How to Fix the Root Causes of Menopause Symptoms (Before Starting HRT) with Dr. Deanna Minich

Today, I'm joined by Dr. Deanna Minick, an internationally recognized health expert and pioneering nutrition scientist with more than 25 years of experience and more than 50 scientific papers published to her name. She is a PhD Nutrition Scientist with a doctorate in medical sciences with a focus in nutrition, and has authored more than seven books, including the Rainbow Diet and the Whole Detox. Today, we are going to discuss hormone replacement therapy and women's health, in addition to diversity of nutrients that are one of the key ways to help to combat inflammation. So, Dr. Deanna, you have shared how right now there's such a jump to just go on hormone replacement therapy. If you think you're in perimenopause, go to hormone replacement therapy. You're going through menopause, jump to hormone replacement therapy. And I want to get your take on how you feel about that approach and what we may be missing.

What I think we might be missing is more of a delving deeper into the root causes of why we might be experiencing symptoms during the perimenopause and even postmenopausally. In functional medicine. We talk so much about the matrix. The matrix has all of these different functional nodes, and one of the nodes that connects into perimenopause especially is the endocrine system, where we talk about the communication highways in the body. So within, we have this very elegant endocrine system. So we are communicating between the hypothalamus, the pituitary, the thyroid, adrenals, and the ovaries. So with menopause, when women are just focused on hormones, what we're trying to do is just hurry up and replete the ovaries, whatever we're losing from the ovaries. But then that's not really going into the more complex biology we have, which is, well, we need to look at the gut, we need to look at adrenals, we need to look at the thyroid, we need to look at brain health, circadian biology. It's a bigger picture. So I think that when we just take the shortcut to hormones and then we expect to have a resolution of our symptoms, we might be surprised, because for some women, they don't have a complete resolution. They still have to do the foundational work. So I think that's what we miss. We miss the fact that menopause is not just a hormone deficiency. It's actually a progressive decline of the endocrine system over her decades of life.

And so I'm seeing all of these women who are experiencing, like, more fatigue or more brain fog. And I'm in the conversations that I'm having with clients and with friends and maybe even women that are just entering the stage of potentially being perimenopausal, or maybe it's postpartum, where it's like they're. The jump is always to, it must be my hormones. It must be my hormones that are out of balance. And I'm interested on how can we be thinking differently than just automatically jumping to the idea that it's the hormones.

Well, if we kind of piece apart all of the different symptoms that she might have. So for most women, the most bothersome symptom is hot flashes. So 75 to 80% of women have hot flashes. But if we look a little bit deeper into why does a woman have these hot flashes? What is the root of that? What do we need to be looking at? Is it just repleting the body with estradiol and having our life back? Not so much. There are still women who take hormones and they still continue to have those symptoms. So if we just look at those vasomotor symptoms and we start to go deeper and say, well, why? What's happening in the body here? We're going to start to see that we might need to be looking at cardiovascular health, that this might actually be an indication of some type of risk factor connected to our heart or our vasculature. It might also signal a dysregulation of the sympathetic nervous system. So maybe this is where now the adrenals come to the forefront, because we haven't dealt with our adrenal dysregulation, we start to have this vasomotor symptoms. So again, I think it's not just like a patching over with hormones, even if we go back premenopausally. And I'm guilty of this as well, because if I think back to my 20s and my 30s, when I was having some menstrual issues, so I had endometriosis, I had all kinds of things going on, and I just decided to take birth control pills because I thought, well, that'll just smooth over the all of these issues and I can just pretend that they go away. Well, eventually I went off of them because I wasn't using them as a contraceptive. I was using the birth control to help modulate my hormones. But in some ways I got better in some ways, and then in others I didn't. So there were also other things I wasn't looking at, like hormone metabolism, hormone excretion from the body. And so I think, again, it's not just oh my gosh. I have these symptoms, like, let me hurry up and get hormones so that the symptoms go away. I feel like symptoms are messengers. They are signaling that we've got some type of root cause that needs to be addressed. The other big issue I think that women have is musculoskeletal pain. So we know of the musculoskeletal syndrome that many menopausal women experience. So why is that? Well, was there an increase in inflammation in the body? Were there changes in bone and maybe changes in bone mineral density? Does she need to shift her regimen in terms of her activity? Does she need to start doing strength training and exercise a little bit differently? So again, I just don't feel like we're taking the shiny object approach to menopause, which is right now the shiny object is hrt, or sometimes we call it mht, the menopausal hormone therapy, because we think that, oh my gosh, it's just that my hormones are out of balance. But really, again, hormones are communicators in the body. They're connected to so many other functions. They're connected to the health of our digestive system, whether or not we have enough nutrients in the body. They're connected to detoxification, they're connected to our structural integrity through our bones, through our muscles. So there's just a whole lot there. And I think for some women, that feels overwhelming, which might be a reason to pull in a health team. And I talk about this with people all the time. You know, if you haven't really tended to your health in your teens, your 20s, your 30s, in your 40s, you're going to need a full on team of maybe a health coach, maybe an acupuncturist, maybe. And this is all in addition to your primary care practitioner. Right. So there could be other things that you really do need to address if you haven't looked at them in years.

Yeah. And I think that it definitely becomes kind of like not that hormone replacement therapy isn't wonderful and so important for a lot of women that have not had access to it because of the Women's Health Initiative. But it does seem like it's being treated as more of like a band aid approach of oh, you just might need some testosterone or you might just need to figure out a better, you know, combination of the estrogen and progesterone or whatever it is that the person's taking. And you know, I tried to, to share like you can't just bypass the, the nutrition that's impacting Your underlying inflammation and potentially insulin resistance. Because as you're talking about like the endocrine system changes, which makes us more insulin resistant. And, and all those things aren't just going to miraculously go away with the addition of hormone replacement therapy, unless you're going to. Going underneath the surface to try to like check off these other buckets.

I love how you said all of that, and that is so true. I mean, there are so many other things to think about, like checking off all of those buckets. I think the, the easy way that I think about it is in the context of what I call stame s t a m e. So that would be synthesis, transport, activation, metabolism and excretion of hormones. So when we just dump a lot of hormones into the body and we don't tend to how those hormones move through the body through transport, through proper hydration, having enough protein to connect and hold on to those different hormones to move them through the body activation are receptors working well at the cellular level, because hormones need to be fit into a receptor to then have activity in the cell. And, and then we have the metabolism of that hormone through the liver and then finally the excretion through the gut. So again, it's not just like an easy one, two punch. We have many different layers of processes that have to be tended to, especially when a woman is on hormone replacement or hormone replenishment therapy in any way. And there is the other aspect of also introducing endocrine disruptors into the body from certain formats of hrt. As an example, we see that with patches. So patches typically have an adhesive. Well, of course they have an adhesive because that's how they attach to the body. And they have to then have the hormones go in that way. So think for yourself just what is the method that I am using to get those hormones into the body exogenously? How do I take them from the outside and move them in? Like, even if you look at prometrium, which is a soft gel, right. You know, it's got a lot of things in there outside of the progesterone that we should be thinking about, like peanut oil, like certain FD and C dyes, even. So, you know, I don't think a lot of women look at that. They don't look under the hood. They just see that, oh, wow. You know, hormones are all the rage. I need to hurry up and get on them. I need to get on the bandwagon. But there's a lot of nuance to it for it to be successful. And again, if she goes into it and then realizes later, oh, my goodness, they didn't solve my issues, then she's going to be at a loss. So I think that's why, again, getting educated, working with the health team, I think that this is really important. Now that all of that said, what you and I come from in terms of our thinking is personalization. There's always going to be a personalized response and a personalized combination and even a sequence of what could happen clinically. You know, one of the things that I think of in order to kind of stack the deck in a favorable way for a woman going through this change of life is to think about her, of course, her nutrition, her lifestyle. I care a lot about circadian rhythm. I care a lot about if she's eating phytonutrients, especially a lot of fiber, because her gut starts to change as she starts to go through that menopausal transition, right? So we need to stack the deck to be sure that, okay, if I have potholes in my road of life where I have deficiencies or insufficiencies, we need to make up for it now. We need to really start to get that solidified. And then separately, you know, you and I were talking off air about how do we just naturally optimize our endocrine circuit? So this is with no hormones, but how can we send signals to our existing endocrine circuit to help to restore the communication, to help to align that hptao access? And one of the botanicals that you and I know about is feminescence. And feminescence is the first natural product shown to have a statistically significant effect on menopausal symptoms and on hormones or actually just, you know, most people don't even realize that hormones can be affected through feminescence. But we do see nice increases in estradiol and in perimenopausal women, also in progesterone, just by nourishing this endocrine axis within. So wouldn't we want to do that before we then move on to bringing in exogenous hormones? Because what we'd like to do is, is just naturally get the body back to its rhythm, right? Just reestablish that communication, whatever can be repaired, because maybe it has been broken and that, you know, the circuit within is just not as streamlined. So I think that nutrition and lifestyle, moving into the. Having the feminescence to help to align the endocrine circuit to naturally produce hormones that would be beneficial for that stage of life. And then with a Health practitioner, really dial in. Okay, do I need a little bit more estradiol or maybe I just need less hormones in general because I'm doing all of those other things. So that's just an idea for a sequence of something that could be tried.

Yes, I love it. I love the sequence, too, because that helps a lot. And so let's talk a little bit more about feminescence, because this can really help for women across many different age ranges from a hormone standpoint. I shared that with you that I had personally used it before I had gotten pregnant with my two kids, and it really helped with some of the hormone imbalances that I was experiencing. But then I know that there's also different products. So tell us what feminescence is and also your role, because you're the scientific advisor for the company that's producing it, correct?

Yeah. Yeah, I'm glad that you. You mentioned that. So I am the chief science officer at Cell Symphony Natural Health. Symphony Natural Health has a suite of women's products. They are called Feminescence. And within the Feminescence brand, there are three individual life stage products. One is called Maka Harmony, and that's probably what you are on. And it sounds like you have feminescence babies, we would call them. Right. So what Maca Harmony does is in a woman who is still having a menstrual cycle, it helps with hormone balance. And we've just heard, you know, the product has been on the market for 18 years or so. And so we've heard so much great feedback in the field from women partners and, you know, just everybody about how they've tried feminescence and what has happened for them in their lives with respect to their fertility babies and lots of good things there, or, you know, even just separate from looking at fertility, looking at things like just reestablishing hormones, hormone balance. So that could even be. We have a case report that has been published in a patient of Dr. Stephanie Hayes in which the patient had PCOS. So she had tried a number of different therapies in combination, one of which was feminescence. Maca Harmony. So good stuff there.

And so can you explain, like, how does maca, how does that, like, affect overall hormone balance? Can you give more of, like, an explanation for that? Because this is a higher dose maca than what you would get from just like a powdered maca that's over the counter, like, that you would just buy from the grocery store.

Yeah. So let me step back. Yeah. So within all of the feminescence products, they are all based in maca phenotypes. So one of the things that I didn't even know Brigid was that there are 17 different kinds of maca and certain ones are really good for men's health, others are good for women's health. Some of them help with bone, some of them don't help with bone, some of them are more targeted to the adrenals, others don't do anything with the adrenals. So Dr. Henry Meissner was the scientist who worked on a lot of the early pre clinical, the toxicology work. Really, really understanding the mechanism of all of these different types of phenotypes. You know, if we just put them into colors, I'm thinking the black, the red, the yellow, orange, there's purple, there's red. These are kind of like the larger camps of color and then there are shades within each. So Dr. Meissner worked with a team in Peru to really understand how to grow and maximize certain actives in the different maca phenotypes. So what you see in feminescence is that this is a concentrated blend of certain maca phenotypes in order to have the desired benefit. So if that is for reproductive health, that has different maca phenotypes than the one for perimenopause, which has other types of maca pheno phenomena. So when I'm talking about the phenotype, it's just the presentation of the maca, the DNA, the physiologic effects, the color. And so each type of maca combination is specific for a certain hormonal effect in women. So the way that we are seeing that it's working based on the work from Dr. Meissner is truly at the level of the hypothalamus and the pituitary. So, so what we know from the hptao access is that we produce certain hormones in the brain that are then signaling the thyroid, that are then signaling the adrenals, that are then signaling the ovary. And then there's a biofeedback back up to the brain. And we know that with the actual maca phenotype intelligence within all three products that we are able to affect reproductive hormones. We can affect fsh, lh, we can look at adrenal hormones, we can look at, sometimes there's an impact on thyroid hormones, and then of course the ovarian hormones like estradiol and progesterone. So there are four published clinical trials looking at the effects of feminescence. Which again, is the commercial name, so you'll see it in the literature as maca goes. But essentially it's the feminescence maca phenotype blend and what they are doing in the body. And it was actually tested in women that would be using it. You know, many times what you find is a supplement for menopause that is taking from the best of science on a variety of different herbs and then putting them together and then just hoping for the best. What Dr. Meissner did with feminescence was actually ran four clinical trials. One clinical trial was in perimenopausal women, and then three of them were in early postmenopausal women. And so he looked at different markers, he even looked at bone mineral density, he looked at lipids, body composition. So he actually went beyond just the hormones themselves to look at what some of the body systems that would be affected by hormones, how would they respond to feminescence? So I love it because when I think about supplements, I think about science, safety and quality. And when it comes to the science, there's a lot of science out there, but many times it's not on the final product and it's not in the population that it's intended for. So with feminescence, we do see that this has been tested in perimenopausal women and in postmenopausal women. And. And we also, because of case reports and just history of safe use with these different maca phenotypes, we also have a connection with fertility and looking at reproductive health. So all in all, it stacks up quite well as it relates to hormones. And there's also, I know that we're just focusing on women, but there is also a line for men's health as well. So those products would have different maca blends or different maca phenotype mixtures for men's health. So that would look different. So it's really intriguing to me because the science of maca is quite deep and profound and has been ongoing for many years. In fact, a lot of this work on women's health started in the 1960s with a woman researcher in Peru, and she started to find that there were these endocrine effects. She published her PhD dissertation on it. So Dr. Meissner really took that on from her to then start to look in, in certain populations. So, yeah, that's how I hope I answered your question as to how feminescence works.

So helpful. So do you recommend, like, for someone. I'm a year and A half postpartum and I haven't been taking feminescence. But do you since my kids, mainly also because of the increase in fertility. In your experience, do you see that staying on something proactively like that through the, the rest of, you know, that postpartum phase into then perimenopause can lead to a decrease in potential symptoms and then also delay the onset of menopause, potentially because of the hormone regulating abilities.

So much depends on whether or not the woman has hormone imbalance. So you just mentioned it right there. If she has symptoms and needs to get back on track and needs to reinstate that communication and get the endocrine system going again, then by all means, for some women in their pre menopausal years, sometimes they just need maybe, you know, six to eight months, six to 12 months of feminescence maca harmony to get her hormones aligned and then she's good. Maybe she has no symptoms and now she has a regular cycle. I would say with the perimenopausal product, it's good for symptom relief. But to answer your question, if somebody were to continue maca harmony because they are cycling and, you know, they want to retain and regain their ovarian vitality as long as possible and they're having symptoms, then yes, I think that being on the feminescence maca harmony would make good sense. It's kind of like creating a kind of endocrine fitness through feminescence.

That makes sense. I think it's amazing. I've had my mom on it as well for a few years and actually I hadn't even connected all of this when I originally reached out to have you on the show to say, just I've benefited from your work in so many ways over the last decade that you have influenced my nutrition philosophy. And so that was really the reason that I wanted to have you on. But now that we're talking about this, like, I've also had my mom on it, I feel like it's so great to be able to have something natural that is science backed, to be able to support health and potentially like even delay the need for additional interventions because of its ability to help to improve various symptoms.

Absolutely. It's great that you brought your mom into it. So I think that if, if women were more attentive to the health of their endocrine system, Even in their 20s, you know, even in their teens, I think that they would fare much better as they start to go through menopause. Right. Because then they're take. They've taken care of the stress response, they've taken care of the thyroid function, they've taken care of their gut. You know, you have, that's why you have so many different ways that women go through menopause. And so I like what you're saying because it really reinforces the idea of trying to get ahead of the curve, trying to get ahead of these changes that will happen in the body. And to minimize any kind of disruption or any kind of flux or change that would be undesirable, at least, you know, we would think that if we're tending to the endocrine system over time, we could minimize a lot of that disruption, which can be very chaotic for some women when they go through it.

And can you explain for people that don't know just what the endocrine system is?

Yes, it's a series of glands in the body. Endocrine refers to the hormone system. So when we think of endocrine, we're thinking of hypothalamus, which is in the brain. That's like a connector into the pituitary gland. The pituitary gland has been referred to as a master gland because it's kind of like the hypothalamus and the pituitary. They're like brother and sister. They kind of work together. Hypothalamus signals the pituitary. When there's some kind of response in the environment or even within the body or circadian wise, you know, just everything. All the inputs that would inform the hypothalamus can then signal the pituitary. Then the pituitary sends out signals to the rest of the other glands in the body. Like the thyroid is actually a gland, right? It's a butterfly shaped gland. Then you have the adrenal glands, which sit on top of the kidneys. You have the ovaries in women which are connected to this communication system. You have the testes in men. So when we talk about glands, when we're classically talking about the endocrine system, it's a gland that produces a hormone that goes on to have an effect somewhere else in the body. So that can also mean melatonin is also seen as a hormone because it is produced by the pineal gland, small gland in the brain, and that is in response to darkness. And when that happens, melatonin travels throughout the body to then connect to the clocks within every cell, right, to kind of synchronize us to the circadian rhythm. So in a true sense, pineal melatonin is Working like a hormone because it's produced by a gland and then it's secreted and it goes out to the body to have action that's considered truly endocrine. You know, there are other ways to talk about hormones like autocrine, paracrine. We don't need to get into all of that. But the endocrine system is a series of glands in the body that are all in some way communicating and connecting through hormones.

Perfect. And then I'd love to explore. I told you when we started that you have influenced my nutrition philosophy in so many ways, especially with the introduction of phytonutrients, phytochemicals being such a core aspect of overall nutrition and one of the most effective ways to combat inflammation. Can you talk about what phytonutrients are and why? They're a very important part for people to be thinking about when it comes to their nutrition.

Phytonutrients are nutrients from plants that are not caloric. So they don't give you energy in the way of, like, calories. And they are also not a vitamin, they're not a mineral, they're not a protein, carbohydrate, or fat. They are unique compounds from the plants exclusively, and there are thousands of them. And what we know about phytonutrients is that they're doing lots of different things in the body. They're controlling stress response at the level of the cell. They are implicated in, gosh, so many different things. Like even at the level of the gut, so much of the gut microbiome is metabolizing these different phytonutrients and then creating other more active compounds for the body that can then communicate between the gut and the brain. So phytonutrients, and just to give you some examples of what they would be, because maybe people don't know the word phytonutrient, but then when they hear an example of a phytonutrient, they say, oh, I know what that is. So here are some examples. So you have polyphenols. Polyphenols are the largest category of phytonutrients. This is about 8 to 10,000 different phytonutrients. So within polyphenols, you have things like resveratrol, which is in grapes. We've heard a lot about resveratrol. You have things like isoflavones and soy. You have things like proanthocyanidins and purple or blue colored foods. So you have that category. And then you have A category of what's called carotenoids. Many people have heard of beta carotene. Beta carotene is what makes carrots orange. So that's actually a phytonutrient. So on its own, you know, again, it's not giving you calories. Beta carotene has a lot of different functions in the body and one of them is actually to convert to vitamin A. So that's just to give you an example of maybe some of the ones that people have heard of. One of the ones that when we were just talking about maca that you find in maca is called glucosinolates. Glucosinolates are compounds that you can find in not just maca, but also cruciferous vegetables. And these seem to be important for detoxification processes in the body. So that's, that's kind of like the high level view of phytonutrients.

And so then practical ways that you can advise people on how to benefit from the incredible way that they're able to combat inflammation. And what does that look like?

Well, if you're asking about inflammation specifically, I would be thinking about a high antioxidant, low pro oxidant way of eating. So we have to look at both sides. If we can reduce the amount of processed foods, the amount of sugar, the amount of alcohol, and make our eating a bit more nutrient dense, high in fiber, high in antioxidants, like a lot of the rainbow colored fruits and vegetables, then we start to tip the scale more in the direction of being anti inflammatory. I'm glad that you ask about that because inflammation is one of the foundational mechanisms related to all kinds of different chronic diseases. So if we can keep the body stable and uninflamed, that's a good thing. You know, just back to menopause for a second. As a woman starts to lose her hormones, she can come into a situation in her body where she has more inflammation or she can't quell the inflammation as well. So it's even more important to be eating, yeah, the rainbow array of different phytonutrients and to be on point with her diet.

And it's why also so many women will say, I haven't changed my diet or physical activity, but I'm starting to see, see these changes in how I'm feeling. And so much of it isn't necessarily that you haven't changed anything. It's the need for changing things because of the body's lack of ability essentially to offset the inflammation as hormones Are shifting.

Yeah. And you could say too well, what's the root cause? I mean, is it just the hormones or is it that so many other things are coming to the surface? Like now we could see that there are issues with the gut. Now we could see that there are issues with toxins in the body. So again, I think the hormones are one piece of it. And it's like the hormones are connected to everything else. As we started out the conversation with. Right, just kind of talking about that. So I think that I know I'm talking a lot about food and inflammation, but food complements lifestyle really well when it comes to actually living an anti inflammatory life. So if you have a lot of inflammation, a lot of reactivity, a lot of heat, a lot of, I would say, stress, you know, I kind of see this as a very inflamed life and it's hard to be creative, it's hard to flourish, it's hard to feel vital when you just feel like you're working off of survival and stress. So that's why bringing in lifestyle methods, you know, whether we're just looking at simple things like breath work or we're looking at physical activity, we're looking at healthy ways to get some quality sleep in, all of this is really essential for thinking about inflammation. Some things you don't have to pay for. It's just a matter of consistency and engaging with those things on a regular basis.

And then when it comes to diversity within the diet, can you talk about why having a diverse diet is important and how that can impact overall health and even inflammation?

Oh, I love that question. You know, in the Rainbow diet book I have four principles. Color, creativity, rhythm and diversity. So when we tap into diversity, we talk about having complexity in the diet. What I have noticed is that people over time are having the same foods over and over again. I call that food ruts. And usually people that are in food ruts, they're in life ruts. So they're doing the same thing every day. They really don't want to be bothered. They can't think beyond the structure of their day to kind of go beyond and try out a new food here or there because they just don't have the bandwidth. But diversity is really important. And when we look at the American Gut project, which is a citizen science project with a few publications, what we see is that people who had 30 or more diverse foods per week actually fared better in short chain fatty acid production in the gut, which is a marker of, you know, gut immune access, gut brain access. Those short chain fatty acids are really important. So in order to get there, it looked like having 30 or more was beneficial compared to the group of people that had less than 10. So what I say to people is aim for 30 to 50 unique foods every week. Like if you have a banana on Monday, you can count the banana on Tuesday, you need to do something else. If you have a Granny Smith apple on Monday, you can't have that on Tuesday and count that towards diversity. But you can count another type of apple variety. So if you had a Red Delicious apple that counts as a different species or different, it would have different phytochemicals. So one of the ways that we can get a lot of diversity is having things like even like herbal teas with combinations having herbs and spices. I feel like people have underplayed and underutilized spices. And spices are great because they enhance the flavor of food. They also amp up the nutrient density and the phytochemical diversity. So one of my curry Powders actually has 11 different spices in it. So already, you know, of course, if I'm using that on one day, I want to start cycling through my spice rack and go into maybe ginger or this morning I had cinnamon, Ceylon cinnamon. So there can be all kinds of different things that we start to think about. And also when the seasons start to change, people need to be thinking about changing their eating, because nature is giving us what we need in order to better adjust our chronobiology, because eating according to circadian rhythm is important. And then eating foods in season will help to further streamline and prime the connection to our circadian biology. So there are actives in things like grapes and cherries and even, you know, teas. Certain teas have polyphenols, which have what's called a chronobiotic effect. So all in all, it's really important to. Again, a lot of these are just principles of nature. They're not even principles of Deanna. They are just, they're out there. So when people ask me, deanna, how should I eat? I just keep it really basic. I talk about the colors of the rainbow and how we need each of the colors and even diversity within each color. We need to be creative about foods and how we bring foods in. We need to be attentive to what time of day we are eating, right? So we want to front load our day earlier in the morning with the light, with foods for our metabolic endocrine rhythm, and then less food at night, which we kind of, many of us already know that that's kind of common sense, but. And the science supports that. And then finally looking at that diversity, which helps the gut, and when we help the gut, it's like we help many different body systems.

So true. And I've even tried to just distill it down to eat enough protein, eat enough fiber, and focus on more phytonutrients and phytonutrient variety. That's like, those are pretty much the three pillars of what we focus on in my nutrition membership, where we create meal plans every week for our members so that we are able to get the diversity. And like focusing on those three pillars because I think that right now there's so much of an emphasis on make sure you get enough protein, make sure you get enough fiber. But the missing piece to me in that messaging is around the color, the phytonutrient variety, and the diversity in your diet that, like you said, is so important for improving the gut microbiome, but then also helping to combat inflammation.

Absolutely, yeah. And just to toss into the mix, I do think that omega 3 fatty acids, like having good, healthy quality fats, is also really important because every single cell, pretty much every cell in the body, has a lipid membrane. Right. It has fats around the wall of it. And so the health of the cell is determined by the health of the. Or the. Yeah, the health of the fats in the diet. And as we move into menopause, our ability to convert fats into longer chain omega 3s starts to reduce, and we might actually need more omega 3s to support brain health or even to support just overall cellular health. So I don't want us to forget about healthy fats because having a good healthy fat ratio so omega 3s to omega 6s will help to establish a healthy inflammatory response in the body.

Yes. Such a good point. So as women go through menopause, their metabolism of omega 3 fatty acids changes. Are there other nutrients that you would highlight as far as nutrient deficiencies that you see very commonly that also play a role that women should be thinking about?

Actually, we may not consider it a nutrient, but I do put it together in the nutrition camp, and that is hydration. I think hydration is really important, and it's even more important as we start to lose estrogen and progesterone because they are part of fluid regulation in the body. So when we start to have less of those hormones, our body can change in its water compartment and even small amounts of hypohydration or like when hydration just goes down a Little bit can affect things like cognition, brain health, fatigue. It can lead to, you know, headaches for certain people, and it can even lead to just more symptoms through the perimenopause. So that's what I have seen just in talking with people. It's kind of hard to determine whether or not somebody is truly hydrated. So we often talk about half one's body weight in ounces. So if somebody is 150 pounds, thinking about 75 ounces of water, purified water throughout the day, but then also bringing in things like just high electrolyte foods or bringing in high water content foods, so leafy greens or melon or coconut water. And then also because water follows salt, right? And we have a culture where so many people have been told to avoid salt. But I do think that a high quality, microplastic free salt. And. And my choice of salt there is the original Himalayan crystal salt, which you can make a solution out of the stones. That's called Soleil. I don't think many people realize this. You know, some naturopathic doctors are aware of this, but you basically make a salt solution, you take a teaspoon of that, and then you put that into 8 to 12 ounces of purified water, and then you have that first thing in the morning to kind of set your day. And I think that that's a good practice because you do want to hydrate at the start of the day because you haven't had anything for like seven to nine hours. And having that little bit of the trace elements and minerals from the salt can also help to, you know, what we know from physiology is to help with the uptake of the water. So I think that that is something that most people don't think of, and especially because during perimenopause, there's thermal dysregulation, not regulation, but dysregulation. Right. So our temperature is different, we feel warmer, and we are sweating more. So we're actually losing fluids from that. And in those fluids, we might also be missing out on minerals. And minerals, as you know, they form the bedrock for so many different metabolic reactions. They compete with heavy metals. We need minerals. I mean, let's just take magnesium for a second. We know that magnesium is used for something upwards of 300 different reactions in the body. So if we're lacking magnesium, it just brings a lot of pathways to a grinding halt. So it's really important that we start to look at minerals. Calcium, magnesium. Typically, iron gets better for women who stop cycling, but in general, in menopause, what we see is certain minerals tend to be lower, like calcium, magnesium. Like I mentioned, zinc should also be looked at because, you know, some of these, if you take too much zinc through a supplement, can actually be toxic. Right. You don't wanna get into that point of toxicity. Selenium would be another one. Copper would also be key. So I think, you know, checking these out with your healthcare practitioner to see how do my minerals stack up, Am I on point? And those minerals are going to be important for lots of different things. For the bone, for metabolic reactions, for the transport of hormones in the body, for cellular activity. So we do need to be thinking about minerals. I think it's a key piece in menopause. And even premenopausally. Premenopausally, we might have more concerns about iron because of the loss of menstrual blood. And in fact, a woman going through her cycle, she can have different nutrients levels, vitamins and minerals at different times of her cycle. So if you go in for a blood test, you should kind of know where, just keep it consistent. Right. Usually we think of day 19 through 21, that that's kind of like a common window for, for getting kind of a window into the physiology of a woman who's cycling. So just for consistency, because there can be a lot of change in the body, a lot of change in lipids, changes in phytonutrients, changes in vitamins. So it just depends. But perimenopausally, you know, obviously there could still be a bit of that, I would say that variability. But I do think looking at minerals is something that, that people need to do and many people don't do it. And there are certain lab tests that are quite easy for even a mainstream doctor to order to be looking at the levels in the blood. You know, what does somebody have circulating in the blood that would be an indication of their tissue stores.

Love this. And let's talk a little bit deeper about iron, because I think that it is such an important one for a lot of women before menopause, as your iron needs are still higher. So what exactly are you looking for when you're looking at iron levels? Because we see so commonly women that have anemia or even just iron deficiency that are experiencing many symptoms because of that deficiency and it takes a long time for them to actually be diagnosed.

Yeah. And there's kind of a composite of different markers to look at, to look at one's levels of iron. Right. So we look at the amount of iron in the blood that is typically bound to A protein. So we look at ferritin. Ferritin is the protein that stores iron. So typically it's. It's good to be looking at that. Sometimes looking at transferrin saturation can tell you about how much of the sites of transferrin are bound to iron. Then there's like total iron binding capacity. So oftentimes practitioners will be looking at a variety of different things. The proteins that carry iron through the body, the actual level of iron, and, you know, just even symptomatically, I think we need to look at that as well. Is she fatigued? Looking at her diet, does she actually have good dietary sources of iron? You know, one of the simple things to do, especially if you want to absorb more iron from food, is to make sure if you do drink tea, to have teas. So like tea, like whether it's green tea or black tea, oolong tea, chai tea, to have that about an hour after an iron containing meal. So you don't kind of compete with the absorption of iron. So I do think iron definitely can be something to look at in women. And, you know, again, looking at functional medicine ranges. So in functional medicine, we have different ranges of what is considered optimal versus just normal. And so I would say best practice here would be if somebody had some concerns around fatigue or, you know, just pale skin or hair loss. Definitely see a practitioner and ask the practitioner to evaluate them for iron deficiency anemia or, you know, just anemia in general, just to see what, what there could be in ter. Or maybe there is nothing there. Maybe that's the thyroid that needs to be looked at if there's fatigue, because a lot of different symptoms, they kind of have overlapping presentations and that might be what might look like anemia could actually be connected to the thyroid. So it's good to check it out with a practitioner. There's not like an easy way to just say, well, just look at this one thing. And that's why having a functional medicine provider practitioner who's well versed in lab tests, I think that that could be helpful.

Yes. So helpful. Especially because in today's era where there's so many lab companies right now that are direct to consumer, which is amazing for increasing the information. I do feel as though the AI interpretation that comes with those tests is typically not adequate enough because it provides very generic recommendations that are not tailored to what you are personally experiencing. And we see clients on a regular basis who are bringing these lab results to us to be able to interpret because there's so much nuance within it. It's not like, for every person that has low iron that we're going to make the same recommendation or for every single person that has a low red blood cell, magnesium, that it's going to lead to the same intervention. Would you agree with that?

Yeah. Yeah. I think that when you're not working with a provider who knows you. Right. And can personalize and you're just working with an online lab service, you're going to get the values like, for example, I use Function Health. I use Mark Hyman's Function Health, and I've been using it for some years, and I know what to look for for myself. Right. But for somebody going in without an understanding of how would I look at lab ranges? What do I do with that information? They really do need to work with a practitioner. They could take their function health results to a provider and then work with them. Because you can actually download the labs and then you can bring that in and you can say, you know, like, to track this and what can I do specifically for myself based on these labs? So, yeah, I think.

Yeah, a lot of our clients do that exactly for that exact reason.

Right, right. So I really like the database, the infrastructure for Function Health, because I can see, like, all the little dots and I can see like, am I improving? Am I in the green? Like, it's. And it's functional medicine ranges. Whereas if I just use a standard lab now, I've got a file folder thick, and I still have this from previous years, but, like, thick of all of these labs. And then it's like, but they aren't synthesized. They aren't put together in such a way that I can see a pattern happening in myself. So for that reason, some of these online labs are really great. But, yeah, to your point, I think that from a personalized approach and then knowing what to do with those labs, that's a whole other conversation.

Yes, Totally agree. Okay, amazing. So if you were to recommend one of the most important nutrition approaches based on everything that we talked about or based on what you're seeing in the latest research, and obviously there's like, I know there's many different things, like, we need enough protein, we need enough fiber. But if you could just pinpoint one thing that you feel like people could really benefit from as far as improving various symptoms and decreasing inflammation, what is that nutrition recommendation that you're making today?

This is an easy one. Brigid. I'm gonna say fiber. To me, the moment you started asking the question, it's like it already came to my mind. I'm Thinking fiber. You know, most people think about protein and they're like, oh, protein has such a halo of goodness. And you know, protein can do no wrong. And everybody knows that, you know, they like to eat protein. We have to look at where people are deficient and most people are just not getting enough dietary fiber. And that has played out in many different countries, not just the U.S. like we see it just, it's pervasive. We are not getting enough fiber. And the reason why fiber is so important is because of exactly what you're asking about. It's really important to help to establish a healthy balance in the gut. And if you're tending to your gut, you're tending to your immune system. If you're tending to your immune system, you're tending to inflammation in the body. And if you're helping with inflammation, you're helping all of the different body systems. And in so many ways, the gut microbiome is then communicating out to the brain through the fiber that is being just metabolized within the gut. Right? So I talked about those short chain fatty acids. They're a big deal. They even signal tissues like muscle. So I do think fiber is a big deal. And I think we need to get a variety of different fibers, not just pack on the psyllium and don't think about it. No, we need to get fiber from food sources, diverse food sources. And then if we need a supplemental fiber, like a flaxseed meal, hemp seeds, Zen basil seeds, lots of different options out there. I like to create blends. In fact, just even right here, I've got a little, I've got my smoothie on the table that I started to make before I jumped on the call. And in my smoothie, every time I have protein powder and fiber, everything else kind of changes. But I always have protein powder and fiber. But again, I think most people understand the protein conversation. They really don't understand fiber. And especially with the push to have more meat, more of a carnivore approach, I do think, I mean, I'm not saying that that's not something that can be done and personalized to an individual, but you're not getting fiber, you are not getting fiber. So if you choose to do something like that, I would say that, you know, you'd have to bring in somehow a supplemental fiber. Because the benefits of fiber are just hands down, I mean, there are health claims on fiber. They're just copious research studies to support having fiber in the diet for so.

Many different reasons and so many different benefits. So I'm glad that you highlighted that because I could not agree more. I feel like you cannot just focus on protein without focusing on fiber in order to improve your health. Just like I also think that you can't just focus on protein and fiber without also focusing on phytonutrients and antioxidants. And if we're like putting the polyphenols into that equation as well in order to really check off all the boxes.

Yeah, it's hard to just give you one thing, right. Because I think that's what's happened in nutrition is that we just got focused on the one thing. So, yeah, I love everything that you just said because it brings in the whole, yes, fiber's important, but we need context. We need kind of the overall blend of different things that would be beneficial. We stack the deck favorably every day through what we're taking in, because that food is information. And whatever we're taking in is informing ourselves, which is informing our physiology, which is informing our next action and thought. So if you think about it, food counts for a lot.

Food is medicine, that and a whole lot more.

Food is love, food is connection, food is inspiration, food is spirituality. Food is, you know, and I'm so glad in some ways that I studied nutrition because I was very resistant to studying it because my mom was really kind of one of those health nuts. And I'm like, what is this? And I really wanted to be a medical doctor. I didn't care about nutrition. And then as I started to go down the path of taking the MCAT and starting to think about med school and working for doctors, I'm thinking, I don't know if I really want to do this. Wouldn't I want to work with people before they get to the doctor? Well, what did that leave me with? A number of different options, but one of them actually was nutrition. And so I went to grad school to study nutrition. Then I did my doctoral research on Omega, well, essential fatty acids overall. So I kind of getting into the research on fat. Then I went to go into the dietary supplement industry, worked in the food industry. So, like, I know food is integral to who we are, and I'm so glad that I've had the ability to research it, experience it, like work with people on it. You know, it's a rich fabric of our day to day life to eat. Right. We punctuate our days with food. So it has a lot of meaning for people in a variety of different ways. It's emotional, it's mental, it's cultural, it's societal. So it's a wonderful path to start with when we don't know where to go first.

This is where I feel like I have learned so much from you at the very start of my career, which was so impactful. But being able to help people create a healthy, nourishing relationship with food, where, like you said, there is an emotional component, you can't just force yourself into this dogmatic approach. And so many people have negative food relationships that have spanned decades upon decades of diet culture and so many things. And so to be able to shift the narrative like you do, to bring it back to like, food is connection and food is love and, and so many of these other amazing and wonderful things that food can do for us, it creates such a holistic relationship with food, which I think is really important for being able to sustain any kind of changes that you're making to your nutrition where it's enjoyable, you, you experience that joy from it that keeps you coming back to it instead of thinking of it as just a diet. So this has been so wonderful. Deanna, thank you so much for being here with me. Tell everyone where they can find you and where they can benefit from your work.

Sure. My website is my name deannaminich.coM-E-A-N-N-A M I N I C-H.com on there you're going to find blogs, my science and spirituality talks podcast. You're going to find so many different resources that you can download then separately. If you're interested in the feminescence that I spoke about, go to symphonynaturalhealth.com and you'll be able to look at all of the products and you'll look at feminescence. You can find the men's product, you can find the plant based melatonin product which I love. Such a super company with lots of great products. So symphonynaturalhealth.com, i would say that would be a great site. And otherwise just find me on social media in a variety of ways. Like Instagram is fun because I tend to be a little bit more experimental and artful. And then Facebook, I kind of nerd out with a lot of studies there. So you can find me@Deanna MedicPhD.

Amazing. Thank you so much for all of your pioneering work. You've been talking about so many of these concepts that have become much more mainstream for literally 25 years before there was even an abundance of science behind them. Just like you were. You have been such a pioneer and have impacted my career in so many positive ways. So thank you for being here, and we'll see you next time.

No, thank you so much for having me. It's been a great conversation.