November 1, 2024 • 25 mins
ADHD symptoms in women can be significantly influenced by hormonal fluctuations, particularly during stages such as perimenopause and menopause. It's crucial for women to understand the connection between their hormones and brain function. Recognize how estrogen and progesterone interact with neurotransmitters like dopamine, which plays a key role in focus and motivation. By understanding these dynamics, women can better navigate their ADHD challenges and explore natural strategies for support.
Takeaways:
- ADHD has historically been mischaracterized as a disorder predominantly affecting boys and men.
- Women's hormonal fluctuations significantly influence ADHD symptoms, particularly during the menstrual cycle.
- Late diagnoses of ADHD in women often coincide with hormonal changes related to perimenopause.
- Estrogen plays a crucial role in enhancing dopamine function, which is vital for focus.
- Insulin resistance and thyroid health are critical factors that can exacerbate ADHD symptoms in women.
- Identifying hormonal imbalances can help women better manage their ADHD and overall brain health.
Links referenced in this episode:
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
For years, ADHD was seen as aboy's disorder.
This means that most research,treatments and even the diagnostic
criteria have been based onmen and boys.
But as we are seeing anincrease in women, especially women
with a late diagnosis of adhd,and women are sharing their experiences
or realizing just how muchwe've missed.
(00:21):
Welcome to ADHD NaturallySmart Solutions for Holistic Women
with Christine McCarroll.
Hi, I'm Christine, and this isthe spot to learn natural strategies
for supporting your ADHD brain.
As a woman with all thehormonal curveballs and unique challenges
that only females face, I'vemade it my mission to uncover the
root causes and little knownsupports for your ADHD brain that
(00:42):
your doctor doesn't know andwon't tell you.
Learn the truth and find your focus.
No prescription required.
Hey, friend.
And welcome back to ADHDNaturally Smart Solutions for Holistic
Women.
Now, if you haven't beenplaying along with the last few episodes,
I just want to remind you thatwe are going through what I'm calling
the boss Brain blueprint,which is my specific methodology
(01:05):
that I've developed forhelping women to have a boss brain
or be able to have focus thatis more like a laser than a disco
ball and have that on demandwhen you want it.
So if you've missed some ofthe earlier episodes on this, I would
invite you to go back to thebeginning of this little mini part
of season one here where westarted with talking about food.
(01:27):
So this methodology is basedon the idea that there are a lot
of underlying factors that caninfluence how our brains feel and
that brain health is essentialto mental health.
And in particular, I want tohighlight the specific role that
women's hormones play in this picture.
So today's episode is allabout that.
(01:49):
It's all about what I wouldcall lovingly the hormone hammer,
or sledgehammer, as the casemay be.
But where we are seeing thedirect impact of women's hormones
on their ADHD symptoms.
Now, one reason why I becameactually, the reason why I became
so interested in this topicwas that when I was diagnosed late
(02:10):
in life at 44, I believe itwas largely in part or largely due
to the fact that my hormoneswere beginning to fluctuate because
of perimenopause.
And what happened right at thesame time was that my daughter was
going through adolescence andher hormones were fluctuating a lot
as well.
And what I call the boil ofADHD had been simmering in both of
(02:32):
us for a long time.
So this was not new.
It's just that it was more manageable.
And once the big old hormonefluctuations of preteen hood and
perimenopause age hit us, thenthose symptoms got a lot worse, and
it really highlighted what hadbeen going on the whole time.
So as soon as I startedresearching this, as soon as I went
(02:53):
deep into the topic of ADHDfor women, I really wanted to understand
this hormonal component.
Now, I also had a specialinterest in this because I've been
been working with women'shealth for the last decade and specifically
looking at holistic hormonebalancing for women.
And I knew already that therewas a massive impact on our brain
function from our hormones.
I just didn't realize how muchof an impact this was having on a
(03:14):
brain that had this underlying adhd.
So why is this different for women?
Well, a big reason for it isthat our hormones interact with our
neurotransmitters.
So I've been talking about theneurotransmitter dopamine, which
is the big hormone that is,or, sorry, big neurotransmitter that
is primarily different.
You know, usually it's beingcleared overly fast in people with
(03:37):
adhd.
And this neurotransmitter issomething that really helps us with
focus and attention andmotivation and reward.
So if we are having a hardtime feeling motivated or getting
focused, it's a lot of timesbecause of this low dopamine state.
And something reallyinteresting that's different for
women is that we have estrogenthat is higher at certain parts of
(03:59):
the month, and estrogenpotentiates dopamine, meaning it
helps it to work better.
So what I've noticed in myselfand in other women is that we already
had fluctuating symptoms priorto any sort of major hormonal change.
So across a lifespan, a lot oftimes women are feeling better, more
(04:19):
able to focus, having bettermotivation, and maybe feeling like
their ADHD wasn't as present.
And actually, for some women,that can be a problem because we
start to doubt whether we evenhave adhd.
We are if we're, you know,exploring the possibility of a diagnosis.
And some of the month you feellike you can hardly function, and
some of the month you'refeeling kind of on it, or at least
(04:41):
better than the other part ofthe month, you might kind of tell
yourself, oh, well, itcouldn't be me.
And the truth is it might beyour hormones, and those hormones
might be affecting howsignificant those symptoms are for
you.
So for most cycling women, thebeginning part of the month is when
our estrogen is higher andwe're going to feel a little bit
better.
(05:01):
So because that estrogen ishelping dopamine along, it's its
little buddy, and they'reholding hands and skipping, and we're
able to access that dopaminemore easily and we're able to stay
on track a little bit more.
Now, that doesn't mean youdon't have ADHD for half the month.
It doesn't mean that yourunderlying brain function or structure
is different.
It just means that things feel better.
(05:22):
And then in the second half ofthe month, when estrogen goes lower,
we tend to not have as good ofan impact.
And the other thing is,progesterone has the counterbalancing
effect on dopamine.
So what we see is we have aless strong effect of dopamine in
our brains during that time.
So that's going to mean thatfor women who are cycling and are
(05:42):
not on some sort of hormonalbirth control, where things are kind
of flattened out, where we'rehaving these fluctuations in our
hormones, things are alreadygoing to be feeling different.
Now, what happens inperimenopause is a couple things.
First of all, progesteronestarts dropping off.
So a lot of timesprogesterone, besides kind of being
an antagonist to estrogen,it's also our calming hormone.
(06:03):
So it's kind of like nature's Prozac.
And when we drop off from thatnature's Prozac, we can tell to feel
more anxious in the secondpart of the month.
And that happens for a lot ofwomen in perimenopause anyway, regardless
of their status with adhd.
And the thing about estrogenis that it's fluctuating really wildly
during perimenopause, whichmeans some days you might have higher
(06:26):
estrogen levels, which feeljust like they did before you were
going through perimenopause.
And, you know, kind of thingsfeel like they, they should have.
And then there's times whereestrogen stripping dropping really
low and you're going, well,why do I feel kind of out of it right
now?
And it's that fluctuation withestrogen really going up and down.
So there's less consistencyand less reliability for our brains
(06:48):
during perimenopause.
And then after menopause,again, we have less estrogen available.
So with that lowered estrogenstatus, we are going to have a lot
of brain impacts.
Now, something to recognizehere is that regardless of where
you are in your hormonaljourney, there is a different impact
for women than there is formen, because men have very stable
(07:08):
hormone levels for the most part.
They.
There is some reduction intestosterone later in life, but they
don't have these hormones thatcould look literally different every
single day of the month likewomen do.
And so their symptoms tend tobe a little bit more static, whereas
for women, we might be havinga more erratic set of symptoms.
The other thing is, when we'relooking at perimenopause and menopause,
(07:30):
women are going to havecognitive function challenges many
times, maybe a majority of thetime, regardless of any underlying
ADHD status.
And so there's a question I'veseen quite a lot, is, is it perimenopause
or is it adhd?
And, you know, the answer isit might be both.
So, you know, there are goingto be those hormonal fluctuations
(07:51):
that create maybe somecognitive havoc for a woman in perimenopause.
And by the way, that period ofperimenopause can last up to 10 years
before menopause sets in.
So you could be going throughperimenopause anytime, really, from
your late 30s into your 40s,and knowing that you may recognize
that, hey, you know, you'vehad some of these cognitive functions
for a while.
Where I look at, you know,where when women are asking, is perimenopause
(08:14):
or ADHD is how has your lifebeen up until now?
So, you know, have youexperienced symptoms of ADHD if you
look back on your life, reallythroughout your life, or is this
something that feels like it'sbrand new to.
To this time of your life, andit feels like, if it feels like it's
brand new, it may not beactually adhd.
It might be kind of those samesymptoms or similar symptoms that
(08:36):
are just cropping up becauseof the changes of hormones in perimenopause
and menopause on the brain.
So knowing this, you know,first of all, I think that knowledge
is power.
So if we know this, we cansay, okay, this is going to be a
big part of the picture forwomen with adhd, and how can we support
our brain health and managethat in a way that's going to help
(08:58):
us feel better during the month?
So a couple of things I wanted to.
To highlight.
First of all, that estrogenand progesterone do have a big impact
on that dopamine system, whichis crucial for focus, but also a
emotional regulation.
So really, I think one of thechallenges of ADHD that I have felt
certainly in myself and I'veseen in other women that I don't
(09:21):
think is really discussedenough perhaps, is that emotional
dysregulation piece.
So there is an emotionalcomponent that is very highly hormone
driven and it's going to feeleven more heightened if you have
adhd.
Pregnancy is a special, aspecial time.
So estrogen levels tend to goreally high in pregnancy.
I mean, they should be.
(09:41):
And they tend to stay stable.
So our hormones are actuallyjust kind of steadily increasing
over the course of pregnancy.
And so a lot of times womenwith ADHD feel fantastic when they're
pregnant.
And it's because that rise inestrogen means that they are having
a better dopamine response.
So we get a good brain benefit.
Now, does this mean that youshould just stay pregnant all the
(10:02):
time?
Probably not.
I don't think that's yourstrategy for managing adhd.
But you do want to be awarethat you could also have a crash
after, after birth.
So if you go from having thatstate of a high hormone state where
you have plenty of estrogenand therefore dopamine is working
better, and then you, youknow, you have your baby and it's
really easy for someone tokind of pass it off as baby brain
(10:23):
and say, okay, well, you know,you've just, you've just had a baby.
All women get baby brain.
Well, maybe it's worse for youbecause maybe you just lost all of
this, you know, this estrogenthat was helping your dopamine and
now you got a double whammy.
So your baby brain might beworse and you should recognize that
as a potential underlying event.
And then menopause, as we havetalked about, when estrogen levels
(10:43):
drop off sharply, a lot ofwomen again, are feeling those perimenopause
or, sorry, are feeling thoseADHD like symptoms and it may or
may not be adhd.
So it's important to recognizeif this has been a long term issue
for you or if this is a newonset because you're going to have
potentially, you know,different strategies for how you
manage that.
So some of the research aroundthis is really interesting to me.
(11:07):
So there's been some smallstudies that have found that ADHD
medications like Strattera canimprove concentration and memory
for perimenopausal orpostmenopausal women.
And actually that is true evenfor women who were not diagnosed
with ADHD before.
So that suggests really thatthere is this link between hormones
and brain function.
That doesn't mean that younecessarily need ADHD medication
(11:28):
just because you're havinghormone fluctuations.
You may want to address yourhormone fluctuations specifically.
A couple other things I wantto highlight here that our changes
Potentially, potentially.
Hormonal changes for women inperimenopause and menopause that
are not what we typicallythink of when we think about hormones
are two important hormonesthat are insulin and thyroid hormones.
(11:49):
Now, I don't think any hormoneconversation is complete without
talking about these hormones.
So if you go back and listento, you know, before I rebranded
this podcast, it was the bitchfix and it was, you know, holistic
hormone balancing for women.
And I have always talked aboutfor years what I call the big dogs
of hormone balance.
And, and what I mean by thatis these are the hormones that have
(12:11):
an outsized impact on the restof the hormone system.
And so, you know, as women, wetend to look directly at estrogen
and progesterone because weknow those as our female sex hormones.
But these other hormones areincredibly important as well, and
here's why they're extraimportant for adhd.
So when we are thinking about insulin.
So insulin is a hormone thathelps, among other things, but primarily
(12:32):
it helps to regulate blood sugar.
Now, blood sugar, if we goback to this idea of, you know, adhd,
challenges with energy andwith brain energy in particular.
So how are the cells of yourbrain actually getting that energy?
Well, your brain, as Imentioned in that first episode about
food, your brain is yourlargest consumer of glucose in the
body.
So it is, it's the smallest byweight and yet is the largest consumer
(12:56):
of your.
Of glucose.
I don't think I said that right.
But by weight, it is, it isthe largest consumer of glucose.
So it's, it's relatively smallcompared to the rest of your body,
but it uses most of yourbody's glucose.
I think I said that moreclearly that time.
In any case, when we developinsulin resistance or if we were
to develop insulin resistancein midlife, that is incredibly common,
(13:18):
first of all.
So it is statisticallyprobable that women in midlife are
going to potentially developinsulin resistance.
It's much more likely, whichmeans that your cells aren't going
to be doing a very good job ofpaying attention to insulin and letting
glucose inside.
So that glucose needs to getinside the cell, because that's what's
going to be able to provideenergy and fuel for those cells to
(13:40):
work to be metabolically healthy.
So when you're resistinginsulin, you're actually also resisting
glucose.
And so you might have highblood sugar, for example, and yet
have starvation for glucoseinside of the cell where it really
needs to be.
And what's interesting aboutthis is that your brain can also
become insulin resistant.
So if you're seeing signs onyour blood work of burgeoning insulin,
(14:03):
you should also be thinking,is my brain also becoming insulin
resistant?
And if your brain is becominginsulin resistant, that could be
that your cells of your brainare actually not able to access that
fuel that they need and that energy.
And so where we have a lot ofenergy dysregulation in an ADHD brain
already now, it can be madeeven worse by this insulin challenge.
(14:24):
The other hormone to consideris thyroid hormone.
Now, I actually haverecommended, you know, for years,
I think every woman needs tohave foundational thyroid numbers.
So if you haven't already, youshould be talk to your doctor about
establishing some baselinethyroid numbers, because many women,
if not most women, willdevelop some sort of thyroid issue
in, in our lifetimes.
(14:44):
And so it's important to knowwhat is your baseline.
And of course, if things getdysregulated, we want to know that.
True, know that too.
But again, when we think aboutthyroid, thyroid is actually partly
responsible for energy metabolism.
So there is emerging researchsuggesting a connection between thyroid
hormones and adhd.
So those hormones can play acrucial role in regulating metabolism
(15:06):
and brain function.
And when we have imbalances inour thyroid hormone that can absolutely
affect focus and mood.
So again, this doesn't meanthat a thyroid imbalance is going
to create adhd, but it couldbe that those symptoms are going
to be feeling worse because ofan underlying thyroid condition.
So if you have ADHD and youhave a thyroid issue, we actually
(15:27):
could be doubling down on abrain that doesn't feel very good.
So in one study, researcherslooked at people who had resistance
to thyroid hormone, and theyfound that higher levels of thyroid
hormones were linked to moresevere ADHD symptoms, particularly
with hyperactivity.
Now, again, resistance to hormones.
So this means that at thelevel of the cell, those cells were
(15:49):
not responding very well toour thyroid hormones.
So some numbers that you mightwant to check out.
When you're looking at yourthyroid, you want to look at your
tsh, which is actually a brain hormone.
It is not actual thyroid hormone.
It's thy stimulating orsignaling hormone.
And then T4 and T3, which areactual products of your thyroid.
And T3 in particular is theone that is going to be having you
(16:12):
feel better.
So T4 is inactive hormone.
It can't do much at a cellular level.
It has to be converted over to T3.
So you don't, you don't haveto remember all that.
But I would encourage you tobe looking at your TSH, your T3,
and your T4 at a very, veryminimum to ensure that you have sufficient
thyroid hormone for goodenergy, good metabolism, and good
(16:33):
brain health and brain metabolism.
So there's a huge overlookedfactor when it comes to women, our
hormones and adhd.
So if you already have ADHDand you notice extra changes in your
energy or focus, it might beworth having that conversation about
thyroid hormone and certainlyinsulin resistance with your doctor.
(16:54):
Now, a lot of what I amextrapolating beyond these things
are those are things that makesense to me based on what I know
of the brain, what I know offemale hormones, and how, what I
understand about thatpotential interaction.
But the frustrating part isthat a lot of the research that we
have on ADHD and hormones isstill rather limited.
It is still in its infancy.
(17:16):
And that's because of what Isaid at the very beginning of this
episode, which is that ADHDhas long been considered an issue
only with boys, particularlylittle boys, and we thought that
they outgrew it.
So when we see that this greatnumber of women are getting diagnosed
in midlife and that thatnumber has essentially doubled in
the last few years, and theaverage age of a woman who wasn't
(17:37):
diagnosed when she was a childis around 36 to 38.
Well, it's.
I can see a lot of reasons for that.
First of all, because we havenot studied women is a huge issue.
Second of all, it could bethat we are becoming mothers and
we are getting children with,with that diagnosis, and then we
can see that in ourselves.
And then certainly thosefluctuating hormones right around
that same period of life couldbe amplifying this impact for women.
(18:00):
But regardless of all of that,we still have this.
This complete imbalance of theamount of research that has been
done on men and boys and thathas been done on women.
So the research that we haveis really new.
I would say, you know, it'sgreat that more and more is coming
out, but really, most of theresearch specifically around women
and ADHD has been done in thelast five years.
(18:22):
So we have to extrapolate alot about what we know about hormones
and the brain and overallbrain health in overall.
And there are fewer researchstudies on the specifics for women.
So we have these gaps in understanding.
And that doesn't mean we don'thave any knowledge or any understanding.
I think we actually have quitea lot.
So what do we do about this?
(18:43):
So knowing that we have all ofthese challenges, well, the first
thing I would suggest is,again, track those basics, those
big dog hormones with your.
With your medical provider.
So you should be able toeasily access, you know, your blood
sugar markers, including Iwould say probably primarily hemoglobin
A1C, which is a three monthaverage of your blood sugar and then
(19:04):
those three thyroid markers,so your TSH, T3 and T4 and you want
those to be your, at least ata bare minimum, your free T3 because
that's really what's theactive hormone that's going to help
you feel.
Well.
Now as far as testing hormonesand we are moving to the part of
this episode where I'm talkingmore about testing.
And just as a quick reminderhere, you know, I started this little,
(19:24):
you know, series within theseries and finishing out season one
here talking about hormones,but talking about things at the beginning
of this little series that wedid not have to test as much like
food and sleep and then endingup with things where we might get
some really valuable data fromdoing some lab assessment.
So again, starting with, withinsulin and blood sugar regulation
(19:45):
and then also thyroid hormone.
Now, as far as women's sexhormones, I do think this is a really
important part of the conversation.
Now for a cycling woman who isnot yet in perimenopause or menopause,
there are a couple ofdifferent ways you can test your
hormones.
So there are, I think the,probably the most effective are ways
you look at your hormonesacross your cycle.
(20:07):
So there are salivary tests,there are urine tests.
The Dutch cycling woman isprobably the one that's most accessible.
Again, I can put a link in theshow notes to where you can access
that on your own if you wantto check that out for yourself.
But you can see what yourhormone levels are doing across the
menstrual cycle, which isincredibly important for women because
as I said earlier, thosehormones really are different every
(20:28):
single day, which is kind ofcool and kind of mind blowing.
Um, now if you are postmenopause you can do something really
similar, um, but it's calledthe Dutch Complete and you would
just want to do that one day.
So you really only need asingle sample because your hormones
are really not fluctuating theway that they were either when you
were cycling or duringperimenopause once you've passed
(20:48):
that, that phase where youhaven't had a period in a year.
Now, for those of us, myselfincluded, who are in this fun roller
coaster middle phase ofperimenopause where we are still
cycling but things are gettinga little bit erratic, our hormone
levels are chang pretty quickly.
Testing is really not thatuseful in and of itself.
(21:10):
So the reason for that isagain, estrogen can be fluctuating
wildly across even thebeginning of the cycle.
So typically, you know, apattern would look like higher estrogen
in that first half of your cycle.
But for a woman inperimenopause, that can be a lot
of up and down.
So you might not get a veryclear picture.
Same thing with progesterone.
We actually expectprogesterone to be lower in the second
(21:32):
half of your of your menstrual cycle.
However, there can be ups anddowns as we go through perimenopause
and those ratios might be different.
So there isn't really a testspecifically that will tell you you're
in perimenopause, which iskind of what everyone wants.
We all like, want, like themagic test.
And there isn't onespecifically that will tell you that.
What I would say in this timeperiod, one thing that is helpful
(21:53):
is knowing how you clear your estrogen.
So doing something like aDutch test will tell you how you're
clearing your estrogen progesterone.
It will tell you if you'retrending more to towards different
types of estrogen, what yourpathways are, how you're detoxing.
So that actually could bequite useful.
The other thing is you mayjust want to go based on your symptoms.
So a lot of those symptoms ofperimenopause, like your, you know,
(22:16):
challenges with sleep and hotflashes, and certainly the one that
has been the shocker for melately is brain fog.
And by brain fog, I mean,like, I just can't find the word.
I don't feel fuzzy most of theday, but I have had challenges just
coming up with specific wordthat is, you know, right there in
my brain and I just can't find it.
So I've recently started onthe journey of investigating and
(22:39):
I've actually just startedsome hormone replacement.
That's not a conversation I'mgoing to have on this podcast today.
And absolutely that's aconversation to be to be had with
your doctor.
However, I am going to alsosay here that a lot of doctors are
not all that well educated onperimenopause and menopause.
So absolutely, this is aconversation for another day to go
in deeper and I'll be lookingto bring on an expert.
(23:02):
By the way, if you have anexpert that you think would be fantastic
for me to bring on and talkabout this, for sure, go find me
over on Instagram, which isprobably the easiest way for you
to send me a message.
Just my name, ChristineMcCarroll, and send me a message
because I'M certainly open tohaving an expert on.
I know a lot of them too, butI think it's an important conversation.
Regardless, hormone therapy isspecific to each woman and so you
(23:25):
absolutely want to be thinkingabout things like your medical history
and your general healthhistory before you are are doing
anything like investigating that.
However, I do think it can bea really, really useful tool in the
arsenal of a woman with ADHDwhen we're looking at optimizing
the health of our brain, whichto me is one of the most vital organs
(23:45):
that there is.
So going back, leaning on someof those things that we talked about
earlier are actually alsogoing to help your overall hormone
balance.
So eating well, regulatingyour blood sugar, making sure that
you are detoxingappropriately, that you're getting
some efficient sleep, thatyour digestive system is working,
all of those are going to helpnot only your brain, but your sex
(24:07):
hormones, your sex hormonebalance, and how easy it is for you
to go through perimenopauseand menopause.
So absolutely start there.
And then there are also someadditional testing options you may
want to consider here.
So hopefully this has been eyeopening for you and helpful.
And if you want to hear moreabout my various strategies and my
(24:27):
blueprint print for getting aboss brain, I made it pretty simple.
The website isgetabossbrain.com and you can find
out more information about that.
And that is that is a wrap forthis first season of of adhd.
Naturally next season.
I am going deep on supplementsand I'm actually just going to be
starting next season next weekso you don't have to wait too long.
(24:50):
We are going to go all in onthe many, many natural supports that
women with ADHD can rely onwithout medication if medication
is not for you.
So tune in next week.
That's what I got coming for you.
Have a great weekend.
Hey love, thanks for making itthis far.
If you're hearing this, you'reone of the magical statistical few
that listened all the way tothe end and I so appreciate your
(25:12):
engagement.
I hope that means the messagetoday resonated with you and you're
taking away a tool trick oraction step that will help you have
your best feeling brain.
If that's you, I have a favorto ask.
So many more women need tohear this Message and your 30 seconds
to leave a rating.
A review will help them hear it.
Just go to the show in yourpodcast player and scroll down until
you see the stars to leave aquick rating and make my day while
(25:34):
you're at it.
Thank you so much.
For years, ADHD was seen as aboy's disorder.
This means that most research,treatments and even the diagnostic
criteria have been based onmen and boys.
But as we are seeing anincrease in women, especially women
with a late diagnosis of adhd,and women are sharing their experiences
or realizing just how muchwe've missed.
(00:21):
Welcome to ADHD NaturallySmart Solutions for Holistic Women
with Christine McCarroll.
Hi, I'm Christine, and this isthe spot to learn natural strategies
for supporting your ADHD brain.
As a woman with all thehormonal curveballs and unique challenges
that only females face, I'vemade it my mission to uncover the
root causes and little knownsupports for your ADHD brain that
(00:42):
your doctor doesn't know andwon't tell you.
Learn the truth and find your focus.
No prescription required.
Hey, friend.
And welcome back to ADHDNaturally Smart Solutions for Holistic
Women.
Now, if you haven't beenplaying along with the last few episodes,
I just want to remind you thatwe are going through what I'm calling
the boss Brain blueprint,which is my specific methodology
(01:05):
that I've developed forhelping women to have a boss brain
or be able to have focus thatis more like a laser than a disco
ball and have that on demandwhen you want it.
So if you've missed some ofthe earlier episodes on this, I would
invite you to go back to thebeginning of this little mini part
of season one here where westarted with talking about food.
(01:27):
So this methodology is basedon the idea that there are a lot
of underlying factors that caninfluence how our brains feel and
that brain health is essentialto mental health.
And in particular, I want tohighlight the specific role that
women's hormones play in this picture.
So today's episode is allabout that.
(01:49):
It's all about what I wouldcall lovingly the hormone hammer,
or sledgehammer, as the casemay be.
But where we are seeing thedirect impact of women's hormones
on their ADHD symptoms.
Now, one reason why I becameactually, the reason why I became
so interested in this topicwas that when I was diagnosed late
(02:10):
in life at 44, I believe itwas largely in part or largely due
to the fact that my hormoneswere beginning to fluctuate because
of perimenopause.
And what happened right at thesame time was that my daughter was
going through adolescence andher hormones were fluctuating a lot
as well.
And what I call the boil ofADHD had been simmering in both of
(02:32):
us for a long time.
So this was not new.
It's just that it was more manageable.
And once the big old hormonefluctuations of preteen hood and
perimenopause age hit us, thenthose symptoms got a lot worse, and
it really highlighted what hadbeen going on the whole time.
So as soon as I startedresearching this, as soon as I went
(02:53):
deep into the topic of ADHDfor women, I really wanted to understand
this hormonal component.
Now, I also had a specialinterest in this because I've been
been working with women'shealth for the last decade and specifically
looking at holistic hormonebalancing for women.
And I knew already that therewas a massive impact on our brain
function from our hormones.
I just didn't realize how muchof an impact this was having on a
(03:14):
brain that had this underlying adhd.
So why is this different for women?
Well, a big reason for it isthat our hormones interact with our
neurotransmitters.
So I've been talking about theneurotransmitter dopamine, which
is the big hormone that is,or, sorry, big neurotransmitter that
is primarily different.
You know, usually it's beingcleared overly fast in people with
(03:37):
adhd.
And this neurotransmitter issomething that really helps us with
focus and attention andmotivation and reward.
So if we are having a hardtime feeling motivated or getting
focused, it's a lot of timesbecause of this low dopamine state.
And something reallyinteresting that's different for
women is that we have estrogenthat is higher at certain parts of
(03:59):
the month, and estrogenpotentiates dopamine, meaning it
helps it to work better.
So what I've noticed in myselfand in other women is that we already
had fluctuating symptoms priorto any sort of major hormonal change.
So across a lifespan, a lot oftimes women are feeling better, more
(04:19):
able to focus, having bettermotivation, and maybe feeling like
their ADHD wasn't as present.
And actually, for some women,that can be a problem because we
start to doubt whether we evenhave adhd.
We are if we're, you know,exploring the possibility of a diagnosis.
And some of the month you feellike you can hardly function, and
some of the month you'refeeling kind of on it, or at least
(04:41):
better than the other part ofthe month, you might kind of tell
yourself, oh, well, itcouldn't be me.
And the truth is it might beyour hormones, and those hormones
might be affecting howsignificant those symptoms are for
you.
So for most cycling women, thebeginning part of the month is when
our estrogen is higher andwe're going to feel a little bit
better.
(05:01):
So because that estrogen ishelping dopamine along, it's its
little buddy, and they'reholding hands and skipping, and we're
able to access that dopaminemore easily and we're able to stay
on track a little bit more.
Now, that doesn't mean youdon't have ADHD for half the month.
It doesn't mean that yourunderlying brain function or structure
is different.
It just means that things feel better.
(05:22):
And then in the second half ofthe month, when estrogen goes lower,
we tend to not have as good ofan impact.
And the other thing is,progesterone has the counterbalancing
effect on dopamine.
So what we see is we have aless strong effect of dopamine in
our brains during that time.
So that's going to mean thatfor women who are cycling and are
(05:42):
not on some sort of hormonalbirth control, where things are kind
of flattened out, where we'rehaving these fluctuations in our
hormones, things are alreadygoing to be feeling different.
Now, what happens inperimenopause is a couple things.
First of all, progesteronestarts dropping off.
So a lot of timesprogesterone, besides kind of being
an antagonist to estrogen,it's also our calming hormone.
(06:03):
So it's kind of like nature's Prozac.
And when we drop off from thatnature's Prozac, we can tell to feel
more anxious in the secondpart of the month.
And that happens for a lot ofwomen in perimenopause anyway, regardless
of their status with adhd.
And the thing about estrogenis that it's fluctuating really wildly
during perimenopause, whichmeans some days you might have higher
(06:26):
estrogen levels, which feeljust like they did before you were
going through perimenopause.
And, you know, kind of thingsfeel like they, they should have.
And then there's times whereestrogen stripping dropping really
low and you're going, well,why do I feel kind of out of it right
now?
And it's that fluctuation withestrogen really going up and down.
So there's less consistencyand less reliability for our brains
(06:48):
during perimenopause.
And then after menopause,again, we have less estrogen available.
So with that lowered estrogenstatus, we are going to have a lot
of brain impacts.
Now, something to recognizehere is that regardless of where
you are in your hormonaljourney, there is a different impact
for women than there is formen, because men have very stable
(07:08):
hormone levels for the most part.
They.
There is some reduction intestosterone later in life, but they
don't have these hormones thatcould look literally different every
single day of the month likewomen do.
And so their symptoms tend tobe a little bit more static, whereas
for women, we might be havinga more erratic set of symptoms.
The other thing is, when we'relooking at perimenopause and menopause,
(07:30):
women are going to havecognitive function challenges many
times, maybe a majority of thetime, regardless of any underlying
ADHD status.
And so there's a question I'veseen quite a lot, is, is it perimenopause
or is it adhd?
And, you know, the answer isit might be both.
So, you know, there are goingto be those hormonal fluctuations
(07:51):
that create maybe somecognitive havoc for a woman in perimenopause.
And by the way, that period ofperimenopause can last up to 10 years
before menopause sets in.
So you could be going throughperimenopause anytime, really, from
your late 30s into your 40s,and knowing that you may recognize
that, hey, you know, you'vehad some of these cognitive functions
for a while.
Where I look at, you know,where when women are asking, is perimenopause
(08:14):
or ADHD is how has your lifebeen up until now?
So, you know, have youexperienced symptoms of ADHD if you
look back on your life, reallythroughout your life, or is this
something that feels like it'sbrand new to.
To this time of your life, andit feels like, if it feels like it's
brand new, it may not beactually adhd.
It might be kind of those samesymptoms or similar symptoms that
(08:36):
are just cropping up becauseof the changes of hormones in perimenopause
and menopause on the brain.
So knowing this, you know,first of all, I think that knowledge
is power.
So if we know this, we cansay, okay, this is going to be a
big part of the picture forwomen with adhd, and how can we support
our brain health and managethat in a way that's going to help
(08:58):
us feel better during the month?
So a couple of things I wanted to.
To highlight.
First of all, that estrogenand progesterone do have a big impact
on that dopamine system, whichis crucial for focus, but also a
emotional regulation.
So really, I think one of thechallenges of ADHD that I have felt
certainly in myself and I'veseen in other women that I don't
(09:21):
think is really discussedenough perhaps, is that emotional
dysregulation piece.
So there is an emotionalcomponent that is very highly hormone
driven and it's going to feeleven more heightened if you have
adhd.
Pregnancy is a special, aspecial time.
So estrogen levels tend to goreally high in pregnancy.
I mean, they should be.
(09:41):
And they tend to stay stable.
So our hormones are actuallyjust kind of steadily increasing
over the course of pregnancy.
And so a lot of times womenwith ADHD feel fantastic when they're
pregnant.
And it's because that rise inestrogen means that they are having
a better dopamine response.
So we get a good brain benefit.
Now, does this mean that youshould just stay pregnant all the
(10:02):
time?
Probably not.
I don't think that's yourstrategy for managing adhd.
But you do want to be awarethat you could also have a crash
after, after birth.
So if you go from having thatstate of a high hormone state where
you have plenty of estrogenand therefore dopamine is working
better, and then you, youknow, you have your baby and it's
really easy for someone tokind of pass it off as baby brain
(10:23):
and say, okay, well, you know,you've just, you've just had a baby.
All women get baby brain.
Well, maybe it's worse for youbecause maybe you just lost all of
this, you know, this estrogenthat was helping your dopamine and
now you got a double whammy.
So your baby brain might beworse and you should recognize that
as a potential underlying event.
And then menopause, as we havetalked about, when estrogen levels
(10:43):
drop off sharply, a lot ofwomen again, are feeling those perimenopause
or, sorry, are feeling thoseADHD like symptoms and it may or
may not be adhd.
So it's important to recognizeif this has been a long term issue
for you or if this is a newonset because you're going to have
potentially, you know,different strategies for how you
manage that.
So some of the research aroundthis is really interesting to me.
(11:07):
So there's been some smallstudies that have found that ADHD
medications like Strattera canimprove concentration and memory
for perimenopausal orpostmenopausal women.
And actually that is true evenfor women who were not diagnosed
with ADHD before.
So that suggests really thatthere is this link between hormones
and brain function.
That doesn't mean that younecessarily need ADHD medication
(11:28):
just because you're havinghormone fluctuations.
You may want to address yourhormone fluctuations specifically.
A couple other things I wantto highlight here that our changes
Potentially, potentially.
Hormonal changes for women inperimenopause and menopause that
are not what we typicallythink of when we think about hormones
are two important hormonesthat are insulin and thyroid hormones.
(11:49):
Now, I don't think any hormoneconversation is complete without
talking about these hormones.
So if you go back and listento, you know, before I rebranded
this podcast, it was the bitchfix and it was, you know, holistic
hormone balancing for women.
And I have always talked aboutfor years what I call the big dogs
of hormone balance.
And, and what I mean by thatis these are the hormones that have
(12:11):
an outsized impact on the restof the hormone system.
And so, you know, as women, wetend to look directly at estrogen
and progesterone because weknow those as our female sex hormones.
But these other hormones areincredibly important as well, and
here's why they're extraimportant for adhd.
So when we are thinking about insulin.
So insulin is a hormone thathelps, among other things, but primarily
(12:32):
it helps to regulate blood sugar.
Now, blood sugar, if we goback to this idea of, you know, adhd,
challenges with energy andwith brain energy in particular.
So how are the cells of yourbrain actually getting that energy?
Well, your brain, as Imentioned in that first episode about
food, your brain is yourlargest consumer of glucose in the
body.
So it is, it's the smallest byweight and yet is the largest consumer
(12:56):
of your.
Of glucose.
I don't think I said that right.
But by weight, it is, it isthe largest consumer of glucose.
So it's, it's relatively smallcompared to the rest of your body,
but it uses most of yourbody's glucose.
I think I said that moreclearly that time.
In any case, when we developinsulin resistance or if we were
to develop insulin resistancein midlife, that is incredibly common,
(13:18):
first of all.
So it is statisticallyprobable that women in midlife are
going to potentially developinsulin resistance.
It's much more likely, whichmeans that your cells aren't going
to be doing a very good job ofpaying attention to insulin and letting
glucose inside.
So that glucose needs to getinside the cell, because that's what's
going to be able to provideenergy and fuel for those cells to
(13:40):
work to be metabolically healthy.
So when you're resistinginsulin, you're actually also resisting
glucose.
And so you might have highblood sugar, for example, and yet
have starvation for glucoseinside of the cell where it really
needs to be.
And what's interesting aboutthis is that your brain can also
become insulin resistant.
So if you're seeing signs onyour blood work of burgeoning insulin,
(14:03):
you should also be thinking,is my brain also becoming insulin
resistant?
And if your brain is becominginsulin resistant, that could be
that your cells of your brainare actually not able to access that
fuel that they need and that energy.
And so where we have a lot ofenergy dysregulation in an ADHD brain
already now, it can be madeeven worse by this insulin challenge.
(14:24):
The other hormone to consideris thyroid hormone.
Now, I actually haverecommended, you know, for years,
I think every woman needs tohave foundational thyroid numbers.
So if you haven't already, youshould be talk to your doctor about
establishing some baselinethyroid numbers, because many women,
if not most women, willdevelop some sort of thyroid issue
in, in our lifetimes.
(14:44):
And so it's important to knowwhat is your baseline.
And of course, if things getdysregulated, we want to know that.
True, know that too.
But again, when we think aboutthyroid, thyroid is actually partly
responsible for energy metabolism.
So there is emerging researchsuggesting a connection between thyroid
hormones and adhd.
So those hormones can play acrucial role in regulating metabolism
(15:06):
and brain function.
And when we have imbalances inour thyroid hormone that can absolutely
affect focus and mood.
So again, this doesn't meanthat a thyroid imbalance is going
to create adhd, but it couldbe that those symptoms are going
to be feeling worse because ofan underlying thyroid condition.
So if you have ADHD and youhave a thyroid issue, we actually
(15:27):
could be doubling down on abrain that doesn't feel very good.
So in one study, researcherslooked at people who had resistance
to thyroid hormone, and theyfound that higher levels of thyroid
hormones were linked to moresevere ADHD symptoms, particularly
with hyperactivity.
Now, again, resistance to hormones.
So this means that at thelevel of the cell, those cells were
(15:49):
not responding very well toour thyroid hormones.
So some numbers that you mightwant to check out.
When you're looking at yourthyroid, you want to look at your
tsh, which is actually a brain hormone.
It is not actual thyroid hormone.
It's thy stimulating orsignaling hormone.
And then T4 and T3, which areactual products of your thyroid.
And T3 in particular is theone that is going to be having you
(16:12):
feel better.
So T4 is inactive hormone.
It can't do much at a cellular level.
It has to be converted over to T3.
So you don't, you don't haveto remember all that.
But I would encourage you tobe looking at your TSH, your T3,
and your T4 at a very, veryminimum to ensure that you have sufficient
thyroid hormone for goodenergy, good metabolism, and good
(16:33):
brain health and brain metabolism.
So there's a huge overlookedfactor when it comes to women, our
hormones and adhd.
So if you already have ADHDand you notice extra changes in your
energy or focus, it might beworth having that conversation about
thyroid hormone and certainlyinsulin resistance with your doctor.
(16:54):
Now, a lot of what I amextrapolating beyond these things
are those are things that makesense to me based on what I know
of the brain, what I know offemale hormones, and how, what I
understand about thatpotential interaction.
But the frustrating part isthat a lot of the research that we
have on ADHD and hormones isstill rather limited.
It is still in its infancy.
(17:16):
And that's because of what Isaid at the very beginning of this
episode, which is that ADHDhas long been considered an issue
only with boys, particularlylittle boys, and we thought that
they outgrew it.
So when we see that this greatnumber of women are getting diagnosed
in midlife and that thatnumber has essentially doubled in
the last few years, and theaverage age of a woman who wasn't
(17:37):
diagnosed when she was a childis around 36 to 38.
Well, it's.
I can see a lot of reasons for that.
First of all, because we havenot studied women is a huge issue.
Second of all, it could bethat we are becoming mothers and
we are getting children with,with that diagnosis, and then we
can see that in ourselves.
And then certainly thosefluctuating hormones right around
that same period of life couldbe amplifying this impact for women.
(18:00):
But regardless of all of that,we still have this.
This complete imbalance of theamount of research that has been
done on men and boys and thathas been done on women.
So the research that we haveis really new.
I would say, you know, it'sgreat that more and more is coming
out, but really, most of theresearch specifically around women
and ADHD has been done in thelast five years.
(18:22):
So we have to extrapolate alot about what we know about hormones
and the brain and overallbrain health in overall.
And there are fewer researchstudies on the specifics for women.
So we have these gaps in understanding.
And that doesn't mean we don'thave any knowledge or any understanding.
I think we actually have quitea lot.
So what do we do about this?
(18:43):
So knowing that we have all ofthese challenges, well, the first
thing I would suggest is,again, track those basics, those
big dog hormones with your.
With your medical provider.
So you should be able toeasily access, you know, your blood
sugar markers, including Iwould say probably primarily hemoglobin
A1C, which is a three monthaverage of your blood sugar and then
(19:04):
those three thyroid markers,so your TSH, T3 and T4 and you want
those to be your, at least ata bare minimum, your free T3 because
that's really what's theactive hormone that's going to help
you feel.
Well.
Now as far as testing hormonesand we are moving to the part of
this episode where I'm talkingmore about testing.
And just as a quick reminderhere, you know, I started this little,
(19:24):
you know, series within theseries and finishing out season one
here talking about hormones,but talking about things at the beginning
of this little series that wedid not have to test as much like
food and sleep and then endingup with things where we might get
some really valuable data fromdoing some lab assessment.
So again, starting with, withinsulin and blood sugar regulation
(19:45):
and then also thyroid hormone.
Now, as far as women's sexhormones, I do think this is a really
important part of the conversation.
Now for a cycling woman who isnot yet in perimenopause or menopause,
there are a couple ofdifferent ways you can test your
hormones.
So there are, I think the,probably the most effective are ways
you look at your hormonesacross your cycle.
(20:07):
So there are salivary tests,there are urine tests.
The Dutch cycling woman isprobably the one that's most accessible.
Again, I can put a link in theshow notes to where you can access
that on your own if you wantto check that out for yourself.
But you can see what yourhormone levels are doing across the
menstrual cycle, which isincredibly important for women because
as I said earlier, thosehormones really are different every
(20:28):
single day, which is kind ofcool and kind of mind blowing.
Um, now if you are postmenopause you can do something really
similar, um, but it's calledthe Dutch Complete and you would
just want to do that one day.
So you really only need asingle sample because your hormones
are really not fluctuating theway that they were either when you
were cycling or duringperimenopause once you've passed
(20:48):
that, that phase where youhaven't had a period in a year.
Now, for those of us, myselfincluded, who are in this fun roller
coaster middle phase ofperimenopause where we are still
cycling but things are gettinga little bit erratic, our hormone
levels are chang pretty quickly.
Testing is really not thatuseful in and of itself.
(21:10):
So the reason for that isagain, estrogen can be fluctuating
wildly across even thebeginning of the cycle.
So typically, you know, apattern would look like higher estrogen
in that first half of your cycle.
But for a woman inperimenopause, that can be a lot
of up and down.
So you might not get a veryclear picture.
Same thing with progesterone.
We actually expectprogesterone to be lower in the second
(21:32):
half of your of your menstrual cycle.
However, there can be ups anddowns as we go through perimenopause
and those ratios might be different.
So there isn't really a testspecifically that will tell you you're
in perimenopause, which iskind of what everyone wants.
We all like, want, like themagic test.
And there isn't onespecifically that will tell you that.
What I would say in this timeperiod, one thing that is helpful
(21:53):
is knowing how you clear your estrogen.
So doing something like aDutch test will tell you how you're
clearing your estrogen progesterone.
It will tell you if you'retrending more to towards different
types of estrogen, what yourpathways are, how you're detoxing.
So that actually could bequite useful.
The other thing is you mayjust want to go based on your symptoms.
So a lot of those symptoms ofperimenopause, like your, you know,
(22:16):
challenges with sleep and hotflashes, and certainly the one that
has been the shocker for melately is brain fog.
And by brain fog, I mean,like, I just can't find the word.
I don't feel fuzzy most of theday, but I have had challenges just
coming up with specific wordthat is, you know, right there in
my brain and I just can't find it.
So I've recently started onthe journey of investigating and
(22:39):
I've actually just startedsome hormone replacement.
That's not a conversation I'mgoing to have on this podcast today.
And absolutely that's aconversation to be to be had with
your doctor.
However, I am going to alsosay here that a lot of doctors are
not all that well educated onperimenopause and menopause.
So absolutely, this is aconversation for another day to go
in deeper and I'll be lookingto bring on an expert.
(23:02):
By the way, if you have anexpert that you think would be fantastic
for me to bring on and talkabout this, for sure, go find me
over on Instagram, which isprobably the easiest way for you
to send me a message.
Just my name, ChristineMcCarroll, and send me a message
because I'M certainly open tohaving an expert on.
I know a lot of them too, butI think it's an important conversation.
Regardless, hormone therapy isspecific to each woman and so you
(23:25):
absolutely want to be thinkingabout things like your medical history
and your general healthhistory before you are are doing
anything like investigating that.
However, I do think it can bea really, really useful tool in the
arsenal of a woman with ADHDwhen we're looking at optimizing
the health of our brain, whichto me is one of the most vital organs
(23:45):
that there is.
So going back, leaning on someof those things that we talked about
earlier are actually alsogoing to help your overall hormone
balance.
So eating well, regulatingyour blood sugar, making sure that
you are detoxingappropriately, that you're getting
some efficient sleep, thatyour digestive system is working,
all of those are going to helpnot only your brain, but your sex
(24:07):
hormones, your sex hormonebalance, and how easy it is for you
to go through perimenopauseand menopause.
So absolutely start there.
And then there are also someadditional testing options you may
want to consider here.
So hopefully this has been eyeopening for you and helpful.
And if you want to hear moreabout my various strategies and my
(24:27):
blueprint print for getting aboss brain, I made it pretty simple.
The website isgetabossbrain.com and you can find
out more information about that.
And that is that is a wrap forthis first season of of adhd.
Naturally next season.
I am going deep on supplementsand I'm actually just going to be
starting next season next weekso you don't have to wait too long.
(24:50):
We are going to go all in onthe many, many natural supports that
women with ADHD can rely onwithout medication if medication
is not for you.
So tune in next week.
That's what I got coming for you.
Have a great weekend.
Hey love, thanks for making itthis far.
If you're hearing this, you'reone of the magical statistical few
that listened all the way tothe end and I so appreciate your
(25:12):
engagement.
I hope that means the messagetoday resonated with you and you're
taking away a tool trick oraction step that will help you have
your best feeling brain.
If that's you, I have a favorto ask.
So many more women need tohear this Message and your 30 seconds
to leave a rating.
A review will help them hear it.
Just go to the show in yourpodcast player and scroll down until
you see the stars to leave aquick rating and make my day while
(25:34):
you're at it.
Thank you so much.
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