Hormone Imbalance - with Magdalena Wszelaki | The Empowering Neurologist EP. 71

Hello everyone, Dr. David Perlmutter. Welcome again to The Empowering Neurologist. You know, one of the great things about doing this show is people send me an awful lot of books, people wanting to be on the program, so I get to read some really exciting books. A new book I just had the opportunity to look at is— it deals with a very pervasive problem in our society, and that is imbalance of hormones. And when I say that, you know, typically people are thinking about the sex hormones— progesterone, testosterone, estrogen— but it's much more encompassing, you know, encompassing things like thyroid hormone in the conversation as well. Well, it wouldn't have served us to have such issues with our hormones being imbalanced as we You know, as we evolved as humans, so something new has been literally brought to the table, and that is some dietary changes that have influenced our hormones, leading to problems. And as such, we have a new book out by Magdalena Shalaki that is in fact called Cooking for Hormone Balance—a super idea and a really well-executed book. Let me tell you a little bit about Magdalena. She's a certified health coach and studied at the prestigious Institute for Integrative Nutrition. in New York. She's the founder of Hormones and Balance, which is a nutrition practice geared at helping women rebalance their hormones through dietary interventions that's based in Boulder, Colorado. But she knows how diet influences hormone balance quite firsthand. She developed hyperthyroidism and then Hashimoto's autoimmune thyroiditis, adrenal fatigue, estrogen dominance, and And this really propelled her to leave a high-pressure advertising career and develop a new way of eating in order to regain her health, in order to repair and balance her hormone situation. She's now symptom-free. She has taken this adversity and has turned it into positivity, not just for herself but for others, by writing the book and also doing a lot of online Uh-huh. Information sharing. She does share her knowledge through these means and, you know, ultimately allows many people to benefit from what she experienced. In her new book, Cooking for Hormone Balance, she draws on current research and explains the essential role that food plays in keeping our hormones in harmony. She offers easy, flavorful recipes that are really in line with a lot of things we've been talking about. She also offers clear and concise action plans for what we need to take out of our diets, what might be threatening our diets, things, for example, like FODMAPs that we're going to talk about today. I'm excited about this interview. Let's jump right in. Hi, Magdalena. Welcome to the program.

Thank you so much. I'm a big fan of your work, so super excited to be here.

Well, thank you. I want to just start off with your experience that you were kind of in a really very busy, crazy kind of job, and then it sounds to me like you crashed and burned and realized that you had hormone issues, and then somehow or another stumbled on the idea that diet might be playing a role. Can you take us through that?

Absolutely. In fact, I think my belief that food can make a profound difference in how I feel and how I look started in my late 20s. See, I was covered in cystic acne, not just on my face here, but on my front, on my back as well. I even had it on my butt. And this is where, you know, as a 23, 24-year-old woman, you go, what is going on here? I'm not a teenager anymore. And I remember finding this article just completely by accident that said that researchers in Papua New Guinea found that teenagers there have never heard of any acne. And I thought, isn't it fascinating that we We are conditioned to believe that that's part of being a teenager. And it said specifically gluten and processed foods. And I took them out. I did a blood test after that. It showed out that I had a problem with dairy and eggs. I cleaned out my diet and my cystic acne completely disappeared. My migraines were gone. My PMS got so much better. And so that was the beginning of the belief and the total surprise that food can make such a profound difference in how I looked and felt. Yeah. And so this is where I didn't keep it up 100%. Combined with an environment of living in very toxic China in 2008, around the Olympics, we all remember the pictures of the haze, as they call it, right? In other words, the smog all around China. Lack of good quality food combined with stress, living from airport to airport, living on hotel food. All of that combined together with the stress, with the quality of food, but also my lifestyle of getting up 5 o'clock in the morning in order to train, because I was a semi-professional athlete, and then working until 9 PM in the office in a very stressful environment. All the perfect ingredients, right, for just crashing and burning. In 2008, I was diagnosed with Hashimoto's disease. Back then, there was only one book about hypothyroidism. I got it shipped over to China immediately. And all they told me was to stop eating soy and bok choy.

Well, it's not a bad— it's actually not a bad first start, truthfully.

That is true. I was a much more complex case than that. And so over the years, it took me like a good 7 years to really figure out all the infections that I had. I had SIBO, I had H. pylori, I had parasite infections that kept coming back. Yeah. Just a lot of stuff going on and clearing out all of that has taken care of the autoimmunity, but just really also combined with honoring my body. I gave up my job. I started my own business, which is supposedly less stressful, although you might argue on that one, but at least I control how I live and what I do. And that has made such a profound difference, so much so that today as a 45-year-old woman, I feel better. In every way, energetically and just clarity of mind and my whole predisposition, quality of my skin. I mean, I'm wearing a little bit of makeup for the camera, but not much. And it all paid off.

Well, there you go. Now we are asking the question then, what is this relationship? And in fact, you developed it so wonderfully, not only in the book, but also in the wonderful foreword that you had written for your book. About the various clues that you receive that our digestion plays such an important role. One of the things right off the bat I wanted to look at is we're going to be talking about individual hormones and their dysfunction and how that might relate to the gut, but you talked interestingly about how body fat distribution can give a clue as to which hormones May be disrupted in the body. Can you take us through that?

Absolutely. So interestingly, the pear-shaped kind of woman, right? So where we store fat around our hips and our butts and thighs, and that includes cellulite as well, which is like the biggest, especially for women who really take care of themselves and just, we can't lose that part, right? It's just so incredibly annoying. And then you go for all these treatments and wraps and spend hundreds of of dollars and trying to get rid of it and it just wouldn't budge. And interestingly, it was estrogen dominance, which hopefully we can talk a little bit more about it because I feel like it's a condition almost every woman experiences in some way or another at some point in her life and most of us don't even know that we have it. Estrogen dominance tends to cause storage of fat around our hips and butts. When it comes to the apple-shaped kind of a lady where you're storing everything around your abdomen, it tends to be more of a metabolic disorder which basically, hormonally speaking, it will be issues with insulin and high testosterone levels, which is caused by basically sugar is the word here.

Well, you actually spend quite a bit of time talking about sugar balancing. And really, I think that's, if I may, one of the cornerstones of your Nutritional intervention is balancing blood sugar. Why is it so critical?

Yeah. So first of all, I will say that, as you probably hear, I'm not American. I moved to the United States 10 years ago. And one of the biggest shockers for me was how much sugar there was in everything and how addicted people were to sugar without realizing how much sugar they're putting in their bodies, right? I mean, sugar in ketchup, sugar in beer, sugar in milk, sugar in— I remember buying this Polish kielbasa and I asked the farmer, why do you Why do you put sugar in your kielbasa? That's not the real recipe. And he says, because that's what people want. And so America is addicted to sugar without even realizing how much sugar we're consuming. A latte from one of the major retail chains contains as much as 32 teaspoons of sugar, 70 grams of sugar. We don't realize that. So why is it so important? I mean, so many things. Sugar is so highly inflammatory. When you're constantly inflamed, your cells shut down, the receptors in the cells shut down to be receiving your hormones as effectively. Whenever you go through the hypoglycemic point where you start feeling shaky, unfocused when you're hungry, people go like, I need something. I need to bring up my blood sugar levels. Well, actually you're crashing. When you're hungry, you shouldn't be crashing and be feeling this way. You should just be hungry, but not be shaky. And the big deal about that is that when we crash that way, we are putting our body into a state of hypoglycemia, which is then the adrenal's job is to bring up your blood sugar levels all over again. And as we all know, adrenals are already so exhausted on a daily basis. Stress in life, finances, kids, job, partner, romantic stuff going on, trauma from the past, all of those things are exhausting adrenals on a daily basis. Every time we crash, it brings up the, you know, it engages the adrenals all over again, right? So, you know, so you're absolutely right. Sugar balance, I feel like it's one of the major cornerstones of hormonal balance, the other digestion and liver function. And just on the sugar balance point, I would mention that, you know, so many women who are going through perimenopause and menopause suffer from hot flashes, right? It's like that one moment where they Hits you, you never know when it's going to come, or night sweats, you wake up in a puddle of water, of sweat, right? Have to change the bedsheets at 3 o'clock in the morning. And guess what? Just by balancing your blood sugar levels, these hot flashes either are going to completely go away or significantly get reduced. Incredible stuff like that.

One of the— I think I was a bit surprised in your book, pleasantly, because I enjoyed that part, dealt with Candida. And I think the segue from blood sugar and sugar in the diet, especially to Candida, is a good one. I'd like to unpack your description of Candida, what it looks like. And also, you talked about— you had a picture in your book about a simple Candida test using a glass of water.

Yeah. Yeah. So Candida, I feel like we all have yeast in the gut, right? It's just the question is how much? And I have found that When I was in private practice, I found that probably about 70% of the women I worked with had Candida and they had no idea that that's what it was. Symptoms can be so, so tricky, right? Because there are some very clear signals that it could be Candida. So those would be things like having uncontrollable cravings for sugar. I mean, you have a person who just cannot walk by a bakery without stopping in just for a little cookie, right? But also women who I remember would argue with me saying, dinner is incomplete without having something sweet at the end. And I'll be like, well, let's treat Candida. Let's just say you have Candida. They're like, no, no, no, no. I don't crave sugar otherwise. It just doesn't feel complete. Well, guess what? When we treated Candida, things had completely turned around for them.

It's amazing how people will try to develop these notions to justify things. One of the things that's always bothered me the most in a response to a question is, well, that's how it's always been done. That's the way we normally do it. I like being disruptive. Tell us about that test that you described in the book where you actually believe you can test for Candida.

Yeah, so very simple thing to do. Make sure you don't eat any dairy the day before. When you go to sleep, Take a glass of water, you know, a glass, right? So you can see through it. And put a glass of water right next to your bed. When you wake up first thing in the morning, what you want to do before you drink anything, don't brush your teeth, right? Don't eat anything. Just build up a bowl of spit and then spit into the glass of water and observe it for the next 20 minutes to see what happens. And there's a few options that can happen. One is that Yeah. The saliva just floats on top over the next 20 minutes and nothing happens. And most likely, that could be an indication there's no Candida at all. Candida, an yeast developing like tentacles of an octopus, that could be an indication that that's where— that's the picture you're holding. And that's an indication that the— that's right, that the tentacles are showing that there could be yeast. The worst one is when it drops.

Because we're on Zoom, if I talk, then that'll bring up that picture. But there you go. That's the kind of findings I think that you're talking about.

Yes. If it drops right to the bottom of the glass, that's a pretty strong indication that you've got a lot of yeast and that's why it drops so quickly. And over the years, there are people who poo-poo that test and it's really pedestrian. But what I have found is that over the years is that when we treat Candida, you know, over a course of 3, 4 months, saliva either floats or it's got little tiny legs only. So I think in many ways it's a really good indication. Candida is so infamously hard to diagnose, right? You can get, you know, I remember when I was struggling with Candida and I did for many years because of heavy metals that I had and, you know, and so you would have these tests like I think I did IgM, IgA for Candida, did stool tests, various different reputable labs, and everything was coming back negative. And so I treated, we treated with my doctor the Candida anyway, and a lot of my symptoms went away right away. So just because a test doesn't show you have Candida, like you said, don't be in denial about it. Address it.

Well, I would say that you're correct. I mean, my experience is that it can be somewhat difficult to diagnose. When you have a high index of suspicion, more commonly in a woman than a man, maybe a history of significant antibiotic exposure, obvious mood alteration, cognitive issues, and significant sugar craving, coated tongue, change in bowel or bladder function, that we become very suspicious. And plenty of times we would treat as well, just based upon our impression. Right. And would go so far as to actually use pharmaceuticals like fluconazole along with a diet that is highly sugar restricted, which for a person suffering from Candida was a big challenge, as I'm sure you know, because they've just— Candida is a yeast. Yeast needs sugar. I mean, if you've ever baked bread, the first thing you do is activate the yeast. You take your packet of yeast, warm water, it doesn't do anything, dump in the sugar, and lo and behold, the yeast is very happy. You also talked about FODMAPs, and I wonder if you can walk through what FODMAPs are all about and why in some people that might be important.

Yeah. So FODMAPs is a diet that was developed in Europe in the 1950s, and Australian University, Monash University, brought it back to the surface probably about 7, 8 years ago, and it's become quite popular for people who suffer from IBS. I don't think it's the only way of dealing with IBS, but I think it's another tool just to consider. So the premise of it is that seemingly healthy foods can contain certain types of sugars. And so FODMAP stands for fermentable oligosaccharides, polysaccharides, and all the different saccharides, right?

Monosaccharides and polysaccharides.

And so they are found, they can be found in beautiful foods like apples and avocados. Dates can have them, right? Even sauerkraut, even though cabbage doesn't have it, sauerkraut has it. Monash University developed a phone app so you can immediately check what it is. And what they have found is that people who have SIBO or have severe IBS are not breaking down these sugars very well and that's causing constant bloating and just the IBS just doesn't heal up. So to me, that's a temporary way of embarking on a protocol like that while doing other things. to address IBS or SIBO, but it just brings down the inflammation. And I have found that, you know, I mean, all these foods we talked about, like onions or garlic for that matter, right? They are wonderful prebiotics, and a lot of times we talk about what are the things that people should be adding into their diets as a form of prebiotics, but a lot of the time the prebiotics that is being quoted are actually very high on FODMAPs, which will cause the person going like, I'm eating all these prebiotics, but I'm looking like a 4-month pregnant woman. Like, what's going on here, right? So there are other prebiotic-rich foods, like for example, jicama, which there are some recipes in my cookbook on. That's why I'm using the low FODMAP prebiotic-rich foods too, to give people options.

I wonder what jicama looks like. I wonder, hmm, what does jicama look like? I wonder if you might have some nearby.

I actually do. Because I'm traveling right now for the book, so I've got sticks of jicama. That I was already pre-cut because it's a wonderful snack.

Our audience needs to know that we rehearsed this ahead of time.

But the actual root is basically a root that looks like this. You know, it's beautiful, smooth, and crunchy, and kind of a little bit, tiny bit sweet. Very pleasant flavor. Just a fantastic little snack to, you know, to munch on.

I think jicama is a terrific food. It's not that commonly available. If I ever become a farmer, and I might, I think I'd like to figure out a way to raise jicama and also vanilla beans. But anyway, as an aside, you talk quite a bit about PCOS, which it's kind of a misnomer, polycystic ovarian syndrome. We now know women can have this issue without actually having multiple cysts in their ovaries. But walk us through PCOS a little bit and how that relates to testosterone. Yeah. And then what does that diet look like?

Yeah, so PCOS is, in terms of symptoms you're talking about, like you said, it could be cysts in the ovaries, but it doesn't have to be. So elevated testosterone levels typically happens with a lot of sugar issues. So women who have high blood sugar levels, right? High insulin. And how it manifests is that, especially for women, it's just such a painful, conditions who suffer from lack of ovulation. So women who are trying to get pregnant who have PCOS just can't get pregnant. So infertility is a big issue. Boldness right in front here. It's interesting with PCOS, with high testosterone as women, we need some of it but not too much, right? Right. And when there's too much of it, then manifests more boldness right in front here when you're starting losing your hair here. It's different from thyroid hair loss. Thyroid is you're beginning to lose hair all around, especially on the sides here. With PCOS, it's right here, but also facial hair. As a man, I don't think you would ever understand that, but we've got these, the hair that's popping out right on top of our lips and right on the chin. Some women even get it on their nipples quite excessively, on their shoulders and back. Right. Then the apple shape we talked about, storing a lot of fat around our abdomen, carrying it there. Those are some of the major ones with PCOS.

For our viewers, I blogged, I believe it was last year, on the relationship of changes in the microbiome, in the gut bacteria and their products, that seem to relate to PCOS. As we're learning today, diet plays such an important role. Now, as we look at the diet through the lens of the microbiome, we recognize that These bacteria are playing a role in the availability of our hormones, and beyond that, the sensitivity of the hormone receptors. This has now been described as being the number one cause of infertility in American women. That is brought on by our dietary changes. Magdalena, what do you recommend then to reverse this if that's the case? Potentially in the cards?

Yeah, so the name— are we talking about PCOS or all the conditions? Yes, PCOS. PCOS. So the name of the game with PCOS is inflammation. It's a systemic inflammation that happens. And so the biggest thing that a woman can do is get rid of sugar. I feel like that's the first biggest inflammatory cause of our issues is getting rid of sugar and repairing our digestion. Yeah. Embarking on— I'm a big fan of getting on the elimination diet, which eliminates the big trigger foods like gluten, dairy, eggs, soy, perhaps nightshade vegetables for some women. So my cookbook is entirely free of all these foods, right? And I'm not demonizing all of that because it could be that eggs are your best friends, but I have found that about 50% of people I work with cannot tolerate eggs. So you wouldn't know until you actually take them out and then reintroduce them. after 4 to 6 weeks and then figure out if they're your friend or foe. So inflammation, so digestion, repairing digestion, minimizing sugar. One of the big things, just a little tip here, is start off with a breakfast that, in the book I call it a PFF kind of breakfast, protein, fat, and fiber-rich breakfast. Put away all those muffins, all these promising shakes that contain sugar in them, right? Just do real food for breakfast. And I've traveled to over 40 countries. I've lived in 7 different countries. I've visited over 40 countries. And to the more developing countries, if you will, where they still eat breakfast, that's one of my favorite things to do. I get up early in the morning. I'm an early riser, right? And one of my favorite things to do is to walk around town and start seeing the city or the place waking up and always have a local breakfast. Well, guess what? Whether you go to Japan, Vietnam, Peru, Ethiopia, no one eats sugar for breakfast. No one, right? It's always savory food. And there's a reason for that. When you're doing things like even cereals and muffins and bagels and toast, right? Toast with, of course, with something sweet on it. You're basically setting yourself up for total disaster. You're elevating your blood sugar levels. The quicker they come up, the quicker they're gonna— the faster they're gonna come crashing down. At 11 o'clock, you start feeling shaky again, and now you need a piece of banana or a coffee or whatever to pick you back up again, and it's like this vicious cycle. What I have found is that ever since I started doing PFF kind of breakfasts with women, especially with metabolic disorders, right, setting yourself up for total success, you're not gonna crash, you're gonna feel very satisfied all the way till lunch, And no sugar crashes. In fact, a lot of women have said to me that they have been sleeping way better when they changed their breakfast. I remember this woman said, in order to change my nights, I had to change my mornings. And so profound difference in how we feel. So that's one huge thing, just a little tip. Because we live in this, especially in the United States, I feel like there is so much a fear of deprivation of food. It's too many calories. Oh, I shouldn't be eating this. They said it's not good for you, right? And all that kind of stuff. And I feel like when you're starting off with a sugar-packed kind of breakfast, then the rest of the day these cravings continue, and then you have this constant battle with yourself. Oh, I shouldn't, I shouldn't, right? And blaming yourself and shaming yourself for caving into sugar.

Well, I think there is so much in this. I'm a cheaterist. Breakfast. Breakfast. You are breaking this fast that has occurred since you had dinner the night before. While you are fasting, your body is finally shifted over to using fat as its fuel source. You're creating ketones. Your body is really very, very happy. When you suddenly jolt that system with sugar, bombard your body with even a glass of orange juice, which is 34 to 36 grams of pure sugar, it is very destabilizing. I'm really excited that you focus on that. I don't think I've had any guests on the program ever involved, especially in nutrition, who hasn't talked about why sugar is such an important player in our health maladies. I think your book is great. We're so glad that you're launching and having the opportunity to share time with you. I wish you all the success in the world. This book is going to really help, I think, a lot of people.

Thank you so much.

Great. Well, wasn't that some really empowering information that our dietary choices and certainly other aspects of our lifestyle choices can have such a huge impact on our hormone levels, on the balance of our hormones, which really are taking a beating these days? You know, so many people are suffering from imbalance of hormones. With a myriad of manifestations, that's for sure. So again, the book Cooking for Hormone Balance by Magdalena Szilagyi, very interesting book. Hope you'll take a look at that and hope you'll join us again next time on the program. I'm Dr. David Perlmutter. Thanks for watching The Empowering Neurologist. Bye for now.