I really want to encourage the perimenopausal / menopausal readers today. I want to help you understand why your dieting and weight loss efforts are helping you, even though you may start having problems since starting to lose weight. To explain these concepts let’s take a walk through the life of Sue…a made up, stereotypical, female, perimenopausal patient.
Sue is in her mid-40s and has noticed that she was starting to have some irregular periods. She visits her OB/GYN and is told that she is most likely in that transition phase from fertility to infertility (menopause). This is called perimenopause. During her medical history she denies having any hot flashes, problems sleeping, irritability, or vaginal dryness. Her exam shows that her BMI (body mass index) places her in the overweight to obese category, her cholesterol levels are slightly elevated and her blood pressure is higher than optimal. She’s offered a statin drug for the cholesterol and blood pressure medication to lower her blood pressure.
Sue is well-read, however, and has discovered that statin drugs and blood pressure medications are probably going to cause more harm than good with her current health situation. She makes up her mind to commit to healthy eating and exercise. She wants to see if she can make some changes without medications. After a few weeks of dedicated exercise and healthier menu choices she is noticing that her weight is dropping on the scale, her clothes are fitting looser, and she is feeling like she is doing the best she can.
The problem? Instead of feeling better…she starts feeling worse! She starts having the sleep problems, hot flashes, irritability and vaginal dryness that she wasn’t having at her last exam. She’s frustrated because she thought the weight loss would help her feel better, reduce her risk of having a heart attack, reduce her risk of getting diabetes, but yet she is feeling worse now since she has lost weight.
Have you ever been where Sue is at?
I see situations like this come into my office on a regular basis. I want to share 3 reasons with you that are most likely causing Sue’s…and possibly yours…increased symptoms even when making healthy choices.
Let me first say this. Losing weight, improving body composition, and making healthy choices is always the right solution. You can never fault yourself for making healthy choices. The end results are worth it. So let’s look at why this may be happening.
(1) Liberated Toxins
Toxins are fat soluble. This means they are stored in your body fat. Guess what happens when you lose body fat? You liberate these stored toxins and they are released into your body. That is why you should never go into a weight loss program without having some way to measure and monitor your fluid distribution to ensure that you are not getting too toxic. That is why we use the RJL Systems BIA measurement on every single patient in our office.
Stored in your body fat are also xenoestrogens. These are estrogen mimickers that come from environmental contaminants. Most are probably familiar with bisphenol A (BPA), and fertilizers, and herbicides, and plastics, and flame retardants, and…the list goes on! These xenoestrogens act like estrogen in your body so they actually tie up the estrogen receptors. The problem is when the receptor is tied up, the small amount of estrogen your body is producing is not allowed to enter the receptor site and do its job. Your body also makes less receptors because it confuses the xenoestrogen binding with real estrogen binding and thinks that your body has enough estrogen so it starts shutting down production.
Big problem! This leaves a perimenopausal woman that was feeling “fine” with all the symptoms we have mentioned already: vaginal dryness, irritability, sleeping problems and the dreaded hot flashes. So liberated toxins can be leading to making you feel worse even though you are making healthier choices.
So What To Do About It?
Make sure that your body fat loss and your detoxification capability keep up with each other. In my office I look at the amount of fluid retained outside the cells. If you lose body fat you need to make sure that your extracellular water also goes down. If the extracellular water goes up with body fat loss it is a sure sign of toxicity, since the solution to pollution is dilution.
In some cases we will use a healthy diet, supplements, exercise, and stress management program and periodically pause the program to support detoxification for a couple of days…or even a couple of weeks in some cases.
(2) Stress
The stress associated with the new diet, the increased exercise, the learning curve can all lead to depletion of the hormone called DHEA. This depletion of DHEA can lead to downstream depletion of estrogens which are required in the healthy form and in the healthy amount. If you combine a stressful job, stress in the home, stress in the finances, or any other stress with the stress of weight loss this could tip the scales on your hormones. If this happens you may find yourself feeling worse with weight loss than before.
So What To Do About It?
We can measure the stress response in a number of different ways. The easiest is really to look at a series of key questions that can help uncover your particular stress type. By knowing this, you can use appropriate adaptogenic herbs that can gently nurture your adrenals back to health and calm the abnormal adrenal stress response. Another way is to look at a number of markers on the in-office testing we do with the Integra profile that looks at urinary chlorides, urinary vitamin C and urinary electrolytes.
In some cases an Adrenal Stress Index is warranted. This test actually measures the hormones of cortisol, DHEA and insulin with a series of saliva samples. This test is very useful in cases of resistant weight loss, chronic stress, depression, anxiety and fatigue.
(3) Decreased Aromatase Activity
Body fat contains an enzyme called aromatase that is responsible for the conversion and synthesis of estrogens. If you lose body fat you may actually lose the activity of the aromatase enzyme and remove some of the reserve your body was using to manufacture more estrogens.
So What To Do About It?
The real key here is to manage the stress response as well, so all the recommendations in the second point would hold true here as well.
If you are committing to a healthier lifestyle, weight loss, improved body composition and overall wellness, then you are on the right track! Don’t let symptoms that may arise discourage you and hinder your progress. Definitely don’t let these things make you stop the healing process! Find someone that understands wellness and can look at your thoroughly to find and correct any underlying imbalances. Work with a clinical nutritionist that can evaluate you properly with a physical examination, diagnostic testing and complete medical history.
Your body gives you signs, we just have to learn how to read them!
