Hormones as Communicators - Ask The Expert Webinar Replay

This is so exciting. I'm so glad that all of you are here and we have. This is really exciting because we have our community, our students and our graduates. And we've also opened it up. So we have a lot of people who joined us. Perhaps they're thinking about becoming health coaches. Perhaps they are already coaches and trained at another program or they're here for their general information. And many people come to study with us for that reason. Because you will get really state of the art evidence based information. I want to introduce our very special guest and I think for most of you, she needs no introduction. I first met Dr. Deanna Minick at IFM and was just so blown away by what she presented. And I thought, wow, this is so the coach approach. And she is a member of our faculty at FMCA and she recently has another position as the Chief Science Officer of Symphony Health. We're going to be talking a lot about a symphony today. In terms of your hormones, you're going to learn a lot about that. So it's a pleasure to have you here. Deanna and I always pick out something colorful when I am with Deanna because she inspires us to have color in our lives, color in our environment, and certainly in the choice of foods that we are eating. So I'm going to turn it over to Deanna. She has a slide presentation. She's going to share her screen and pull up some slides. So enjoy this presentation on hormones as communicators. And as she's getting her slides prepared, I want to say that at FMCA we have an entire module about hormones. And this is something I feel strongly about. We follow the ifm's curriculum. So you're not just learning motivational interviewing as other programs may offer, just the coach approach, but you are doing a pretty deep dive into these areas. So take it away. Deanna.

Super. Thank you, Sandy. Thank you for that warm introduction and it's lovely to be here with all of you. I believe we have a very diverse audience and so we might have FMCA graduates, we might have active coaches, we might have students, we might have the general public. So I think that this is great to have us all here together in this incubator talking about hormones. Hormones are such a hot topic, aren't they? Because we know that these are truly the biochemical components within us that drive our emotions and drive our behavior. So if coaches are truly about behavior and working with clients in that way, it's really important to understand hormones. Are they creating a symphony or is there this static or Noise in the background so my goal today with you is to talk about how health coaches can support their clients with hormone health with educational tools and options around hormones. And then we're going to have some space at the end to kind of go through some Q and A. So enough of different tools that I'm going to be showcasing here and I know how much that health coaches like tools. So my disclosures, and as Sandy mentioned, I'm chief science officer at Symphony Natural Health. So Symphony is a company that has a number of different plant based products that are specific to hormone health. So I'm going to be talking about a few of them today. So why would a health coach become a hormone coach? I have so much passion around this. Especially while I was going through the perimenopausal period, I'm still in the throes of it. And I was thinking, gosh, this is such an opportunity because if we think of the different aspects of one's lifespan and how they're punctuated by different hormonal transitions, often these are long transitions. If I just think about perimenopause, that could be between 10 to 15 years. If I think about postmenopause, that could be between, goodness, 50 to 60 years of somebody's life or even the pre menopausal years where somebody is actively seeking help on contraception, menstrual health, fertility topics. This is also a big booming area because there are so many different developments. You are probably aware of the over the counter contraceptive that just became available was just FDA approved on July 13th and it's called Opill. So there is so much going on in those particular areas for women's health. And let's not forget that men's health also has some opportunity there with low testosterone emerging in the 20s and the 30s for men. So that's truly an issue for us to be thinking about as well, that men need help with looking at testosterone, their androgens, even the glucocorticoids. And then another type of area would be that of melatoninopause. So as we get older, we start to lose a lot of these different hormones in our lives. And as Sandy and others have talked about, within functional medicine there's such a focus on longevity and longevity connects to hormones. So during these shifts is when people need your guidance, they need your support and coaching because, you know, things can get kind of frenetic. They need an advocate, somebody to navigate that space for them. So this is how I think of it. I do think that there are many different kinds of pauses that we experience in life. If you just look at this, you know, five different ones that I have listed here. Adrenal pause. Looking at the lowering of adrenal hormones. Now, that's a big one, right? That's definitely an area that many of you have probably already been coaching to. Then there's the peri and the postmenopause, which I'm going to dive much deeper into. Andropause, which is that low testosterone, somatopause, or low growth hormone and melatoninopause, melatonin. So that as we get older, what tends to happen is we start to see pauses in a number of these different hormones. And ultimately, this can coincide with increased risk for chronic diseases of all types. Neurodegenerative, cardiometabolic. So why the pause? You know, often I like to think of the physiology, but then also the psychology. And if I think of all of these hormones that start to lower throughout the different decades of living, I also think that there's an opportunity here for coaches to be in reflective mode with clients. So is there a second half of life that is meant for less doing, more being, more reflection? And how do you cultivate that space? And I think that the particular area that needs a lot of coaching is that transition, you see, where those lines become very jagged, because there's a lot of shift, there's a lot of flux, there's a lot of dance. And those are the times where we might have changes in mood, cognition, greater levels of things like anxiety, and a lot of different shifts in things like lifestyle that relate to things like sleep. So we need help to move into that period of our lives where we start to reevaluate and transform our life purpose. Many of you already know this, but for those of you who are newcomers, hormones are seen within the functional medicine matrix as the communicators, the communication node. And I think that we can help our clients, and even for us, to be thinking about how communication plays out physically and psychologically, what does it mean to communicate? Well, and oftentimes, our inner communication is communicating externally as well. So how can we look at that sense of communication in a physical approach with nutrition and lifestyle, but also the emotional, mental, spiritual aspects that start to come to the surface during these hormonal transitions. So here's a potential scenario. And again, I'm not advising on scope of practice. I'm, you know, all of you know this much better than I do, but here's kind of how I'm envisioning it. There is a primary care practitioner, and some of you as health coaches, are actually primary care practitioners yourselves. But in general, what I'm thinking is that the primary care practitioner is focusing on all of the tests, the physical, the biochemical aspects that would relate to some kind of, whether a prescriptive guidance or some kind of therapeutic intervention that then the health coach follows up on, and the health coach is there to support the client's journey throughout that process of change, that dynamic flux. You know, I often think of a parallel here, especially for people going through other types of journeys. So one that comes to my mind is the cancer journey. We talk about that within functional medicine that often you need an advocate to take you through that process. And I think in a similar way, through hormonal transitions of many types, we need somebody to take us through. We need that advocate. We need somebody to hold that sacred space for us. So giving education, allowing for that communication, using tools, books and natural therapies, and really bringing in, I would say, the whole self, not just the physical, but the emotional, mental and spiritual. So I'll give you some ideas as far as tools and what you might want to be thinking about there. I am going to talk about hormone replacement therapy because that does enter into the conversation, especially for prescribing practitioners. But the health coach is not able to prescribe. Right. So we have to think, well, how do we actually support the client whether or not they choose to do bioidentical hormone replacement therapy or hormone replacement therapy, and all the many choices that people have to act on or not. So I'll get a little bit more into the weeds on that. I also put together this matrix some time ago about, okay, if you are going to focus on women's health, men's health, or even circadian health, which is truly part of that hormone health umbrella, you can approach it from the physical, the emotional, mental and spiritual perspective. And again, just for terms and defining, we define spiritual in functional medicine as a sense of meaning and purpose. And when is that usually up for looking at and discussion? Usually through these hormonal transitions. So I have some ideas here, and some of you may be able to do more of these than others. So it's just part of the larger matrix of all of the many different entry points into that conversation about hormone health. So hormones and aging, hormones and vitality and vigor. These are big topics right now. One of the things I do want to mention too is that so often hormones get pigeonholed and we just think of it as estrogen, progesterone, testosterone, cortisol, and we kind of stop there. There is a distinction here in the way of the interconnectedness of the endocrine circuit. So when I think of the body in terms of communication, I think of the endocrine system as this super highway of interconnection. So everything is connected here. So that would be thyroid, heart, the hypothalamic pituitary gland, the pineal gland. So it's not just saying hypothalamus, pituitary, adrenal access. And for many people, they focus downstream on the adrenals. They call it adrenal fatigue, adrenal exhaustion. But if we go upstream, there's a lot more there. There's this ripple through effect. And again, think of it as a communication highway. And for some clients, they may have certain impacts in certain parts of the body more than others. So I have reframed this as the psycho, which speaks to the mind, neuro, which speaks to neurotransmitters and the endocrine system. And in fact, if you look at literature from Dr. Candace Pert and others, they refer to this as the pnei psychoneuro endocrine immune system. So just think of this as if you can get the client to be thinking about that. So superhighway within them and how maybe it's the thyroid that gets impacted by hormones that are off. Maybe it's actually the insulin and glucagon aspects of the digestive tract. So they're all interrelated. And if there's an issue with one, many times there's an issue in another. So one of the things that can get in the way of endocrine function is endocrine disruptors. And I teach on this for the Institute for Functional Medicine, right through the Environmental Health Advanced Practice module. So one of the things that you can do as coaches is help to coach to environments that are reducing endocrine disruptors. So this toxic exposure list that I just more or less recently put together, and this is something I'm willing to share with you, I send out in my newsletters every week, more or less, a lot of these different educational downloads. And some of you may already have this, but this is one entry point that you can start to have that conversation. And then if we think a little bit more broader, here's how I think about the infrastructure of how to impact hormone health. We can think about it from the standpoint of how do we help to build hormones in the body, how do we help to transport them, how do we activate them at the cellular level, how do we metabolize them and ultimately eliminate them. That is, you know, I think of this acronym that I just made up, S T A M E stain. It's, it's this whole structure of, okay, how do we help to unblock the synthesis? How do we help with hydration and flow for the transport? How do we activate with things like phytoestrogens or fats and proteins in the diet? How do we emphasize metabolic detoxification and help with liver health health to enable better metabolism? And how do we help with dietary fiber to help the gut microbiome as well as to bind things that need to come out of the body? So you as a health coach, and even for those of you who aren't health coaches that are on, there are all kinds of opportunities here in order to get into that endocrine superhighway and to try to figure out nutritional and lifestyle strategies. And I'm actually going to walk you through some ideas of how to do do this so you can address all five of these areas. So let's talk about plants. One of the things that I, and I very fond of, as Sandy mentioned, I'm all about eating the rainbow. And so I'm going to bring a bit of that eating the rainbow into our conversation here with the endocrine system. So let's first start with adrenal pause and talking about cortisol. This is truly the bedrock. This is what I see as the foundation. This is stress survival and safety. And for so many people it requires starting here. And this could be a very extensive conversation, but I'm going to just high level it for you in terms of adrenal health because there are many different things that you can do. Helping with healthy blood sugar support, which ties into stress response, looking at vitamins. And one thing that I think gets overlooked with adrenal health is that of adequate hydration. I do think that water is, is the next level medicine in so many ways. There's so much reinvention and discussion and discovery about how do you actually assess hydration and how do you optimize for hydration. So looking at bringing in certain salts, like Himalayan crystal salts, you know, one of the things that I just learned just even over the past year is the whole idea of soleil therapy. S O L E pronounced soleil. This is coming from naturopathic medicine, actually, where you create a supersaturated salt solution. So it's not taking crystals of salt and putting them in water, but making a salt solution, taking a teaspoon of that and then Putting that into about 8 to 12 ounces of water. So Himalayan crystal salt is one example of a salt that you can use in order to bring in trace minerals together with the water, and then you bring back to the water what it has lost through purification. And so many different ways that people try to filter their water to make it cleaner. And we need those minerals, especially when we're having issues with adrenal health. And in fact, one of the things that I teach within the IFM module is that essential minerals compete with heavy metals. They have a similar chemical configuration, so they're divalent cations. So if you have more in the way of magnesium, iron and zinc, you're going to compete with things like mercury, lead and arsenic, because they kind of look similar from a charge perspective. So keep that in mind as it relates to the entire endocrine circuit, because it ties into the transport aspect of hormone health. Now, the one that I'm going to spend more time on is that of perimenopause and post menopause. And here's where we see a lot of symptoms, the perimenopausal symptoms. And there are different questionnaires for that. So maybe if you are more interested in that particular area and having that orientation into your coaching, you get a symptomatic assessment. You know, the medical symptom questionnaire is good, but it doesn't specify to perimenopausal symptoms. So we can see things like hot flashes, inflammation can go up, joint pain, night sweats. And so her sleeping rhythm is disturbed. You start to see more weight gain, especially in the visceral area. So the belly fat changes in libido and appetite and mood. So just to kind of high level that from a physical perspective. I'll show you that again. So in terms of terminology, I think that this is important because on social media I see that this gets. That's a little bit confusing for some people. When we think of premenopausal. This is the menstruating period, stage of life. This is when a woman is most fertile. This is before she has gone through perimenopause or is entering into that phase. The perimenopausal phase is that that can stretch between three to 15 years. And during that time we start to see changes in estrogen, progesterone, luteinizing hormone, follicular stimulating, horm. And these particular hormones are all tracking and all kind of going through that dance and we start to see changes and some of those changes and some of those decreases start to lead to perturbations in mood, sleep, and even the physical body. Now, menopause should really only be used as a term to describe that one day period of a woman not having her menstrual cycle for 12 consecutive months. Right? So for 12 consecutive months that she is not having a menstrual period. And that is done in a natural way that essentially she has arrived at menopause and now she enters into post menopause. So this is where this is a long cycle of life where there can be changes in brain and the bone especially, but then also things like the cardiovascular system. So the average woman will spend a large portion of her life, especially now that people are living longer in that postmenopausal phase. So again, just to do a quick recap on physical changes, if you look at some of these that are listed here, skin changes, hair loss, dryness, changes in appetite, but increases in weight gain, loss of balance. This is where, you know, especially some of you that are focused on physical activity, really bringing out things like resistance training and focusing on things like balance and skeletal muscle. I know Sandy has been great about doing that on her Instagram and really focusing on resistance Pilates. This is so important, especially during this time of life. Emotionally there's going to be a lot of mood swings, a lot of upheaval. So we see that rates of depression are up to 20% during perimenopause. So she can't focus, she may have bouts of crying or depression, just this feeling of like not being able to handle everyday stressors. So again, this is where I think having a health coach is so important to guide her through that process and to use these emotional upheavals for creativity to enable her to express those emotions in creative ways that allow her to better transform through her own heroine's journey. There can be mental changes, as I've been alluding to, in the way of her not being able to focus. She has less drive. You know, her testosterone is also coming down together with estrogen and progesterone. She might be fatigued more readily, may not be able to remember as well. And then I think spiritually, and this is the one that I always find very intriguing, is that there is a sense of a renewed purpose during this time of life. During the 50s, 60s, 70s and on up, we start to look at our, our meaning for living. Many women going through this time of life might be empty nesters. And so now, you know, they've raised children, they, they've done a variety of things and now they're Looking at, well, what do they most want to have from their lives? So looking at their connections into the larger sphere and how they connect in as an individual. So when I think here, and I'm just going to zoom into educating you on two particular areas of where you can get at a root cause functional medicine approach, where I think this is truly a first line approach. So how can we help her body to better synthesize hormones naturally? So even though she's coming down, there may be some opportunity there to bolster the endocrine system to enable it to better optimize its hormone production. So we might be able to bump that up a little bit more to buffer against that ovarian decline. The other thing again down to metabolize is I want to talk about metabolic detoxification because I think that there's an opportunity there. You know, one of the things I saw some years ago with some of the, the research on different plant modulators was that if you can modulate not just the hormones, but the hormone metabolites, you can help to reduce some of the symptoms that she might have premenopausally as well as perimenopausally. So let's talk about MACA go. Maca go. The G stands for gelatinized, the O for organic. And this is a term in the research. I want to talk a little bit about maca and specific maca phenotypes that may help with the synthesis part of the endocrine system. And this is really unique. So first, just to set the stage, when a woman is going through this time of life, many times because she's got all of these symptoms, she starts to look for options. She starts to go to her doctor and says, you know, what can I do? Can I start taking estrogen, progesterone? And since the Women's Health initiative back in 2002, there's been a lot of debate about whether or not to introduce exogenous hormones, whether that's in the form of hormone replacement therapy or even what we might refer to as bioidentical hormone replacement therapy. And for some women, they just feel it's kind of an ethical thing. They just don't want to do it. They don't want to mess with their own bodies. They feel that, no, I'm just going to go through this naturally. I'm just going to weather the storm. So, you know, there, there is that, then there's all. There are also the women who are not able to do hormone replacement therapy because maybe she has a personal history that would contraindicate her from taking these hormones. That might be something along the lines of cancer. Maybe she has a family history of certain health conditions that would exclude her from taking hormone replacement therapy. And then some other women may actually start the hormone replacement therapy, but then they get S symptoms and they can't tolerate it, or they go on it for some time, but then they come off of it. So there can be a lot of different issues there. And in fact, I was just on a call this morning with Dr. Wendy Warner, and I know that she teaches for you through fmca. She also teaches as part of the hormone module for ifm. And, you know, in terms of just looking at a balanced approach here, personalizing to the client, and we know that the primary care practitioner does have that driver's seat in terms of evaluating those options. But I think that as a health coach, what you can do is educate her on how can you optimize your hormones? What are all the things that we know from nutrition, lifestyle, and even certain phytonutrients that may help to optimize your endocrine access without bringing in any kind of exogenous hormones. So, as you all know, a healthy diet and lifestyle at this time of life are going to be key. And within this whole context of looking at plants, because we already know that there are certain plants that act as adaptogens or they actually help the cells to work better. Typically, we think about that as it relates to the adrenal health or adrenal hormones. But there is the one particular product which I am going to talk about in the literature, known as maca go, which is these specialized MACA phenotypes that actually helps to optimize the hypothalamus, pituitary, thyroid, adrenal, ovarian access, so that think of this endocrine access as being nourished or modulated or even optimized so that she can better produce whatever she needs to during that time of life to bump those levels up. So again, this is more looking at the root cause approach. You know, there are many different ways to address the perimenopause. You can give exogenous hormones and just fill that gap. Or what you can also do is work in sync with that endocrine circuit in order to optimize each of these glands. And at least I know of one particular type of plant to get in and help to modulate that entire circuit. So I'm just going to teach you a little bit about Maca, because Maca, even when Dr. Warner and I were talking about it because she's also on the medical team for Symphony Natural Health. You know, there have been a lot of stereotypes about MACA and what MACA does, and there's a lot of nuance in the way of how you can use maca. So just to get some education on that. So, again, if we think of that endocrine circuit, we are optimizing the entire flow and we will get to melatonin. I can't leave this conversation without touching upon the pineal gland. But right now I'm going to talk more about the pituitary gland. The pituitary gland, which is basically in the middle of the head and speaks or communicates to the ovaries, to the thyroid, to the adrenals. It is seen in many cases as the master gland. So with that master gland, there is a way again, which I'm going to showcase some of the science of that. But again, I just want to get the overall philosophical approach down that if we look at this triangle and think of what are the functional basics really needing to get clear on? Hydration, minerals, omega 3 fatty acids, especially for the cell membrane, which will help in receptivity. The fibers, which will help with elimination. And then moving on up that triangle to be thinking about, well, how do I help the endocrine system to work better? How do I just give plants in such a way? And specifically through MACA phenotypes, which have been tested and shown to do this to optimize a woman's production of hormones. And then if there are other indications where things like BHRT or HRT are brought in, that would be done through the prescribing practitioner. Now, some of you might be thinking, can all of these coexist together? And they can. And in fact, all of them, especially the food, lifestyle and even the MOCA geo could support the HRT and bhrt. So a little bit about maca. First of all, it's a food. You see it up in the top right here. It is a tuber, it's a root. And so, you know, in Peru, it's used as a foodstuff. It's used as part of the daily diet. It's also used as medicine. And in fact, one of the early pioneers in maca, and I have her book even on my desk, was a woman, a Peruvian woman, who was working on her PhD on Maca. And together with her husband, they identified. Now, this is many years ago. Now, you know, this is, you know, they did their research more than 50 years ago. And this is still coming to light. And what she identified was that there was this endocrine effect. You know, most people, especially botanists and botanical experts, they think of maca as an adaptogen, just working on the adrenals. But what Dr. Chacon had identified, and it's really interesting, again, her research was that, no, it's more than an adaptogen. It's actually working at the level of the pituitary to signal the endocrine access better. And it's optimizing that. And we actually know that because it does influence hormones like fsh, LH and acth, all which come from the pituitary. I just love it. It's so exciting in that way. So, medicinal uses of maca. So maca, again, is. It's a root veggie, and it's part of the same botanical family as that of the cruciferous vegetables. Now, they're not one in the same. So it doesn't mean that if you take maca, that you can stop taking sulforaphane or stop eating broccoli. They're cousins. They are not within the same identical family. They're part of the same overarching. They have the same last name, but they're not part of the same immediate botanical family. Very complementary, though, because they do also have the glucosinolates, which are shared by the cruciferous vegetables. So traditional use of maca has been mostly for energy. It's. It has kind of this aspect of libido and vitality, but it's been used overall for many different uses within Peru over the years. So, again, in botanical medicine, it's been siloed as an adaptogen, meaning that it helps the cell to work better in its response to stressors. So this is where I get really excited, because what was found through Dr. Chacon's work and then later through other researchers like Dr. Henry Meissner, was that within this Lepidium family, so that's the genus Lepidium Peruvianum. This is the cultivated version of maca Within Peru, what they found was that there were different types of maca. There were colors of maca. There's like a rainbow of maca. And each of these colors has different phytochemicals, different DNA, and as a result, they're going to have different functional profiles and signatures. So what that means is that not all maca is created equal, meaning that you can't just go to the grocery store and buy a big tote of maca powder and then just be using that for perimenopause. For pcos, for stress, for adrenals, for andropause. It doesn't work like that. In its more sophisticated way, we know that there's nuance to plants. So there are certain phenotypes within Lepidium peruvianum that have been identified to help perimenopausal issues specifically, as well as postmenopausal issues and even premenopausal issues. So the core specialized maca phenotypes that's referred to in the literature, as you could see below, as maca go, and then through fine tuning of these different phenotypes, through different studies, different compositions were put together for different types of functional benefits. So again, I really want to educate you all on the fact of not all maca is the same. And when you go to the grocery store and just pick up a bag of maca, this is like garden variety maca, you don't know what you're getting because it's just whatever the harvest brings in. Those plants are dried up, ground up, put into a powder. Whereas there are very specific phenotypes that have very specific phytochemicals that have specific clinical applications. So there have been up to 13 different maca phenotypes identified. And that again is coming from Dr. Chukan's work and others. Now, in addition to Peru, there's been a lot of interest in China to grow these different types of maca plants. But it's really interesting because in China they can't seem to get the same. They just don't have the same phytochemical signatures, which tells us that there's an environment effect. Now in Peru, it's high altitude. You know, this is like 4,500 meters. You know, this is 15,000ft. This is very high altitude. So that's a lot of stress on the plant. And that environmental stress, along with the high winds, the high heat, the extreme temperatures. And we all know this in functional medicine, right? We remember Dr. Bland talking about xenohormesis, where the environment of a plant can lead to its phytonutrient signature. So there's something really special about where the maca is grown, the colors it gets. You can get different colors just within certain altitudes. So keep that in mind that the environment is everything when it comes to a plant. And we all know this, right, because we think of organically grown food versus conventional. So here is just so you can see some of the colors of maca, and this is not all of the 13, but you can just kind of See what they look like and some of the corresponding colors. So maca go in the studies, it's not an extract and it's not a phytoestrogen. Because you might be thinking, well, maybe she's, she's talking about a phytoestrogen here like resveratrol or soy or red clover, or maybe she's talking about something to modulate neurotransmitters like black cohosh. But I'm actually talking about none of those things. In fact, this is very novel in its activity and it has novel phytochemical. It has things like, for those of you who like to geek out on the phytochemical part of it, it's got things like plant sterols, alkaloids, and this family of glucosinolates with nine distinct glucosinolates that are very unique to this maca go composition. So there have been four clinical trials and I'm not going to get into the weeds on this other than to just kind of high level show you. And you know, I presented a poster on this at the recent IFMAIC meeting. So if you were there, you would have seen a bit of it. But essentially there is a study in perimenopausal women. There's also some robust work in postmenopausal woman looking at not just symptoms but also bone health. So just to kind of give you the bird's eye view, if you look off to the left, we have two panels with perimenopausal women. So this is just taking some of the research from those studies, especially the one on perimenopausal women and the way that the research was done. Now, the first panel is estradiol. So looking at serum estradiol, then the one at the bottom is progesterone. So the researchers put these women on. You see where you have this purplish bar here, these, this one and then this one. This is when they were taking the maca go. Now, keep in mind, this is a placebo controlled study. So these women at baseline, they're on the maca phenotypes, their estrogen goes up naturally. This is again introducing no exogenous hormones. This is just again optimizing her endocrine access. Then when she was transitioned off into the placebo, right here, you can see how those levels came down both for estrogen and progesterone. Similarly, if you look over to the right under the postmenopausal women, what you see here is side by side, two different groups so one of the groups was followed, just taking the placebo. And you can see how those bars, those darker charcoal gray bars, they kind of stay at the same level as what they were at baseline. But when the group was put on maca go, look at how her estradiol went up and then went to this comfortable limit. So it doesn't keep going up and up and up. It starts to plateau at a comfortable level, which is well within the postmenopausal range. So we're not going to high, high levels of estrogen here. Similarly with FSH, this is a marker of menopause. So when FSH, a pituitary hormone, is greater than 30, that is seen as a marker of menopause. So what we see here is that we're not taking women out of menopause, we're just bringing those levels down a bit, which would sync up very nicely with those increases, those subtle increases in estradiol. So again, I'm not showing you all of the research. Again, there are four studies, and so I'm just trying to give you some education on some of the scientific publications and what was seen. This is looking at symptoms. And you can see here that as she is taking the maca go, which by the way, the commercial name for maca go is feminescence. You might have heard that name before. What you see here is that her symptoms go down. Now, I like this, and Sandy might also like this because, you know, she and I are very focused on our muscles and our bones. And what we see is that when women were just taking placebo, they continue to lower their bone mineral density. Okay, so that's the, you see the zero and you see how that goes down. At month four, when she was taking the maca geo, the feminescence, that bone mineral density actually increased. So it's not even that it plateaued. It actually increased over and beyond what it was at baseline, which is really important because that is one of the long term issues that women struggle with. So the maca geo comes in three different types, depending on if a woman needs support for menstrual health, perimenopausal support, or postmenopausal support. And again, each of these have different maca phenotypes that would functionally be helping with those symptoms. All right, I could tell I'm seeing a lot of questions coming in. Let me just get through just the section on melatonin and then we'll close and have some time for questions. The other aspect is detoxifications, and I do think that it's really important to focus on detoxification as it relates to hormone health. And there are many different ways that you can do that. Alfalfa is one example of a green that can help with alkalization. It can help with introducing chlorophyll carotenoids. I don't know if you're aware of the research on ovulation and ovarian health, but having beta carotene is important for ovarian health even, right? So having things like beta cryptoxanthin, having some of those orange foods, even though this is green, it still contains some of those carotenoids that can be important for helping with ovarian vitality and also a two prong approach helping with detoxification. So I always think it's good to bring a greens in. Ph quintessence is the one that Symphony Natural Health has. Our medical team has reported a number of different benefits. Everything from gut motility, which we know would be important for detoxification, to binding toxins, better skin health, and just simply for people who can't get enough in the way of greens. All right, so let me close very briefly on talking about melatonin, because this is an opportunity for all of you health coaches who want to coach to sleep. There can be so many different conditions that arise when there is a sleep disturbance. And I'm sure that you've heard me talking on certain podcasts if you're interested in melatonin. I've done a number of them so far, Most recently with Dr. Carrie Jones on her Root Cause Medicine podcast. So you can listen into that. We published this article, this is through the Symphony Medical team, looking at whether or not melatonin is the next vitamin D. So let me just put into context how you could frame this up for a client. You know, during the pandemic, we learned so much about sunlight, sunlight deficiency. We needed to get out into the sun, we needed to get our vitamin D, and people started to wake up to this absence of sunlight. What I would also say to that is that there is a counterpart in that of darkness. And many people have what we would call a darkness deficiency, meaning that now that we have focused on sun, we need to focus on getting adequate darkness so that our pineal gland can produce melatonin. So one of the tools for you as a coach, and this will be available to the FMCA grads in a follow up email, is you can actually quantify whether or not your clients have darkness deficiency and open up to that conversation. So this is an actual questionnaire that our medical team helped to put together where you can quantify the degree of darkness deficiency. And then what do you do about it? You start to work with your environment. So as we get older, what tends to happen, as I showed before, is that we start to produce less and less melatonin. Many of you know of melatonin as it relates to sleep. It's very important for circadian rhythm. It helps to regulate our core body temperature, which potentially might be one of the factors as to why perimenopausal women have hot flashes and night sweats. So we start to bottom out. And that is an issue because melatonin is used throughout the body for so many different things, for the brain, for the mitochondria. So now you, as a health coach, you may not be able to to assess melatonin through laboratory measures like getting a urine test to look at melatonin metabolites. So here is another educational two page guide that we have for the FMCA grads in which you can sit down with a client and say, okay, how do we know you might be low in melatonin? What are some of the things that are happening in your life? Your general health status? What are you eating in your diet? How are you working? What are your activities? What is your home environment like? What is your sleep like? So this is just a basic needs assessment. Do you have a need to change your darkness at night? This is a great conversational piece for you to bring this out a bit more. It's also important to mention that there's brain detoxification that happens during sleep, right? So when we are sleeping, this is when the brain can actually let go of those amyloid and those protein buildup metabolites in the brain and start to let go of that into what's called the glymphatic fluid. That's called the glymphatic fluid flux. That also happens as you can see. The eye also needs to get rid of these deposits. The eye is part of the brain. The eye signals to the brain to ultimately make melatonin, right? So we want to take care of our entire nervous system during sleep. And if we look at the levels of different things in the body at night, what we see is that melatonin skyrockets at night, right? That's when it's being produced during darkness. But we also see a number of other compounds that are. It's like the troops are being called in to repair and rejuvenate and detoxify the brain, right? So that's why in the morning you can think better because you don't have all of the noise, right? We talked about the symphony or the noise. You don't have the noise in the brain. So working on darkness deficiency is a really big thing. And in fact I've asked, we're going to be teaching in October. We have the advanced practice module on environmental health. And I asked the team, I said we need to focus on artificial light at night and how this is an endocrine disruptor. It's not only impacting melatonin, it's impacting thyroid hormone, our stress hormones and even our sex steroid hormone production. So think of this as a really, it's a pivotal point. You know, it's an added feature to that coaching conversation. So if somebody is doing all they can, they're changing their light at night, they're changing their diet. One of the things that you can also educate them on is melatonin supplements. Just talking generally about all the different ones out there. What is a good quality supplement? What are some of the things to look for? Of course I prefer plants and I prefer a plant melatonin and that melatonin is the same kind of melatonin that's in our bodies. However, this particular one that I'm referring to is called erbatonin and it's been studied against synthetic melatonin, which is the majority of melatonin that's on the market and found to outperform synthetic melatonin. So in this study I was just showing you, that was published in 2021 in Molecules. What those researchers did was in head to head studies, they took erbatonin, they took synthetic melatonin and compared them for antioxidant potential. And they found that the plant melatonin, the erbatonin was 958% greater in its antioxidant potential. It was up to 470% greater in free radical scavenging activity in a skin cell line. It was double in its impact in order to quench a lot of those reactive oxygen species. And it was also shown to be 646% more anti inflammatory. And these are all of the other adjunctive functions of melatonin that most people don't even know about. They only think about it for sleep, but they don't realize that it has across the board functional activity throughout body systems. So here's another triangle for you as a coach to be thinking about as it relates to how do you talk about melatonin? Because melatonin is a hormone that connects to all the other hormones. So get the darkness at night, reduce that blue light exposure, bring in red light at night. Eating more protein for that tryptophan that eventually converts into melatonin. Getting different nutrients from plants and then if needed again bringing in supplemental erbatonin might be a way to coach. Right, so this is a website, it's a non commercial website. It's phytomelatonin.com if you have questions because many times what will come out is like a news blip on melatonin and then you want to understand like is there anything to that? Was there anything that I need to know? How do I understand the science of that study? What you can do is you can check this website. This is a place where different aspects of news related melatonin research articles are put out there along with a summary and a critique. So again I want to close the conversation or perhaps open it further with thinking of this endocrine circuit. This is your inner super highway, right? And when this is working well, you are going to be optimized, a healthier, happier person throughout all of life. You'll be communicating signals on the outside that are conducive to good health, good healthy mood, healthy emotional state. Because on the inside this is taken care of. So what I want to leave you with are just some final tools in the way of like how can you reach out. So this is the medical team at Symphony Natural Health. You can see that a few of us are IFMCP folks. So we've been certified in functional medicine. Wendy and I actually teach for ifm. You're free to reach out to me directly. You can use that email that's up above if you have specific questions which I know we won't have the time to answer. I also separately put together some of the, you know how I was talking about the synthesize, transport, activate, metabolize, eliminate and then of course the entire endocrine circuit. So if you just take a picture of that QR code in the far right, you can download all of those materials and then just use them in your practice and you can just use them as well in just as you'd like as an individual. And then finally I have some of my colleagues here with me, Lisa Schenck and Mary Beth Evisich and they are going to follow up with you after this with the slides. The Darkness Deficiency Questionnaire, the Melatonin Insufficiency Questionnaire for those of you who are FMCA graduates. And if you're Not a graduate. But you still want this information. You will get a copy of the PowerPoint. So I am going to stop there. We've got five minutes. There we go. Now I could see all these smiling faces again.

Thank you. That was amazing. So before we get to we can take a few questions, but rest assured that we take your questions seriously and we will make sure that they are answered after the webinar is finished. And before I introduce Patti, I want to say a couple things. First of all, that we are working with Symphony Natural Health. There will be additional opportunities if you are intrigued by hormones. If you want to become a coach who specializes in hormones, there will be opportunities for that. So stay tuned. I also want to say that we are enrolling for September 1st, our next class. If you liked what you heard heard, this is what we do at fmca. And we'd also add in these ask the experts very, very frequently. Every figure in functional medicine, Positive psychology, we bring them on live as part of the training. So let me introduce Patty to moderate. She is our director of alumni development and strategic partnerships. And we can go through a few questions and then look at the rest at another time.

Great.

Yeah.

Well, thank you. This is so great. And I always like to kind of recap for our students and grads. Can we just summarize now all the different areas where coaches can work within scope in this area to optimize hormones.

So well. And I lean on you. And Sandy, one of the things that I think is most important is that we stay within the guardrails of educating, providing information, giving, whether it's books and tools. And that's why I focused on some of these handouts because these can be great articles of discussion that really bring to light, you know, what could be going on, what are some of the options and choices. So I think, you know, maybe, Sandy, if you wanted to say something further, but I see this as education. This is bringing the science out and, you know, just wanting to teach you a little bit more about the endocrine system because that directly ties into hormones.

And during that, you go ahead.

So as an example, coaches cannot directly recommend prescribed supplements. But for example, if they share that wonderful study that you have, that chart about MACA and that, so they're providing that education from a trusted resource from research, and then that client can decide on their own. Oh, this sounds like a product I might want to try.

Yes, yes. Being that it has the science. Sorry, Patti, I was just going to say being that you have the scientific publications. Right. This is not, you don't have to bring in commercial material. It can simply be the scientific studies from PubMed of which, again, there are four. And then there's one looking at the erbatonin versus synthetic melatonin.

And health coaches work at that, at the bottom level of the matrix. So stress and sleep and movement and relationships and nutrition. And obviously we've seen all parts of their. So coach to that. And I'll give you an example. Someone had asked in the Q and A, what would be the best, best exercise to do, you know, if you have high DHA or cortisol. And so this is a perfect question that you would talk with your health coach about, because the right exercise is the one that you will do, is the one that works with your body. And to really elicit that, it takes a good conversation with someone who listens and knows and educated into all the different options that you have. So that's one of the questions that we had. Additionally, we have a lot of questions specifically about is maca safe or autoimmune cancer different health conditions? And so do you have a little bit more information around those areas?

We do. I mean, goodness. I mean, feminescence has been in the market for some time. So we actually have a packet of all the different types of clinical conditions and even doses things to be aware of. And so I would lean on, I would say, for you to email medical.teamymphonynaturalhealth.com if you are an FMCA grad. Right. And then we can give you more information and go and actually have a phone call and conversation with you and kind of take you through this a bit more. What Mary Beth and Lisa are here with me to do too, is we can also offer separate trainings where we go a little bit deeper. Like you, if, if your client has pcos, can you give them MACA phenotypes? Can you give them feminescence? Right. How would you approach that and how do you do it from an educational perspective? So we would be glad to do that. There's a lot there to share and unpack. Absolutely, yes.

And I know all of those resources that you have, they're not only the questionnaire. So how would you as a coach take those questionnaires? And that would open up a conversation that you could have that you specifically talk about what would be best for that client. And it's. There's so many other very detailed specific questions I think that we'll send to you and then we can send them out with.

I think that would be good. Yeah, it's hard just. And we're at the top of the hour and I want to be respectful of everybody's time. But if you send forth all of the questions, we're very happy and willing and again we have a medical team that can be on the phone with you and talk through these things. If you have questions talking about autoimmunity, that would be great to bring that topic for sure. So I want to thank all of you for being on the call. It looks like a lot of great feedback and hopefully some of you will be inspired to go this route in your practice. I think that there's a real need and I want to thank Patty and Sandy for having this open forum to have the conversation and I'm excited for what's to come in terms of going deeper in this area.

Well, I'm excited to work with you. And just as a reminder for those who are new, thank you for coming. We welcome you to our community and we hope that if you are thinking this perks your interest, you think, well, I could be a coach then this would be a way that I can work with hormones to help people to make those changes that are so important for their well being. And thank you to everybody who was here. We will have more programming like this, so stay tuned. Thank you all.

Thank you. Bye bye everybody. Bye.

Thank you.