Midlife women and ADHD: What’s really going on with focus and fatigue?

ADHD diagnoses are rising in midlife women, but is it really ADHD or something else? Brain fog, forgetfulness, and overwhelm often point to an overloaded system, not a neurodivergent brain. Today I'm speaking with Claudine Francois, who will uncover what's really behind these symptoms and how women can reclaim focus, energy by supporting smarter, not pushing harder. Welcome, Claudine.

Thank you so much for having me. It's great to be here again.

Oh, it's always great to have you on the show. We love our sessions. You always share such great information. And really, Claudine, as a functional medicine practitioner, you would see so many women with these symptoms, you know. And I don't know, really, when women go through perimenopause and menopause, I don't think real I don't think anyone in the room could put up their hand and honestly say they're not suffering from one of those symptoms I just described. It is debilitating, but depending on the severity of your symptoms. So in your experience, what are the most common root causes of these ADHD-like symptoms, and how do they differ from a traditional ADHD? ADHD diagnosis?

What are the symptoms of ADHD in perimenopause versus what we would consider traditional ADHD? And the, and the delineation between the two, as you alluded to, is not very clear, partially because there could be women who have had undiagnosed ADHD for a long time. Right? So we're talking about, maybe they can't stay focused, they lose their train of thought mid-sentence, A lot of us have experienced you forget why you walked into a room. You might struggle to finish any of the 15 things you had on your list, right? You might snap at your partner for breathing too loud or something. That's pretty common experience. And when we have a lot of estrogen when we're younger, right, prior to perimenopause, estrogen is a buffer for a lot of things, right? And one of the things it's a buffer for is cortisol. One of the things things it keeps in line is neurotransmitters. So if you think of serotonin and dopamine, so when that estrogen drops, our buffer drops. So maybe you have women who really had ADHD, like they may have noticed it, say, in their luteal phase, like we would call that PMS phase of their cycle, uh, but they, they were fine the rest of the time, and that's because the estrogen was buffering them. Or it could just be that Some women are truly having perimenopausal symptoms, which are showing up because their estrogen is dropping.

Yes.

The problem is the symptoms are the same, and some of the root causes are the same. So the root causes of traditional ADHD could be gut dysfunction, blood sugar dysregulation, mineral imbalances, nervous system dysregulation, so chronic stress, and we can break down all of these. Yeah, but those could be, uh, creating an ADHD experience for someone regardless of whether it is a quote-unquote traditional ADHD or a perimenopausal version of ADHD.

Because in functional medicine, you like to get down to the root cause. And sometimes I know in, in, you know, medical science and that I hope I'm not quoting this wrong, that it's more of a brain dysfunction, you know, is ADD. But in functional medicine, you'd like to look at the root cause, that maybe even for that there is something else going on that could be causing that, that that's not the primary, it could even be the secondary, which I find so interesting because I think everyone could actually have a look, even if they've got this diagnosis, and then think, but is it really? Are there things that could change it for me? You know, like, do I have to be on prescription? Even though, you know, prescription helps so many, and I'm certainly not knocking it because it really does help so many, but there may be a deeper cause and you don't need to take the prescription. You know, especially at this stage in a woman's life, there's a lot of stress. So how does stress and a dysregulated nervous system make these ADHD symptoms worse?

Chronic stress is a huge driver of our ability or inability to focus, right? If you think about it, if you're running away from the tiger, right? The traditional, what most people think of as the traditional stress response, right? You need to run away from the tiger. Your body's not thinking, oh, I need to save some energy for cognitive thinking. I need to remember where I put my keys. It's like, no, no, we have to literally run as far and fast as we can to get away from the tiger or the threat, whatever the threat is. So it, it diverts power from the thinking parts of your brain into your energy. It's like giving you the glucose and the, um, the energy to, like, the cortisol and the adrenaline to run away. Unfortunately, in our modern world, that's not what we typically need when we're stressed, right? It's more like, my boss just sent me an evil email, or I just got in a fight with my spouse or my teenager. But that— we don't need to necessarily run away from something, but our body hasn't evolved to understand that, right? It just understands, oh, we are having this elevated stressful experience, we need to increase the cortisol. And then your brain function drops. So you don't need that brain function when you're stressed. And if you have chronic stress, then you're feeling that all the time, right? So then you're having foggy brain, you're forgetting where you put things, you don't remember why you walked into a room. So that's how cortisol is impacting it. Not to mention the fact that cortisol impacts your gut. So we might want to talk about gut a little bit. A little hint as to what's to come.

Yeah, exactly, exactly. That is to come. I've got a question around that. But before we go to I really like the way you talk about energy leaks. And what do you mean by leaking energy, and how can women stop this?

Well, there are a couple things that impact our energy. One is our minerals, okay? So if you think of minerals as the little tugboats that get everything in the port where they need to go— so like all the big ships in the port, if the tugboats go on strike, the ships don't go anywhere, right? Nobody's getting into the slip that they need to get into. And minerals are like those tugboats for our body. They help everything get to where it needs to go. So if you're low on calcium, magnesium, sodium, potassium, those are the big 4. If you're low on any one of those, you're literally not getting nutrients into your cells. And if you aren't getting nutrients into your cells, you cannot have energy. There is no energy without fuel. So that's mineral that's the mineral balance part of that energy leakage. The other is blood sugar dysregulation. And this is something that I think is newer in people's— and just like in general, like in this society, like we're talking about it a little bit more. There are people like the Glucose Goddess who've made blood sugar really popular. But when we don't have steady energy, when we aren't keeping up with, say, 20 to 30 grams of protein per meal, And let's say we're just snacking, or we're going for too long without eating, or we're only eating carbs without a protein or a fat with them. We're basically causing our blood sugar to go up and down, right? Just think up and down, up and down, up and down all day, which drains our body of energy. We want to have steady blood sugar, which is why if you eat a more protein-heavy meal, you feel more satiated for longer. You don't have that big spike. Spike of energy like you would get from having an ice cream or drinking some juice, right? If you think about that level of energy, this— the, the protein and fat heavier, uh, energy is much more stable.

In menopause, sometimes you feel bloated, your digestion's not working that great, or you're tired, and you're tired. Sometimes you just don't feel like a heavy— well, a heavy meal or protein-rich meal. And so that's why You know, snacking. I think snacking can be so prevalent during that time. And what you're saying is, then I can hear like, well, if you're snacking and your blood sugar is all over the place, well, there's concentration and focus gone. Irritability would come in, all those kind of symptoms that are labeled ADHD. You know, you're restless, you're nervous, you're irritated, um, you can't focus, you start getting disorganized. Would you say all of that, that's expressed by this, you know, dysregulated sugar level?

Absolutely. And I will be the first to admit that for years I did not know this was a thing. I thought, oh, I'm eating healthy, I'm not eating, you know, inflammatory foods, I'm eating all my vegetables, you know, all this stuff. But I was a— I was, I was in love with carbs. Oh my goodness, I could make an almond flour cake I'm sorry, a what cake? An almond flour cake. Oh, an almond flour cake. I have an orange almond flour cake with an almond butter chocolate frosting.

Oh, yum.

But it's gluten-free, it's dairy-free, it's refined sugar-free, but it is still going to spike your blood sugar. And it wasn't until I wore a continuous glucose monitor, a CGM, that I started to believe it because people would tell me, maybe you should check your blood sugar. And I was like, what do you mean? I'm so healthy. But then I looked at it and I could see not only what I was eating, how what I was eating was affecting my blood sugar, but also when I was stressed, also when I didn't sleep well. Um, what happened if I walked after a meal? I could see the good and the bad of my blood sugar swings from that little device. That I was scared to put in my arm. I had my husband do it, and then I was like, oh, I didn't even feel that.

There are so many, uh, channels on social media that really do promote, oh, you can eat this, it's healthy, there's no refined sugar, there's no dairy, etc., but it's still not helping your body to stay stable, or even like your mind. You, you need your— in especially in menopause, we still have life. People still working, they've got family. Like, the stress is actually higher than when you're in your 30s.

And the worst part is, not only is your stress higher, your body's response to stress, its ability to handle stress, is reduced. Because remember, estrogen is that stress buffer. So as our estrogen drops, everything seems so much harder.

And how do our hormones You know, really play a part in that?

Absolutely. So we've talked about estrogen. Estrogen is the queen bee of our hormones, and it is on every, every cell of our body, or every system of our body has estrogen receptors. So our bones have estrogen receptors, which is why you have more of a prevalence of osteoporosis and osteopenia as we get older. Your liver, your gut, your brain, your heart, your thyroid, every single system in the body relies on estrogen. So as it starts to decline, we start to notice what we would call problems pop up, or just things that are unusual for us, right? As we mentioned, everything seems harder. But that declining estrogen, it also lowers our serotonin and our dopamine. So serotonin's the happy chemical, dopamine's the reward center. And so when those are lowered, that can either make us think we have ADHD or it can exacerbate symptoms of ADHD like irritability, brain fog, mood swings. Now, at the same time that estrogen is dropping, so is progesterone. And progesterone is a calming hormone. So not only do we have our estrogen buffer, our cortisol buffer dropping, We have the progesterone drop, which means we are more likely to have anxiety. We are more likely to have sleep issues. And we all know when we don't sleep well, we're not exactly the calm, cool, collected—

Excellent.

The next day, which then also contributes to mood regulation problems. So as that hormone—

as those hormones drop, we start to have these mood regulation and Is there anything that someone can do, uh, just at home naturally to help increase or balance their estrogen and progesterone?

So I think the key would be to balance the systems that make the progesterone and estrogen and that balance— and balance the systems that, that clean out old hormones. Right, so we're talking the gut, the liver. Your gut health and your ability to detox things via your liver are key to balancing hormones. I will say that for my clients, of course, I do functional medicine testing. I can see their exact levels, and we can talk about supplementation because I do like trying the natural route first. I do have one client who loves to take she loves to do the the um. The wild yam cream, which is a natural way to get progesterone, right? Some women like to do seed cycling. So like flaxseeds help create— you know, there are certain foods that create phytoestrogens in the body. So you can do that depending on how your gut is working will determine how well that process works for you. So really, if you really wanted to dig in very far, of course you could get all the testing and have someone look at it for you. But there are definitely some basics that we've started to touch upon.

Yeah.

There's definitely some basics you can do to help all those systems. So, like, for balancing blood sugar, I mentioned eating 20 to 30 grams of protein at each meal. I find that if I eat the 20 to 30 grams of protein at each meal, I don't crave the sugary, salty snack, right? You also need to eat consistently throughout the day. I know fasting is a big deal, but for women in this perimenopausal, early menopausal age group, your body is already under a lot of stress and fasting is another stressor. Fasting is not the way to go here because it's going to just add another layer of stress that your body isn't able to handle right now. So making sure you're eating every 3 to 4 hours, an actual meal. So So not just grabbing and go, but eating an actual meal. A lot of the women that I work with, they literally don't eat, right? They'll skip lunch, they'll have coffee for breakfast, you know, they'll forget, they'll feed everybody else, they'll do all the things for other people, but they forget about themselves. If they want their hormones to work better, if they want their energy to work better, if they don't want to have these ADHD symptoms, they need to fuel. their cells. And you fuel your cells, of course, with all of the good things— healthy fats, fiber— but the protein and, and some fat too are really going to help keep you satiated and keep that blood sugar stable throughout the day.

And I must admit, I could put my hand up to being a person who would just eat like crackers and cheese during the day and then, you know, overeat at night. Because I was so hungry. And then, you know, too full and then you can't sleep properly. It was just like this vicious cycle until I realized, you know what, I'm going to eat like— well, we're traditionally Italian background, and I thought, I'm going to eat like the Italians do. I'm going to have my bigger meal during the day at lunchtime, and then I'm going to eat light, you know, still a bit of protein but light at night. And you know what? That really did turn things around. Let's just mention a little bit more on the lifestyle factors that contribute to people thinking that they do have ADHD because it is a little bit going around now and people go, check these boxes and if you're well, then you're, you know, more than likely, like 80% have ADHD. I find that a little bit misleading and can be a little bit harmful because it's so easy for someone to go, that's me, I've got it, you know, whereas you may not because of so many other reasons, root causes that you keep finding. So let's talk a little bit about lifestyle and what are the best things for people to do and eliminate out of their life.

Well, the best things for people to do are one, Balance blood sugar. We talked about that. 2, they can replenish their minerals. As I mentioned, those 4 key minerals—

Yeah.

Calcium, magnesium, sodium, potassium. People have different variations of these minerals. You can always test for them. But one that I see that pretty much everyone is depleted in is magnesium, because when we are stressed, magnesium is one of those first minerals to go. And I'm— I don't know about you, Rita. Do you know anyone who isn't stressed?

Absolutely not.

Actually, in midlife, like I said, everything hits harder, so everything seems more stressful than it used to be, right? So you can do adrenal cocktails, which help restore your sodium and potassium if you're low in sodium and potassium. Just a caveat, if you have high blood sugar, check with your practitioner first because you don't want to be adding a bunch of salt if you have high blood pressure or adding a bunch of potassium if you are on a potassium prescription. So, but if you aren't, then, and you're noticing that your, your energy is flagging, you could try an adrenal cocktail. So the way I do adrenal cocktails is 4 cups of water, a quarter teaspoon of Celtic salt, you know, like a high mineralized salt, and a quarter teaspoon of cream of tartar, and a half of a lemon squeezed. And that gives you your sodium, potassium, and vitamin C. Right? So it's like a little bit of love on your adrenals. And I drink— I have mine here. I drink 2 of these a day in a container that you just showed.

Looks like it's about— well, here I would say a liter. I don't know what you'd say, a gallon or something is a liter.

It's about 7 cups. Most people, I just tell them to have 2 4-cups a day. I just like 8 cups. Thirsty.

Yeah, 8 cups. Would the 1 teaspoon of salt go go across that 8 cups?

So for every 4 cups, it's a quarter teaspoon of salt and a quarter teaspoon of cream of tartar.

That, that's like a homemade electrolyte, isn't it?

It's exactly what it is, yes. And with the— but you add the lemon, and so then it, uh, that's that vitamin C as well.

I hear many people say that women should exercise differently once they're in perimenopause and menopause. How important is exercise For alleviating these symptoms, even if you do have a traditional diagnosis? And what type of exercise?

Exercise is really important for everyone, but especially for women in perimenopause. There's a specific type of exercise that is better for us than others, and that type of exercise is strength training, right? So using weights to build muscle, because for one thing As we age, this is so annoying. As we age, we become more insulin resistant, which means you could be eating the exact same things you ate 5 or 10 years ago, and you're going to be heavier, right? Because our body is holding on to weight. It's a protective mechanism, right? So as we get older, if we get sick, we have more of a buffer. If you don't like that, if you don't want to be more insulin resistant, doing that strength training is a great way. What— not only does it strengthen your bones, Right. But it also balances your blood sugar, right? Keeps your blood sugar more stable, and it addresses that insulin resistance. You become less insulin resistant, which means you're not going to hold on to that weight as much because your body's like, oh, well, we're going to use it, right, for building muscle.

Mm-hmm.

And this is also why having that protein is important, right? Because if you are strength training and you're not eating enough protein, you're not going to build the muscle. I will say there's a caveat here. Some of the women who come to me are so depleted, they are so exhausted, their minerals are so low, or their gut microbiome is so, um, disbalanced or unbalanced that they cannot strength train, right? So they need to start where they are. So I tell them, just do some kind of movement. Do a walk in nature because that has like more than one benefit, right? The walk in nature not only affects your nervous system, right, it helps you relax, but it also, um, it helps keep you moving, right? So it's giving you some kind of movement. So the reason I say this is because I had mold toxicity for a while, and mold can really mess up your gut, your thyroid, your hormones. And when you have mold toxicity, you are wiped Out. I tried to do my normal workout routines when I had mold toxicity. I literally had no energy, so I had to resolve that first before. So if you have that kind of issue where you're just completely depleted, please check that out. If you're not in that situation and you feel good, then the strength training is the best for you.

Gut health and how gut health affects everything, but especially our brain. You know, especially when we're going through this period and having all these symptoms of forgetfulness. And you know, I know you mentioned before. about, uh, what was it, someone drinking. I, I know that honestly my husband is a bit of a loud chewer when he eats. Sometimes I have to leave the room, otherwise I might find myself in jail. That is actually one of the symptoms of having traditional, you know, diagnosed ADHD, that, that kind of noise, that eating, munching, um, slurping, drinking, whatever, those noises Are very irritating. Let's before we find anybody in jail, let's talk about let's talk about the gut health and how that affects everything in perimenopause and menopause, and especially the brain function.

And gut health is what a lot of people miss because you can run a neurotransmitter report which will tell you your dopamine levels, your serotonin levels, your GABA, your norepinephrine, your epinephrine. You can run a report. To show what yours are. But then the question is, if they're low, which mostly they are, when I, when I look at people's reports, they're mostly low. Why are they low? And they are typically low because there is an issue in the gut. If you think about it, 90% of serotonin is produced in the gut. Most of our neurotransmitters are made in the gut. So if your gut is off, you're not going to be making serotonin, dopamine, and all these feel-good chemicals because your body's prioritizing survival. It's not prioritizing you enjoying that ice cream cone or enjoying time with your family. It's prioritizing you getting out alive. So when we look at what's going on in the gut, if your digestion is compromised, which for a lot of women in this time of life it is, I see a ton of women with bloating, constipation. Some even have low appetite or nausea, like they just don't want to eat. But that bloating and constipation, I would say, are heads and shoulders above in terms of the symptoms that I see, you know, like number one, not top of the, top of the charts, um, that is an indication that your digestion is compromised and therefore your liver is going to be compromised because your gut sends all of its problems off to the liver, which means your thyroid is going to be compromised because that's where the thyroid conversion happens. Your hormones are going to be off because that's where a lot of the hormone excretion happens. You might even have high cholesterol. I see a lot of women who come to me with high cholesterol and they're like, I eat super healthy, there's no reason. Well, if your liver's backed up, it can't clear out old cholesterol, so it just recirculates. And then of course, the impact on your neurotransmitters, your brain, which is what we're talking about, that gut-brain connection, which I think is becoming more well known in, you know, the general parlance of the day. So when our gut is compromised, We're not producing those neurotransmitters, and therefore we can have more of those ADHD-like symptoms.

So many people, you know, the saying, if, you know, if you're really angry and irritable, look at your liver. So, you know, when you— that's like in traditional Chinese medicine, they have that theory that, you know, your liver is the seat of anger. So it makes so much sense, you know, with the backing up into the liver. What Are the most common problems that you see? Is it things like SIBO, or is it Candida? What are the contributing factors, or what do most women in perimenopause, menopause get— happens to their microbiome?

Well, what happens in the microbiome— again, the microbiome is impacted by estrogen, so our good— the ratio of good to bad bacteria changes. But also, remember how I said that Stressors hit harder.

Yes.

You're stressed, it seems more stressful. When you're stressed, your digestion stops. So if you think about how digestion works, you're— you normally, when you eat food, your body produces hydrochloric acid, that stomach acid, to break down the food. If you're stressed, releasing hydrochloric acid, because again, you're trying to run away from the tiger, you don't need to digest food. But if you're chronically stressed, and you have low stomach acid, that food isn't broken down. It moves over to the small intestine undigested, and then your immune system goes, whoa, whoa, whoa, what are these big food particles? All right, it doesn't actually recognize them as food. What are these invaders? What are these toxins? And you have an immune response. So what your immune system does, it goes in and grabs these big pieces of food It puts them in a histamine bubble because like a little histamine jail, which is inflammation, and it shuttles them off to the liver and your liver has to deal with it. So now you have your liver's backed up. This is the process of leaky gut. This is why a lot of people start having food sensitivities. They start having this bloating that starts hurting when they're eating, and then they don't want to eat things, and the normal things that they eat make them exhausted rather than energized. So that is the process of how stress is affecting the gut. And what I end up seeing on the— it's called a GI map, is the report we use. I see a lot of women who have low digestive enzymes, right? So they can't digest protein or they can't digest fat. They can't break it down and use it, which we know we need. They end up having high zonulin, which is the marker for leaky gut. They might have high inflammation. And when you have all of these things stacked onto each other, Your body then isn't able to mount a response when it, it actually has an invader. So you're more likely to have parasites, you're more likely to have bad bacteria, you're more likely to get any number of pathogens stuck in your body because your body can't deal with them. It's so worn out already from dealing with all these other things, right?

Very much. And I guess that's why you do functional medicine, such a whole body process. The symptoms that someone may be feeling of the ADHD or have ADHD is kind of like the end result of all these other layers. Like, you have to keep digging deep. So even if someone is traditionally ADHD, the severity of their condition could be modulated by these lifestyle changes or these corrections. Would you say that's right?

Absolutely. So yes, the someone who has ADHD, it could become worse because of these things, or someone could feel like they have ADHD because of these things.

Wow. So it doesn't— to me, it doesn't sound like it's a brain thing. It sounds like it's just like an overloaded symptom, uh, system. Like our whole body is just totally overloaded, and you have to find the root cause for each individual, which is obviously uh, different for everybody. But is there one kind of correlation between the whole thing that you could see that most women have?

Different. And I will say that the reason why it's different is because people who are older, like 70s and 80s, they have not been exposed to as many toxins in their lifetimes as people who are 40. And so for people who are in their 70s and 80s, when I see their microbiome, I am shocked that it is not worse. But anyone who's in their 40s and 50s, maybe even into their 60s, I see a lot of things. And the digestive enzymes is pretty much everyone has either low elastase, which is the one that digests protein, or low— excuse me, or high steatocrit, which basically tells me they aren't digesting or absorbing their fat. That's pretty common. Usually there are usually some markers showing an imbalanced microbiomes, either too many good bacteria— excuse me, either too many bad bacteria or too few good bacteria. But other than that, it does vary based on the person, based on how long someone has been experiencing something, and based on their bodies. Because I might have gut issues, you might feel your issues more in, in the brain, right? Or someone else might have— like, I used to get migraines. That was my body's way of telling me, hello, there's something wrong. Somebody else might have infertility. Somebody else might have joint pain or be getting gallstones or kidney stones. Like, our body has an amazing way of giving us these red flags if we listen. And then, then we can go back and, and figure out the root cause, like what is actually creating the problem that we're seeing.

That's one of the takeaways I want people to have from this episode is that it is individualized, that it— you have to get down to your specific root cause. Just going straight to either natural supplement or pharmaceutical isn't necessarily your first port of call. Like, let you know, it may be if there's— if something's severe, but let's have a look at what's actually happening for you. And I just I love— that's why I love everything about what you do. You know, we don't need to push harder, you need to support smarter. I love that saying. It is, and that's what it is about, supporting our system to then work optimally. And then you can work out, were my symptoms of ADHD hormonal or menopause, or is it a traditional diagnosis? Can you just leave our audience today with what's one thing that you would really like to see them do starting today? Just something simple to help gain more clarity, you know, and focus.

I'm gonna tell you what I think people should do, and you're gonna laugh because it's so simple, ridiculously simple. But I will literally start a lot of my client calls this way. I have them take 3 big breaths. And the way I have them do it is I have them take a breath where it's like into 75%, hold, go in a little bit more, and then just let it all out. And if you do that 3 times, you're resetting your nervous system. Because many of us get caught up in the stressors of all everything going on in our day, right? We have this full calendar, we have to take care of all these people, we have all of these, the All the things that we have to do, all the responsibilities, so easy to get caught up in it. Taking those 3 deep breaths in the way that I mentioned can just calm your nervous system, tell your body we are safe, we can digest our food. Let's do this. Like, definitely do it before you eat, right? And that will help basically stop the cascade of downstream events like we were talking about with the gut.

And for everybody who's listening, if you'd like to go deeper and understand Claudine's work, she has written a book. It's a new book, The Midlife Code. Tell us a little bit about it. And you do have a free quiz for the audience, which will be in the show notes.

Yes, it's called The Midlife Body Code: How to Decode Symptoms, Realign the Body, and Reclaim Control. It is written specifically for midlife women who are wondering what Is going on with my body? Why does nothing I try work anymore? So it is coming out soon. And if you want to get on my list that you know all about it, you are more than welcome to join. I will give you the quiz. The quiz is a great way to know which of those 3 stages you're in. Are you in the decode stage where you need to figure out what's going on? Are you in the realign stage where you pretty much know what's going on, but like, what are you going to do about it? Or are you in the reclaim stage where it's all about just tweaking and perfecting now? So the quiz is easy, super simple. It's 7 questions and you'll get that information. You will also be invited to join my list so that you can be notified of the book and all the special bonuses I'll be having as the release date gets closer.

Thank you, Claudine. What a great tool to offer. And I do urge everyone to go to the show notes and take advantage of that. Claudine, you always share just fantastic information to help women. I love having you on the show, and thank you again for coming on.

My absolute pleasure. Thank you for having me.