#51 Balancing Hormones with Dr. Erin Kinney

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Hi and welcome. I would love to introduce Dr. Erin Kinney today. She is a naturopathic doctor practicing in Maryland, but also practicing virtually online. And Erin and I love, both love to think about and talk about hormones. And so we thought it would be so much fun to get to talk with each other and share it with all of you, our perspective on hormones, especially women's hormones. So thank you so much for joining me today, Erin. I really appreciate it.

Oh, thank you so much for having me. I'm excited. We, as you said, I think we have very similar or like minded in how we think about looking at the body, particularly women's bodies and women's hormones. And there's been a lot going on with women's hormones in the last year and a half that we've, in this crazy time that we've had. I don't know about you, but I've been seeing people who just are having, you know, their hormones are just out of whack and it can cause all kinds of different symptoms. And yeah, and I think this is the common thing that I see is that women will go to their regular doctor, they don't feel good. There's usually five or six things that aren't feeling good and they go to their doctor and their doctor's like, oh, yeah, here's an antidepressant and here's the birth control pill. And that should just, you should be fine. And they leave that office being like, wait, there's something wrong with me and I don't want to take a pill. I want to figure out what's wrong. And so then they end up in my office or your office or, you know, in someone else's who's going to do a little bit of a deeper dive. And yeah, I'm sure you see this a similar thing, right?

Absolutely. And we know that stress, as you're insinuating, is this stress of especially this past year, that's been even more stress for everyone, affects our hormones. But before we dive into more about that, tell us a little more. How did you even become a naturopathic Doctor inspired you to think about hormones and all this stuff?

Well, so my journey was kind of similar to what I was just mentioning with women going and getting just, here's a prescription. I. In my early 20s, I graduated from college. I was kind of on this career track doing. Working in a family business. And I got really depressed. I got really depressed. And I started. I was sleeping all the time. I gained a bunch of weight, My joints hurt, I was exhausted and I didn't feel good. And I was crying all the time and had a lot of anxiety. And I went to my GP at the time and started telling him before I could even finish listing my symptoms. He's like, oh, here's some Wellbutrin. And, you know, sent me on my way. And I had grown up leading a really kind of more natural life. And I thought, this. There's gotta be something else to this. I had been a vegan. I was running a lot. I had, you know, I just graduated from college. There were a lot of lifestyle things and situational things. I was like, this has got to be affecting me. So I talked to my therapist and she referred me to a naturopathic doctor who had just moved to town. There weren't a lot of them in the state I was in. I was in Maryland, where I am now. And I went and saw this naturopathic doctor and he spent two hours with me. He asked me all these questions. He ran different blood. You know, he did what naturopathic Doctors do. And six to eight weeks later, I felt 80% better. And I thought, wow, that was the most amazing experience. And I had way long prior had been in pre med. I'd always been interested in medicine, but didn't really want to go the regular medicine route. I think I did an overnight stint in an ER when I was in undergrad and was like, this is not for me. I don't do well with no sleep anyway. So I ended up having lunch with this doctor maybe six months later and said, hey, how did you become. How did you do this? And he. He told me not to become a naturopathic doctor. He said, this is not an easy career. No one's going to know what you do. You're going to have to be an entrepreneur. And I said, that's great because I've always wanted to run my own business. So I didn't listen to him and I went to school. I mean, he obviously was very supportive and is still a good friend of mine, but.

But it's good, you know, it's true. Like it's good to kind of really get clear about a career path. And I think when a person feels really passionate, I know when people contact me who are interested in becoming a naturopathic doctor, I know that if it's really something they're passionate about, they're going to push past the things that might be difficult or even fall in love with. Like you're saying, fall in love with the things that might seem difficult to other people, but to us it's like, this is what we love. This is what we're passionate about. We want to help more people know that it's a possibility. And. Oh, that's. I love your story. That's so great. Thank you for sharing.

Yeah.

Oh, you're welcome. I mean, and you know, then throughout my years in naturopathic school was such a cool experience, you know, learning. And I had hormone issues at the time. And so I was, you know, looking at the hormone charts and figuring out what was going on in my body. It was just so fascinating to me. And I still, I still, I love the fact that, you know, in, when you're learning about biochemistry, most med students learn that for the test and then they never look at it again. But if you're a naturopathic doctor, you use biochemistry or some of these basic things almost every day. I'm constantly drawing on my whiteboard. I'm like, okay, here's what happens. This is how estrogen gets built, this is how it gets broken down. And so it's like, I actually feel like I'm using a lot of what I got. And so I'm a nerd and I like that stuff.

And I really find it, and I'm curious if you do too, that the more that people understand about how their body works, people don't have to take a biochemistry class or physics class because we have that information and we can translate it into a way that they can use it on a day to day basis. Because understanding your body makes a difference in the willingness to make different choices. And I think there's something about the way, the effect it has on people just by right, just by understanding what's going on in your body.

I 100% agree. I think that in the principles of Naturopathic Medicine, is it number two, as teacher, you know, it is our duty to teach patients, hey, why are you taking this medication? Why are you supposed to be on this diet? Why are your hormones doing what they're doing? So many women don't even understand what happens in the female. Like, hey, why do I Feel like this two days before my period. So I think you're exactly right. Understanding why makes you one. You feel empowered, right? You feel empowered about your own body and it makes you more likely to make the changes. Oh, well, I'm not eating this certain food because we ran a test and we understand that I have an allergy to this and this is affecting my digestion, which then affects my ability to break down hormones or build them or whatever the case may be. And I think when you understand why, you make better choices.

Absolutely, absolutely. And then it just integrates into your day to day. So the other thing you're speaking of, principles of naturopathic medicine, another one is looking at the body as a whole. And I think that's key with hormones, right? Because these hormones are going everywhere. It's not like the hormones are just one area of our body. Even though, like, even female hormones, they're made in the ovaries, but they still circulate everywhere. And so this concept of being able to stand back and look at the whole body, I think really can help us solve hormone imbalances that might not be solved otherwise. If a practitioner isn't looking at the whole body, they're not going to see the whole picture.

Yeah, definitely. I always talk to my patients when we're talking about hormones. Everyone's heard of estrogen, they've heard of progesterone. But I think having to understand the concept of a hormone that it has to bind to a receptor. And as you were just saying, we have receptors for estrogen in almost every cell type or tissue type. So the estrogen, I always love this when people are like, oh, I'm on the nuvo ring, it's a local hormone. And I say, okay, now we have to talk about this. Hormones are never local. Hormone goes into the body. It's not just going to stay in the vaginal tissue or it's going to go all over the body and it will bind to wherever there is a receptor. Wherever it binds, it's going to have an action. So hormones do affect everything. So, you know, when you, if you are a woman listening to this and you feel like you know all of your symptoms, whether they're joint related or gut related, they get worse right before your period and someone tells you it's not related to your cycle, you have to, you know, be like, no, it actually, it probably is related to your cycle, right? It's related. Hormones, they affect everything.

They really do. Everything from mood. I mean, if we look at PMS as an example, right, Because I think a lot of women can relate to what we refer to as PMS or premenstrual syndrome. That kind of week before your period where we tend to have more symptoms. We can see that the symptoms are all over the place. It could be mood changes in the nervous system, right? Anxiety or depression or sleep issues. It's in the digestion. A lot of women get changes in there. Definitely in the bowels, right. More constipated or bloating. There's also changes in other hormones in the body. There can be changes in blood sugar levels, changes in thyroid, you know, like these other hormones start to shift too. And then the, even the immune system or inflammation can shift, which is why there could be more pain or cramping.

Or, you know, so it's like you.

Start, I'm always thinking in those four systems, by the way, I'm always like, you know, nervous system, digestion, immune system, hormones, and they get affected by shifts in estrogen and progesterone. And of course that week before the period is when what we want is we want the estrogen progesterone to be equally kind of high and then they equally drop off, which causes the period to happen. So of course that's when, that's of course when our body's gonna give us more symptoms because the hormones are doing this kind of like rise a change.

Yeah, yeah, yeah. And I always talk, I think usually, I don't know if you do this, but I usually will test when we're doing hormone testing, test around a week before the period around day 21, which is a lot of women start to get symptoms then. So I think it's important when you're doing hormone testing to test on the day when you get your symptoms so we can see what things look like. Unless you're doing month long tests. But I think that when you are stressed in particular, I'm just jump right into. A lot of times what will happen is progesterone will end up getting shunted over. If the body has a need for cortisol or greater need for cortisol because of external or internal stressors, that progesterone molecule will get kind of shunted over into cortisol. And then you'll see this problem with estrogen being higher than progesterone and progesterone in that second half of the cycle sometimes can help keep some of those symptoms from happening. So when we get unopposed estrogen, it kind of goes crazy.

Yes, I do test hormones. I mean, I'm curious how what you do as well, because, of course, I find it's most helpful to see it in like a urine sample. You can also do saliva samples of estrogen progesterone and you could possibly do blood levels, but it's never as easy to clearly see it. Just everyone knows if your doctor does blood levels of estrogen progesterone, even if it's on day 20, 21 of your cycle.

The ranges in the blood work are so wide.

So wide. Yeah.

All in the normal range. And so you can't really see.

You can't see it. I will start with blood work just because it's covered by insurance and sometimes it's an easy thing to do. We're testing for a whole bunch of other things because I like to figure out a lot of my patients are coming in that are really stressed and like I said, there's external. Yeah. So we do that and then if we can't really tell and they're still, then we'll go to a urine or something else. And oftentimes, like you said, there's a wide range that the blood work will say. But there's a functional range that we look at. We're like, okay, yes, your progesterone is within the normal limits, but it's lower than it should be.

Or.

Sometimes you can see it that way. And then. And then, yeah, if you're, if you've done blood work and it's not clear, then you could always, you know, then.

You go to something else.

And the urine saliva testing is not usually done by. Whereas blood testing a gynecologist might run for you.

In your saliva. You're probably going to need to meet with a naturopathic doctor who can order those tests, who can order that for you. But it's such a good point that, you know, like, as soon as the, the estrogen and progesterone are not no longer sort of equal to each other, as soon as the most common. I think, even though, like you said, is more likely that the estrogen goes high and the progesterone is low when we're under stress and that that's what a lot of times gets called estrogen dominance. Although I tend to think of it more like a progesterone deficiency deficiency.

Yeah, well, I think there can be both. Right. I think when there's, when there's just stress, I think it's more a progesterone deficiency. The estrogen is normal. But I think that if people have liver issues and if they're not breaking, if they're not clearing their estrogens and they're exposed to a lot of exogenous estrogens, which if you're microwaving plastic or if you're drinking out of plastics or you're putting a lot of products on your body or using perfumes, you're going to be exposed to these chemicals that can mimic estrogen in the body and sometimes that can affect the liver. And so.

People will have normal progesterone levels, but their estrogen levels are high because the liver is not clearing it. And that, you know, usually you'll see a lot of acne, a lot of other signs of kind of sluggish liver stuff which are. Right. Like. And so, and that's an important, important thing to look at is liver function.

And totally. And what, what you're just to clarify is to say the ovaries make estrogen, but then estrogen does. It has to get out somehow. It doesn't just float around until it goes away. It actually has to go through the body, through the bloodstream, to the liver. And in the liver is where it goes through a detoxification process. There's a two step detoxification process in the liver and then the third step is where it goes out in the bile to the intestines and it has to go out in the stool. So if that doesn't happen, if say you have constipation or it has a chance to kind of sit in the intestines too long, it can be reabsorbed into the bloodstream. And so this is what you're referring to is where not only do you have the amount of estrogen, estrogen your ovaries are making, but then you have this extra that might have gotten reabsorbed from the digestion and you might have even more extra from sources in your environment like plastics. You're mentioning where you're. So we end up with all this extra estrogen that, you know, wasn't even in the plan from the ovaries. Now it's floating around causing extra estrogen symptoms. And another one might be, well, certainly like menstrual cramps and heavy bleeding. So once you even get to the period, if you're having more like heavy bleeding and menstrual cramps, that might be that there's this higher estrogen and lower progesterone. Either or both.

Yeah.

And also I was going to say like, you know, even, you know, can vary. Right. It could be more irritability, it could be more weight gain, it can be breast tenderness, it can Be, you know, it can show up differently in different people. So even if you don't fit exactly what people describe as pms, but you don't feel good in your own way at that time period, then you can figure something. The estrogen progesterone are likely a little bit out of balance. And for a long time before we even had very good testing, we would just go by how symptoms feeling and then treat it nice based on that.

Yeah, I was going to bring up, do you ever see patients that have a lot of their symptoms instead of before their period, they get them around ovulation. I've had a whole, I feel like I've seen an increase in that in the last year is that my patients are complaining that they feel fine right before their period. But the week that they're ovulating, so usually starting around day eight or nine, if they have a 28 day cycle from day eight or nine until day 16, that's when they're seeing lots of breast tenderness, irritability, moodiness, bloating, cramping, and again, estrogen levels can be too high at that point or you can have a. Something else could be going on. And I always like to think of it, if you're really stressed and you're of, you know, you are ovulating your body, it takes a lot of energy to ovulate, right. Your body is like putting out this egg. And if you're really stressed, there's not, there's almost like there's not enough energy available to help the body ovulate. I see a lot of people that tell me they're exhausted the week that they ovulate. They're like, I'm so tired, I feel fine before my period. Do you see this? Do you have patients?

Absolutely. Yeah.

There's definitely women who experience symptoms with ovulation or even like and sometimes it coincides with some spotting. Like you might get spotting right then too. Because there again it means to me that the hormones are a little out of sync. And so now the body's a little confused and you get spotting right in the middle of the cycle. And then you're like, wait a minute, is this a period? Is it not a period? And it also could be a kind of missing ovulation sometimes when we're stressed. Like you're saying if the ovaries are just, you know, getting the message from our brain that the body has to deal with stress instead of putting attention to ovulation, sometimes you'll skip an ovulation and then you're definitely, you know, more likely to have this period after two weeks after the last one. And you're like, what's going on here?

Yeah, what's happening? Yeah, which, you know, and we were chatting before we got on that. You know, I find I treat a lot of women who've been diagnosed with pcos, which stands for polycystic ovarian syndrome. And it's kind of this junk box diagnosis where women end up with a whole host of. And can be some of the PMS symptoms we already talked about. Sometimes there can be hair growth, there can be skipped ovulations or skipped periods. You don't get period for months. And there can be weight gain and insulin stuff. But I find a lot of women are. They're having difficulty getting pregnant and they're just, oh, here you've got pcos. The treatment is the birth control pill. Just take the pill and you won't have any issues. And. And for some women, that might be fine. And well, but if you're trying to get pregnant or you really want to know what's going on, they end up in my office or in your office being like, what is happening here? And I think in most of the cases that I see in women that have been diagnosed with that they really just have a hormonal imbalance. And sometimes we've talked about estrogen and progesterone, but there's also testosterone and some of the kind of more androgenic hormones which women make a little bit of. And sometimes in pcos, those hormones can get elevated and can block the production of the other hormones. But that usually, and I usually find, and I'm wondering if you do as well, that there's usually a liver issue going on there, that again, the liver is not breaking down that testosterone or there's androgenic hormones, and then we get elevated that. And then it stops ovulation and causes all kinds of other issues.

No, it's so true. And pcos, I think, is such a. It's an interesting term. Sometimes I think we use it without even really realizing it stands for polycystic ovarian syndrome. But it's such a broad diagnosis of criteria for diagnosis. So a person doesn't even have to have ovarian cyst to have what we refer to as polycystic ovarian cyst syndrome. And it's really. I agree with you. I think it probably could have a better name. It could really probably better named just hormone imbalance issue, because it does vary so much from women to women. And a Lot of women find that it takes them years and years to even get the diagnosis of pcos. And then as you said, then their treatment is often just. Well, just take a birth control pill to take over for your ovaries, so then you don't have to worry about it. But a lot of women are more and more, yeah, like you said, wanting to be able to help their body ovulate themselves and balance their hormones and especially with fertility. I mean, I, I can say over. For more than 20 years that I've been helping women with this, that every patient who had a diagnosis of pcos, who I came to me for help with getting pregnant, was able to successfully get pregnant. So it doesn't, you know, don't believe.

Doesn't mean. Yeah, that that's. I have a very similar thing. I feel like patients come to their IPCOs and they, they all, they get pregnant, you know, like, unless. Unless there's something, you know, really seriously some other major issue. But most of the time it's just a hormonal imbalance. And even so that I feel like the textbook PCOS is someone has elevated testosterone, they have hair growth, and usually there's a blood sugar issue going on. There's insulin resistance. So they're, you know, they're kind of type 2 diabetic. But if you can get that all straightened out, in most cases you can get the period to start again and we can, you know, you can become fertile. So, yeah, I always sit people down. I'm like, just because you have this diagnosis does not mean you're never going to be able to get pregnant. And I think sometimes that's really important for people to hear. So if you're listening and you have pcos, don't worry, there's hope.

Definitely. There's so much we can do. I think it was so interesting when that research came out about insulin and blood sugar levels with pcos, because we can apply that even to cases that are not officially diagnosed as pcos. It just shows us that our blood sugar levels and our insulin function affects our ovaries, which you wouldn't normally even think that. I don't think anyone would be like, what do you mean my blood sugar has something to do with my ovulation? It's like. But we end up finding that, of course, when we're under stress and we have this cortisol either too high or too low for the time of day, it's going to affect the insulin function, it's going to affect our blood sugar levels, and those blood sugar Levels and insulin levels are going to affect the ovary function. So that could up as any of the things we've already talked about. It could show up as issues with getting pregnant. It could show up as pms, it could show up as menstrual cramps, it could show up as pcos. But it's just to say that the blood sugar balance affects ovaries. It's pretty amazing, isn't it?

It's really amazing. I always talk about the three major parts of our endocrine system we have, and I was watching that. We've got the adrenals, we've got the thyroid, and we have your sex hormones. And they're kind in this delicate triangular balance where if any one of them moves, it's going to affect the other two. But at the center of those is blood sugar. So if blood sugar's off, it's going to affect all three of them. I mean, blood sugar. As you said earlier, we treat the body as a whole, and every cell in the body needs glucose in order to function. And if you have insulin resistance, that means that the glucose actually can't get inside the cell. And so if your cells can't get inside, can't get glucose, they can't do their job. So, you know, so the ovary, for example, it can't produce an egg if it's not getting glucose. So, yeah, so it affects, you know, blood sugar, affects everything, which is why eating a healthy diet is so important.

Like some of these basic, you know, we start with that, right? We like, okay, that's one of the first things I know I start with, with patients is, okay, let's. Because sometimes you don't even realize your blood sugar is out of balance. Like you, maybe it even looks normal in your blood work. Maybe you feel like you haven't really noticed that your blood sugar is an issue. And certainly you don't have to have a diagnosis of diabetes. It can just be where it's relatively minor imbalance. You know, when we eat where our blood sugar should go up and the insulin, like you said, helps the glucose get into the cells and then the blood sugar should come back down again. But as soon as we're on this, like really high, like, of course, carbs and sugar throw this off for sure. The more carbs and sugar, the higher the blood sugar goes, the more insulin is required. And also the larger meals that we have, we need more insulin to manage those. And so just by some of these helping people to balance their blood sugar with their diet, like, okay, how Do I take out the sugar, the sneaky sugar that sneaks in everywhere? How do I balance my meals? So it's not all carbs, but we need some protein and fat in there and how do I eat smaller quantities so that it's what we can digest and what our insulin can handle. Right. It's amazing how that can make a huge difference with the menstrual cycle and hormones in general.

Yeah, yeah. I think sometimes, sometimes we forget just as human beings that some of the basic things that we do to take care of ourselves have such a profound impact on some of the physical symptoms that we feel and particularly the menstrual cycle. I feel like for, for a woman, you know, it's, it's so important to know what your cycle is doing and what's happening. You know, if you're. I always the first thing I have patients doing, like make sure you're tracking your cycle. Get an app, track it so you can understand, you know, what's going on. And I think it's super cool. You know, a lot of my patients will tell me that they cycle with the moon. They get their period on the full moon or the, or the new moon and just like seeing what happened, you know, how your body fits into the, you know, to the world and how your body talks to you. Right. Like anytime you get symptoms, I think it's your body trying to tell you, hey, something's off.

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Sometime in that week, I feel like that week before your period, especially if you're prone to getting a lot of symptoms, that's the week that you need to make sure you're focusing on your diet, keeping your blood sugar balanced, getting extra rest, prioritizing yourself a little bit that week so that you don't have the crazy symptoms.

No. And it's so true. And I love apps in that way that it can help us really learn more about our body and get more in touch with what actually the signals are that our bodies are giving us. You know, because it's. First of all, we're stressed, we're so distracted with everything else going on. And. And then we also can have this tendency to look to external information instead of relying on, hey, what is. What's actually going on in my body. And I love that. Just even starting by tracking your cycle to really, to kind of put together, hey, is it aligned with the moon cycle or not?

Yeah.

When am I having worsening symptoms and not, you know, like that information gathering process is so key.

Yeah. And I think you can use it.

I keep wanting to put together a workshop about this, about how to kind of play into the different weeks in your cycle. Because I know for me personally.

From when I start to bleed that first week, I have tons of energy. I get things done really well. I'm really sociable. And then there's a point usually around day 21 of my cycle, I'm really tired. I need to retreat and be. And so I try to look when my periods are regular, I try to schedule things out. You know what? I'm not going to schedule something like that on day 21 because I'm going to be really tired or maybe I'm going to take that day off to kind of work within your cycle almost. If you're a busy mom or a busy woman, which most women are busy, to look at your cycle and say, oh, you know what? I'm going to feel this is the day that I should do a really hard workout because that's day four of my cycle or whatever. And knowing your body and knowing when you're going to function the best, which I think it's an important, important thing to do. And sometimes I mention that to patients and they're like, oh, I never even thought about that. It's kind of a cool thing.

That.

We can actually have that influence on our schedule based on what our needs are. Right. Like we go, oh, need, I'm going to need to rearrange this.

Because we.

It's true. I think we're really. That's not the way that society kind of has been. I'm hoping it's shifting, but a little more quiet time.

And it reminds me like well, you mentioned adrenals and thyroid, so maybe we can touch on that a bit too. I mean it reminds me that just from what you're describing with giving yourself a break is like what a great time to have a stress recovery, you know, like, and to acknowledge that our bodies need, that we need not only, you know, for just because you don't feel good, but it's actually a chance for your adrenals to reset, for your ovaries to do their best job of making hormones for you give your body that support it needs for these hormones to be more in balance.

Yeah, I think that's a good point, is not trying to rest only when you don't feel good. I think we need to prioritize rest even when we do feel good. I like to tell my patients, I'm like resting. It's like earning energy. So it's like you have this energy bank, right? And so if you only if you think about it like you would in terms of money, if you, if you only save money when you need it, you're not going to have like, if you really need it, you're not going to have a savings built up. So it's like every time you rest, you're putting energy into a savings account so that if something really bad does happen, you have that extra energy there. And I think, and when someone, you know, I work with a lot of patients with adrenal fatigue and when they're coming out of it, a lot of times they'll start to feel better and then they stop. The self care practices that we added in, they're like, well, I feel great. I don't need to meditate anymore. I don't need to go to bed that extra hour. And then three months later they're back and they're like, I feel like crap again. And I'm like, well, you know, you didn't build up that, you didn't put anything into your savings account. You paid off your debt, but your savings account still is empty, which is a nice analogy. I feel like people kind of go with like they understand that analogy. So it's important to rest even when you're not super tired or you're not feeling bad. And that will ultimately help. I feel like the balance of the hormones as well.

Absolutely. Oh, I love that idea of thinking about it as a savings account because we're used to that concept now. We might all not be that great at putting money in our savings accounts.

Yes, very true.

Both at the same time, you know, because you know, it does you want. It's by doing that, by making that choice, it means you're getting some self care on a regular basis. And that's going to help you to be more resilient for whatever comes along. Whether it's a hormone shift, like even say with perimenopause. Right. It's these are hormone shifts that are happening within our body. Or postpartum, I find is another good example where this is a natural hormonal shift, but it can end up creating symptoms. And so that means it's an important time to really pay attention to again, your blood sugar, your adrenals, and really giving your body that self care to get through that transition time. Feeling your best.

Yeah, yeah. And women, we go through a lot of transition times. It's like every. There's lots of them that we go through. Yeah, constant. And I think it's important if you're a woman listening to know that, you know, you might have different needs during different times of your life. You know, I find I get aand. I'm sure you see this a lot of women, either in menopause or perimenopause, and they're like, the diet that used to work for me doesn't work anymore. And they're so frustrated. They're like, I used to be able to do this to lose weight or feel good, and now I don't feel good. I'm like, well, your hormones are completely different right now. So.

It'S not unreasonable to think that you might need a different, you know, a different support, like self care routine. You might need a different diet or, you know, your sleep might look different or, you know, your body has different needs at different times. What's going on hormonally.

It reminds me that with perimenopause and menopause, it comes back to this insulin thing again, where then insulin doesn't function as well as it used to. And I think, you know, that's a common reason for that. Extra weight gain with perimenopause and menopause is like, oh, wait a minute, you know what's happening. The insulin isn't able to move the glucose as effectively. And so then it ends up going into storage around your waist.

And that's sometimes the first kind of symptom or signal that, oh, there's another hormonal shift happening here. And we're going to, you may need to shift your diet and become a little more careful with your carbs and insulin to help get through that without having the weight gain that you don't Want.

Yeah, yeah, that's a good point. To bring up the insulin stuff, perimenopause, I don't often I need to check that more on some of my perimenopause patients.

Well, and also makes me realize like.

That'S higher hemoglobin A1C, which is our.

Average blood sugar level, also increases risk of not just diabetes, but also breast cancer and dementia. And so it's a really important time to go, hey, what's happening with these blood sugar levels and insulin function? Because not only is it going to help in the moment, but it's going to help in the long term to prevent, prevent these other health concerns, even heart disease associated with the higher blood sugar levels. So it's like you're right to what you were saying earlier. Like we just, we need to constantly be coming back to how do we optimize our blood sugar in order to help all our other hormones and help prevent other health issues. But I also want to touch about the thyroid because.

Oh yeah, you know, there is a.

Lot of times that thyroid comes into play here with these various symptoms.

Like, like even as, you know, certainly with perimenopause, I see a lot of thyroid changes, but also with PCOS and PMS and infertility. And infertility, yes. It can be kind of in the background even if it's not like a major hypothyroid, maybe just a minor under functioning of the thyroid can also have an influence here.

Yeah. I call patients, I tell them it's a subclinical hypothyroid. I'm like, you don't have hypothyroidism, but your thyroid is not functioning optimally. And I think it gets overlooked a lot. Right. Because doctors will just test TSH and maybe they'll test a T4. But T4 isn't your active thyroid hormone and they don't test antibodies. And there's my favorite like sneaky thyroid test I call it is the T3 uptake test, which I think doesn't get tested a lot, but that tells us actually how much of the active form of thyroid is getting into the cells. So you can have, it's very similar to glucose. You know, you can have glucose levels, but if the glucose isn't in the cell, it can't do its job. And thyroid hormone, same thing there. You have thyroid receptors on a lot of different cells in your body. But if that T3 doesn't get into the cell, you could have totally normal T3 and T4 levels and look like your Thyroid, but you might still have hypothyroid symptoms because you're not getting the thyroid, you know, the T3, into the cell. So I like that T3 uptake test, and I find it low on a lot of my patients going through a lot of stress, or they've got, you know, they're going through a hormone change, or they're deficient or they have gut issues. You know, there's a whole host of issues that can cause that. That, you know, uptake to be lowered.

Well, and especially because it's, you know, we. The thyroid makes the T4, but then the conversion to T3 happens in other areas of the body.

So it's.

Yes, like, thyroid is. The thyroid hormone function is so dependent on the rest of our body and the nutrients, like you said. I mean, iron is a key nutrient for thyroid function, and iron is one of the most common deficiencies. Right. Especially if you're having menstrual irregularities or heavy periods. Now the iron is low, and it's going to affect the thyroid. So it becomes this vicious snowball cycle.

Yeah. I think it's just you have to make sure you get all of this, like, all of this stuff as addressed, you know, back to that whole. Whole body, like, make. You've got to make sure that all of the systems are functioning. You know, I always say that for most of our bodies to go, it's like. Like, it's like we're a perfectly orchestrated ballet and we have all these different dancers, and they have to be wearing the right costumes, and they have to be doing things at the right time. Because if you have one or two dancers that run through at the wrong time of the stage or they're wearing the wrong costume, it can disrupt the entire ballet.

Absolutely. Yeah.

Yeah.

We just have to make sure that, you know, like, I think the iron and thyroid one's a great example. I find a lot of people have subclinical iron deficiencies. You know, they're not anemic, but their ferritin's really low or their iron saturation is really low. And so that's not enough iron for the thyroid to do its job.

These are not always, again, tested that.

Are in your usual annual blood work. So this is where, you know, when Erin and I work with patients, we're like, okay, we need to do these specific tests because if we really want to understand what's happening in your body in a way where we can help it out on a nutrient level, a dietary level, lifestyle, we want to understand exactly where the IMBALANCES are, because the key is that if we can see where the imbalances are, then we can address them. You know, it's like, then we can start to shift the orchestra. You know, we can start to tune instruments and you know, fine tune the choreography because we can see where what needs to be dialed in.

Yeah. Instead of just being like, oh, I'm going to take this drug and see what happens. Because sometimes, and sometimes, you know, not to knock, you know, sometimes an anti anxiety medication or if you need to be on the birth control pill for birth control or for other, you know, if you need to be on those, that's totally fine. But there, a lot of women don't want that. You know, they want to be feeling their best and they want to be doing the fine tuning. And how can I be functioning optimally?

Well, even like with thyroid, I mean, you can, you know, there's the common, you know, say if low thyroid function is identified, a common thing would be to prescribe a T4 or syndrome levothyroxine, which is okay, but it's just T4. It still has to get converted to T3 in your body. So a lot of people will find, okay, then what if I can take a thyroid hormone? Now this is to add extra thyroid hormone into your body. If your thyroid is really struggling, we can add T4 and T3. And now we're helping out on the T3 level as well. But I think you'll agree that we want to also at the same time be helping your thyroid work better. What if we can actually solve some of these nutrient deficiencies and as you mentioned, solve the cortisol, the blood sugar, the gut health, so that your thyroid has a chance to in the liver, Your thyroid can now do a better job and your thyroid conversion works better on its own. So you're less reliant on outside sources of thyroid hormone.

Yeah, I think that's all. Yeah. And thyroid, I would say that probably 90% of my practice are patients that have thyroid issues, whether they're full blown thyroid issues or, or like I said, those subclinical thyroid issues. It's a big thing that women, we struggle with. And I think there's a lot of reasons environmentally that there's certain things that we ingest or don't ingest that can. If you're a swimmer, for example, I've got a family and I treat all their teenage kids and they're all competitive swimmers and they are in a chlorinated pool or have been for the past 10 years. And they all have hypothyroid because chlorine will compete out for the iodine. And iodine is really important for thyroid health. And so there's some other things that there's a lot of different. There's so many different players to look at.

It is.

And that's what makes it, you know.

For you and I, we're like, it's.

Fun because it's like solving, constantly solving a puzzle and it's different for each person. So it's, it's, there's a lot of.

You know, like, variety.

It's not, it's never the same. Right.

Like, yeah.

Even though it's common to have. I agree with you. I see so many patients with low thyroid function of various degrees and types, but it's, they all have their slight differences. And it makes it so, you know, those of us who love helping to understand those unique differences, you know, then it, it makes it so, you know.

Even like we're excited to help you.

Solve it versus feeling like, oh, just, you know, because I think a lot of times people end up hearing that they should just deal with it or, or just take your Synthroid and go on with your life. And at a certain point you might be like, wait a minute, I still feel tired. I still. Maybe your mood is off, maybe your digestion's off, maybe your menstrual cycle's off or you're trying to get pregnant and you're like, no, this is not okay. I want to get it fine tuned.

Then we can.

And a lot of times with hypothyroidism, of course there can be Hashimoto's, which is autoimmunity, where the immune system is trying to protect us from our own thyroid gland.

And that is quite common.

But it's not always some. Like you're saying some people have low thyroid for other reasons like stress or chemical exposures, and we need to, we need to solve for that. But we can also solve autoimmunity. Right?

Like, this is where we need to kind of go, okay, you know, we.

Don'T have to just stop with the hormones. We can go, oh, there's autoimmunity happening. Okay, let's think that through. That means that the digestion. There's probably leaky gut or some imbalanced gut bacteria, the stress is affecting there. We need to take another step to solve. And then we can actually decrease the autoimmune antibodies.

Yeah, yeah. Which is, that's another huge thing. That's like a whole, it's a whole other whole Other show, we can talk.

About Hashimoto's and Another Day, but it's like, again, just to show that it's. These interconnections happen. And then as naturopathic doctors, that's what we do is we help to solve those interconnect kind of. It can become almost like a knot in your body. It feels like there's a knot, but then if we just little by little, we can loosen the knot and get everything, you know.

Yeah, that's a great analogy, because I think sometimes everyone's like, I want to find the. There's probably one thing, and there's usually not one thing. There's usually a multitude of different things, particularly if you've got a hormonal imbalance. You know, very rarely I've had some rare cases where it's been. One hormone was. You know, there was one issue, and we need to fix that. But usually it's a whole bunch of things. It's diet, it's liver, it's gut, it's immune system. It's, you know, a lot of different things, like you said, that are all in a big knot. And we just have to slowly, you know, figure out. Sometimes there is like, okay, we figured out that you're, you know, you have celiac disease, and you're not, you know, you're not absorbing this, and we need to cut out the gluten and that. That helps the knot unravel a lot faster or. But usually it's a lot of small things that we're adjusting so that things can start to unravel. I like that analogy. That's a good one.

Oh, good, good. I'm glad. This is where talking. Sometimes I'm very visual. You must be, too, where we think visual analogies. And I think it can help because then it gives patients kind of lights on the journey, because otherwise it can feel hard to believe that it's possible. And what's my next step gonna be? But when you kind of have a visual for it and kind of know, okay, this is a journey I'm on. I'm on the journey of reversing these vicious cycles and rebalancing and, you know, getting the orchestra. I like that analogy to getting the orchestra or the, you know, getting the. The. The knot untangled, you know, like, yeah, these are. This is the journey that that takes place, and it becomes a. Also a journey of acceptance of yourself and empowerment of yourself in the process. And that all of that together ends up, you know, helping you to stay. Like, once you solve a lot of these things, then you can continue that going forward because you learn so much along the way of what you can identify when things just start to go off and you know what to do versus having to wait for them to get worse before you try to solve them.

Yeah, I like what you said about journey, because I sometimes. This is a common question that I get when patients first call and they're like, wondering, what does it look like, like to work with a naturopathic doctor? How long is it going to take? And like, when will I feel better? And there's never a. I can never give someone, okay, you're going to feel better in six weeks or it's going to take a year or whatever, you know. But I usually will tell women that if we're working on something that we know is. We're trying to. I call it rejiggering your hormones. It usually takes about three months for all of the feedback loops for brain. Like, you're going to have three cycles. We got to give it three cycles in order to really see if what we're doing is working. And sometimes, sometimes I'm sure you see that when you're on this journey, sometimes things get a little bit worse before they get better. You know, sometimes, you know, we start you on something to, you know, to kind of reset your hormones, and you might have a really weird period the first time or the first two times. And that's not a sign that things are going wrong. So if you're someone who is like on this journey already and you're like, wait, it's not working. You have to give it a few months. Right. Especially when we're resetting hormones because it's. There's all of these. It's. The brain will tell the ovaries to make a hormone and then. Then the hormones go back to the brain to turn off the hormone production. And so it takes three months for that whole orchestra or ballet to get reset. It's like, you got to retrain the dancers and it can take a while for them to learn their new roles. If we're going to go with that analogy, it's so true.

It's so true. And it's a great analogy. And I think it's definitely. You want to be.

You have to kind of have your.

Mindset in it for the long term. Because otherwise, I think if we're hopeful for something short term, we then end up sort of setting ourselves up for disappointment. And then we're. We set into this kind of like anxious and angry and resentful and that's not going to help either. That's just more stress. So it's better to kind of set out with. Okay, my mindset is I'm going to learn from my body each month. I'm going to do the tests that.

Are helping me gather information.

I'm going to implement some changes and I'm going to check back in and see what my progress is and keep tweaking until you, you know, you really get it to where you're trying to go.

But it's.

Yeah, it's much better to come at it with that mindset.

Yeah.

Yeah, I love it. Oh my gosh, it's been so fun to talk with you.

I know. It's been really fun. Like, wow, it's been so long. This went by so fast.

Well, that's what I figured. Like, you know, when, when you put two of us together that love talking about hormones, we're gonna be like two naturopathic doctors. We're like, this is our best day ever.

I love it. I love it more. Like if someone wants to connect with you more. And I know you just also started your own podcast.

Yeah, I just started a podcast. It just launched in the last couple weeks and it's called the Dr. Kinney Show. And I'm talking about all kinds of topics. So if you're interested in learning more about naturopathic medicine, just in general or even just alternative medicine, come check it out. You can follow me on Instagram, I'm Rkinney. Or on Facebook Rkinney. And yeah, I do a lot of videos like Dr. Wilson does here about stress and about hormones and so come follow. And I really like to give people the knowledge so they can make better informed decisions about their healthcare.

Which I think we're very like minded in that we want people to understand how your body works.

Absolutely, absolutely. And I want to just say verbally that Kinney is spelled K I N N E y. So if you're searching for Dr. Erin is E R I n and then K I n n E y just so it's easier for you when you're looking for her website. I'll post A as well so you can find her on social media and at her website, which is drarinkinney.com so D R aarynkinney.com and she's, as you heard, you know, available to connect with you as patients, one on one or online for more information. And thank you again so much for joining me. It was so, so informative. I think people will really. Listeners will really get a better sense of what's possibly going on with their body and what's possible in terms of working with a naturopathic doctor to get more information to help you solve your health issues and just feel better.

Yeah, thanks so much for having me.

Thanks for listening to how humans heal. If you liked this episode, leave a rating and a review. And for more resources, visit drdani.com.