuild the body and stimulate natural mechanisms of healing. Women who maintain a healthy habits, hormones and weight will help stave off risks for osteoporosis, cardiovascular disease and cancer.

Solutions to menopausal weight gain include healthy diet, exercise, sleep hygiene, hormone balancing with acupuncture and plant medicines, nutritional and hormonal supplementation.

Dr. Laura M. Brown, ND

References:

Jung SY, Vitolins MZ, Fenton J, Frazier-Wood AC, Hursting SD, Chang S. Risk Profiles for Weight Gain among Postmenopausal Women: A Classification and Regression Tree Analysis Approach. Hsu Y-H, ed. PLoS ONE. 2015;10(3):e0121430. doi:10.1371/journal.pone.0121430.

Franklin RM, Ploutz-Snyder L, Kanaley JA. Longitudinal changes in abdominal fat distribution with menopause. Metabolism. 2009 Mar; 58(3):311-5.

Gietka-Czernel M. The thyroid gland in postmenopausal women: physiology and diseases. Przegla̜d Menopauzalny = Menopause Review. 2017;16(2):33-37. doi:10.5114/pm.2017.68588.

Van Pelt RE, Gavin KM, Kohrt WM. REGULATION OF BODY COMPOSITION AND BIOENERGETICS BY ESTROGENS. Endocrinology and metabolism clinics of North America. 2015;44(3):663-676. doi:10.1016/j.ecl.2015.05.011.

Williams LT, Hollis JL, Collins CE, Morgan PJ. The 40-Something randomized controlled trial to prevent weight gain in mid-age women. BMC Public Health. 2013;13:1007. doi:10.1186/1471-2458-13-1007.

Zheng Y, Manson JE, Yuan C, et al. Associations of Weight Gain From Early to Middle Adulthood With Major Health Outcomes Later in Life. JAMA. 2017;318(3):255-272. doi:10.1001/jama.2017.7092.

Karvonen-Gutierrez C, Kim C. Association of Mid-Life Changes in Body Size, Body Composition and Obesity Status with the Menopausal Transition. Parthasarathy S, ed. Healthcare. 2016;4(3):42. doi:10.3390/healthcare4030042.

Dr. Laura: Root Cause Medicine

Root Cause Medicine

 

How do you get to the root cause of your health problems?

Welcome a medical professional who:

  • Goes over the underlying patterns identified in your recent blood work, imaging and lab reports.
  • Considers laboratory values within ranges and patterns to achieve optimal health, not necessarily waiting until there is frank disease.
  • Collects a detailed health history.
  • Reviews medication side effects
  • Performs an in-clinic physical health screen to look for patterns of cellular health deficits and nutritional decline.
  • Appreciates a medical consideration of how your body, emotional, cognitive and spiritual systems orchestrate and integrate.
  • Knows how to guide you to use food and plants as medicine.

 

Doctor as Teacher

You, at any time, can ask questions. Learn about your condition so you can make an informed decision about your health. You are living in your body 24/7 – so it’s your temple abode. You help your practitioner understand your experience and your practitioner helps you understand why you might feel the way you do.

It is not a one or the other mentality.  You may choose to see your family doctor, your specialist and your naturopathic doctor.

The fist appointment with a naturopathic doctor is about an hour. Based on what is discovered in the first appointment, a treatment plan is created. Things like sleep hygiene, understanding how stress affects the body, diet tips and detoxifying naturally are a part of the general plan, made are made specific to the individual needs.

Recommendations for further testing may be made. Further testing may include things like comprehensive hormone panels, stool analysis, organ system testing, organic acid testing, genomic, nutritional or cardiac profiles, food sensitivity analysis or environmental toxicity.

You may choose to engage in a specific program which helps stimulate your body’s natural mechanisms of healing. These programs may be executed in follow-up sessions that last about 30 minutes and may take place once a week for 4-6 weeks, or may be spaced out more or less, depending on the needs of the individual.

Upcoming Free Educational Seminars

Location: Goodness Me! Guelph

Wednesday April 25, 6:30-8:00pm Simplifying Stress

Wednesday May 16,  Beautiful Botanicals

Wednesday June 13, GUT Circadian Rhythm

Dr. Laura M. Brown ND is a Naturopathic Doctor with a Functional Medicine approach. She is a Certified Gluten Practitioner, a HeartMath Certified Practitioner and is a graduate of Adapt Level 1 at Kresser Institute of Functional Medicine. Essentially, Dr. Brown helps people better digest their food and the world around them. www.forwardhealth.ca

 

Dr. Laura: GUT Circadian Rhythm

Insomnia, pain, fatigue, stress? How do you get to the root cause of your health problems?

SLEEP?

HORMONES?

OUT OF BALANCE?

Do you have sleep issues? Hormone issues? Or just feel out of balance?

 

Learn How Gut Microbes

Affect Your Circadian Rhythm

Join Dr. Laura M. Brown ND, Wednesday June 13, 2018 and  you will learn how circadian rhythms of gut microbes ultimately intertwine with our own circadian rhythms, which regulate our sleep/wake cycles, hormone release, and metabolism.

Comprehensive Stool Analysis 

Dr. Laura is a registered Naturopathic Doctor with a functional Medicine approach. Dr. Laura gets to the root cause of your health issue and stimulates the natural mechanisms of healing. Her individualized protocols are designed with time-proven remedies and the latest scientific research. Her inviting nature will meet you where you are, and inspire you toward a more healthful, purpose-filled life.

Dr. Laura: Micro biome linked to fatigue, insomnia and hormone regulation

Did you know? You can fix your fatigue, insomnia, and hormones by focussing on your flora. Find out how and why your gut affects your biorhythms in the next complimentary seminar with Dr. Laura M. Brown.

The GUT-Circadian Rhythm Connection

Dr. Laura M. Brown, ND, is a licensed naturopathic doctor, Certified HeartMath Practitioner, Ceritified Gluten Practitioner and has a Functional Medicine approach in her practice. What she really does is help people better digest their food and the world around them.

Wednesday, July 12th 6:30-8:00pm @ Goodness Me

Register Now!

Feeling Stuck?

If we miss or get stuck at a point in our life, there is potential for emotional buildup that may present as sickness in the body.

When a person is “stuck” at a certain level, a homeopathic remedy, acupuncture, a Chakra clearing, yoga exercises, focused breathing, or other therapeutic efforts may “lift” the person and help them better perceive and move on from their current situation.

Understanding the Stages of Life

Whether we look at Erikson’s Stages of development, Scholten’s Homeopathic Table of Elements, Maslow’s Hierarchy, the Chinese Five Elements or the Chakra system, we can see the natural progression of development we embark on through our journey of life.

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Often, it is a combination of acupuncture, a Chakra clearing, yoga exercises, focused breathing, massage homeopathy or talk therapies that gets us on our way and eventually to the top of the mountain. What is most important is to enjoy some sights on the path along your journey.

Chakras

The common thread of our personal development is woven from ancient yogis, Chinese Medicine, psychologists and psychotherapists. We all need to have our basic needs of life met before we can develop an element of safety. We need to know who we are as individuals and how we belong into our society before we can further develop the area of our heart and be able to share it interdependently with others.

It is when we can be comfortable with ourselves, we can then withstand the swell of the tide of outside influences.

Keeping the mind steady and calm while the world swells around us, is the first stage of actualization.

Once we have mastered the space of a calm and equitable mind, we can then practice the ability to let all the world go and connect with and allow our spiritual self to unfold.

Balancing the “fight or flight” (sympathetic) and the “rest and digest” (parasympathetic) nervous systems helps gain access to this blissful balanced state of what Heart Math people call “coherence”. It is not only reserved for yogis, meditation artists, super-energetic or “smart” people. It is for us all to climb mountain, at our own pace, with our own challenges and with our own set of earthly and heavenly guides.

The fact is we are all able to achieve this pinnacle of self-actualization, however we are all also susceptible to fall and crumble back down to the basic needs of life. We may actually experience many rises and falls over the course of a lifetime. In each rise and fall, it is like a breath in and out, so long as we live, our breath will rise and we will too again. Hopefully, overall, we are making steady progression up the mountain.

Sometimes it takes intense focus in one area of our life, while the others lay dormant for some time. That is, we can invest heavily in school or career while putting family life or personal relationships on hold. If we excel strongly in one area of our life, without giving time for balance in others, we miss out on the cross-training type of personal development that we need in order to rise to our greatest potential. It is important to loop back and catch ourselves to keep a steady progress in all areas of our life. Sometimes we need the chance to develop one aspect of our being before we are ready and hold the wisdom to get on to the next.
Wisdom is more precious than gold, as we learn from Soloman in the Book of Proverbs and if we do not learn from our mistakes and move forward, then this is the greatest crime.

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In Chinese Medicine the circles of life go on a 7 year cycle for women and an 8 year cycle for men. At age 7 the vitality of the young girl is vibrant, 14 she begins to menstruate and the governing and conception vessel are primed. Age 21, a woman’s essence peaks, she has reached her physical limit of growth and the wisdom teeth come in. Age 28 the tendons and bones of a woman are strongest and the hair flourishes. Age 35 the Yang channels weaken and the woman’s complexion withers and hair begins to fall. This progresses and the hair grays at age 42. Age 49 the conception and governing vessels are empty and the uterus closes and infertility sets in. This is a time now for more creativity and personal embarkment of growth as the energy is no longer needed to tend the womb. Menopause offers a later life fire that is more than just about hot flushes!

Later Life Fire

™Time to get moving on what you have put off:
–Careers
–Fitness goals
–Relationships
–Talents
–Travel
–Personal development

For males, the Chinese Medicine 8 year cycle begins similarly with abundance of energy at age 8, mounting at age 16 when the sperm arrives and Yin and Yang are harmonized in the male making him capable of producing a child. At age 24, the male’s physical energy peaks and the wisdom teeth arrive. At age 32 his  tendons and bones are strongest and by age 40 the hair begins to fall and teeth become loose. At 48 year old man’s Yang Qi is exhausted and his face darkens as his hair turns gray. At age 56 the male’s liver energy (testosterone) is weakened and tendons stiffen and the sperm dries up. At age 64, from the ancient Chinese circles of life, the hair and teeth are gone.

We can calm the storm within and age more gracefully

Eat well
Sleep well
Control stress
Limit excessive sexual activity.
Thai Qi, Qi Gong and Yoga and HeartMath incorporate breathing exercises that help increase the vitality and essence of our aging being.

From the heart and mind of Dr. Laura M. Brown, ND. Dr. Laura offers personalize lifestyle coaching and professional means to help you Move Forward in Your Health.

Picture credits: pinterest.com, healingtherapist.com

How Does Acupuncture Work?

Acupuncture is a Traditional Chinese Medical therapy that has been in practice for over 2000 years. It treats imbalances in the body, mind & spirit and is very effective at reducing pain. So much so, there are doctors in China that use acupuncture as their sole form of pain block for things as critical as open heart surgery!

At Forward Health, Dr. Laura M. Brown, ND is licensed to provide acupuncture and Traditional Chinese Medicine. Any ache or pain may be relieved by acupuncture, but so too are things like hot flushes, constipation, diarrhea, PMS, stress, anxiety, depression, urinary flow challenges, swelling, fibromyalgia, headache, insomnia, infertility and more.

Transforming Energy

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Traditional Chinese Medicine (TCM) dates back to the Zhou Dynasty (700-1000 BC). The balance of Yin and Yang and the flow of Qi are very distinctive concepts in Chinese Medicine.

Energy is never lost or created, it is only changed from one form to another. In Chinese medicine, the solid matter is Yin and Yang the energetic or wave of motion.

Qi is the motive force behind all physiological processes.

Acupuncture helps move blood and Qi. If there is stagnation, there is congealment of blood. If there is too much energy flow, there is rising of Qi. The body, soul and spirit are in constant flux and it is the harmonious flow of energy from one form to another that makes us feel in sync.

Acupuncture helps you feel like yourself again.

The Five Elements are how the rhythm of our health cycles with the environmental impacts and aging process. Five elements are Fire, Earth, Metal, Water and Wood. There are seasons, organs, body parts, senses and times that relate to each element.  Acupuncture accesses the channels of the body that relate to organs, nerves and brain centres.

Your symptoms and your pulse, tongue and disposition will help Dr. Laura formulate the best combination of points to relieve your pain, stress or fatigue. Typically it will take 6 weekly 30min session to re-align your being, however you can feel relief from the first appointment. Pain relief in sciatica, for example can last up to 5 days after a single treatment.

Stainless steel, single use needles are used in specific points on the body. Sometimes infra  red heat or electrostimulation is applied to the points to help intensify the healing process.

Acupuncture is increasingly recognized by mainstream medical professionals. Here is a short 1 minute video that WebMD put together for your interest.

From the heart and mind of your local naturopathic doctor, Dr. Laura M. Brown, ND.

Traditional Chinese medicine

5 Hidden Secrets of Weight Loss

When diet and exercise aren’t enough… you just can’t shake that extra weight. There may be hidden obstacles that need your attention before you can achieve your healthiest goals.

This Saturday, in a free public health forum, Dr. Laura Brown, ND will discuss ” The 5 Hidden Secrets to Weight Loss” at Guelph’s Goodness Me! Find out what may be the hidden reason for holding you back from your goals.

registernow

Saturday Oct 17th at 10-11:30am. Register Here

What do the following products have to do with weight loss?

Find out this and so much more this Saturday, October 17th at 10am at Goodness Me!

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