Episode 127: Anxiety in Perimenopause: How Hormones, Blood Sugar Imbalances and Inflammation Are Impacting Your Mood

In this re-release of a 2021 episode, Dr. Lisa and Dr. Toni discuss the increased levels of anxiety moms in perimenopause are currently experiencing over the pandemic and what you might be doing to make it worse. There are many effective approaches to naturally deal with your anxiety so you don’t have to suffer. 

Did you know?

A research study that followed 3000 Canadian moms over 12 years showed that symptoms of anxiety and depression almost doubled between May and July of 2020 compared to levels between 2017 and 2019. 

Another study on the impacts of COVID-19 on Canadians reported that 24% of people rated their mental health as fair or poor compared to 8% in 2018. 88% of participants experienced at least 1 symptom of anxiety in the 2 weeks prior, with 71% feeling nervous, anxious or on edge, 69% becoming easily annoyed or irritable and 64% having trouble relaxing.

What is anxiety?

Anxiety refers to anticipation of a future concern and is more associated with muscle tension and avoidance behavior.

Anxiety disorders differ from normal feelings of nervousness or anxiousness, and involve excessive fear or anxiety. 

If you have 3 or more anxiety symptoms for a period of 6 consecutive months on an almost daily basis, you might be diagnosed with Generalized Anxiety Disorder. Consult with a licensed therapist for support and confirmation of diagnosis.

What are symptoms of anxiety?

Psychological or mental and emotional symptoms you might be experiencing can include:

    • Fear

    • Irritability

    • Restlessness, inability to relax

    • Difficulty concentrating

    • Decreased libido

    • Decreased emotionality

Somatic or physical symptoms you might be experiencing can include:

    • Arrhythmia or heart beat irregularities, increased heart rate or palpitations

    • Increased shallow or difficulty breathing

    • Nausea

    • Diarrhea, reflux or IBS

    • Sweating

    • Tremor

    • Increased urination

    • Increased appetite

    • Dizziness or vertigo

    • Increased sensitivity to pain 

    • Headaches 

    • Worsening of skin conditions like eczema, hives, psoriasis

Postpartum anxiety can happen to you even a year after you have given birth. 

Symptoms of postpartum anxiety can include the above symptoms, as well as:

  • Feelings of worry or dread
  • Racing thoughts
  • Problems sleeping
  • Hot flashes

What are possible causes of anxiety?

  • Hormonal change and fluctuations in perimenopause
    • Your brain’s response to hormonal changes can impact if you experience anxiety
    • Women with a history of mental illness, including postpartum depression and anxiety, are more at risk, as well as women whose moods are sensitive to hormone changes and have experienced PMS and PMDD
    • About 18% of women in early perimenopause and 38% of women in late perimenopause experience symptoms of anxiety and depression
  • Life or situational stressors
    • Changes in work, home, family
  • Individual genetics
    • Your genes can impact your neurotransmitter balance eg. COMT
  • Drug-induced anxiety
    • Alcohol, cocaine, caffeine, cannabis (see Episode 80 for more info on cannabis)
    • Amphetamines
    • Corticosteroids
    • Anticholinergics including some antidepressants
    • Hallucinogenics
  • Thyroid conditions (see Episode 42 for more info on thyroid)
    • Hyperthyroidism and Hashimoto’s thyroiditis 
  • Hypoglycemia
    • Low blood sugar can increase stress hormone cortisol
  • Lung conditions like COPD
  • Heart failure or arrhythmia
  • Brain inflammation or encephalitis, eg. traumatic brain injury, concussion
  • Nutrient deficiencies
    • Vitamin B12
    • Magnesium
    • Iron
  • Trauma, chronic stress and Post Traumatic Stress (PTS)

What are the conventional medical options for dealing with anxiety?

Prescription medications used to treat anxiety include:

  • Benzodiazepines like clonazepam, lorazepam, diazepam
    • High risk of developing side effects, dependence and tolerance
    • Nutrient depletions can include melatonin and glutathione
  • SSRI and SNRI antidepressants
    • High risk of side effects including impact on libido
    • Potential of worsening of symptoms in first 2-3 weeks
    • Nutrient depletions can include sodium, folic acid

What laboratory testing can be helpful for determining the root cause or factors of your anxiety?

Blood work – Iron panel, thyroid panel, vitamin B12 and D

Urine organic acids and hormone testing eg. DUTCH

Beck anxiety questionnaire

What are some natural approaches to address your anxiety?

  • Reduce alcohol, caffeine, sugar
  • Learn your situational triggers eg. running late
    • Avoid the avoidable
    • Prepare for the unavoidable
  • Practice RAIN – work of Tara Brach
    • Recognize – name the feeling
    • Allow – lean into the feeling, let it be, breathe
    • Investigate – physical feeling, self-talk/beliefs, what do you most need right now
    • Nurture – talk to yourself like friend, direct self-compassion
  • Interrupting anxiety or changing your state
    • Breathing exercises or humming to activate the vagus nerve
      • Diaphragmatic breathing with long inhalation and longer exhalation, research study showed lowers stress hormone cortisol practiced twice a day over 8 weeks
    • Splashing or drinking cold water
    • Ground yourself in the present by checking into your physical body, using your sense including smell and sound
    • Journalling
  • Prioritize sleep – see Episode 73 for more info
  • Exercise and moving your body
    • Bonus if you go outside for fresh air and sunshine!
  • Practice mindfulness and meditation eg. loving kindness practice
  • Avoid multi-tasking to prevent:
    • Increased heart rate
    • Feeling wired
    • Reduction in cognitive function and emotional control
    • IQ dropping by up to 15 points
  • Balance blood sugar and reduce pro-inflammatory foods – see Episode 45 for more info
  • Prevent anxiety-like hypoglycemic symptoms
  • Reduce inflammation fuelling anxiety

Supplements to consider:

  • Lavender, lemon balm, kava, tulsi, chamomile, passionflower
  • Adaptogenic herbs like ashwagandha, rhodiola, eleuthro, reishi
  • L-theanine, Lactium, taurine, 5-HTP, glycine, inositol, phosphatidylserine 
  • B complex
  • Omega 3 fatty acids
  • Magnesium 
  • Vitex for hormone regulation

Prescription medications to consider:

  • Bio-identical progesterone
  • CBD (also available without prescription in specific retail stores in Canada)

Other resources available:

  • Cognitive Behavioural Therapy (CBT)
  • Tapping or Emotional Freedom Technique (EFT)
  • Wellness Together Canada online portal

Today’s Mama Must Have: 

Dr. Lisa loves using her morning routine to set the tone for her day, including meditation, humming and chanting exercises

Dr. Toni highly recommends carving out some solo time for personal development and is currently enjoying the Living Passionately online seminar through Landmark Worldwide. It has made a huge impact on her mental health and helped to reduce the stress of the “should”s.

Dr. Toni’s next HypnoBirthing session for expecting parents looking to decrease fear and anxiety around labour and birth is happening this summer. Join her at https://www.hypnobirthingcalgary.com/register

Dr. Lisa’s Wild Collective in Fall 2022: get on the waitlist: wildcollectivetoronto.com

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Stay safe and healthy everyone!

Disclaimer: The information provided is not meant to replace treatment with a licensed health care practitioner. It is for informational purposes only. Consult with a Naturopathic Doctor or other licensed health care professional to determine which treatments are safe for you.

Episode 88: Exhausted, Gaining Weight and Forgetful – Is it Your Thyroid? (previously released as Episode 42)

We refer to this past episode from October 8, 2020 so often that we decided to re-release it! Is your thyroid the reason you are exhausted, depressed, constipated, forgetful and gaining weight? We discuss signs and symptoms of hypothyroidism, how to properly diagnose imbalances, how to eat to support thyroid health and how we approach assessment and treatment as Naturopathic Doctors.

One in eight women will develop thyroid disease at some point in their life and women are 5-8 times more likely than men to experience thyroid issues.

As Dr. Lisa shared previously in Episode 3, she realized that her thyroid wasn’t functioning properly after giving birth to her son. It is common for women to discover thyroid issues in the postpartum period. Proper blood work, addressing stress and taking dessicated thyroid were crucial for Dr. Lisa to feel her best. 

Why is your thyroid so important?

Your thyroid gland regulates your temperature, energy production and metabolism. When your thyroid is under functioning, it is called hypothyroidism. High thyroid function is called hyperthyroidism.

Symptoms of hypothyroidism include:

  • Fatigue and exhaustion
  • Unexplained weight gain
  • Increased sensitivity to cold and temperature changes
  • Constipation
  • Dry skin and thinning hair
  • Puffy face
  • Cravings for sugar and carbohydrates
  • Muscle weakness, aches, tenderness and stiffness
  • Pain, stiffness or swelling in your joints
  • Heavier than normal or irregular menstrual periods
  • Depression and anxiety
    • as many as 15% of women on antidepressants have an undetected thyroid problem as the cause of their depression 
  • Brain fog, poor memory and concentration
    • Studies of women in their 60s have shown that low thyroid function can cause dementia-like symptoms and treatment can improve cognitive function and have a protective effect on the brain
  • High cholesterol
  • Increased risk of heart attack, cardiac arrhythmias and congestive heart failure due to the regulatory control of the thyroid on heart rate and rhythm
  • Fertility issues, increased risk of miscarriage and preterm birth
  • Increased risk of prenatal and postpartum depression

Why do so many women have thyroid issues?

Possible Causes of Your Thyroid Issue Include:

  • Environmental exposure to different chemicals, xenoestrogens and heavy metals
  • Certain medications including birth control pill
  • Vitamin and mineral deficiencies
    • Iodine, selenium, vitamin D, zinc, iron, vitamin A
  • Low calorie diets
  • Infections
  • Stress
    • High cortisol levels due to chronic stress:
      • reduces thyroid hormone production
      • inhibits your conversion of the inactive form of thyroid hormone T4, to the active form T3
  • Gut issues
    • Leaky gut (also known as intestinal hyperpermeability) and imbalances in your gut microbiome have both been shown to impact hormone imbalances and fluctuations, like when you are postpartum or in perimenopause
  • Autoimmunity
    • Environmental toxins, chronic stress, nutritional insufficiencies, leaky gut, food intolerances and having chronic inflammation are all factors that can contribute to autoimmune disease
    • Your immune system is triggered to produce antibodies that can attack your thyroid, which is what is happening when you have Hashimoto’s thyroiditis

How do you properly test your thyroid function and the underlying causes of thyroid issues?

Blood work: 

Full thyroid panel: TSH, free T4 and T3, thyroid peroxidase antibodies, thyroglobulin antibodies, reverse T3

Vitamin D, iron

Celiac screen 

Gluten and other food sensitivity

Saliva and urine testing for hormones including cortisol, estrogen, progesterone

Urine testing for heavy metal exposure (eg. cadmium, mercury)

Temperature checks every 3 hours during the day to see if your body is using your thyroid hormones properly

What can you do about an underfunctioning thyroid?

Avoid raw goitrogenic foods – soy and Brassica family veggies like broccoli and cauliflower

Increase your intake of thyroid supporting foods 

  • Seaweed like dulse for iodine, brazil nuts for selenium, pumpkin seeds and oysters for zinc

Reduce toxin exposure

Replace nutrient deficiencies

Consider adrenal and stress support:

  • Address your throat chakra – speaking your truth, asking for help
  • Herbal support with ashwagandha, kelp, bladderwrack, Coleus forskohlii

Thyroid hormone replacement with Synthroid or Dessicated thyroid

  • Take in the morning, on an empty stomach, away from caffeine

Why would you consider dessicated thyroid?

  • If you’re on monotherapy like Synthroid (T4), you still night suffer from anxiety and depression even if your TSH levels are normal
  • T4 may not be enough to restore your T3 levels in your blood and target tissues
  • It contains all four natural thyroid hormones – T4, T3, T2, T1, plus iodine, thyroglobulin

Today’s Mama Must Have:

Dr. Toni loves having a healthy and easy recipe like Egg Muffins from Amanda Naturally that the whole family will eat for breakfast or a snack. Check out Episode 5 for more tips for healthy food habits from Amanda.

Dr. Lisa knows that Dessicated Thyroid is an absolute must have for her!

Thank you for joining us today! 

Connect with us at our website www.perimenopausalmamas.com, on Facebook and on Instagram. We’d love you to subscribe, leave us a review and a 5-star rating if you enjoyed this episode.

Please tell your perimenopausal mama friends about us, too!

Stay safe and healthy everyone!