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Brain Health in Menopause (Part 1)

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If you are over 40, maybe you can relate to walking into a room and wondering why you were there? Or running around looking for your keys and finding out they were in your hand the entire time?  Or maybe you just can’t remember phone numbers or names as well as you used to?  These are the moments that you wonder if it’s just normal aging or if you are literally losing your mind.  As we enter menopause, it’s time to consider the steps we need to take to preserve our brain health and prevent cognitive decline.  

As we get older, some of us may be caring for parents who suffer from varying degrees of dementia or possibly Alzheimer’s disease.  Losing our mental ability and function is the #1  fear we have in aging but does it have to be?  Statistics show that 1 in 8 senior citizens develop Alzheimer’s Disease (AD). Is there something we are doing, or not doing, to preserve our brain health for ourselves and our families? 

In the last 5 years alone, the research around preserving our brain health has exploded in the functional medicine community. It is encouraging to  know that we can be in control of our brain health by the way we live our lives: diet, nutrition and exercise.  I encourage you to read Dr. Dale Bredeson’s book, The End of Alzheimer’s for the prevention of this type of brain decline.

Neurotransmitters involved in overall brain health:

  • Serotonin– for happiness and joy
  • Dopamine – for experiencing pleasure, motivation
  • Acetylcholine– for learning and memory
  • GABA – for relaxation and calm, sleep

Menopause

As we enter peri-menopause, approximately 8-10 years prior to menopause – or when menstrual cycles stop- our brains seem to change profoundly as we experience viscous mood swings that make us question our sanity! It is often treated as normal and ‘just a part of menopause’ but it’s not normal and we can do something about it. These changes in moods, depression & anxiety is caused from hormone-driven neurotransmitter imbalances, or our brain chemistry.

Our neurotransmitters rely on hormonal balance for receptor site sensitivity and  effective communication.

Andropause 

As Men enter this phase of life called andropause, or male menopause, and hormone imbalance impacts neurotransmitters that creates the tired, ‘grumpy old man’ syndrome we associate as normal in middle age. We know that low testosterone causes depression in men but more importantly, it’s a sign of brain degeneration of the frontal lobe. Statin-drugs, are known to lower testosterone in men and also tend to drive the cholesterol below 150 which is also detrimental for brain health
.

There is good news. We can help ourselves, and the men & women in our lives, to be pro-active in preserving our hormone balance & brain health.

Women can target hormone imbalance with adrenal or thyroid support, stabilizing blood sugar or bio-identical hormone therapy, if needed, for optimal brain functioning. 

      • Women with low estrogen levels can cause many of the symptoms we experience heading into menopause such as depression, anxiety and sleep disorders.  Knowing if your estrogen is high or low is essential for healthy serotonin levels.
      • Women who struggle with high testosterone levels  tend to have insulin resistance and can re-balance with a low-carb, slow-carb lifestyle.  High testosterone also causes lower estrogen & progesterone levels that neurotransmitters need to function at their best.
      • In men, chronically high blood sugar or diabetes contributes to low testosterone by the conversion of testosterone to estrogen through an enzyme called aromatase.  As estrogen rises, insulin becomes resistant and blood sugar stays elevated – a viscous cycle.
      • Men can raise testosterone and lower estrogen by eliminating sugar & refined carbohydrates, excessive alcohol, and processed foods.
      • Men are encouraged to follow an anti-inflammatory diet and manage stress for hormone balance.
      • Warning for men: supplementing with Testosterone  without dietary & lifestyle changes will end in frustration as the testosterone continues to be aromatized, increasing estrogen instead of testosterone.
      • Men need to make these necessary dietary and lifestyle changes to improve testosterone levels that improve moods, motivation and brain health.  It’s always important to ask why the Testosterone level is low and start from there.

Thyroid-Brain Connection

We also have to be proactive if we have thyroid conditions, even if you are taking thyroid medication, as the thyroid hormone significantly impacts our brain health. Brain-related symptoms are connected to poor thyroid function caused by a significant imbalance of our neurotransmitters in both men and women.

Shockingly, of all the women who complain of brain fog, forgetfulness, depression, anxiety or fatigue and have hypothyroid condition, 60% will go undiagnosed. The American Thyroid Association states that 1 in 8 women will suffer from a thyroid condition. Furthermore, undiagnosed hypothyroidism causes serious conditions such as cardiovascular diseases, osteoporosis and infertility. The first step in prevention is to get screened with the correct labs – the full thyroid panel with antibodies, not only the TSH.  Please refer to my blog post on Thyroid Health to learn more.

How to Support Your Neurotransmitters:

      1. Serotonin:  requires adequate estrogen to sensitize receptors, adaquate protein, iron,  5-HTP is a precursor to serotonin and can improve low mood and poor sleep, P5P (B6), methylcobalamine (B12), magnesium and folate (5-mthf) are essential for the production of serotonin.
      1. GABA: is supported by progesterone, valerian root, phenibut, L-theanine, tourine, and precursors P5P (B6), zinc, manganese, and magnesium.  Many people who suffer from GABA-related issues could also be gluten-intolerant which may mount an auto-immune response to the enzyme responsible for making GABA in the brain. *GABA supplementation does not cross blood-brain barrier unless leaky brain is present.
      1. Dopamine: supported by testosterone in men & progesterone in men and women, high protein (beef, chicken fish, eggs, chocolate) provides phenylalanine or N-acetyl l-tyrosine, adequate iron, P5P (B6), folate (5-mthf) or green leafy vegetables.
      1. Acetylcholine (poor memory, difficulty with numbers, decreased creativity): supported by estrogen in women and testosterone in men, adequate choline in the diet including eggs, tofu, nuts and cream/milk. Fat-free diets and gallbladder disorders may cause deficiency of this neurotransmitter. Estrogen & testosterone improve receptor sensitivity with clear, focused thinking.
      1. DHA from Fish oil and other essential fatty acids like fish, nuts, seeds, olive oil and avocados are essential for brain health- but DHA, a component of fish oil, is specific for targeting the brain for improved memory.
      2. Thyroid Hormone impacts all neurotransmitter receptors in men and women. It is important to check for autoimmune antibodies if you are diagnosed with hypothyroid/hyperthyroid so you are able to support calming the immune response with Vit D, fish oil EPA/DHA and supporting proper thyroid function with nutrients like zine & selenium.

We can make an informed effort to control our health and, ultimately, our destiny, but many people don’t realize what they are experiencing as nagging symptoms may be brain inflammation and decline.

  • Depression or anxiety
  • Poor focus or memory
  • Worsening constipation or digestive disorders 

The key is prevention, click here to for simple steps take: Brain Health (Part 2) – A guide for prevention of decline

If you are a women and want to continue the conversation, I invite you to join our new private Facebook group, MoreThanMenopause for weekly FB live with Q & A.  What are you waiting for? We are excited to meet you!

 

Resources:

https://kupdf.com/download/why-isn39t-my-brain-working_597ed1fadc0d60695f2bb17f_pdf

https://www.thyroid.org/media-main/about-hypothyroidism/

http://www.biologicalpsychiatryjournal.com/article/S0006-3223(11)01193-0/fulltext

https://academic.oup.com/biomedgerontology/article/61/11/1166/630432

https://www.amazon.com/End-Alzheimers-Program-Prevent-Cognitive/dp/0735216207

Brain Health in Menopause (Part 2)

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Brain Health in Menopause/Andropause – A Guide to Brain Health

Prevention of brain deterioration is possible when we know what harms our brain as well as what we can do to support our brain health, and ultimately, the quality of our lives as we age. We can take control of our health by making informed choices that truly prevent or reverse chronic conditions that in the past seemed to be blamed on simply  ‘luck of the draw’.  Here is your guide for prevention.  For Brain Health in Menopause (Part 1), click here.

 

  1. Balance your Blood Sugar: According to a study in The New England Journal of Medicine in 2013, elevated blood sugar -even without Diabetes – was shown to be a risk factor for developing dementia, or decreased brain function.  Insulin resistance is one of the most studied areas involving risk for Alzheimer’s disease and has been referred to as Type 3 Diabetes – as it damages brain circulation and tissue.  In insulin resistance, glucose has difficulty entering your cells, including your brain cells, and therefore, is deprived of it’s main food source.  Too much glucose & insulin in the blood, and too little in the actual cell. If you feel sleepy after a meal, you could be suffering from insulin resistance.
      1. Focus on more vegetables, lean protein and ‘slow carbs’ like sweet potato and quinoa
      2. No snacking: allow your body to use your glucose reserves between healthy meals to avoid the blood-sugar roller-coaster 
      3. Fiber & good fats help to slow glucose metabolism and help you stay away from sugar cravings.  Try ground flax seeds, chia seeds, avocado, olive oil, free-range eggs and wild-caught fish
      4. Read Dr. David Perlmutter’s book: Grain Brain for more information on how a high carbohydrate diet high in gluten & grains affects your brain.  https://www.drperlmutter.com/about/grain-brain-by-david-perlmutter/

  1. Reduce Stress: A shocking Yale study shows that our prefrontal brain actually shrinks when exposed to high levels of stress. They found that even the brains of subjects who had only recently experienced a stressful life event showed markedly lower gray matter in portions of the medial prefrontal cortex, an area of the brain that regulates not only emotions and self-control, but physiological functions such as blood pressure and glucose levels. So stress not only damages our brains, but also prevents us from dealing with stressful situations in the future. Again, prevention is key! 
      1. Reduce stress with mindfulness practices: HeartMath (heart math.org), meditation, yoga, acupuncture, qi gong and tai chi.
      2. Remove stress on your physical body such as inflammation from poor diet, too much alcohol/smoking, food allergies/sensitivities, gut infections, dental infections, heavy metal toxicity, neurotoxins (aspartame, excessive alcohol, pesticides)
      3. Pin point source of stressors in your life and find specific ways to reduce or become more resilient with proper brain nutrition and lifestyle. High cortisol also causes a deficiency of DHEA & pregnenolone which are the building blocks of our hormones.  Please read my blog post about Adrenal Health.
  1. Feed your Brain: Your neurons require glucose, oxygen & stimulation for healthy functioning. Inflammation, hormone imbalance or poor blood sugar control all contribute to an imbalance of neurotransmitter communication. An anti-inflammatory diet, targeted nutrition and botanicals can impact brain chemistry in a way that most medications cannot.
      1. Vitamins & minerals for neurotransmitter production:  B vitamins (B6, B12, B3 (riboflavin), Folate), zinc, magnesium, manganese
      2. Good fats:  Essential fatty acids (EFAs) are essential for your brain! EPA/DHA in fish oil, avocado, nuts, seeds, olive oil.  EPA is great for inflammation but DHA specifically targets the brain and memory. C
      3. Supplements: Serotonin boosters- 5 HTP, St John’s Wort, SAMe. GABA boosters- valarian root, L-theanine, taurine. Dopamine boosters- Macuna pruriens, PEA (chocolate) anti-oxidants like blueberry extract, alpha-lipoid acid, liposomal glutathione or N-acetylcysteine
      4. Iron: low iron or anemia inhibits the production of neurotransmitters and can be caused by low dietary intake, low iron absorption with hypothyroidism or low Hydrochloric acid, heavy menstrual bleeding or uterine fibroids.

4.  Exercise your Brain: Your brain requires good oxygenated blood flow to be healthy. Red

     flags that you may have poor blood flow to your brain include cold hands & feet, 

     hypoglycemia or diabetes, low blood pressure, low iron or anemia, or sedentary lifestyle.

      1. Abdominal breathing, allowing abdomen to rise with each inhale, allows for the diaphragm to be fully engaged and fuller breaths for better brain oxygenation.  When we are stressed, we tend to breathe in short, shallow breaths from our chest region only.  By incorporating abdominal breathing, you will feel calmer and your brain will thank you!
      2. Aerobic exercise physically brings oxygenated blood to your brain!  Just find something your enjoy and do it at least 4-5 times a week – dancing, walking, jogging or high intensity interval training (HIIT). A 2006 study from the University of Illinois shows that brains of older adults in those that participated in aerobic activity had significantly less atrophy compared to older adults that engaged in only stretching exercises.

 

5.  The Gut-Brain Axis:  The GI-system and the brain are connected via the vagus nerve that starts at the brain-stem and goes to all the organs, as well as the gut.  We call this the enteric nervous system – our second brain. This is important for brain health for many reasons but specifically for early detection of Parkinson’s Disease or mild cognitive impairment (brain deterioration). 

When the vagus nerve isn’t communicating, there is a higher risk of leaky gut, increase permeability of the intestinal lining, which can lead to leaky brain.  Leaky brain is a permeability of the blood-brain barrier and causes significant brain inflammation. Improving our gut health is important for this reason alone! Constipation or bloating that is progressively getting worse is a sign that the vagus nerve doesn’t work correctly causing slowed motility of the gut and decreased secretions of digestive enzymes. 

Early symptoms include:

      1. Constipation (poor peristalsis or motility)
      2. Difficulty digesting protein and fats (from low hydrochloric acid)
      3. Gastro-esophageal reflux or GERD (from low hydrochloric acid)
      4. Difficulty digesting fats (from low pancreatic enzymes)
      5. Gallbladder disorder (from low pancreatic enzymes)
      6. Leaky gut or increased permeability of the intestinal wall (poor vagal activation)

So you are probably wondering how can we improve function of our vagus nerve? Prolonged gargling of water or singing loudly activate the vagus nerve – like push ups for our gut-brain connection!

Remember, we have choices everyday that guide & determine our health and vitality as we age. In the words of Benjamin Franklin, ‘an ounce of prevention is worth a pound of cure’!

If you want to know more, please schedule a phone consultation to talk about the many ways to promote our brain health!  https://Rgreenberg.intakeq.com/booking

As a gift to yourself, please download this copy of Dr Kharrazian’s book, Why isn’t my brain working? An extremely informative book for anyone, of any age, who wants to prevent brain decline or improve their health.  https://kupdf.com/download/why-isn39t-my-brain-working_597ed1fadc0d60695f2bb17f_pdf

 

Resources:

https://www.thyroid.org/media-main/about-hypothyroidism/

http://www.nejm.org/doi/full/10.1056/NEJMoa1215740

http://www.biologicalpsychiatryjournal.com/article/S0006-3223(11)01193-0/fulltext

https://academic.oup.com/biomedgerontology/article/61/11/1166/630432

Heart Disease Prevention during Menopause & Beyond

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heart healthMenopause doesn’t cause cardiovascular disease, but as women get older, there are diets and lifestyle adjustments that can help decrease your risk for hypertension, unhealthy cholesterol ratios, heart attack and stroke. The American Heart Association states that 1 in 3 women will be affected by heart disease after menopause and is the leading killer of women.

Estrogen and Heart Health

Before the results from the Women’s Health Initiative (WIH) became apparent, doctors routinely prescribed synthetic estrogen or hormone replacement therapy to post-menopausal women to protect them against heart disease. The thinking was that estrogen is protective and important for keeping the arteries healthy for optimal blood flow and prevention of cardiac events as women age. But 5.6 years into the randomized study, researchers found that women taking synthetic estrogen & progestins were actually at a higher risk for heart disease, stroke as well as breast cancer. In fact,  after eight years, the women on combination hormone therapy were 69% more likely to develop heart disease.The study was stopped early as it was apparent that synthetic hormone therapy was not beneficial for preventing heart disease and in fact, put these women at higher risk.1

High Blood Pressure?

Common advice from your doctor decreasing sodium intake to help decrease your blood pressure – but the real problem is often that you are not taking in enough potassium – or not absorbing enough from the fruits & vegetables that you are eating. Often, diuretics will cause this imbalance which can cause a viscous cycle since many people who have high blood pressure are also taking diuretic medications.

Magnesium supplementation also will help to increase absorption of potassium for natural lowering of your blood pressure.

Stress also can cause high blood pressure – it’s important to take a good look at all the stressors in your life and address them one by one to for overall stress reduction. Both physical and mental stress can cause increase cortisol – the stress hormone- that can increase your blood pressure significantly. A daily meditation practice, whether it’s a walking meditation or 5 minutes in the morning and at night, can help the body and mind reconnect for improved stress resiliency and calmer outlook on life events. hypertension

High Cholesterol? All Fat Is Not Created Equal…

We have also been told to decrease fat in our diet when our cholesterol is high but actually, studies show that Excessive amounts of omega-6 polyunsaturated fatty acids (PUFA) and a very high omega-6/omega-3 ratio, as is found in today’s Standard American diets, are the cause of many chronic diseases, including cardiovascular disease, cancer, and inflammatory and autoimmune diseases. Higher omega 3 fatty acid – and lower Omega 6 fatty acid intake often helps to improve risk for heart disease. Improving your Omega 6:3 ratio to less than 4:1 (most people on a standard American diet are 10:1) improves your risk for a cardiac event by 70% over 2 years. But improving your ratio can also decrease your risk for Type 2 Diabetes by decreasing grains and high glycemic carbs for a lower HGbA1c and fasting insulin levels.2

Cholesterol is also used to make hormones like progesterone, testosterone, cortisol; estrogens- driving your cholesterol level below 150 can affect your hormone balance negatively. Cholesterol can be made from almost every cell in our bodies and is extremely important for the health of each cell.

Statin drugs are often recommended by your doctor to decrease cholesterol levels but these drugs can carry risks and are definitely worse for women. Statin drugs, as well as beta-blocker medications for high blood pressure, deplete your body of an enzyme called CoQ10 – causing muscle cramps, muscle fatigue and neuropathic pain, tingling in extremities and even mental confusion or memory problems in the elderly. This enzyme is extremely important for optimal cell functioning for the production of energy or ATP. If taking a statin or beta-blocker medication, take at least CoQ10 100mg/day for adequate replacement and energy production. Supplementing with CoQ10 also has been shown to improve arterial blood flow for decreased hypertension regardless if you are taking statins or not.

Having a high cholesterol level is not always a bad thing, unless this cholesterol is being carried around in the wrong lipoproteins (fats).

For example, having a lot of low density lipids (LDL) lipoproteins is associated with heart disease, while having a lot of high density lipids (HDL) lipoproteins is associated with reduced risk for heart disease- this is the simplified version of the story. But advanced laboratory testing can pinpoint if you are at risk for cardiac disease – looking deeper than HDL and LDL. Looking at the LDL ‘particle number’ as well as inflammatory markers like homocysteine is a more accurate risk factor that is rarely measured but an important way to look deeper into your heart health. Interesting to note that refined sugars and carbohydrates- and not fat- are what increases LDL particle number.3

Calcium Intake and Arterial Plaque

In menopause, we are often told to increase our calcium for our bone health. Sounds logical but we are now finding too much of the wrong calcium supplementation can actually increase our risk for atherosclerosis (plaque in our arteries) from calcium being deposited into the lining of our arteries – putting women at risk for heart attack. Many studies confirm the dangers of traditional calcium supplementation – especially when taken without Vitamin D3, magnesium, and Vitamin K2. Vitamin K2 assures that the calcium supplementation that is being taken into the body gets deposited into the bones – and not the arteries or kidneys. Post-menopausal women should increase their intake of green leafy vegetables and food-based, calcium (non-dairy if possible). If taking calcium supplementation, doses higher than 800mg/day should be avoided as the focus should be on calcium-rich foods for proper absorption and bone health.

Path Toward Prevention

It is easy to feel overwhelmed and not sure of what to do or what steps to take for proper heart health. Here are 5 steps you can take today to start your path toward prevention:love your heart

  1. Fiber: Flaxseeds are tiny seeds that contain soluble fiber, lignans, and plant-based omega-34 fats. All of these components may have an effect on the health of arteries or the level of blood cholesterol. As a bonus for women, lignans found in ground flax seeds help to eliminate estrogens from the body that can cause cancer. Increase your soluble fiber with vegetables and whole grains as well – oat bran in particular. A large 2015 review on the metabolic effect of oats on type 2 diabetes and Cholesterol levels. The study concluded that oat fiber significantly reduced fasting blood sugar, total cholesterol and LDL lipoprotein cholesterol levels. A meal consisting of oatmeal also reduced the post-meal blood sugar and insulin response making it the ultimate ‘slow carb’ for a low glycemic diet. Increase oat bran to 35-50gms/day to improve your LDL particle numbers and blood sugar.
  2. Supplements: magnesium, CoQ10, Vit D3, Vit K2 are all important supplements and can often be found combined in high-quality supplement brands for your heart health.
    Omega-3 fish oil, avocado, or cooking with avocado oil and olive oil as well as grass-fed beef are all great sources of Omega 3 fatty acids to add to your daily diet. The elimination of vegetable oils, transfats and minimal intake of commercial red meat can help decrease your omega 6 intake to improve your 6:3 ratio.
  3. Pay attention to your heart energy – The Heart Math Institute (heart math.org) has numerous studies explaining the importance of connecting with your heart in meditation for stress reduction and improved stress resilience in our everyday lives. Science meets mind-body medicine! Heartmath.org

Diet & Lifestyle is more important than your genetics and your genetics are not your destiny. There is much talk about your DNA profile or maybe your family history of heart disease and stroke. It is good to know your risk but it can be overwhelming. Even if you have specific genetic polymorphisms (SNPS) that put you at risk, daily choices about your diet, exercise and stress levels may be more important for prevention or reversal of heart disease. If you have a family history of high blood pressure, heart attack or stroke, it is empowering to know what you can do to prevent heart disease to make positive changes in your family history.

If you would like more information about women’s heart health programs, schedule your FREE 15 minute phone consultation – Learn how to become a Partner in your own Hormonal Health!

 

 

References:
Writing Group for the Women’s Health Initiative Investigators. Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal WomenPrincipal Results From the Women’s Health Initiative Randomized Controlled Trial. JAMA. 2002;288(3):321–333. doi:10.1001/jama.288.3.321. Retrieved from https://jamanetwork.com/journals/jama/fullarticle/195120

US National Library of Medicine National Institutes of Health. The importance of the ratio of omega-6/omega-3 essential fatty acids. Simopoulos AP. Biomed Pharmacother. 2002 Oct;56(8):365-79. Review. PMID: 12442909. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/12442909

ScienceDirect.com. Effects of coenzyme Q10 on vascular endothelial function in humans: A meta-analysis of randomized controlled trials. October 25, 2011. https://www.sciencedirect.com/science/article/pii/S0021915011010173

Nordqvist, Christian. (2017, December 20). Can fish oils and omega-3 oils benefit our health?  https://www.medicalnewstoday.com/articles/40253.php

American Heart Association. (2015, July). Menopause and Heart Disease. Retrieved from http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Menopause-and-Heart Disease _UCM_448432_Article.jsp#.Wox736inHIU

US National Library of Medicine National Institutes of Health. A low-carbohydrate/high-fat diet reduces blood pressure in spontaneously hypertensive rats without deleterious changes in insulin resistance. Am J Physiol Heart Circ Physiol. 2013 Jun 15;304(12):H1733-42. doi: 10.1152/ajpheart.00631.2012. Epub 2013 Apr 19. PMID: 23604708. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23604708

BMJ 2013;346:f228. Long term calcium intake and rates of all cause and cardiovascular mortality: community based prospective longitudinal cohort study. Retrieved from http://www.bmj.com/content/346/bmj.f228%20

BMJ 2010;341:c3691. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. Retrieved from http://www.bmj.com/content/341/bmj.c3691