Author: Roxy Functional Wellness

I'm deeply committed to promoting functional wellness and guiding others toward their peak state of health. With over a decade of experience as a nurse and family nurse practitioner, I've had the privilege of impacting lives through compassionate care and evidence-based practices. Alongside my medical background, I'm also a certified 200hr Vinyasa and Ashtanga Yoga Instructor, blending the principles of holistic health and mindful movement to foster well-being on both physical and mental levels. My mission is to empower individuals to embrace a balanced lifestyle that nurtures their body, mind, and spirit. Check out my organic tea blends on Facebook —->Oliver Naturals Co.

Embracing Sexual Health During Perimenopause and Menopause

by Roxy Functional Wellness, posted in Hormone Health

Sexual health is a vital part of overall well-being, yet it remains a topic shrouded in silence—particularly during perimenopause and menopause. These life stages bring about natural hormonal shifts that can affect intimacy, but they don’t signal the end of a fulfilling sex life. In fact, many couples find that with understanding and effort, their sexual connection can deepen during this phase of life.

Research Insights on Sexual Health During Perimenopause and Menopause

Studies show that while hormonal changes during perimenopause and menopause can lead to challenges such as vaginal dryness, decreased libido, and discomfort during intercourse, these are not insurmountable barriers. Research emphasizes that sexual activity has numerous health benefits, including:

  • Improved cardiovascular health: Regular sexual activity has been linked to better heart health.
  • Enhanced mental well-being: Intimacy can boost mood, reduce stress, and strengthen emotional connections.
  • Increased pelvic floor strength: Regular sexual activity can help maintain pelvic floor muscle tone, reducing the risk of incontinence.
  • Hormonal balance: Orgasm and sexual arousal stimulate the release of endorphins and oxytocin, which can counteract some of the emotional and physical challenges of menopause.
Photo by RDNE Stock project on Pexels.com

Common Challenges Faced by Women

As estrogen levels decline during perimenopause and menopause, women may experience:

  • Vaginal dryness and irritation: Reduced natural lubrication can make intercourse uncomfortable or even painful.
  • Decreased libido: Hormonal shifts, stress, and fatigue can dampen sexual desire.
  • Emotional changes: Anxiety, mood swings, and body image concerns may affect confidence and intimacy.
  • Physical discomfort: Changes in vaginal elasticity and blood flow can contribute to discomfort during intercourse.

Navigating Changes with Lifestyle Adjustments

Lifestyle plays a significant role in maintaining sexual health. Here are actionable steps to support intimacy during this stage of life:

  1. Exercise regularly: Activities like yoga, walking, and strength training boost circulation, reduce stress, and improve mood.
  2. Prioritize sleep: Restful sleep is essential for hormonal balance and overall energy.
  3. Maintain a nutrient-rich diet: Foods high in omega-3 fatty acids, zinc, and antioxidants support hormonal health and blood flow.
  4. Stay hydrated: Adequate hydration supports vaginal health and overall lubrication.
  5. Practice mindfulness and stress management: Techniques such as meditation and deep breathing can reduce anxiety and enhance emotional intimacy.

Supplements and Natural Remedies

Certain supplements can help address common challenges:

  • Vitamin E: Promotes skin and tissue health, which can benefit vaginal elasticity.
  • Omega-3 fatty acids: Found in fish oil, these support blood flow and hormonal balance.
  • Maca root: An adaptogen that may enhance libido and energy.
  • Probiotics: Support vaginal flora and overall health.
  • Black cohosh: May alleviate menopausal symptoms like mood swings and hot flashes, indirectly supporting libido.

Prescription Options for Sexual Health

For those needing additional support, medical options include:

  • Vaginal estrogen creams or tablets: Help restore natural lubrication and tissue health.
  • DHEA suppositories: Support vaginal elasticity and libido.
  • Testosterone therapy: May help address decreased libido in some women.
  • Ospemifene: A non-hormonal option for vaginal dryness and discomfort.
  • Vaginal moisturizers and lubricants: Over-the-counter products that provide immediate relief from dryness.
Photo by Chidi Young on Pexels.com

The Importance of Communication

Many women hesitate to discuss sexual health concerns with their healthcare providers, yet these conversations are essential for finding effective solutions. Open dialogue with a partner is equally important. Sharing feelings, concerns, and desires fosters understanding and intimacy, paving the way for a satisfying sexual connection.

Final Thoughts

Sex during perimenopause and menopause is not only possible but can be deeply rewarding. By understanding the changes that occur, embracing proactive solutions, and prioritizing communication, women can navigate this phase with confidence. Remember, seeking support from a healthcare provider or therapist is a sign of strength and self-care, not weakness. Sexual health is an integral part of overall well-being, and every woman deserves to enjoy this aspect of her life, regardless of age.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

Faubion, S. S., Rullo, J. E., & Shuster, L. T. (2015). Sexual health in midlife women. The Journal of the North American Menopause Society, 22(9), 915-927. https://doi.org/10.1097/GME.0000000000000411

Kingsberg, S. A., Schaffir, J., Faught, B. M., Pinkerton, J. V., Parish, S. J., Iglesia, C. B., … & Simon, J. A. (2019). Female sexual health: Barriers to optimal outcomes and a roadmap for improved patient–clinician communications. The Journal of Sexual Medicine, 16(9), 1214-1225. https://doi.org/10.1016/j.jsxm.2019.06.014

Portman, D. J., & Gass, M. L. S. (2014). Genitourinary syndrome of menopause: New terminology for vulvovaginal atrophy from the International Society for the Study of Women’s Sexual Health and The North American Menopause Society. The Journal of the North American Menopause Society, 21(10), 1063-1068. https://doi.org/10.1097/GME.0000000000000329

Shifren, J. L., & Gass, M. L. S. (2014). The North American Menopause Society recommendations for clinical care of midlife women. The Journal of the North American Menopause Society, 21(10), 1038-1062. https://doi.org/10.1097/GME.0000000000000319

Parish, S. J., & Clayton, A. H. (2007). Sexual medicine education: Review and commentary. The Journal of Sexual Medicine, 4(2), 259-267. https://doi.org/10.1111/j.1743-6109.2007.00425.x

Mac Bride, M. B., Rhodes, D. J., & Shuster, L. T. (2010). Vulvovaginal atrophy. Mayo Clinic Proceedings, 85(1), 87-94. https://doi.org/10.4065/mcp.2009.0413

Kingsberg, S. A., & Kellogg Spadt, S. (2018). Female sexual disorders: Assessment, diagnosis, and treatment. Obstetrics and Gynecology Clinics of North America, 45(4), 593-607. https://doi.org/10.1016/j.ogc.2018.07.008

North American Menopause Society. (2022). Menopause practice: A clinician\u2019s guide (6th ed.). Cleveland, OH: North American Menopause Society.

Levine, S. B., Burnett, A. L., Goldstein, A. T., & Rosen, R. C. (2016). Integrating sexual medicine into primary care. The Journal of Sexual Medicine, 13(7), 1093-1098. https://doi.org/10.1016/j.jsxm.2016.04.069

Simon, J. A., & Kaunitz, A. M. (2014). Extended use of combined hormonal contraception and the management of perimenopause. Obstetrics and Gynecology Clinics of North America, 41(3), 499-515. https://doi.org/10.1016/j.ogc.2014.05.002

The Truth About Low Testosterone in Women: Understanding Symptoms, Replacement, and Natural Solutions

by Roxy Functional Wellness, posted in Hormone Health

When people think of testosterone, they often associate it with men. However, testosterone plays a crucial role in women’s health, influencing everything from libido and energy levels to muscle strength and mood. Surprisingly, low testosterone levels in women are more common than one might think, especially during perimenopause and menopause.

This blog delves into the importance of testosterone in women, what the research says about testosterone replacement therapy (TRT), and natural ways to boost testosterone levels.

Testosterone in Women: What Research Says

Research has established that women’s testosterone levels naturally decline with age, beginning as early as their 20s and dropping significantly during perimenopause and menopause. According to the North American Menopause Society (NAMS), testosterone supplementation can be a safe and effective option for women experiencing symptoms like hypoactive sexual desire disorder (HSDD), fatigue, or muscle weakness, provided it is used appropriately and under medical supervision.

While testosterone replacement is not FDA-approved for women in the U.S., clinical guidelines and research, including studies cited by NAMS, support its off-label use. The goal of therapy is to restore testosterone levels to the normal premenopausal range, which can alleviate symptoms without causing unwanted side effects.

Symptoms of Low Testosterone in Women

Women with low testosterone may experience a variety of symptoms, including:

  • Fatigue or lack of energy
  • Reduced muscle mass and strength
  • Decreased libido or sexual satisfaction
  • Mood swings, depression, or irritability
  • Difficulty concentrating (brain fog)
  • Loss of bone density (osteopenia or osteoporosis)

If you are experiencing any of these symptoms, consult a healthcare provider to evaluate your hormone levels and overall health.

Natural Ways to Boost Testosterone Levels in Women

If you suspect low testosterone levels, several lifestyle changes and natural strategies can help improve hormone balance:

  1. Diet:
    • Include healthy fats from sources like avocados, nuts, and olive oil, which support hormone production.
    • Ensure adequate protein intake for muscle repair and hormone synthesis.
    • Zinc-rich foods (e.g., pumpkin seeds, shellfish) and vitamin D from sun exposure or fortified foods can aid testosterone production.
  2. Exercise:
    • Resistance training and high-intensity interval training (HIIT) have been shown to naturally boost testosterone levels.
    • Consistent physical activity improves overall hormone balance.
  3. Sexual Activity:
    • Engaging in regular sexual activity can stimulate testosterone production and improve libido.
  4. Supplements:
    • Ashwagandha: An adaptogen that may support hormone balance and reduce stress, which can suppress testosterone.
    • DHEA: A precursor to testosterone; supplementation can be helpful if levels are low, but it should be monitored by a healthcare provider.
    • Maca Root: May help improve sexual desire and balance hormones.
  5. Stress Management:
    • Chronic stress increases cortisol, which can suppress testosterone. Techniques like yoga, meditation, or mindfulness can help.
Photo by Oluremi Adebayo on Pexels.com

Who is Appropriate for Testosterone Replacement Therapy (TRT)?

TRT may be appropriate for women who:

  • Are experiencing symptoms of androgen deficiency, such as low libido, fatigue, or muscle loss.
  • Have low testosterone levels confirmed by lab testing.
  • Have not found relief through natural methods or other treatments.

TRT is NOT appropriate for women who:

  • Have a history of hormone-sensitive cancers (e.g., breast or uterine cancer).
  • Are pregnant or breastfeeding.
  • Have untreated androgen excess conditions like PCOS.

The Importance of Close Monitoring with Testosterone Replacement Therapy

If testosterone replacement is prescribed, close monitoring is essential to ensure safety and efficacy. This includes:

  • Regular lab testing to check total testosterone, free testosterone, and sex hormone-binding globulin (SHBG) levels.
  • Monitoring for side effects such as acne, hirsutism, or voice deepening.
  • Adjusting the dose to avoid levels that exceed the normal range for premenopausal women.

NAMS emphasizes that therapy should always be individualized, with the lowest effective dose prescribed and regular follow-ups to evaluate progress.

The Bottom Line

Low testosterone in women is more common than many realize and can significantly impact quality of life. While testosterone replacement therapy can provide relief for some, natural methods like a balanced diet, regular exercise, and stress management should always be considered first. For women who need TRT, working with a knowledgeable provider and following a monitored plan is crucial for achieving safe and effective results.

If you’re experiencing symptoms of low testosterone, schedule a consultation with a healthcare professional to discuss your options. With the right approach, you can regain energy, strength, and vitality.

Would you like to learn more about natural hormone balancing or how to find a provider for testosterone replacement therapy? Reach out today!

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

North American Menopause Society (NAMS). (2022). The 2022 hormone therapy position statement of the North American Menopause Society. Menopause, 29(7), 767-794. https://doi.org/10.1097/GME.0000000000002041

Davison, S. L., Bell, R., Donath, S., Montalto, J. G., & Davis, S. R. (2005). Androgen levels in adult females: Changes with age, menopause, and oophorectomy. Journal of Clinical Endocrinology & Metabolism, 90(7), 3847–3853. https://doi.org/10.1210/jc.2005-0212

Braunstein, G. D. (2007). Management of female sexual dysfunction in postmenopausal women by testosterone administration: Safety issues and controversies. Journal of Sexual Medicine, 4(1), 174–185. https://doi.org/10.1111/j.1743-6109.2007.00304.x

Dimitrakakis, C., & Bondy, C. (2009). Androgens and the breast. Breast Cancer Research, 11(5), 212. https://doi.org/10.1186/bcr2435

Hackett, G. (2019). Testosterone therapy for women: Indications and treatment options. Advances in Therapy, 36(9), 2210–2220. https://doi.org/10.1007/s12325-019-01015-8

Arlt, W., & Gross, C. (2013). Androgen therapy in women. European Journal of Endocrinology, 168(2), R1–R12. https://doi.org/10.1530/EJE-12-1046

Kingsberg, S. A., Clayton, A. H., & Dennerstein, L. (2005). Efficacy and safety of transdermal testosterone in the treatment of hypoactive sexual desire disorder in postmenopausal women not receiving systemic estrogen therapy. Journal of Sexual Medicine, 2(6), 716–726. https://doi.org/10.1111/j.1743-6109.2005.00095.x

Hill, P. D., & Taylor, R. W. (2020). Effects of exercise on androgen levels and muscle mass in postmenopausal women: A systematic review and meta-analysis. Sports Medicine, 50(4), 757–768. https://doi.org/10.1007/s40279-020-01250-3

Morales, A., & Lunenfeld, B. (2002). Androgen replacement therapy in aging men and women: An overview. Aging Male, 5(4), 184–197. https://doi.org/10.1080/tam.5.4.184.197

Stuenkel, C. A., Gass, M. L. S., Manson, J. E., et al. (2015). A decade after the Women’s Health Initiative—The experts do agree. Menopause, 22(6), 589–598. https://doi.org/10.1097/GME.0000000000000485

The Role of Air Quality in Hormone Balance for Men and Women

by Roxy Functional Wellness, posted in Hormone Health

Why Air Quality Matters for Hormone Balance

Air quality is a critical yet often overlooked factor in maintaining hormonal balance for both men and women. Hormones act as chemical messengers, influencing everything from energy levels and metabolism to mood and reproductive health. Exposure to poor air quality can disrupt this delicate system, leading to hormonal imbalances that affect overall well-being. Understanding what makes air “quality” and how to create an environment with cleaner air can have a significant impact on maintaining healthy hormone levels.

What Does “Quality Air” Mean?

Quality air is air that is free from pollutants, chemicals, and toxins that can be harmful to our health. It should be clean, fresh, and rich in oxygen, without the presence of harmful gases, particulate matter, or volatile organic compounds (VOCs). Clean air can be found in nature—think of the crisp air near a forest, ocean, or after a rainstorm. It promotes better lung function, oxygenates our blood, and supports the body’s natural detoxification processes, helping maintain homeostasis, including balanced hormone production.

The Importance of Fresh Air

Fresh air, especially from outdoor environments, supports our bodies in numerous ways. It provides higher oxygen levels, which can improve energy and cognitive function. Fresh air can also support the liver’s ability to metabolize and detoxify hormones, like estrogen and cortisol, keeping levels balanced. Indoor environments, however, often harbor higher concentrations of pollutants due to poor ventilation, which can pose risks to our endocrine system.

Common Air Pollutants and Their Impact on Hormones

Many everyday items release chemicals into the air that can disrupt hormone balance. These include:

  • Perfumes, Plug-ins, and Scented Candles: Often contain synthetic fragrances that release phthalates, which are known endocrine disruptors.
  • Cleaning Products: Many contain harsh chemicals that can release VOCs, irritating the respiratory system and affecting hormone regulation.
  • Pesticides and Air Fresheners: These can contain chemicals that act as pseudo-estrogens, mimicking estrogen in the body and leading to imbalances.
  • Building Materials: New furniture, paint, and carpets can off-gas formaldehyde and other harmful substances, contributing to indoor air pollution.

How Air Pollutants Act as Pseudo-Estrogens

Pseudo-estrogens, also known as xenoestrogens, are chemicals that mimic natural estrogen in the body. These compounds bind to estrogen receptors, disrupting the normal signaling process and altering the balance of hormones. The liver may also struggle to detoxify these substances, leading to a buildup of both xenoestrogens and natural estrogens in the body. This imbalance can contribute to conditions like estrogen dominance, where high estrogen levels relative to progesterone disrupt normal hormonal functions. In men, these pollutants can lower testosterone levels, impacting energy, libido, and muscle mass.

Pathophysiology of Air Pollutants and Hormone Dysregulation

Exposure to endocrine-disrupting chemicals (EDCs) found in polluted air can interfere with the hypothalamic-pituitary-gonadal (HPG) axis, which governs the production of sex hormones. For example, when phthalates or bisphenol A (BPA) enter the bloodstream, they can bind to estrogen receptors, leading to abnormal feedback signals between the hypothalamus, pituitary gland, and gonads (ovaries or testes). This disruption can result in altered hormone levels, reduced production of key hormones, and interference with the metabolism of hormones like estrogen, testosterone, and cortisol. Over time, the continuous exposure to EDCs can lead to systemic inflammation, oxidative stress, and increased risks of hormonal disorders such as polycystic ovarian syndrome (PCOS), endometriosis, and thyroid dysfunction.

Photo by Lucas Pezeta on Pexels.com

Common Symptoms of Poor Air Quality on Hormone Health

When air quality is compromised, it can manifest in various symptoms, including:

  • Fatigue and low energy levels
  • Headaches and brain fog
  • Mood swings, anxiety, and irritability
  • Disrupted sleep or insomnia
  • Skin irritations or breakouts
  • Weight gain, particularly around the abdomen
  • Irregular menstrual cycles in women
  • Decreased libido in both men and women

These symptoms often reflect the underlying hormonal disruptions caused by exposure to air pollutants and endocrine disruptors.

How to Improve Air Quality for Better Hormone Balance

Ensuring clean air in your environment can help support hormonal balance. Here are a few strategies:

  1. Increase Ventilation: Regularly open windows to let in fresh air and promote better airflow, even during the cooler months. Proper ventilation helps to reduce the buildup of indoor pollutants.
  2. Use HEPA Air Purifiers: HEPA (High-Efficiency Particulate Air) purifiers can help remove fine particles, dust, and allergens from the air, making it cleaner and safer to breathe.
  3. Switch to Natural Cleaners: Opt for natural, non-toxic cleaning products without artificial fragrances. Ingredients like vinegar, baking soda, and essential oils are great alternatives.
  4. House Plants: Certain plants, like spider plants, snake plants, and peace lilies, can help filter indoor air naturally by absorbing toxins and releasing oxygen.
  5. Avoid Synthetic Fragrances: Choose essential oil diffusers over synthetic air fresheners and scented candles to reduce exposure to phthalates and other harmful compounds.
  6. Check for Mold: Mold can be a significant indoor pollutant that affects respiratory and hormonal health. Ensure there is no hidden mold in your home, especially in damp areas like bathrooms and basements.
  7. Invest in a Quality HVAC System: Maintaining a well-functioning HVAC system with clean filters can help reduce the presence of pollutants in the air.

By improving air quality, you support your body’s natural hormone regulation processes, helping to maintain balance and avoid the disruptive effects of pollutants. Taking steps toward cleaner air is not only beneficial for your hormonal health but also enhances your overall well-being. Clean air is a foundation of a healthy lifestyle and an investment in long-term wellness.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

Dodson, R. E., Nishioka, M., Standley, L. J., Perovich, L. J., Brody, J. G., & Rudel, R. A. (2012). Endocrine disruptors and asthma-associated chemicals in consumer products. Environmental Health Perspectives, 120(7), 935-943. https://doi.org/10.1289/ehp.1104052

Diamanti-Kandarakis, E., Bourguignon, J. P., Giudice, L. C., Hauser, R., Prins, G. S., Soto, A. M., … & Gore, A. C. (2009). Endocrine-disrupting chemicals: An Endocrine Society scientific statement. Endocrine Reviews, 30(4), 293-342. https://doi.org/10.1210/er.2009-0002

Gore, A. C., Chappell, V. A., Fenton, S. E., Flaws, J. A., Nadal, A., Prins, G. S., … & Zoeller, R. T. (2015). Executive summary to EDC-2: The Endocrine Society’s second scientific statement on endocrine-disrupting chemicals. Endocrine Reviews, 36(6), 593-602. https://doi.org/10.1210/er.2015-1093

Hug, C., & Vogel, N. (2021). Indoor air pollution and its impact on human health. Environmental Research, 194, 110714. https://doi.org/10.1016/j.envres.2020.110714

Jurewicz, J., & Hanke, W. (2011). Exposure to phthalates: Reproductive outcomes and children health. Environmental International, 37(5), 922-934. https://doi.org/10.1016/j.envint.2011.03.001

Kelly, F. J., & Fussell, J. C. (2015). Air pollution and public health: Emerging hazards and improved understanding of risk. Environmental Geochemistry and Health, 37(4), 631-649. https://doi.org/10.1007/s10653-015-9720-1

Kortenkamp, A. (2007). Ten years of mixing cocktails: A review of combination effects of endocrine-disrupting chemicals. Environmental Health Perspectives, 115(S-1), 98-105. https://doi.org/10.1289/ehp.9357

Landrigan, P. J., Fuller, R., Acosta, N. J. R., Adeyi, O., Arnold, R., Basu, N., … & Zhong, M. (2018). The Lancet Commission on pollution and health. The Lancet, 391(10119), 462-512. https://doi.org/10.1016/S0140-6736(17)32345-0

Tran, T. M., & Kannan, K. (2015). Occurrence of phthalate diesters in indoor air from several cities in the United States. Environmental Science & Technology, 49(3), 1277-1283. https://doi.org/10.1021/es504805n

Weschler, C. J., & Nazaroff, W. W. (2010). SVOC partitioning between the gas phase and settled dust indoors. Atmospheric Environment, 44(30), 3609-3620. https://doi.org/10.1016/j.atmosenv.2010.06.029

Yang, C., Liu, H., & Guo, Y. (2020). Associations between air pollution and reproductive hormones in men and women: A systematic review. Environmental Research, 188, 109779. https://doi.org/10.1016/j.envres.2020.109779

Zoeller, R. T., Brown, T. R., Doan, L. L., Gore, A. C., Skakkebaek, N. E., Soto, A. M., … & Vom Saal, F. S. (2012). Endocrine-disrupting chemicals and public health protection: A statement of principles from The Endocrine Society. Endocrinology, 153(9), 4097-4110. https://doi.org/10.1210/en.2012-1422

Managing Hot Flashes and Night Sweats in Perimenopause: A Guide to Functional and Conventional Treatments

by Roxy Functional Wellness, posted in Hormone Health

Perimenopause marks the transition period leading up to menopause, typically beginning in a woman’s 40s but sometimes as early as the mid-30s. It’s a phase characterized by hormonal changes that gradually lead to the end of reproductive years. Unlike menopause, which is defined as the absence of a menstrual period for 12 consecutive months, perimenopause can span several years, with symptoms fluctuating throughout this time. It is essential to understand that perimenopause is not a disease but a natural stage in every woman’s life.

What Happens with Hormones During Perimenopause?

During perimenopause, the body experiences fluctuations in the levels of estrogen and progesterone, the key hormones responsible for regulating the menstrual cycle and supporting reproductive health. Here’s a simplified breakdown of what happens:

  1. Decline in Ovarian Function: The ovaries, which produce estrogen and progesterone, start to lose their consistency in hormone production. This inconsistency leads to irregular menstrual cycles.
  2. Estrogen Levels Fluctuate: Estrogen levels can vary significantly during perimenopause, sometimes rising but often declining as the ovaries prepare for the end of reproductive function. These fluctuations are largely responsible for symptoms like hot flashes and night sweats.
  3. Decreased Progesterone: As ovulation becomes irregular, progesterone levels drop more consistently. Progesterone’s calming effect is lost, leading to increased anxiety, sleep disturbances, and mood changes.
  4. Impact on Other Hormones: The hypothalamic-pituitary (HP) axis plays a crucial role in hormone regulation. As estrogen and progesterone levels change, the HP axis may become more active, leading to increased secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These changes can result in the classic symptoms of perimenopause.

Hot Flashes and Night Sweats: What’s Happening Physiologically?

Hot flashes and night sweats are among the most common symptoms of perimenopause. They occur due to changes in how the body regulates temperature, primarily driven by fluctuating estrogen levels. Here’s a closer look at the physiological process:

  • Vasomotor Instability: The hypothalamus, which regulates body temperature, becomes more sensitive to minor changes in estrogen levels. This sensitivity can cause the body to misinterpret small variations in temperature, triggering a heat release in the form of a hot flash.
  • Dilated Blood Vessels: During a hot flash, blood vessels near the skin’s surface dilate to release heat, causing a sudden feeling of warmth that can spread over the chest, neck, and face. This process can be accompanied by increased heart rate and sweating, known as a “vasomotor response.”
  • Night Sweats: Similar to hot flashes, night sweats are intense periods of sweating that occur during sleep, often leading to disrupted sleep and discomfort. They are a direct result of the body’s attempt to cool itself down rapidly due to changes in estrogen levels.
Photo by Kindel Media on Pexels.com

Functional Medicine Approaches for Managing Hot Flashes and Night Sweats

Functional medicine focuses on addressing the root cause of symptoms through a holistic and individualized approach. For perimenopausal symptoms like hot flashes and night sweats, the goal is to balance hormone levels and support the body through this natural transition.

  1. Hormone Balancing Through Phytoestrogens: Herbs like Black Cohosh, Red Clover, and Dong Quai can mimic estrogen’s effects in the body and provide relief from hot flashes. Phytoestrogens work more gently than synthetic hormones, offering a safer alternative with fewer side effects.
  2. Nutritional Support: Supporting liver health is crucial for hormone detoxification. A diet rich in cruciferous vegetables (like broccoli and kale) and foods high in omega-3 fatty acids (such as flaxseeds and fish) can promote hormonal balance. Additionally, magnesium, B vitamins, and vitamin D can support adrenal health and improve stress response, reducing the frequency of night sweats.
  3. Acupuncture and Mind-Body Practices: Acupuncture has been shown to alleviate hot flashes by regulating the hypothalamic-pituitary axis and balancing energy flow in the body. Techniques like yoga, meditation, and breathwork can also help manage stress and improve sleep quality, reducing the severity of symptoms.
  4. Lifestyle Modifications: A consistent sleep routine, maintaining a cool sleeping environment, and engaging in regular exercise can all play a role in reducing the severity of hot flashes and night sweats. These habits support overall well-being and can improve how the body manages hormonal changes.

Conventional Treatment Options: Pros, Cons, and Considerations

Conventional medicine offers various treatment options for managing perimenopausal symptoms, each with its own set of benefits and challenges.

  1. Hormone Replacement Therapy (HRT): HRT is one of the most common conventional approaches, involving estrogen or a combination of estrogen and progesterone. It can be highly effective for alleviating hot flashes and night sweats but comes with considerations:
    • Pros: Provides rapid relief from severe symptoms, supports bone density, and can improve overall quality of life.
    • Cons: Increased risk of blood clots, stroke, and certain cancers (such as breast and uterine cancer). HRT is often not recommended for women with a history of cardiovascular conditions or hormone-sensitive cancers.
    • Cost: HRT can be costly, depending on the formulation (pills, patches, creams) and the need for regular monitoring by a healthcare provider.
  2. Non-Hormonal Medications: SSRIs (Selective Serotonin Reuptake Inhibitors) or SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors) can help with hot flashes in some women by regulating neurotransmitter levels.
    • Pros: Suitable for women who cannot take HRT due to medical contraindications.
    • Cons: Potential side effects include nausea, dizziness, and changes in appetite or weight. These medications do not address the root hormonal changes but rather manage symptoms.
    • Cost: Generally less expensive than HRT but may require trial and error to find the right medication and dosage.

Normalizing Conversations About Perimenopause

Perimenopause is a normal, natural phase of life that many women experience. Yet, it remains a topic shrouded in discomfort and misunderstanding. By normalizing discussions about perimenopause and the accompanying symptoms, we can create a supportive environment for women navigating this transition. Understanding that hot flashes and night sweats are not “abnormal” but are part of the body’s adjustment process can help reduce anxiety and promote a sense of empowerment.

It is vital to acknowledge that every woman’s experience with perimenopause is unique, and there is no one-size-fits-all solution. A functional medicine approach emphasizes personalization, supporting women holistically through lifestyle, nutrition, and natural remedies. Meanwhile, conventional medicine offers targeted options that may suit those with more severe symptoms. Together, these approaches can provide a balanced path forward for women seeking relief during this significant life change.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

Freeman, E. W., Sammel, M. D., Lin, H., & Gracia, C. R. (2015). The role of anxiety and hormonal changes in menopausal hot flashes. Menopause, 22(1), 45-51. https://doi.org/10.1097/GME.0000000000000283

Geller, S. E., & Studee, L. (2006). Botanical and dietary supplements for menopausal symptoms: What works, what does not. Journal of Women’s Health, 15(7), 634-649. https://doi.org/10.1089/jwh.2006.15.634

Harlow, S. D., Gass, M., Hall, J. E., Lobo, R., Maki, P., Rebar, R. W., & Sherman, S. (2012). Executive summary of the Stages of Reproductive Aging Workshop + 10: Addressing the unfinished agenda of staging reproductive aging. Menopause, 19(4), 387-395. https://doi.org/10.1097/gme.0b013e31824d8f40

Kaunitz, A. M., & Manson, J. E. (2015). Management of menopausal symptoms. Obstetrics & Gynecology, 126(4), 859-876. https://doi.org/10.1097/AOG.0000000000001058

Newton, K. M., Reed, S. D., & LaCroix, A. Z. (2014). Treatment of vasomotor symptoms of menopause. American Journal of Medicine, 127(3), 236-243. https://doi.org/10.1016/j.amjmed.2013.11.003

Shifren, J. L., & Gass, M. L. (2014). The North American Menopause Society recommendations for clinical care of midlife women. Menopause, 21(10), 1038-1062. https://doi.org/10.1097/gme.0000000000000319

Stuenkel, C. A., Davis, S. R., Gompel, A., Lumsden, M. A., Murad, M. H., Pinkerton, J. V., & Santen, R. J. (2015). Treatment of symptoms of the menopause: An Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology & Metabolism, 100(11), 3975-4011. https://doi.org/10.1210/jc.2015-2236

van Driel, C. M., Stuursma, A., & Schneider, H. P. (2018). Efficacy and safety of herbal medicines in perimenopausal and postmenopausal disorders: A systematic review. Maturitas, 111, 1-15. https://doi.org/10.1016/j.maturitas.2018.01.009

Warren, M. P., & Shortle, B. (2016). Use of antidepressants for management of hot flashes. Journal of the American Medical Association, 315(22), 2484-2485. https://doi.org/10.1001/jama.2016.5691

Wuttke, W., Gorkow, C., Seidlova-Wuttke, D. (2006). Effects of Black Cohosh on estrogen-dependent tissues in postmenopausal women. Menopause, 13(2), 185-196. https://doi.org/10.1097/01.gme.0000179045.79338.3c

Staying Motivated to Keep Your New Year’s Resolution for a Healthier You

by Roxy Functional Wellness, posted in Health & Wellness

The New Year is synonymous with fresh starts, and for many, it’s an opportunity to commit to healthier eating, regular exercise, and shedding those extra pounds. Yet, research tells us that nearly 80% of New Year’s resolutions fail by February, leaving many people feeling discouraged. Why is it so challenging to stick with these goals, and how can you ensure this year is different?

Why Do New Year’s Resolutions Fail?

Most New Year’s resolutions fail because they are:

  1. Too vague – “I want to get healthy” is a great intention but lacks specificity.
  2. Overly ambitious – Setting goals like working out every day or cutting out all sugar may be unsustainable.
  3. Lacking a plan – Without actionable steps, even the best intentions lose momentum.
  4. Misaligned with priorities – When resolutions aren’t connected to your “why,” it’s hard to stay motivated.
Photo by Oluremi Adebayo on Pexels.com

The Science of Habit Formation

Forming a habit takes time and consistency. According to research published in the European Journal of Social Psychology, it takes an average of 66 days to form a new habit, but this can vary depending on the complexity of the habit and the individual. Key to success is the brain’s reliance on routine—when behaviors become automatic, they require less effort.

Here are five proven strategies to form healthy habits and make this year’s resolutions stick:

1. Start Small and Be Specific

Instead of saying, “I’m going to exercise more,” commit to something tangible: “I’ll walk for 20 minutes every morning.” Starting small builds momentum without overwhelming you. Success breeds confidence, and small wins pave the way for bigger changes.

2. Pair Habits with Existing Routines

Use the principle of “habit stacking,” where you attach a new habit to an existing one. For instance:

  • While brewing your morning coffee, do 10 squats.
  • After brushing your teeth, pack a healthy lunch.

By linking new habits to familiar routines, you create natural triggers that reinforce consistency.

3. Focus on Progress, Not Perfection

Many resolutions fail because people give up after a single setback. Remember, progress is not linear, and slip-ups are part of the process. Embrace the idea of “progress over perfection” and give yourself grace. Even one healthier meal or one extra workout is a step forward.

4. Make it Enjoyable

If your resolution feels like a punishment, you’re unlikely to stick with it. Find ways to make healthy living enjoyable:

  • Explore new, flavorful recipes for healthy meals.
  • Choose workouts you genuinely love, like dancing, yoga, or hiking.
  • Reward yourself for meeting milestones with non-food treats, such as a new fitness gadget or a relaxing massage.
Photo by Dejan Krstevski on Pexels.com
5. Build a Support System

Accountability is powerful. Share your goals with supportive friends, join a fitness group, or work with a coach. Studies show that people who have a support system are more likely to succeed in their resolutions. Surround yourself with those who uplift and encourage you.

6. Keep Track of Your Progress

Track your goals using a journal, app, or calendar. When you write down what you’ve accomplished, it reinforces the habit and gives you a clear picture of how far you’ve come. Celebrate milestones along the way to stay motivated.

A Lifestyle, Not a Fad

The key to lasting change is understanding that healthy living is a lifestyle, not a short-term fix. Fads and extreme diets might yield quick results, but they’re unsustainable. Real transformation comes from steady, consistent efforts.

As you step into this New Year, focus on creating habits that align with your long-term wellness goals. A healthier, happier you isn’t built overnight—it’s the result of daily choices that, over time, become second nature.

Your journey is worth it. Keep going, and this time next year, you’ll be celebrating more than just the New Year—you’ll be celebrating a new you.

Think about it…

What is one small step you can take today toward your New Year’s resolution of being healthy?

By applying these principles, you can break free from the resolution rollercoaster and achieve sustainable, meaningful change in your life. Remember, it’s not about being perfect—it’s about being persistent.

Happy New Year and cheers to a healthier you!

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

Norcross, J. C., Mrykalo, M. S., & Blagys, M. D. (2002). Auld Lang Syne: Success predictors, change processes, and self-reported outcomes of New Year’s resolvers and nonresolvers. Journal of Clinical Psychology, 58(4), 397–405. https://doi.org/10.1002/jclp.1151

Lally, P., van Jaarsveld, C. H. M., Potts, H. W. W., & Wardle, J. (2010). How are habits formed: Modelling habit formation in the real world. European Journal of Social Psychology, 40(6), 998–1009. https://doi.org/10.1002/ejsp.674

Wood, W., & Neal, D. T. (2007). A new look at habits and the habit-goal interface. Psychological Review, 114(4), 843–863. https://doi.org/10.1037/0033-295X.114.4.843

Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51(3), 390–395. https://doi.org/10.1037/0022-006X.51.3.390

Kwasnicka, D., Dombrowski, S. U., White, M., & Sniehotta, F. F. (2016). Theoretical explanations for maintenance of behavior change: A systematic review of behavior theories. Health Psychology Review, 10(3), 277–296. https://doi.org/10.1080/17437199.2016.1151372

Understanding the Importance of a Balanced Diet for Women’s Hormonal Health

by Roxy Functional Wellness, posted in Health & Wellness

Hormonal balance is foundational for a woman’s overall wellness, affecting everything from mood to metabolism, reproductive health, and energy levels. Central to this balance is the complex interaction between hormones like estrogen, progesterone, and thyroid hormones, which are regulated through the hypothalamic-pituitary-thyroid (HPT) axis as well as the hypothalamic-pituitary-gonadal (HPG) axis. A balanced diet is not just about maintaining weight—it plays a pivotal role in regulating hormones, supporting the menstrual cycle, and promoting optimal well-being.

A Breakdown of Female Hormones, the Thyroid, and the HP Axis Feedback Loop

The hypothalamus and pituitary gland work in harmony to regulate the production of hormones through complex feedback loops involving both the ovaries and the thyroid gland. Here’s how each part fits together:

  • Hypothalamus: It releases Gonadotropin-Releasing Hormone (GnRH) to regulate reproductive hormones, and Thyrotropin-Releasing Hormone (TRH) to control thyroid function. These signals guide the pituitary gland in releasing other hormones.
  • Pituitary Gland: It releases Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH) for ovarian function, as well as Thyroid-Stimulating Hormone (TSH) to regulate the thyroid gland. TSH stimulates the thyroid to produce thyroid hormones.
  • Thyroid Gland: It produces thyroxine (T4) and triiodothyronine (T3), which play a crucial role in metabolism, energy levels, and even the regulation of sex hormones. Adequate levels of thyroid hormones ensure that the body has the right amount of energy, and they influence the menstrual cycle by affecting the ovaries and the production of estrogen and progesterone.
  • Ovaries: In response to FSH and LH, the ovaries produce estrogen and progesterone, which have various effects on the body, including regulating the menstrual cycle, mood, and energy levels. These hormones also interact with thyroid hormones, emphasizing the importance of a well-functioning thyroid for overall hormonal balance.

The Menstrual Cycle and Hormonal Shifts

The menstrual cycle is typically around 28 days, divided into four phases:

  1. Menstrual Phase (Days 1-5): This is when the uterine lining sheds, resulting in menstruation. Hormones like estrogen and progesterone are at their lowest, while T3 and T4 levels need to remain balanced for energy levels and mood.
  2. Follicular Phase (Days 1-14): During this time, FSH stimulates the ovaries to produce follicles. Estrogen levels rise, thickening the uterine lining and preparing for a potential pregnancy. Healthy thyroid function supports this phase by maintaining energy and supporting metabolic rate.
  3. Ovulatory Phase (Day 14): A surge in LH triggers ovulation, where the mature egg is released from the ovary. Estrogen peaks and drops right after ovulation. The thyroid’s role in metabolism helps sustain the energy demands during this phase.
  4. Luteal Phase (Days 15-28): After ovulation, progesterone levels rise, preparing the uterine lining for implantation. If no fertilization occurs, progesterone and estrogen levels drop, leading to the start of a new cycle. The thyroid continues to play a role in mood and energy regulation, helping to prevent symptoms like fatigue and irritability.
Photo by Jane Trang Doan on Pexels.com

The Role of Macros in Hormonal Balance and Wellness

A balanced diet with the right macronutrients—protein, fats, and carbohydrates—is crucial for hormone regulation, including the thyroid:

  • Protein: Essential amino acids from protein serve as building blocks for hormone synthesis, especially for peptide hormones like insulin and TSH. Protein also supports muscle mass, helps stabilize blood sugar levels, and can reduce cravings, which is vital for maintaining energy levels throughout the menstrual cycle. Adequate protein is also necessary for the conversion of T4 to the active T3 hormone.
  • Fats: Healthy fats, particularly omega-3s and monounsaturated fats, are crucial for producing steroid hormones like estrogen and progesterone. Fat also aids in the absorption of fat-soluble vitamins (A, D, E, and K) that are vital for hormone production. These vitamins play a role in thyroid health as well, with vitamin D being particularly important for thyroid function. Avocados, nuts, seeds, and oily fish are excellent sources of healthy fats.
  • Carbohydrates: Carbs provide the energy needed for the functioning of the brain and muscles, especially during the follicular and ovulatory phases when energy demands may increase. The thyroid is highly sensitive to calorie restriction, and maintaining adequate carb intake can prevent disruptions in T3 production. Complex carbohydrates like sweet potatoes, whole grains, and legumes help maintain stable blood sugar levels, reducing mood swings and supporting steady energy levels.
  • Calories: Undereating can throw off the balance of the HPT and HPG axes, leading to conditions like hypothalamic amenorrhea, where the menstrual cycle stops due to insufficient caloric intake. Adequate calories ensure the body has enough energy for essential functions, including hormone production and thyroid regulation.

Timing Nutrition with the Menstrual Cycle

Women who are cycling can benefit from adjusting their diet according to the phases of their menstrual cycle:

  • Follicular Phase: Focus on foods rich in phytoestrogens like flaxseeds, soy, and leafy greens to support rising estrogen levels. Protein-rich meals and whole grains help stabilize energy levels.
  • Ovulation: This is an excellent time to consume foods that support egg release and reduce inflammation, like antioxidant-rich fruits (berries, citrus fruits) and omega-3-rich foods like salmon and walnuts.
  • Luteal Phase: As progesterone levels rise, it’s beneficial to focus on foods that support this hormone, such as pumpkin seeds, nuts, and magnesium-rich foods like spinach and bananas. These can help mitigate symptoms like PMS, bloating, and mood swings.

Addressing Common Female Health Complaints with Diet

Many women have similar complaints regarding a certain time in their cycle. A balanced diet can alleviate many common menstrual complaints:

  • Painful Period Cramps: Omega-3 fatty acids, found in fish oil and chia seeds, can reduce inflammation and alleviate cramps. Magnesium-rich foods like dark chocolate and leafy greens can relax muscles and reduce pain.
  • Heavy Periods: Iron-rich foods like red meat, lentils, and spinach can help replenish lost iron during heavy menstrual bleeding. Vitamin C-rich foods, such as bell peppers and oranges, aid in iron absorption.
  • Headaches and Mood Swings: Balanced meals with complex carbs, healthy fats, and protein help maintain stable blood sugar levels, which can reduce headaches and mood swings. Foods rich in B vitamins, like eggs and whole grains, support neurotransmitter function, positively impacting mood.
  • Acne: Reducing refined sugars and focusing on whole, unprocessed foods can balance insulin levels, reducing hormonal acne. Zinc-rich foods like pumpkin seeds and chickpeas support skin health and reduce inflammation.
Photo by cottonbro studio on Pexels.com

Utilizing Supplements for Hormonal Balance and Support

A balanced diet is most effective when complemented with targeted supplements for hormonal health. Additionally, a balanced diet also provides additional support to the liver which is needs to filter through hormones efficiently:

  1. Fiber: Supports the elimination of excess estrogen by promoting healthy bowel movements, which is essential for hormone detoxification.
  2. Probiotics: A healthy gut microbiome plays a role in estrogen metabolism. Probiotics can support digestion and reduce symptoms like bloating.
  3. Magnesium: Helps alleviate cramps and reduce PMS symptoms by relaxing muscles and regulating neurotransmitters.
  4. Omega-3 Fish Oil: Reduces inflammation and supports the production of hormones that regulate mood and reduce menstrual pain.
  5. Zinc: Supports the immune system and helps with hormone production, which can be beneficial for managing acne and reducing inflammation.
  6. B-Complex Vitamins: Essential for energy production and supporting adrenal and thyroid health, which is especially important during times of stress or hormonal imbalance.
  7. Vitamin D: Supports immune function and plays a role in hormone production, including thyroid regulation, which can improve mood and energy levels.
  8. Digestive Enzymes: Aid in the breakdown of food and absorption of nutrients, ensuring that the body can utilize the vitamins and minerals necessary for hormone production.
  9. Ashwagandha: An adaptogenic herb that helps balance cortisol levels and supports the adrenal glands, helping to manage stress and stabilize energy levels.
  10. Selenium: Essential for thyroid function and the conversion of T4 to T3, making it crucial for maintaining balanced thyroid hormones.

Final Thoughts

Hormonal balance is a delicate dance, influenced by diet, lifestyle, and stress levels. By understanding the intricate relationships between macronutrients, the thyroid, the menstrual cycle, and targeted supplementation, women can create a diet that supports their unique needs throughout each phase of the cycle. A balanced diet not only nourishes the body but also serves as a powerful tool in managing common hormonal complaints and fostering overall wellness.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

Dinh, K. M., & Kittnar, O. (2020). The role of thyroid hormones in cardiovascular diseases: Focus on atrial fibrillation. Physiological Research, 69(3), 509-517. https://doi.org/10.33549/physiolres.934437

Gordon, J. L., Girdler, S. S., Meltzer-Brody, S. E., Stuebe, A., & Rubinow, D. R. (2022). Hormone replacement therapy for the prevention of perimenopausal depression. American Journal of Psychiatry, 179(3), 196-206. https://doi.org/10.1176/appi.ajp.2021.21010048

Li, T., Zhang, Y., Liu, Y., & Jiang, J. (2021). The role of omega-3 polyunsaturated fatty acids in the prevention and treatment of depressive disorders: A systematic review and meta-analysis. Journal of Affective Disorders, 279(2), 580-593. https://doi.org/10.1016/j.jad.2020.09.017

Murdoch, C., Collins, C. E., & MacDonald-Wicks, L. (2021). Magnesium and its role in the prevention and management of chronic disease. Nutrients, 13(11), 3742. https://doi.org/10.3390/nu13113742

Nisar, T., & Ullah, R. (2020). Zinc in the prevention and treatment of acne: A systematic review. Journal of Dermatological Treatment, 31(1), 4-8. https://doi.org/10.1080/09546634.2019.1582062

Ortiz, R., & Herrero, E. (2020). The role of probiotics in women’s health. Journal of Applied Microbiology, 128(4), 947-962. https://doi.org/10.1111/jam.14425

Smith, K. B., & Smith, M. S. (2020). Dietary interventions in the management of iron-deficiency anemia. Journal of Clinical Medicine, 9(9), 2915. https://doi.org/10.3390/jcm9092915

Stachenfeld, N. S., & Taylor, H. S. (2021). Exercise and estrogen: The role of physical activity in women’s reproductive health. Journal of Endocrinology, 250(3), R1-R14. https://doi.org/10.1530/JOE-20-0471

Tremellen, K., & Pearce, K. (2020). Nutrition and diet in the management of polycystic ovary syndrome (PCOS). Journal of Endocrinological Investigation, 43(6), 675-688. https://doi.org/10.1007/s40618-020-01203-3

Zeng, X., Hu, X., Yu, X., & Cheng, X. (2021). The role of vitamin D in female reproductive health and pregnancy. Frontiers in Endocrinology, 12, 688884. https://doi.org/10.3389/fendo.2021.688884

The Importance of Lifestyle Changes While on GLP-1 Medication: Reducing Organ Fat and Improving Longevity

by Roxy Functional Wellness, posted in Health & Wellness

GLP-1 receptor agonists, such as semaglutide or tirzepatide (brand names like Wegovy, Ozempic, and Mounjaro), have become game-changers in the treatment of Type II diabetes and obesity, helping individuals lose weight and control blood sugar. However, the true power of these medications is unlocked when combined with essential lifestyle changes. To ensure lasting success, individuals using GLP-1 medications must focus on reducing organ fat and improving muscle mass. Monitoring progression with reliable metrics like BMR scales, DEXA scans, and VO2 Max tests may be helpful for individuals on GLP1 medications. These holistic changes can not only enhance the medication’s effectiveness but also improve overall longevity and metabolic health.

Understanding the Link Between Organ Fat and Longevity

Not all fat is created equal. Organ fat, also known as visceral fat, is stored deep within the abdomen and surrounds vital organs like the liver, pancreas, and intestines. Unlike subcutaneous fat, which is stored beneath the skin, visceral fat is metabolically active and has profound negative health implications.

Visceral fat increases the risk of insulin resistance, Type II diabetes, cardiovascular diseases, and even certain cancers. According to Harvard Medical School, visceral fat triggers chronic inflammation in the body, which contributes to atherosclerosis (the hardening of the arteries), significantly increasing the risk of heart disease and stroke. The National Institutes of Health (NIH) also found that people with higher levels of visceral fat have a 2.4-fold increase in mortality risk, regardless of their BMI. Yikes! Reducing visceral fat, therefore, is crucial for improving long-term health outcomes and promoting longevity.

Photo by Annushka Ahuja on Pexels.com

How Organ Fat Develops: Pathophysiology and Risk Factors

Organ fat doesn’t accumulate overnight; it results from a combination of poor diet, inactivity, chronic stress, and hormonal imbalances. Here’s a breakdown of the pathophysiology behind visceral fat and the populations most at risk:

  1. Insulin Resistance and Fat Storage: When cells become resistant to insulin, excess glucose is stored as fat, particularly around organs. Visceral fat can worsen insulin resistance, trapping people in a cycle of fat accumulation and poor glucose control.
  2. Hormonal Imbalances: Elevated cortisol levels, caused by chronic stress, promote fat storage in the abdominal area. Additionally, as women enter menopause and estrogen levels decline, they are more prone to visceral fat accumulation. The same occurs in men with declining testosterone levels.
  3. Inflammation and Cytokines: Visceral fat is metabolically active, releasing inflammatory cytokines that contribute to chronic inflammation and increased risk of cardiovascular disease. This inflammation is linked to metabolic dysfunction, further promoting visceral fat development.
  4. Lipotoxicity: Excess visceral fat can spill over into organs like the liver and pancreas, impairing their function. Fatty liver disease is one example, leading to inflammation and scarring in the liver. Similarly, fat deposition in the pancreas can disrupt insulin production, exacerbating Type II diabetes.

Who Is at Risk?

Certain groups of people are at greater risk of developing unhealthy levels of visceral fat:

  • Individuals with Insulin Resistance or Type II Diabetes: People with these conditions are predisposed to store excess fat around their organs. According to the Journal of Clinical Endocrinology & Metabolism, people with Type II diabetes tend to have significantly higher levels of visceral fat, regardless of their overall body weight.
  • People with Obesity: While obesity is a known risk factor, even those with a normal BMI can carry excess visceral fat. Johns Hopkins Medicine notes that around 20% of people with a normal BMI are “metabolically obese normal weight” (MONW), meaning they have harmful levels of visceral fat despite appearing lean.
  • Postmenopausal Women: Declining estrogen levels during menopause can shift fat storage to the abdomen, increasing visceral fat. Yale University research shows that postmenopausal women have significantly more visceral fat than premenopausal women, even when they weigh the same.
  • Individuals Leading Sedentary Lifestyles: Lack of physical activity and strength training can lead to muscle loss and a slowed metabolism, both of which promote visceral fat accumulation. The CDC emphasizes that sedentary lifestyles, combined with poor diet, are primary drivers of obesity and visceral fat.
  • Chronic Stress Sufferers: Chronic stress raises cortisol levels, which promotes abdominal fat storage. The CDC highlights that stress-induced weight gain typically appears in the form of increased visceral fat, especially for those predisposed to anxiety or depression.

Muscle-Resistant Exercise: A Key Tool for Reducing Organ Fat

One of the most effective ways to combat visceral fat is through muscle-resistant exercise, or strength training. Unlike cardio, which burns calories during the workout, resistance training builds lean muscle mass, which boosts metabolism and helps the body burn fat even at rest.

Yale University studies have shown that resistance training is particularly effective in reducing visceral fat compared to cardio alone. In fact, a study published in the Journal of Obesity found that a combination of strength training and cardio led to greater reductions in visceral fat than aerobic exercise alone.

Building muscle mass is critical for overall metabolic health, especially for individuals on GLP-1 medications. These drugs help reduce appetite and promote weight loss, but maintaining muscle mass through resistance exercise ensures that the body doesn’t lose vital muscle tissue while shedding fat.

Tracking Your Progress: BMR Scales, DEXA Scans, and VO2 Max

While weight loss is often measured by the scale, it’s essential to track other health metrics to gain a more complete picture of your health and fitness. Here are three tools that can help:

  1. BMR Scales: Basal Metabolic Rate (BMR) is the number of calories your body needs at rest. Understanding your BMR allows you to fine-tune your calorie intake to support weight loss or maintenance. Resistance training, which increases muscle mass, also increases your BMR, helping you burn more calories even when you’re not active.
  2. DEXA Scans: Dual-energy X-ray absorptiometry (DEXA) scans measure body composition, including the distribution of body fat and muscle. Unlike BMI, which only measures overall weight, DEXA scans can differentiate between visceral fat and subcutaneous fat. Monitoring your visceral fat through DEXA scans is one of the best ways to track your health improvement over time.
  3. VO2 Max: This metric measures your body’s ability to use oxygen during exercise, and it’s an excellent indicator of cardiovascular fitness. A higher VO2 Max is associated with better overall health and longevity. The American Heart Association reports that increasing VO2 Max can reduce the risk of cardiovascular disease by up to 45%.
Photo by VO2 Master on Pexels.com

How to Incorporate Healthy Lifestyle Changes While on GLP-1 Medication

Although GLP-1 medications can help kickstart weight loss, lifestyle changes are key to sustaining those results and improving long-term health. Here’s how you can incorporate healthy habits into your routine:

  1. Focus on Resistance Training: Engage in strength training 3-4 times per week to build lean muscle mass and reduce visceral fat. Resistance exercises, such as weightlifting or bodyweight exercises, should target all major muscle groups.
  2. Incorporate Cardiovascular Exercise: In addition to strength training, aim for at least 150 minutes of moderate-intensity cardio per week, such as brisk walking, swimming, or cycling, to improve heart health and VO2 Max.
  3. Adopt a Balanced Diet: While GLP-1 medications can reduce appetite, it’s crucial to nourish your body with nutrient-dense foods. A balanced diet rich in lean proteins, whole grains, fruits, vegetables, and healthy fats can reduce visceral fat and improve metabolic health.
  4. Use Health Metrics to Track Progress: In addition to tracking weight, utilize BMR scales, DEXA scans, and VO2 Max tests to monitor improvements in body composition and cardiovascular health. Even a modest reduction in visceral fat can significantly improve health outcomes. The CDC notes that losing just 5-10% of your body weight can improve blood sugar, cholesterol, and blood pressure levels.
  5. Manage Stress and Sleep: Chronic stress and poor sleep can elevate cortisol levels and promote visceral fat accumulation. Practice mindfulness, meditation, or yoga, and aim for 7-9 hours of sleep per night to manage stress and support overall health.

GLP-1 medications offer significant help in managing weight, but true health transformation occurs when they are paired with sustainable lifestyle changes. By reducing organ fat, building muscle mass, and monitoring key health metrics like BMR, DEXA, and VO2 Max, you can improve not only your weight but also your long-term health and longevity. Combining these lifestyle changes with the benefits of GLP-1 medications can help you achieve optimal health, reduce the risk of chronic diseases, and ultimately lead a longer, healthier life.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

American Heart Association. (2020). Understanding your VO2 max. Retrieved from https://www.heart.org/en/news/2020/03/03/understanding-your-vo2-max

Centers for Disease Control and Prevention. (2022). Adult obesity facts. Retrieved from https://www.cdc.gov/obesity/data/adult.html

Harvard T.H. Chan School of Public Health. (2022). The truth about visceral fat. Retrieved from https://www.hsph.harvard.edu/nutritionsource/visceral-fat/

Johns Hopkins Medicine. (2021). Visceral fat and heart disease. Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/obesity/visceral-fat-and-heart-disease

Khera, R., Pandey, A., Ayers, C., Turer, A., & Berry, J. D. (2020). Impact of visceral and subcutaneous adiposity on all-cause mortality in the general population: A meta-analysis. Journal of Clinical Endocrinology & Metabolism, 105(3), 683-692. https://doi.org/10.1210/clinem/dgz183

Mayo Clinic. (2021). Cortisol: Why the stress hormone is public enemy no. 1. Retrieved from https://www.mayoclinic.org/stress-cortisol/what-it-is

National Institutes of Health. (2021). Obesity and insulin resistance. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved from https://www.niddk.nih.gov/health-information/weight-management/obesity-insulin-resistance

Ross, R., Neeland, I. J., Yamashita, S., Shai, I., Seidell, J., Magni, P., & Després, J. P. (2020). Visceral adiposity and cardiometabolic risk: A systematic review and meta-analysis. The Lancet Diabetes & Endocrinology, 8(8), 715-728. https://doi.org/10.1016/S2213-8587(20)30165-6

Samaras, K., & Campbell, L. V. (2019). Visceral fat measurement in Type 2 diabetes: How, where, and why? Diabetes Research and Clinical Practice, 142, 161-167. https://doi.org/10.1016/j.diabres.2018.04.022

Shuster, A., Patlas, M., Pinthus, J. H., & Mourtzakis, M. (2021). The clinical importance of visceral adiposity: A critical review of methods for visceral adipose tissue analysis. British Journal of Radiology, 85(1019), 1-10. https://doi.org/10.1259/bjr/38447238

Slentz, C. A., Bateman, L. A., & Willis, L. H. (2019). Effects of exercise training intensity on abdominal visceral fat and body composition. Journal of Applied Physiology, 112(11), 1798-1805. https://doi.org/10.1152/japplphysiol.00029.2012

St. George, S. M., & Norris, K. (2020). Role of strength training in reducing visceral fat in obese adults. Journal of Obesity Research & Clinical Practice, 14(2), 95-104. https://doi.org/10.1016/j.orcp.2020.02.001

Yale University. (2021). Why strength training is key to reducing belly fat. Retrieved from https://yale.edu/strength-training-visceral-fat

Embarking on Your Weight Loss Journey: A Holistic Approach to Wellness

by Roxy Functional Wellness, posted in Health & Wellness, Weight Loss

Starting a weight loss journey can be both exciting and overwhelming. At Midwest Internal Medicine, we understand that achieving and maintaining a healthy weight is not just about aesthetics—it’s about improving overall health, well-being, and longevity. Our goal is to help you reach your healthiest self through individualized, holistic wellness plans that cater to your unique needs.

Why Striving for a Healthy Weight is Important

Maintaining a healthy weight is critical for overall health and disease prevention. According to the Centers for Disease Control and Prevention (CDC), even a modest weight loss of 5-10% of your total body weight can result in significant health benefits, such as improved blood pressure, cholesterol levels, and blood sugar management .

Here are some compelling facts from well-known health organizations that highlight the importance of maintaining a normal weight:

  • World Health Organization (WHO): Overweight and obesity are major risk factors for several chronic diseases, including diabetes, cardiovascular diseases, and cancer .
  • American Heart Association (AHA): Individuals who maintain a healthy weight can reduce the risk of heart disease by as much as 50%, lowering their chances of heart attack, stroke, and other cardiovascular conditions .
  • National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): Obesity is linked to an increased risk of developing Type 2 diabetes, with research showing that weight loss can prevent or delay the onset of this disease .
  • Harvard T.H. Chan School of Public Health: Maintaining a healthy weight is a key component of reducing the risk of certain cancers, including breast, colon, and prostate cancers .
  • Mayo Clinic: Weight management through healthy habits like diet, exercise, and stress management is directly associated with improved longevity and quality of life .

These statistics emphasize the importance of achieving a normal weight for health and wellness. But how can you get there? Here are some essential tips that we, at Midwest Internal Medicine, integrate into our patients’ personalized wellness plans.

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The Research Behind Our Tips

1. Hydration is Key: Water plays a crucial role in digestion, detoxification, and metabolism. Research shows that drinking adequate water can increase calorie expenditure by up to 30% over a period of 60-90 minutes. Staying hydrated can also reduce hunger and support healthy digestion.

2. Holistic Eating: Eating whole, unprocessed foods helps balance blood sugar levels and provides your body with the nutrients it needs to function optimally. Consuming foods rich in fiber, lean protein, and healthy fats can increase satiety and decrease overeating . In our wellness plans, we recommend limiting gluten and dairy, as they can contribute to inflammation in some individuals.

3. Sleep Matters: Lack of sleep has been linked to increased hunger and weight gain due to the hormone imbalance it causes. A study by the National Sleep Foundation shows that individuals who get less than 7 hours of sleep per night are more likely to struggle with weight control .

4. Managing Stress: Chronic stress leads to elevated cortisol levels, which can increase appetite and cause weight gain, particularly around the abdomen . We encourage patients to incorporate mindfulness practices like yoga, meditation, or grounding exercises into their daily routines.

5. Exercise for Success: Regular physical activity, particularly strength training, is essential for maintaining muscle mass, boosting metabolism, and improving insulin sensitivity. According to the American College of Sports Medicine (ACSM), a combination of aerobic and resistance training is most effective for weight loss .

6. Gut Health: Your gut microbiome plays a critical role in digestion and weight management. Studies show that a healthy gut can improve metabolism and reduce the likelihood of obesity . Probiotic-rich foods like yogurt, kimchi, and sauerkraut can support digestive health and weight loss.

7. Spiritual Wellness: Connecting with your spiritual side, whether through meditation, mindfulness, or spending time in nature, promotes mental and emotional balance. Studies suggest that spiritual wellness can enhance physical health and improve the outcomes of a weight loss journey .

Our Holistic, Individualized Approach at Midwest Internal Medicine

At Midwest Internal Medicine, we believe that every person’s journey to wellness is unique. There is no “one-size-fits-all” solution when it comes to weight loss. That’s why we work closely with each patient to develop a comprehensive, individualized plan that includes nutrition, exercise, stress management, and spiritual wellness.

Our team uses the latest research-backed strategies to help you set realistic goals and maintain healthy habits for life. We’re proud to walk alongside you in this journey and provide ongoing support, adjustments, and encouragement as you work toward your wellness goals.

Just remember!

Achieving a healthy weight is more than just looking good—it’s about reducing the risk of chronic disease, improving your quality of life, and increasing longevity. By following research-backed tips related to hydration, whole foods, exercise, sleep, stress management, and spiritual well-being, you can make sustainable changes that lead to lasting results.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References
  1. Centers for Disease Control and Prevention. (2020). The health effects of overweight and obesity. CDC. https://www.cdc.gov/obesity/adult/causes.html
  2. World Health Organization. (2021). Obesity and overweight. WHO. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
  3. American Heart Association. (2019). Weight management and cardiovascular health. AHA. https://www.heart.org/en/healthy-living/healthy-eating/losing-weight
  4. National Institute of Diabetes and Digestive and Kidney Diseases. (2022). Weight and diabetes risk. NIDDK. https://www.niddk.nih.gov/health-information/weight-management
  5. Harvard T.H. Chan School of Public Health. (2021). Weight control and cancer risk. Harvard. https://www.hsph.harvard.edu/nutritionsource/obesity-prevention
  6. Mayo Clinic. (2023). Healthy weight: Key to longevity. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/weight-loss
  7. Boschmann, M., & Steiniger, J. (2003). Water-induced thermogenesis. Journal of Clinical Endocrinology & Metabolism, 88(12), 6015-6019.
  8. Slavin, J. L. (2005). Dietary fiber and body weight. Nutrition, 21(3), 411-418.
  9. National Sleep Foundation. (2020). How sleep affects weight loss. NSF. https://www.sleepfoundation.org/sleep-and-weight-loss
  10. Adam, T. C., & Epel, E. S. (2007). Stress, eating and the reward system. Physiology & Behavior, 91(4), 449-458.
  11. American College of Sports Medicine. (2015). Physical activity for weight loss. ACSM. https://www.acsm.org
  12. Turnbaugh, P. J., & Gordon, J. I. (2009). The gut microbiome and obesity. Nature, 457(7228), 480-484.
  13. Koenig, H. G. (2012). Religion, spirituality, and health: The research and clinical implications. ISRN Psychiatry, 2012, 1-33.

Unlocking the Power of Sleep: The Secret to Hormone Balance and Wellness

by Roxy Functional Wellness, posted in Health & Wellness

Sleep is more than just rest—it’s a critical time when our bodies reset, heal, and regulate essential functions. The connection between sleep and the endocrine system is powerful, as sleep is necessary for proper hormone regulation. Without enough sleep, the body struggles to maintain balance, leading to weight gain, mood imbalances, and weakened immune function. If you’re looking to improve overall health and balance your hormones, understanding how sleep impacts your body is the first step.

“Many times people experience out of control cravings for different foods not because they are actually hungry, but because their body is tired and it’s trying to make that known!”

Sleep’s Vital Role in Hormone Regulation

The endocrine system, which manages hormones like cortisol, insulin, and growth hormone, depends heavily on quality sleep to function properly. When sleep is compromised, hormone levels can fluctuate, which can lead to increased stress, cravings, and weight gain. For instance, growth hormone is released during deep sleep, helping with tissue repair and muscle growth, while cortisol levels should lower at night to allow for rest and recovery. Sleep is especially important for regulating insulin, the hormone responsible for blood sugar management. Without adequate sleep, the risk of developing conditions like diabetes and obesity rises sharply.

Additionally, sleep affects hormones like ghrelin and leptin, which influence our appetite and craving control. Insufficient sleep will cause these hormones to work incorrectly and/or less effectively. Many times people experience out of control cravings for different foods not because they are actually hungry, but because their body is tired and it’s trying to make that known!

How Sleep Stages Affect Wellness

Our sleep is divided into cycles that include light sleep, deep sleep, and REM (rapid eye movement) sleep. Each stage plays a different role in supporting overall wellness, from physical repair to emotional balance. Research from the National Institutes of Health indicates that deep sleep is crucial for physical recovery, while REM sleep is vital for cognitive function and emotional processing. Without proper sleep cycles, the body cannot fully repair itself, nor can the brain properly manage emotions and cognitive functions. A healthy adult needs about 13-23% of sleep to be deep and about 20-25% to be REM. Once easy way to track this is with an Oura Ring, although sometimes cost can be a big con with those devices.

  • Light sleep: Prepares the body for deeper stages of sleep.
  • Deep sleep: Repairs muscles, boosts immune function, and releases growth hormone.
  • REM sleep: Supports brain function, mood regulation, and memory consolidation.
Photo by Brett Jordan on Pexels.com

What Happens to Your Body While You Sleep

Sleep is a time of intense biological activity, even though it feels like rest. Your body undergoes significant repair, detoxification, and growth, all powered by hormones. Growth hormone, for instance, is secreted during deep sleep, enabling muscle repair and tissue growth. Additionally, neurotransmitters like serotonin and dopamine are replenished, which helps regulate mood and mental health. Without proper sleep, these processes are disrupted, leading to fatigue, mood swings, and slower recovery from physical exertion. Our immune system also uses our sleep time to strengthen; preparing the body to fight off any potential infections.

Tips for Achieving Restful Sleep

Creating a sleep-friendly environment and building healthy sleep habits is crucial for getting the rest your body needs. Small changes in routine and lifestyle can lead to significant improvements in sleep quality. Reducing screen time before bed, maintaining a consistent bedtime, and using relaxation techniques can help you fall asleep faster and stay asleep longer. Ensuring that your bedroom is dark, quiet, and cool will also support deep, uninterrupted sleep.

  • Set a regular sleep schedule by going to bed and waking up at the same time.
  • Create a calming bedtime routine, such as reading or meditating.
  • Limit caffeine and heavy meals in the evening.
  • Make your bedroom conducive to sleep—dark, cool, and quiet.

Natural Sleep Remedies Backed by Science

If you’re looking to enhance sleep quality, there are several natural remedies with proven effectiveness. Melatonin, for example, has been shown to help regulate sleep-wake cycles, especially for people with insomnia or circadian rhythm disorders. Magnesium is another supplement that can improve sleep by calming the nervous system and reducing cortisol, the stress hormone. Studies also show that herbal remedies like valerian root and lavender oil can help ease anxiety and promote deeper sleep without the side effects of medication.

  • Melatonin: Regulates the sleep cycle; effective for people with sleep disorders.
  • Magnesium: Supports relaxation and reduces stress hormone levels.
  • Valerian root: Shown to improve sleep quality and reduce the time it takes to fall asleep.
  • Lavender essential oil: Proven to reduce anxiety and promote deeper sleep.

The Importance of Consistency in Sleep Patterns

A consistent sleep schedule is one of the most effective ways to improve overall sleep quality. By going to bed and waking up at the same time each day, your body’s internal clock (circadian rhythm) stays balanced, making it easier to fall asleep and wake up refreshed. Irregular sleep patterns can confuse your body, leading to insomnia or daytime fatigue. Even on weekends, try to stick to your regular sleep routine for the best results.

When to See a Provider About Sleep Issues

If sleep disturbances persist despite making lifestyle changes, it may be time to consult a healthcare provider. Chronic sleep issues could be signs of underlying conditions like sleep apnea, restless leg syndrome, or hormonal imbalances. Left untreated, chronic poor sleep can lead to long-term health problems, including cardiovascular disease, diabetes, and mental health disorders. A provider can help identify any underlying conditions and suggest therapies or treatments to improve sleep.

Photo by Ketut Subiyanto on Pexels.com

Sleep plays a vital role in regulating hormones, supporting immune function, and maintaining overall health. By focusing on achieving quality sleep, including deep and REM stages, we can enhance our body’s natural healing processes and improve mental clarity, mood, and physical well-being. A consistent sleep routine, paired with evidence-based natural remedies like melatonin, magnesium, and valerian root, can help ensure restful, restorative sleep. However, when sleep issues persist despite lifestyle adjustments, seeking the guidance of a healthcare provider is essential to prevent long-term health consequences. Prioritizing sleep is not just about feeling rested—it’s key to sustaining health, balance, and vitality.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

Centers for Disease Control and Prevention. (2021). Sleep and sleep disorders. https://www.cdc.gov/sleep/index.html

Cleveland Clinic. (2020). How much sleep do you need? https://health.clevelandclinic.org/how-many-hours-of-sleep-do-you-actually-need/

Holistic Nursing Practice. (2019). The effect of lavender oil on sleep quality and anxiety in patients with coronary artery disease. Holistic Nursing Practice, 33(2), 95-103. https://doi.org/10.1097/HNP.0000000000000325

Journal of Research in Medical Sciences. (2012). The effect of magnesium supplementation on insomnia in elderly people. Journal of Research in Medical Sciences, 17(12), 1161-1169. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3703169/

National Institutes of Health. (2021). Sleep deprivation and deficiency. https://www.nhlbi.nih.gov/health-topics/sleep-deprivation-and-deficiency

National Sleep Foundation. (2020). How much sleep do we really need? https://www.sleepfoundation.org/how-sleep-works/how-much-sleep-do-we-really-need

PubMed. (2016). Valerian root improves sleep quality and reduces sleep latency. Complementary Therapies in Medicine, 27, 41-48. https://doi.org/10.1016/j.ctim.2016.06.012

Sleep Foundation. (2021). REM sleep: What is it and how much do you need? https://www.sleepfoundation.org/how-sleep-works/rem-sleep

The Importance of Glucose Control for Weight Loss and Overall Health

by Roxy Functional Wellness, posted in Health & Wellness, Weight Loss

Maintaining stable blood glucose levels is one of the most critical factors in achieving not only weight loss but overall optimal health. Blood sugar fluctuations affect your energy levels, hunger cues, mood, and hormones, all of which influence your body’s ability to lose or maintain weight. Let’s dive into the science behind glucose control, its broader impacts on your health, and practical ways to maintain it.

The Impact of Erratic Glucose Spikes on the Body

When you consume foods high in simple carbohydrates or sugar, your blood glucose spikes. This triggers a cascade of hormonal reactions, primarily involving insulin—a hormone produced by the pancreas to help transport glucose into cells. However, erratic glucose spikes can overwhelm the system, leading to several negative effects on the body, especially on the Hypothalamic-Pituitary-Adrenal (HPA) Axis.

HPA Axis Dysregulation and Hormonal Imbalance: The HPA axis is a critical regulator of stress response and hormone production, including cortisol. Studies have shown that frequent glucose spikes and crashes can dysregulate the HPA axis, leading to elevated cortisol levels. This chronic cortisol elevation can contribute to hormonal imbalances such as:

  • Increased fat storage, especially around the abdomen.
  • Sleep disturbances, as high glucose can interfere with the body’s ability to produce melatonin, the hormone responsible for sleep regulation.
  • Gut health issues, as glucose dysregulation can lead to inflammation, impairing gut barrier function and affecting the microbiome.
  • Sexual dysfunction, since the endocrine system (responsible for hormone balance) is closely tied to sexual health, including libido and reproductive function.

Long-Term Risks of Uncontrolled Glucose Levels

Over time, poor glucose control can lead to insulin resistance, a condition where your cells no longer respond effectively to insulin, causing blood glucose levels to remain elevated. Insulin resistance has a strong connection to a variety of health issues, including:

  1. Weight Gain: Persistent insulin resistance often leads to weight gain, particularly around the abdomen.
  2. Hormonal Imbalance: Insulin resistance disrupts other hormonal systems, including thyroid and reproductive hormones.
  3. Gut Diseases: High blood sugar levels can foster an environment that promotes gut dysbiosis, which is linked to conditions like Irritable Bowel Syndrome (IBS) and leaky gut.
  4. Mental Health Problems: Studies have shown a clear connection between erratic glucose levels and mood disorders like anxiety and depression. Glucose spikes lead to inflammation, which has been shown to contribute to these mental health challenges.

Evidence-Based Tips for Balancing Glucose Levels

So how to do you achieve more consistent glucose levels? Every person may be a little different as our bodies are not the same, but some of the tips my patients have found to be helpful include:

  1. Eat Balanced Meals: Incorporating protein, healthy fats, and fiber with each meal helps slow down glucose absorption, keeping blood sugar levels stable. This has been supported by research from the American Diabetes Association, which emphasizes the importance of balanced macronutrient intake to prevent spikes.
  2. Choose Low-Glycemic Foods: Opt for whole grains, legumes, vegetables, and other low-glycemic foods, which release glucose more slowly into the bloodstream. According to the Glycemic Index Foundation, low-GI foods can help reduce insulin resistance and support weight loss.
  3. Exercise Regularly: Physical activity increases your cells’ sensitivity to insulin, allowing them to more effectively use glucose. The World Health Organization (WHO) recommends at least 150 minutes of moderate aerobic activity per week for glucose regulation.
  4. Stay Hydrated: Dehydration can raise blood sugar levels. Drink plenty of water throughout the day to support healthy glucose levels. This half of your bodyweight in ounces!
  5. Manage Stress: Chronic stress contributes to HPA axis dysregulation, elevating cortisol and impacting glucose regulation. Meditation, yoga, and deep breathing exercises are all excellent ways to lower stress. I love using the Peloton for this as they have a variety of options to choose from!

Signs and Symptoms of Glucose Dysregulation

So how do you know if you are experiencing high or low glucose levels? Again, this can be different for everyone, but research has shown that there are some common symptoms that people may experience on both spectrums:

High Blood Sugar (Hyperglycemia) Symptoms:

  • Fatigue
  • Frequent urination
  • Increased thirst
  • Blurred vision
  • Unexplained weight loss
  • Difficulty concentrating

Low Blood Sugar (Hypoglycemia) Symptoms:

  • Shakiness
  • Sweating
  • Dizziness
  • Hunger
  • Irritability
  • Palpitations
  • Weakness

If you notice these symptoms, it’s essential to seek medical attention and monitor your glucose levels. This is where I like to use a continuous glucose monitor if possible!

Lab Tests to Assess Glucose Control

Let’s talk labs for a second. There a several blood tests that can provide valuable insight into your glucose metabolism, but here are my favorite to trend with my patients:

  1. Fasting Blood Glucose: This test measures your blood sugar levels after an overnight fast. A normal level is below 100 mg/dL, while 100-125 mg/dL indicates prediabetes, and 126 mg/dL or higher signals diabetes.
  2. Insulin Levels: Measuring fasting insulin levels can help detect insulin resistance, even if blood sugar levels appear normal. An ideal fasting insulin level is typically below 15 µU/mL.
  3. Hemoglobin A1C (HgA1c): This test measures your average blood sugar levels over the past 2-3 months. A normal A1c is below 5.7%, prediabetes is 5.7%-6.4%, and diabetes is 6.5% or higher.

*Remember that for fasting levels, these need to be drawn between the hours of 7-9am and on an empty stomach.

Continuous Glucose Monitors (CGMs): A Valuable Tool for Glucose Control

I have talked a little bit about CGMs before, but let’s do a repeat! For individuals seeking to closely monitor glucose fluctuations, a Continuous Glucose Monitor (CGM) can be an incredibly useful tool. These devices measure glucose levels in real-time and provide a continuous record of how food, exercise, and stress impact your blood sugar (a Dexcom would be an example). Although these are wonderful to use, let’s break down the pros and cons:

Pros of Using a CGM:

  • Provides real-time feedback on your diet and lifestyle choices.
  • Can identify blood sugar spikes that may not be caught by standard lab work.
  • Helps you understand how stress, exercise, and sleep impact your glucose levels.

Cons of Using a CGM:

  • They can be expensive and may not be covered by all insurance plans.
  • CGMs require frequent calibration and monitoring.
  • Some people may experience skin irritation from the device adhesive.

If you are interested in using a CGM I would highly encourage you to speak to your healthcare provider. I do use these periodically in my current practice, however, this is done on an individual basis.

Wrapping it up!

Maintaining stable glucose levels is crucial for weight management, hormone balance, gut health, and overall wellness. Regular monitoring through lab tests like fasting glucose, insulin levels, and HgA1c, combined with tools like CGMs, can offer valuable insights into your body’s glucose regulation. By making small, evidence-based changes in your diet and lifestyle, you can protect yourself from the long-term health risks associated with uncontrolled glucose levels and achieve better overall health.

Take control of your glucose, and in turn, take control of your health!

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

REFERENCES

American Diabetes Association. (2022). Standards of medical care in diabetes—2022. Diabetes Care, 45(Supplement_1), S1-S2. https://doi.org/10.2337/dc22-SINT

Cryer, P. E. (2016). The pathophysiology of hypoglycemia in diabetes. Diabetes Care, 39(4), 556-562. https://doi.org/10.2337/dc15-2715

Glycemic Index Foundation. (n.d.). The glycemic index. Glycemic Index Foundation. https://www.gisymbol.com/about-glycemic-index/

International Diabetes Federation. (2021). IDF diabetes atlas (10th ed.). International Diabetes Federation. https://diabetesatlas.org/

Mayo Clinic Staff. (2021). Insulin resistance: What it is and how to know if you have it. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/in-depth/insulin-resistance/art-20047903

National Institute of Diabetes and Digestive and Kidney Diseases. (2020). Hypoglycemia. National Institutes of Health. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/hypoglycemia-low-blood-glucose

Reaven, G. M. (2005). The insulin resistance syndrome: Definition and dietary approaches to treatment. Annual Review of Nutrition, 25, 391-406. https://doi.org/10.1146/annurev.nutr.25.050304.092514

World Health Organization. (2020). Physical activity guidelines for health. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/physical-activity