April 3, 2025 • 45 mins
Supplement confusion is at an all-time high, with social media feeds flooded with miracle promises targeting menopausal women. But how do you know what you actually need, what works, and what's just expensive snake oil?
Pharmacist and nutritionist Sarah Gray brings her dual expertise to this conversation, offering practical guidance for navigating the overwhelming world of supplementation.
Unlike most health professionals who specialise in either conventional medicine or natural approaches, Sarah bridges both worlds, providing uniquely balanced insights into what supplements might actually benefit women in midlife.
This episode delivers specific, actionable advice you can use immediately. Learn the simple trick for identifying quality supplements (look for the AUST-L or AUST-R code), understand which baseline blood tests you should request from your doctor, and discover why blindly following supplement trends can waste your money and potentially harm your health.
Sarah warns against the common practice of continuously adding supplements without removing any, explaining how this can lead to accidental overuse of certain nutrients.
We take a deep dive into the essential blood work every midlife woman should request annually. Sarah explains how certain symptoms commonly attributed to perimenopause could signal nutritional deficiencies that won't necessarily improve with hormone therapy.
And you don't want to miss our discussion about Creatine - arguably the most evidence-backed supplement for women in midlife - which offers benefits for muscle strength, mood regulation, and the immune system.
Take control of your health by understanding exactly what your body needs rather than what clever marketing suggests you buy. Your journey through perimenopause and beyond deserves an evidence-based approach to supplementation that works.
Links
Sarah Gray - Nutrition Pharmacist website
Sarah on Instagram
Sarah on Facebook
The Benefits of Creatine by Dr Mary Claire Haver
Why Creatine Matters for Women 40+ by Harvard Lifestyle Medicine
Thank you for listening to my show!
Join the conversation on Instagram
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Sonya (00:01):
Welcome to the Dear Menopause podcast.
I'm Sonya Lovell, your host Now.
I've been bringing youconversations with amazing
menopause experts for over twoyears now.
If you have missed any of thoseconversations, now's the time
to go back and listen, and youcan always share them with
anyone you think needs to hearthem.
This way, more people can findthese amazing conversations,
(00:25):
needs to hear them.
This way, more people can findthese amazing conversations.
Welcome to Dear Menopause thisweek.
I am delighted to be joinedtoday by Sarah Gray.
Sarah (00:37):
Welcome, Sarah.
Thank you so much, Sonya.
Sonya (00:38):
Thanks for having me Really excited to be here on
this wonderful podcast.
So let's jump in.
Why don't you do a much betterjob than I did and explain to
everybody who you are and whatyou do?
Sarah (00:46):
Yeah, absolutely, I'm a nutritionist and a pharmacist.
I started by studying pharmacyin my first degree out of high
school and I learned a few yearsinto working in community
pharmacy that there was just abit more I wanted to be able to
help people with.
I felt like I would give themthings to fix their problems,
but not necessarily try andprevent things so much so I had
(01:08):
a really interested in nutrition.
So, being the curious person Iam, I went and did a master's of
human nutrition at DeakinUniversity and so now I hold
both those degrees and it'sreally interesting.
Actually, I thought I'dactually hang my pharmacist hat
up and put my nutritionist haton, but as time went on, hang my
pharmacist hat up and put mynutritionist hat on, but as time
went on I realised the twoactually went really well
(01:29):
together and there's more andmore I explore about this every
day.
Yeah, they work well togetherin terms of being able to look
at someone holistically andthink about medicines,
supplements, lifestyle, havingthat pharmacy background of
medical conditions.
It's actually turned out to beperfect.
Sonya (01:46):
Sarah, that's amazing and I can absolutely see how,
working in a pharmacy, you wouldespecially if you're someone
that was quite kind of holisticin your approach to health
really feel that there was areaswhere you could be able to
expand on that advice.
And I've actually come across apharmacist and a nutritionist
before.
My local pharmacist was anutritionist as well, so it
(02:08):
totally makes sense and I thinkthat's a beautiful use of all of
your skills and probably allyour interpersonal skills as
well.
So how do you support womentoday as a nutritionist and a
pharmacist?
Sarah (02:20):
I don't still work in a pharmacy.
I do the odd shift to helpfriends if they need some help.
I do love working there, butI'm probably much too talkative
and want to have a fullconsultation with people, so I'm
not probably the fastest asthey would like.
But what I do now is I have anonline clinic where I help all
people, but I tended to get lotsof women booking in and I was
(02:40):
getting lots of women comingwith low energy.
It was a common theme.
That was just time after timeafter time and then when you do
further exploration, you'd findthere's the brain fog, the
stubborn belly fat and hormonalsymptoms and not saying it was
every time, but tended to bearound these kind of hormonal
changes.
So I now say that my mission isto help women better navigate
(03:02):
the really confusing health andwellness space, because this
then means you're sort ofempowered to make those great
choices and you can spend yourcash on things that will work,
based on science.
You can get cut through theoverwhelm, because the biggest
thing that happens is they cometo see me and they say I've
eaten eight different types ofsupplements, I've tried
intermittent fasting, I've triedall types of different things,
(03:23):
I've cut out carbs.
But when I asked them, well,have any of those things made
you feel better?
The answer is generally no.
So my mission is to try andhelp people use things or try
things that work, and if theydon't work, know that it's okay
to sort of trial things, butdoing it with a systematic
approach is better for you andyou'll feel better because of it
.
Sonya (03:42):
Yeah, that's so awesome, so important and so needed.
So one of the things that weagreed when we sat down and
chatted about recording anepisode was what aspect of all
the amazing work that you do canwe really narrow our focus on
and speak specifically to, atopic that I know is really top
(04:03):
of mind for a lot of people whenthey are trying to feel better
and they're on that elusivesearch for whether it's
supplements or nutrition advice.
But today we decided we weregoing to really focus in on
supplements.
We're going to deep dive intosome of the things you touched
on then, which were reallybeautiful around.
How do you not waste your moneyon supplements, which is super
(04:24):
easy to do.
We've all done it.
How do we know what is a goodsupplement to take, versus the
marketing hype that exists andis just being further amplified
now that menopause in particular, and perimenopause is this hot
topic, and how do we know whenwe actually need supplements?
So they're the kind ofconversations that you and I are
going to dive into today.
(04:44):
So, sarah, why don't we startoff with?
How do we know what is a goodsupplement Like?
How do we know we're not justflushing our money down the
toilet at the end of the day.
Sarah (04:54):
Yeah, such a great question and I do have some tips
I give people.
I'll go through them in areally sort of simplified way
because we don't want to have ascience lesson today, but I'll
give you some tips that are kindof practical that you can use
next time.
You're kind of staring at thatmega aisle of supplements or
online choosing or beingrecommended.
So the one thing I do want tostart with is it is best to get
(05:15):
personalized advice, because Ioften hear, oh, my friend used
this, or my neighbor used this,or my Pilates teacher used it
and I overhear it, probably verytuned into these conversations.
But just because it works foryou and it was safe for you
doesn't mean it will work forsomeone else or be safe for
someone else.
So it's very personal.
I tend to find women are takinga whole bunch of things just
(05:36):
because people have told themand they just add and add and
add.
So my first recommendation isif you want to treat or
alleviate a symptom or prevent adisease, you'll need a
therapeutic product.
So you can get foods that arekind of I call them kind of
dressed up in fancy marketingpackaging to make them look like
supplements, and some of them.
A few of them are actuallycompliant with the claims they
(05:58):
can make, but some of them oftengo a bit off kilter on being a
bit exaggerating on things theycan do.
It's hard to be able to tellthat.
So the first thing to do is say, well, I'm treating something
therapeutic, I should get atherapeutic good.
And the way you can find thatis by looking on the label for a
little OST-L or OST-R on thebottom right-hand corner of the
label.
So that's your first tick tosay this is actually a
(06:19):
supplement.
Sonya (06:20):
So sorry, Sarah, is that OST-L?
Sarah (06:27):
And why so sorry Sarah is that OST, a-u-s-t-l yes, okay,
and then R?
Now, the reason that that's agood idea is because foods don't
usually have the right dose ofan active ingredient at the
right amounts and formats togive a therapeutic outcome.
Because they're foods that arefunctional, they boost and
support the diet.
So they still have a place.
But if you want to improve yoursleep, you may need a dose of
magnesium of a certain formatthat's proven to help you with
(06:47):
sleep in certain conditions.
That's why you can do that.
It doesn't mean it's perfect,it just means it's the first
thing that you can look at andin a space where it's so hot
this topic right now, it can beoverwhelming with what you get
served up.
So that can be your first thing.
Then the second, which I wishwas much more wide, but it's
particularly only for sportssupplements is there a
(07:08):
third-party certification thattells you tick, this product is
and you probably know about thiswell, sonia in your space like
is this a high-quality,high-potent product?
Is it something I can rely on?
So a third-party comes in thathas nothing to do with the
supply or manufacture or sellingof the drug or the supplement,
I should say, and they put astamp on it.
Independent, more for sportssupplements, but super relevant
(07:31):
because things like magnesiumand creatine, which are becoming
popular in this space becauseof their efficacy, will often
have those.
So it's another thing you canlook for.
The third is the claims.
Can you trust the claims?
Now, this is what I say is theultimate can of worms, and I
wish I had a really easy way oftelling you what you could and
couldn't trust.
(07:51):
I will say the TGA products canonly contain ingredients that
are approved by the TGA and onlylist claims that are from a set
of claims the TGA allows you toselect from, so that's a good
thing.
However, not every singleproduct is detailed reviewed by
the TGA allows you to selectfrom, so that's a good thing.
However, not every singleproduct is detailed reviewed by
the TGA before it goes to market.
You sort of apply for it, youget a number and then they may
(08:13):
check you afterwards.
So there may be some claimsthat are exaggerated, but it's
less likely for the therapeuticgood.
So this is my kind of pragmaticway of how you should check
this, based on what I've seenLook at the label, which is
usually really compliant becauseit's highly regulated and if
the label is completelydifferent to what's on the
Instagram page and the website,that's a red flag.
(08:35):
So the label says it maysupport energy levels.
If the Instagram page saysyou're going to go from one to
10 out of 10 energy levels intwo days, well, that sounds a
little bit exaggerated.
So that to me, is a red flagthat you may want to choose a
different brand in that case,just because you can't be
confident that's truthfulinformation, because it's
exaggerated.
Sonya (08:55):
I think that's a really good point to dwell on for a
moment and that is thatexaggeration of claims in
marketing.
And I've actually seen a fewexamples of these recently crop
up in my social media feeds ofparticular products.
And there was one recently thatcaught my eye.
I'm not going to name what theproduct was, although I don't
know.
Sometimes I am tempted to nameand shame, but I'm not going to
(09:16):
today and it had a image of aprobably middle-aged woman and
she was standing side on so thatyou could see her shoulder and
she had like a tank top on.
I think she looked like she wasat the gym, maybe exercising,
and she had her hand up andwritten on her hand with a
(09:36):
marker looked like she'd writtenit on there said frozen
shoulder disappeared in and thisisn't going to be correct, but
it was something like five daysor two weeks it was an actual
time and it was quite from myperspective, very short period
of time and it was anadvertisement for a particularly
well-known menopause related.
(09:58):
It really caught my eye becauseI thought that is hugely
exaggerated, because I know thatyou are not going to fix a
frozen shoulder taking thisparticular product in that
period of time, and I thinkthat's really good to point out
to people because it is a reallyeasy way to identify.
Does this claim that theproduct is making seem
(10:20):
exaggerated?
Does it seem a little likethey're expecting great things
in very short periods of time?
yeah I'm glad you brought thatup, because I think that's
something we need.
Sarah (10:31):
We can easily look for, but we can also really easily
fall prey to yeah, and my commonsaying is and this is in
everything in life, not justthis space if it sounds too good
to be true, it probably is.
And um, but the reason why Ianchor you back to looking at
the label is they are often verycompliant on the label.
So if you see an ad like that,think, oh, I'm not sure if the
(10:52):
label doesn't say it's going toremove your, alleviate your
frozen shoulder in three days,it's probably not something that
they were probably allowed tosay within their claim.
So use the label as your guide.
That's a really kind of youknow less markety type piece
that tells you what it might do,so that hopefully they're
helpful.
The next one is around safety.
(11:13):
So, although this is not howyou can choose one, just being
more conscious when choosing,just because a supplement's
natural or herbal, it doesn'tmean it's 100% safe.
Often can interact with othersupplements, medication, foods,
certain diagnosed medicalconditions.
You shouldn't take them.
So be very careful to read thewarnings or speak to a health
professional and be conscious ofthat.
(11:33):
Don't just think if I can biteso easily, it must be safe.
It's not the case, and we seethings like ashwagandha, a very
commonly used adaptogen herb,which does have its place for
some people, being used really alot at the moment, and then
studies showing that higherlevel doses over extended
periods may actually impact ourliver.
So remember that they are stillactive substances most of the
(11:55):
time, so just bearing that inmind is really important.
Sonya (11:58):
I think that reminder as well of interactions with either
other conditions or othermedications or even sometimes
other supplements that you'retaking, can be really
problematic, which is why Ithink your very, very first
advice, of seeking advice froman expert first, is actually so
beneficial and highly suggested100%.
Sarah (12:21):
And I end with that one again just to kind of double up
on the importance.
But the reason why I end onseek advice at the end is just
check who you're getting theadvice from too.
So is the person.
Not all health professionals dothe same thing.
We all do different things.
So I sort of put the analogylike I wouldn't tell somebody
how to manage a chronic dentalissue, I would refer them to a
dentist.
(12:41):
Or how to manage their frozenshoulder'd probably send them to
a physio and a doctor.
So just be conscious that justbecause you have one
qualification doesn't mean youknow so good things to look for.
Are they sort of pharmaciststhat generally have the
knowledge?
Have they got added like lovelyto hear that you're older.
Where you used to live thepharmacist there was also
nutritionist degree qualifiednaturopaths.
(13:01):
So just checking, they've got adegree.
Lots of the ministry havewonderful health science degrees
now clinical nutritionists andintegrative doctors.
So have they got that expertise?
Because they're more able tosupport you in a more rounded
way as well.
Sonya (13:14):
So yeah, and do you happen to know where GPs would
fall into that?
Obviously, we see our GPs toprescribe medications, but many
women and I think I've probablydone this myself at some point
in time has been having thatconversation with the GP and
what supplements should I takeas well?
My girlfriend's taking creatineshould I?
So are GPs likely to be aseducated in supplements?
Sarah (13:38):
Good question.
It again depends on the GP.
They'd have a very goodknowledge of the things we're
talking about.
Whether or not they're expertsin specific types of supplements
would be another question.
So it really is dependent.
There is also GPs you can findthat have done a lifestyle
medicine degree and you can findthat on the lifestyle medicine
website and also integrativedoctors, through the Australian
(14:00):
Institute of IntegrativeMedicine, I believe.
So you can actually check fordoctors who have done additional
study.
That's more about lifestyle andsupplements.
So that's the case.
But you may also find there's aGP in your area who really has
specialised in this and lookedinto it.
So just look into it, becausethey'll often say, on the hot
doc or wherever you book,they'll say what their specialty
is.
Sonya (14:19):
Yeah, fantastic.
Sarah (14:21):
Then you're more likely to get a sort of more
well-rounded response, I guess.
Sonya (14:25):
Yeah, great advice.
And while we're talking abouthealthcare practitioners, let's
dive into.
One of the most commonquestions that I imagine comes
up is how do I actually knowwhat I need to take?
You touched on earlier likeeveryone at the moment is
talking about creatine, andpersonally I think that's for
good reason.
I think creatine is amazing.
I've been taking creatine dailyfor about five years, but I
(14:47):
just continue to see more andmore studies come out.
Isn't it the most researchedsupplement that's on the market?
So you might be someone that'sheard a lot of buzz about
creatine and so you're thinking,oh, do I need to take creatine
or do I need to take magnesium?
Do I need to take vitamin D?
Like there are so manyquestions around, just because
someone else is taking it orbecause it's getting a lot of
media attention, how do I knowif I need it?
(15:08):
So what's your recommendationin getting to the bottom of that
?
Sarah (15:12):
Yeah, I do agree with you on creatine.
I think it's as wonderful, asyou say as well.
I guess.
A couple of things.
Firstly, we mentioned bloodtests earlier when you and I
were talking before this sessionwas recording.
So blood tests are really great.
Once a year Check for any, or ifthere's any specific symptoms.
First we want to say, well, dowe have any deficiencies or sort
of at-risk areas that mightneed a bit more of
(15:35):
supplementation?
That's the first place, becauseyou want to correct anything
that needs correcting.
The other thing then issymptoms.
So are there specific symptomsthat you can't manage with diet
and lifestyle?
So I have this analogy.
It's about a cake.
I know not all cakes arehealthy, but I love cakes, so I
use the analogy of cake.
So when you've got a cake,you've got the flour, the eggs,
(15:55):
the butter, the base of the cake.
For me, that is if you've gotany symptoms.
You've corrected nutritionaldeficiencies through blood work.
You've got symptoms.
Is your diet optimized?
Is your lifestyle optimized?
Are you doing all those goodthings movement, mindfulness.
Then supplements are kind oflike the carrot and walnuts or
the chalk chips or whatever theflavor is.
It makes the cake taste better.
You don't really need it, butin some cases it makes the cake
(16:17):
better and it actually boosts it.
And then, for me, then, theicing on top, which I know we'll
talk about later, is that hrtor mht, which you know not all
cakes need.
It is that HRT or MHT, whichnot all cakes need it but often
taste better with it and makethem easier to eat.
So it's kind of a weird analogythat I've built up over time to
explain that.
But supplements you need arethings to help you treat
symptoms.
So if you're let's use anexample so when you sit down and
(16:40):
think about what symptomsyou're having, you've corrected
your nutritional deficiencies,let's just say, with blood tests
, so your iron's back to normalif it wasn't, et cetera, but you
still cannot sleep.
That's where we think, okay,what can we do before we go to?
Maybe sleeping tablets?
Or if you are on HRT, we cantalk about that.
But what can we do to try andsupport your body to sleep?
So we look for something like amagnesium glycinate or
(17:03):
bisglycinate, which is arelaxing form of magnesium.
We try that, but we don't justkeep taking that forever.
We try that for three, fourmonths.
Is it making a difference?
No, it's not making adifference, then we might try
something different.
So it's about treating thesymptoms and if they don't work
I often ask this question ifit's not making a difference,
you shouldn't continue taking it.
(17:24):
Some things you can't feel, forexample, caveat with if you're
using certain types of omega-3sto manage your cholesterol
levels and your HDL and LDL,your good and bad cholesterol.
You won't feel that, but youwill know if that's having an
impact when you have that nextblood test, which may be more
frequently than 12 months ifyou're treating a cholesterol
(17:44):
imbalance.
So that's sort of the way Ilook at it.
You know, is it a deficiency ordo you have symptoms?
And the other one would be.
Then I have kind of a set ofgeneral supportive supplements
that are really great for womenin this phase of life.
Creatine is one of them.
Probiotics are another reallygood one.
But again, firstly, have welooked at how you might get some
of those pre and probioticsthrough diet?
Firstly, have we looked at howyou might get some of those pre
(18:06):
and probiotics through diet?
Not possible for everybody, sothere's some that I sort of have
as kind of general supportivesupplements that I'll recommend.
But generally you want to lookat symptoms and see how you can
support somebody.
Sonya (18:13):
Okay, cool, doing some blood panels with your
healthcare practitioner to getan idea of those, the big
identifiable markers.
Like you mentioned, iron, Iknow vitamin D is one of those
ones that you can test on aregular basis, looking at where
those are sitting with yourhealth practitioner, but then
also going through thatsymptomology.
(18:34):
And I loved your suggestion ofjust because you start taking
something doesn't mean you keeptaking it forever, checking in
every 12 weeks, six months,whatever it is, and saying, okay
, but am I actually noticing adifference?
Because of this, I think that'sreally good advice.
Sarah (18:51):
And also what happens is sometimes people layer things on
, layer things, and I'll justgive an example where that
actually might be not great.
So vitamin B6 recently has beenin the media with the TGA.
So if you have too much vitaminB6, it actually can cause
things like tingling or numbnessin your extremities and a range
of symptoms because it cancause kind of nerve sort of type
(19:12):
damage.
But vitamin b6 is actually sortof thrown into a lot of
supplements, like if you'retaking a women's health blend or
a greens or this or that, itcan often be added in.
And what the tga were findingis people were taking lots of
different things, just keptadding and adding and adding oh,
I'm not sleeping, I'll add thegreens, I'm not doing this or
that, and that cumulativeincrease in the b6 was actually
causing almost a toxicity.
(19:33):
So it's not about one's notworking.
Add another, put, put aBand-Aid on that, it's about
well, I don't like recommendingmore than one or two supplements
at a time for someone, becauseif you add five and it's working
, what do you do?
You stay on the five.
Sonya (19:46):
Well, yeah, it's a great point, isn't it?
Like how do you then join thedots of which one is actually
having the most impact?
So I think that's good advicetoo.
Sarah (19:53):
Yeah yeah, that's good advice too.
Sonya (19:54):
Yeah, yeah, that's how I see it.
Awesome.
Now, I did ask my Instagramcommunity for any questions and,
while we're talking on thistopic, I think there's one that
is relevant to this.
I'm going to throw it in rightnow.
So, whilst we're talking aboutdiet as well as supplementing on
top of that, if we looked atthe population in general, how
(20:15):
many of us are actually gettingwhat we need from our diets on a
day-to-day basis without thenthe need for additional
supplements?
Sarah (20:24):
Yeah, and I haven't looked at sort of any evidence
to respond to this one, but interms of like statistical views,
because really our nationalnutrition survey is pretty dated
so we probably don't reallyknow how well people are eating,
I would just say, anecdotally,you'd be surprised like most
people are actually getting alot of what they need.
So if you're eating, you knowyou may not be eating that great
(20:46):
in terms of snacking and thingsin between, but if you're
getting sort of three decentmeals and you're generally
getting most of what you need, Ido find that people who don't
get what they need, they can'teven a buckets, so they might
have a chronic disease wherethere's impact on the way that
they can eat.
If you've got an ulcer orsomething, it may impact the
amount of food you have, ormaybe it's somebody who is
(21:06):
eating more plant-based, sotherefore they're really going
to have trouble with our iron,our B12 and some other things
and creating deficiencies there.
So, without having a statistic,I'd probably say like seven or
eight out of 10 people that Isee I generally feel pretty
comfortable that they're gettingthe right type of food.
It's just are they getting itin the right quantities to
optimize their health.
(21:27):
So and we'll talk about bloodwork later but you know you get
that range of okay if you getyour iron tested.
It can be from the low range tothe high range and a lot of
people, yes, are in the middleof that average, but many people
sit right at that bottom edge.
So they might be getting enough, but are they getting enough to
actually optimize their energylevels and ensure that they're
(21:48):
in a really optimal range?
So it's that view of you knowthe doctor's view more is it
outside of the range?
It's a traditional view,whereas a more integrative
practitioner might say well,actually towards the bottom end,
so let's actually give you somenow to improve your outcomes
later.
So without a percentage, that'smy kind of best guess at that
one.
Sonya (22:06):
Yeah, that's great, and I think it's also really
encouraging to hear that, fromyour perspective and the
anecdotal evidence that you'rekind of got available to you at
your fingertips, that there is ahigher percentage of people
that are actually getting a lotof what they need from their
diet.
And yeah, which, again, if wego back to that marketing kind
of hype, it can be a trope thatgets rolled out there, isn't it
(22:28):
that you know, like you're notgetting this in your diet, so
therefore, you should, you know,be topping it up with our
wonderful supplement.
Sarah (22:41):
And maybe I have a skewed view of the world because
people come to me want to workon their health.
I don't know, maybe they'realready doing that, so at a
population level I wouldn't know.
But yeah, I do often think, youknow, are we sort of making
people fear they have to havethese powders and things daily
to top up their nutrition, wherethey're probably not doing too
bad a job anyway, yeah, awesome,yeah, if you're really getting
your, your serves of veg andyour fruit and, like you said,
you're dripping your protein outthroughout the day and all
(23:02):
those things.
Sonya (23:03):
I think one of the things you touched on there which is
so important, because it doesn'tjust come down to protein, but
that plant-based diet versus andeven for someone like me who
eats everything that's on offer,except I am not a big seafood
eater and so therefore, I use anomega supplement because I know
(23:23):
that I don't eat anywhere nearas much seafood or fish as I
would need to get that naturally.
So that, for me, has alwaysbeen something I've been really
cognizant of.
Yeah, but I think, yeah,there's many people that perhaps
aren't as aware of how muchthey're eating of certain things
across their day versus theirweek to understand what they
(23:45):
should and shouldn't take.
Sarah (23:46):
Yeah, don't get me wrong.
We do, as a nation, need to eatmore vegetables, but we've
always needed to eat morevegetables ever since I've known
.
So you can always throw in afew extra serves of veg in.
Yeah, but yeah, on the wholepretty good.
Sonya (23:57):
Awesome, fantastic.
Thank you for answering thatquestion and I hope that it
answers the question for thelistener that sent that through.
So let's talk about blood work,because we have touched on it a
few times already.
I am a huge believer and if thegovernment follows through on
their promises, we will begetting a specific Medicare code
(24:18):
for this.
But I'm a big believer thatthere should be a midlife health
check for women that they go inand they have, whether it's
when they turn 40 or when theyturn 45 or somewhere in those
fees that triggers this checkup.
That is really broad.
I firmly believe everybodyshould get a DEXA scan and know
what their bone density is atthat point in time.
(24:39):
But let's focus on blood work.
So what blood work do yourecommend for women that fall
into, let's say, this midlifehealth check?
Sarah (24:49):
Focus in on more is what are those kind of general things
you want to get checked.
When I'm saying, oh, go to thedoctor and get your annual blood
test, well, what do you need?
And if you go to the doctor andask for that, they're probably
just going to give you the basicstuff, which is fine.
But it can be a goodconversation to have with them
about some of the other thingsthat you might like to have
tested as well, and I can giveyou examples of what I usually
(25:09):
recommend.
And the good thing as well is Ihave this other sort of full of
analogies, but full of likesort of analogies, but like we
shouldn't have tunnel vision onthis either, because even though
we're in our midlife phase andwe are likely to be going
through hormonal changes as wetransition into menopause, there
may actually be something elsegoing on too.
So it's important that we don'tjust assume that our brain fog
(25:31):
or our low energy is becausewe're in perimenopause.
That could be things like lowiron or issues with thyroid
levels.
So that's why, also, like Ireally I'd love that idea what
you said there, sonja with thedexa and everything else being
incorporated, because there'sother things at play that you
may just pick up as well um inthis and be able to sort of
treat those.
So then you can treat thehormonal stuff kind of
(25:52):
separately.
So I have a few things Irecommend.
So a full blood count.
What that just means is it'scalled an FPC.
That just means they're goingto look at your red blood cells,
your white blood cells, yourplatelets, checking all your
immune cells.
Already you've got enough redblood cells.
It's a pretty kind of baselinetest that you'll do and most
blood tests would have this.
And the second would be acomprehensive metabolic panel.
So this one looks at thingslike your liver function, your
(26:14):
kidney function, really want toknow how they're operating.
Also, that impacts the types ofmedicines and herbs you can use
, because if it's not optimalsome things won't work as well
or aren't as safe.
They'll also look at yourhydration level, so look at
electrolytes like sodium andpotassium and sort of give you
an idea about that.
So they're the first kind ofalmost like the baseline.
Then the next, most important Ithink, is the lipid profile.
(26:34):
So your doctor will test yourlevels of hgl, your good
cholesterol, which takes thecholesterol out of the body, the
bad cholesterol, triglyceridesand total cholesterol, just four
different ways of talking aboutcholesterol.
The doctor will give you anindication, but essentially you
want more of the good, less ofthe bad, and we especially want
this because estrogen worksreally hard during our lives to
(26:56):
earlier lives to help us controlcholesterol.
And then we're losing thatamount of estrogen, getting to
very low, if none, towards verylow, I should say, in menopause,
and therefore you know yourrisk of heart problems actually
rises, particularly see somedyslipidemia or lipid changes.
The third is around diabetes.
So fasting, blood glucose andwhat we call hba1A1c.
(27:17):
What are we looking at here?
So we know that as wetransition, we can actually see
some women experience what'scalled insulin resistance, which
just means your body doesn'trespond.
You have sugar, your body, yourpancreas, shoots out some
insulin to help you get thatsugar and use it up for energy.
Essentially, in a nutshell, asyou transition into this phase
(27:38):
of life, your body's not asresponsive to insulin for some
people.
So tests like these can helpyou understand.
Is that a problem for me?
And it's not a problem foreverybody.
You might read it is, but itactually may only impact some
people more than others.
So you want to test fasting,which is kind of like random, if
you.
And then hb1c, which actuallylooks at your average blood
(27:59):
sugar control over the past twoto three months.
Then nutritional deficiencies wespoke about a couple of these.
These are where it gets alittle bit, I wouldn't say,
confusing.
But vitamin d great one thatyou brought up before.
So you're really good becauseit's important, especially with
our bone health and immunehealth and a bunch of other
things and things like zinc, youknow and check if you how
you're going with that, becauseit can health and immune health
and a bunch of other things andthings like zinc, you know and
check how you're going with that, because it can impact your
(28:20):
immune system and things likethat.
Then the one that I say isinteresting is magnesium.
So there's lots of studies whenit comes to magnesium For the
example I used earlier to keepthat kind of story going with
magnesium glycinate for sleepthat show that you really get
most benefit out of that forthat particular indication.
If you're deficient inmagnesium, however, the
(28:41):
magnesium blood test isn't asaccurate as we would like, so
we're actually only about onepercent of all the magnesium in
your body is in that blood serumoh, wow yeah.
So even though you want to getit tested to have an idea, I
often recommend with magnesiumthat trial or error kind of
thing that I spoke about before.
So try it for a few with sleep.
It's about a month or two ifyou're not getting any benefits.
Sonya (29:02):
Yeah, and that's a good thing to note with magnesium,
isn't it?
I actually had thisconversation with my husband the
other night.
There is a compounding effectwith taking the magnesium
glycinate to when you are tryingto get it to help for sleep.
And this comes almost into whatyou were saying before about
take something for 12 weeks orbefore you judge whether it's
(29:23):
something you need to continuewith or not.
And I'm going to assume thatmagnesium is not the only
supplement that this is the casewith, where you do need to
build those building blocks tobuild to a level and then
maintain that level, and thatcan take a little bit of time.
It doesn't happen the firstnight that you take your
magnesium.
Sarah (29:41):
That's a really, really great point, sonia, and I've
actually thought of explainingthat.
So thank you for asking thatquestion.
It's not like a Panadol thatyou take two Panadol and your
headache goes.
A lot of these nutrients andsupplements herbal supplements
take time.
Another one is iron, forexample.
You don't just take iron.
It's actually a very slowprocess to use iron supplements
and increase your iron.
But then even things like youcan talk about ashwagandha,
(30:03):
which I recommend for somepeople therapeutically.
You don't necessarily need itevery day in a hot chocolate,
but we can park that.
But the ashwagandha, which isquite an adaptogen helping with
your nervous system response,like even that one system
response, like even that one.
You're not going to just buythe ashwagandha gummies and feel
calm that evening.
It's actually going to have acumulative effect.
So it's actually a great point.
So that was it.
(30:23):
Nutritional deficiencies then.
I know this is a lot, but ifyou just try and bucket them
into I've sort of tried tobucket them into six for us all.
So the fifth is iron studies,which is pretty standard in an
annual blood test as well.
You want to know how your ironstores are going, because iron
is one of those things I'vefound with my clients and over
time it actually can reallymimic that brain fog, energy
(30:46):
level and dizziness that isquite well-known with
perimenopause menopause.
Sonya (30:52):
And really important, and you may be going to touch on
this anyway but specifically inthat perimenopause phase, if you
are having heavier bleedingthan you might normally have or
you're having more regularperiods at some point, then the
iron becomes really important,because we don't always link the
fact that we're bleeding withwe're losing iron 100% and I
(31:16):
think it's something like youonly lose about 80 mils of blood
, so you don't have to lose alot more for it to start to
having that impact on iron.
Sarah (31:26):
That's 100%.
In this age it becomes quitecommon to see iron issues
because of that.
So in that case of course wewant to treat that and you've
got a wonderful episode I justlistened to about heavy periods
and what to do around that aswell, and I often find the brain
fog is really common with irondeficiency anemia.
So that means your iron's gotsuch a low point that the amount
(31:46):
of oxygen that's attached toevery one of your red blood
cells is reduced.
So you've got not as muchoxygen kind of circulating in
the body and that can actuallyreally lead to brain fog.
That's a real big one that Ilike to have checked for people,
and especially plant-based aswell.
So again, it's a bit harder toget the iron absorbed in those
cases.
And then thyroid so a couple ofreasons Like thyroid disorders
(32:08):
are really common in women and alot of us aren't aware we even
have them.
Sonya (32:12):
So first of all, and a lot of the perimenopause
symptoms can mimic thyroidproblems.
Yeah, a hundred percent.
Sarah (32:18):
It's like a kind of double-edged sword.
They can mimic it, but thenchanges to estrogen might alter
the thyroid hormone levels, solike it's really very important.
My tip for this one is, if youcan ask for a full thyroid
function test the whole panelyou want to see your thyroid
stimulating hormones, the onethat normally gets checked and
that's kind of looking at.
It's kind of the opposite.
(32:38):
So a higher level of TSH saysyou're not producing enough
thyroid hormone and a low levelsays you're producing too much.
It's kind of opposite.
But you also want to look at T4and T3, which are the different
types of thyroid hormone.
But then there's some anti uhsort of I should say antibodies,
anti-tpo and anti-thyroidglobulin, being technical.
(32:58):
But just ask the doctor for afull panel if you can, if
they're open to that, becausethey actually give you not just
the tsh, sort of says, okay, youeither got too much thyroid
hormone or not enough.
These other tests on the panelgive you a more specific
diagnosis that make treatment ofthose things just change or
tweak slightly.
So for the panel once a year, Ithink is a reasonable thing to
(33:18):
be asking for.
And then you know they're themain ones.
If you've got other symptomsthe doctor might also want to do
things to look for inflammation, so ESR or CRP, but that's
usually if something's going onand those six are probably
enough anyway.
But they're pretty standard onkind of an annual test to check
that everything's happeningwithin your body the way that
you would like.
Sonya (33:39):
Yeah, great.
So your recommendation, withthese blood panels and all those
pillars that you've just talkedabout ticking off with that,
would be to keep that an annualexercise, at the very least.
Sarah (33:50):
Yeah, it is.
And my other big tip is whenyou get the results, or if you
get told, oh, your results arenormal, you don't need an
appointment, my highrecommendation is that you
please ask them for a copy ofyour blood test results that you
keep for yourself and you mayshare that with your
nutritionists or personaltrainers or other relevantly
qualified health professionals.
(34:11):
I've got a wonderful personaltrainer that has done a bit of
extra training in this as wellto understand it.
So if you have that, then ifyou go and book an appointment
with a naturopath or anutritionist, they've got that
information, which is reallyuseful for them in the way
they're looking at your health,and then you've got a copy of it
for yourself.
My Health Record should makethat easier over time.
Yeah, health, and then you'vegot a copy of it for yourself.
Sonya (34:30):
My health record should make that easier over time.
Yeah, over time.
But not everybody is subscribedinto the my health record, so
that does become a little bitproblematic for some people.
I'm one of those people, butI've always always asked for my
copies of my blood works.
It is actually quite easy, ifyou you do a little bit of
research, to understand what.
And I think the most importantthing and you mentioned this
earlier is that some medicalpractitioners will literally
(34:52):
just look at the baselines thisis what's low, this is what high
, and you fall within those, soyou're okay.
But if you do see a naturopathor a dietician or an integrative
doctor and a lot of GPs now arebecoming more educated on this
is if you are still at thatbottom or even the high.
You need to address that.
It can't just be well, you fallwithin this, so you're okay.
(35:12):
If you are on that low end orthe high end, you need to be
looking at the why behind thoseand is it something that needs
to be addressed?
Sarah (35:19):
100%.
It's certainly very importantto contact the doctor and speak
about it for them to give youthe top level if there is things
that are out of range.
Sonya (35:26):
Oh yeah, always Of course .
Sarah (35:27):
but having it for yourself that means you've got a
copy of that, and usually ifyou go back to the same GP then
we'll get sort of columns of theblood tests that will kind of
show the dates.
Sonya (35:36):
I know I love that.
Sarah (35:38):
Well, you may also may not this day and age.
You may not have a regular GPeither, so make sure, if you've
got it, then you can keep thatyourself.
Sonya (35:47):
Yeah, that's right.
Awesome, that was wonderful.
Thank you so much for coveringoff all of that and questioning
around blood work and pathology,and I think that's awesome
information.
So if we throw hormone therapyinto the mix, just for a moment,
so if somebody is also usingHRT or MHT however they prefer
to refer to it one of the thingsthat I think we need to talk
(36:08):
about consistently is thatthat's not a silver bullet to
anything other than topping upyour hormones.
So, on top of that, you need tostill always be addressing your
nutrition.
You need to be looking at yourexercise.
You need to be looking at sleepand stress management, that
lifestyle medicine degree thatyou talked about before, which I
love so much.
I have a friend who's doing hermaster's in it at the moment
(36:30):
and I think it's just amazing.
I'm tempted.
Yeah, I know, don't worry, itcrossed my mind too, and then I
was like no, sonia, you don'tneed to do anything else right
now.
But so if we consider hormonetherapy in that same kind of
like holistic approach, where dosupplements sit within that?
Sarah (36:50):
yeah, I love that question.
It's sort of my cake that Ispoke about.
But you know, hrt, or mht asyou mentioned, tops up the
hormones and should mitigatemost of the hormonal symptoms
you've got and then does areally great job, as you would
know too, sonia of sort ofpreventing that kind of helping
prevent the longer term kind ofrisks of heart disease and bone
osteoporosis etc.
But first I would say, ifyou're taking HRT and it's not
(37:13):
really making things better, thefirst thing I would do is go
back to speak to the doctor orspecialist because it might not
be the right dose, like Iactually was writing an article
the other day about the types ofHRT and I can't, even as a
pharmacist, keep up with thedifferent formats, types that
come out all the time.
So there's different ones youcan try.
Sonya (37:30):
And it is very much something that, like we were
talking about with supplementsbefore, needs to be tweaked,
takes a little while to kind ofget into your system and start
working on that compounding kindof effect.
Yeah, but yeah, and you know, Ithink that's so important that
you must always remember that itis a therapy that is going to
be unique to you 100%.
(37:51):
It's got to be tweaked and youshould be going in and having
regular checks, particularly inthose early few months when you
start on it, to make sure thatyou are getting the right dosage
that you are absorbing.
There are so many differentlittle nuances with it.
So supplements, absolutely thesame.
Sarah (38:08):
Yeah, so if the tick box is go check, everything is good
with that, then you may actuallyneed some supplements, as you
mentioned, sonia, like HRT isnot going to solve everything.
So back to that kind of ironexample if you're deficient in
iron, hrt is not going to fixthat, you will need an iron
supplement.
Or if you want to try creatinefor the muscle, health and other
benefits, that's not reallygoing to be something that HRT
(38:30):
is going to do for you.
So you again look at thosesymptoms or things you want to
prevent or support and you mayadd them on.
The other thing that I alsofind interesting is something
that remember at the start I wassaying take off the pharmacist
hat, throw on the nutritionisthat, but now I think I wear both
hats is there's some nutrientdepletions that drugs can cause
(38:50):
as well.
So I just wanted to touch onthat briefly.
I do want to caveat with itdoesn't happen for everybody,
but it is a possibility thatsome of our hormone replacement
therapy medicines might actuallyimpact us and deplete our body
of certain nutrients.
So just something to bear inmind.
Give some specific exampleshere Estrogen therapy therapy
and I believe this is similarfor bio body identical and
(39:12):
synthetic estrogen, again beingquite the same possible in the
literature.
So it means it could happen mayactually deplete your magnesium
levels, which, if we know wespoke about before, it's kind of
hard to know what yourmagnesium level is, so again, we
might be compounded by havingless magnesium.
So trying some might be a goodchoice.
Again, the right format.
So I spoke about glycinate, butthere's lots of other formats
(39:35):
for different things.
Then vitamin B6, another onewe've spoken about.
It can impact that metabolism,either making you more likely to
have low or high levels.
So again, that's something else.
If you're having sort of weirdkind of neural symptoms, it
could be you've got too much B6.
So I find that superinteresting.
The B6, I should caveat to saythat's more so with the oral
(39:56):
contraceptive pill.
It often has more syntheticforms but also a lot higher dose
than HRT.
So that's, if you put on anoral contraceptive pill which
generally I see happen, as wementioned before, to help with
those heavy periods and forcontraception, that can actually
have a depleting effect on theB6.
Increased calcium needs in thisage of life I think it's 1,300
(40:16):
milligrams a day for a lady inmenopause and so therefore you
know the fact that it mightimpact.
That makes it even moreimportant to get your regular
tests around your vitamin D, butalso making sure your calcium
levels are being topped up,dietary as well.
Your doctor or nutritionist canhelp you navigate that if you
think or want to ask questionsabout that for your personal
(40:36):
situation.
Sonya (40:36):
Yeah, brilliant.
Thank you.
That was some really goodinformation.
Okay, I want to end on apositive note.
My first question is if you hada magic wand, what would you
change about the supplementindustry?
Sarah (40:47):
Yeah, yeah, I think this will be positive.
I would like there to be aworld and we're imagining it's
just complete free reign herethat there's a world where every
single supplement that comes tomarket has gone through a
rigorous process of being testedDoes it actually work, are the
claims right?
Is it suitable for all thethings it says it's going to do?
It's all checked thoroughly.
(41:08):
And then we see really hugesort of restrictions, which
exist, but like huge penaltiesthat happen really fast when
they do the wrong thing.
There are things that TGA aretrying to do about this, but
there are only so many peopleand there's so many things
happening.
And I will say, in a positivenote, we are really lucky in
Australia.
So we might think that thesethings frustrate us, that we see
(41:31):
these claims they can't make,but compared to other countries,
we've actually got a prettygood handle on this stuff and
the TGR are doing a really goodjob.
The magic one give them moreresources, time and money to be
able to make it even better, sopeople get what they need, it
works and they're not wastingtheir money.
That's the bit I hate.
Sonya (41:55):
These things are expensive, so that would be a
perfect world, in my opinion,amazing.
All right, we talked about itright at the very beginning and
I think it's a really hot topicright now.
But what makes creatine such agreat supplement?
Not looking at athletes,necessarily, but specifically
for women in this midlife phase?
Sarah (42:09):
I was actually hoping this question would come up, I
just think because it has theevidence that supports so many
different things, which is andyou mentioned before it's so
well researched.
I feel like it's having itstime in the sun, but I've been
talking about ages, I'm sure youhave been too.
So if we think about, yes, ithelps with your muscle mass and
(42:31):
strength, which is a huge thingin this phase of life, we're
losing our muscle tone, ourmuscle strength.
We want to make sure we dostrength training and all that
sort of stuff to do that.
I personally love strengthtraining, optimizing that.
But the thing that I love aboutit is what's coming out around
how it can actually improve moodand actually really help with
that.
Some of those hormonal thingsand for me, also very, very
(42:53):
minimal side effects I'llmention one shortly but and also
really only if you've gotsevere kidney problems, you
can't take it.
So it's pretty great for most,most of us in this phase of life
and it helps with our muscles,it helps with our hormone
balance, it helps with our mood.
So really it does a lot ofthings with one scoop and often
it's unflavored, so you can addit to things or add a few
(43:14):
electrolytes or add it towhatever you can you can add it
to your coffee yeah, add it towhatever the brand suggests you
can on the back of the pack,because they'll know whether
it's heat tolerant, whicheverone.
That it is right.
But what a great thing.
And look, if you hear that itmay cause weight gain I'm sure
you've heard this sonia like.
It pulls water in, which is oneof the things it does.
So at the start you might feela bit more sort of bloated or
(43:35):
puffy.
That will go away and I canguarantee I think you may have
seen all these things on socialtake it every day for 30 days.
That's three to five grams, andthen you make it.
You make a decision andremember we're saying don't take
things if you don't notice adifference.
You will notice a difference, Ithink, with this, and most
people tell me they do.
So I love that it actually doeswhat it says it's going to do
(43:57):
yep yeah, and, as I mentionedearlier, there's just so much
research.
Sonya (44:02):
even though it's already so well researched, there is so
much research consistentlycoming out about it.
The one one that blew me awayrecently is I think I've
mentioned on here I've had COVIDrecently for the first time.
One of my biggest fears isgetting long COVID and I
definitely want to do everythingI can to avoid that the way I'm
feeling right now.
I'm pretty sure I've managed todo that.
(44:22):
But a lovely friend, angeliqueClark, who is a dietician and
nutritionist, she sent me someresearch whilst I was ill
showing that four grams ofcreatine taken daily for six
months was showing wasresearched evidence that it was
helping prevent or helping torecover from long COVID.
(44:46):
I'll send you the researchpaper and for anyone listening,
I'll also link it in the shownotes because it is quite a new
piece of research and it justreally shows the breadth of the
supplement.
Sarah (44:58):
Sometimes it can be a bit .
You get a bit stuck in thesocial media and think these
things are being recommended,but this is one that makes me
smile, I think.
Oh, it's having its time in thesun and it should be having it,
so it's a good thing of socialimpact.
Sonya (45:10):
Yeah.
Sarah (45:10):
This one really is the one that you can get on board.
Sonya (45:13):
Awesome.
I'll link through in the shownotes just some general
information on creatineWonderful From great
evidence-based sources, as wellas that paper that we just
talked about, and I'm going tolink through to your website as
well so that if anybody that'slistening is as intrigued as I
am by all of this conversationand they want to know more about
you and perhaps potentiallylook at how they could work with
(45:34):
you, they'll have all theinformation they need in today's
show notes.
Sarah (45:36):
Very kind, thank you.
Sonya (45:38):
Absolute pleasure, Sarah.
Thank you for being my guesttoday.
Welcome to the Dear Menopause podcast.
I'm Sonya Lovell, your host Now.
I've been bringing youconversations with amazing
menopause experts for over twoyears now.
If you have missed any of thoseconversations, now's the time
to go back and listen, and youcan always share them with
anyone you think needs to hearthem.
This way, more people can findthese amazing conversations,
(00:25):
needs to hear them.
This way, more people can findthese amazing conversations.
Welcome to Dear Menopause thisweek.
I am delighted to be joinedtoday by Sarah Gray.
Sarah (00:37):
Welcome, Sarah.
Thank you so much, Sonya.
Sonya (00:38):
Thanks for having me Really excited to be here on
this wonderful podcast.
So let's jump in.
Why don't you do a much betterjob than I did and explain to
everybody who you are and whatyou do?
Sarah (00:46):
Yeah, absolutely, I'm a nutritionist and a pharmacist.
I started by studying pharmacyin my first degree out of high
school and I learned a few yearsinto working in community
pharmacy that there was just abit more I wanted to be able to
help people with.
I felt like I would give themthings to fix their problems,
but not necessarily try andprevent things so much so I had
(01:08):
a really interested in nutrition.
So, being the curious person Iam, I went and did a master's of
human nutrition at DeakinUniversity and so now I hold
both those degrees and it'sreally interesting.
Actually, I thought I'dactually hang my pharmacist hat
up and put my nutritionist haton, but as time went on, hang my
pharmacist hat up and put mynutritionist hat on, but as time
went on I realised the twoactually went really well
(01:29):
together and there's more andmore I explore about this every
day.
Yeah, they work well togetherin terms of being able to look
at someone holistically andthink about medicines,
supplements, lifestyle, havingthat pharmacy background of
medical conditions.
It's actually turned out to beperfect.
Sonya (01:46):
Sarah, that's amazing and I can absolutely see how,
working in a pharmacy, you wouldespecially if you're someone
that was quite kind of holisticin your approach to health
really feel that there was areaswhere you could be able to
expand on that advice.
And I've actually come across apharmacist and a nutritionist
before.
My local pharmacist was anutritionist as well, so it
(02:08):
totally makes sense and I thinkthat's a beautiful use of all of
your skills and probably allyour interpersonal skills as
well.
So how do you support womentoday as a nutritionist and a
pharmacist?
Sarah (02:20):
I don't still work in a pharmacy.
I do the odd shift to helpfriends if they need some help.
I do love working there, butI'm probably much too talkative
and want to have a fullconsultation with people, so I'm
not probably the fastest asthey would like.
But what I do now is I have anonline clinic where I help all
people, but I tended to get lotsof women booking in and I was
(02:40):
getting lots of women comingwith low energy.
It was a common theme.
That was just time after timeafter time and then when you do
further exploration, you'd findthere's the brain fog, the
stubborn belly fat and hormonalsymptoms and not saying it was
every time, but tended to bearound these kind of hormonal
changes.
So I now say that my mission isto help women better navigate
(03:02):
the really confusing health andwellness space, because this
then means you're sort ofempowered to make those great
choices and you can spend yourcash on things that will work,
based on science.
You can get cut through theoverwhelm, because the biggest
thing that happens is they cometo see me and they say I've
eaten eight different types ofsupplements, I've tried
intermittent fasting, I've triedall types of different things,
(03:23):
I've cut out carbs.
But when I asked them, well,have any of those things made
you feel better?
The answer is generally no.
So my mission is to try andhelp people use things or try
things that work, and if theydon't work, know that it's okay
to sort of trial things, butdoing it with a systematic
approach is better for you andyou'll feel better because of it
.
Sonya (03:42):
Yeah, that's so awesome, so important and so needed.
So one of the things that weagreed when we sat down and
chatted about recording anepisode was what aspect of all
the amazing work that you do canwe really narrow our focus on
and speak specifically to, atopic that I know is really top
(04:03):
of mind for a lot of people whenthey are trying to feel better
and they're on that elusivesearch for whether it's
supplements or nutrition advice.
But today we decided we weregoing to really focus in on
supplements.
We're going to deep dive intosome of the things you touched
on then, which were reallybeautiful around.
How do you not waste your moneyon supplements, which is super
(04:24):
easy to do.
We've all done it.
How do we know what is a goodsupplement to take, versus the
marketing hype that exists andis just being further amplified
now that menopause in particular, and perimenopause is this hot
topic, and how do we know whenwe actually need supplements?
So they're the kind ofconversations that you and I are
going to dive into today.
(04:44):
So, sarah, why don't we startoff with?
How do we know what is a goodsupplement Like?
How do we know we're not justflushing our money down the
toilet at the end of the day.
Sarah (04:54):
Yeah, such a great question and I do have some tips
I give people.
I'll go through them in areally sort of simplified way
because we don't want to have ascience lesson today, but I'll
give you some tips that are kindof practical that you can use
next time.
You're kind of staring at thatmega aisle of supplements or
online choosing or beingrecommended.
So the one thing I do want tostart with is it is best to get
(05:15):
personalized advice, because Ioften hear, oh, my friend used
this, or my neighbor used this,or my Pilates teacher used it
and I overhear it, probably verytuned into these conversations.
But just because it works foryou and it was safe for you
doesn't mean it will work forsomeone else or be safe for
someone else.
So it's very personal.
I tend to find women are takinga whole bunch of things just
(05:36):
because people have told themand they just add and add and
add.
So my first recommendation isif you want to treat or
alleviate a symptom or prevent adisease, you'll need a
therapeutic product.
So you can get foods that arekind of I call them kind of
dressed up in fancy marketingpackaging to make them look like
supplements, and some of them.
A few of them are actuallycompliant with the claims they
(05:58):
can make, but some of them oftengo a bit off kilter on being a
bit exaggerating on things theycan do.
It's hard to be able to tellthat.
So the first thing to do is say, well, I'm treating something
therapeutic, I should get atherapeutic good.
And the way you can find thatis by looking on the label for a
little OST-L or OST-R on thebottom right-hand corner of the
label.
So that's your first tick tosay this is actually a
(06:19):
supplement.
Sonya (06:20):
So sorry, Sarah, is that OST-L?
Sarah (06:27):
And why so sorry Sarah is that OST, a-u-s-t-l yes, okay,
and then R?
Now, the reason that that's agood idea is because foods don't
usually have the right dose ofan active ingredient at the
right amounts and formats togive a therapeutic outcome.
Because they're foods that arefunctional, they boost and
support the diet.
So they still have a place.
But if you want to improve yoursleep, you may need a dose of
magnesium of a certain formatthat's proven to help you with
(06:47):
sleep in certain conditions.
That's why you can do that.
It doesn't mean it's perfect,it just means it's the first
thing that you can look at andin a space where it's so hot
this topic right now, it can beoverwhelming with what you get
served up.
So that can be your first thing.
Then the second, which I wishwas much more wide, but it's
particularly only for sportssupplements is there a
(07:08):
third-party certification thattells you tick, this product is
and you probably know about thiswell, sonia in your space like
is this a high-quality,high-potent product?
Is it something I can rely on?
So a third-party comes in thathas nothing to do with the
supply or manufacture or sellingof the drug or the supplement,
I should say, and they put astamp on it.
Independent, more for sportssupplements, but super relevant
(07:31):
because things like magnesiumand creatine, which are becoming
popular in this space becauseof their efficacy, will often
have those.
So it's another thing you canlook for.
The third is the claims.
Can you trust the claims?
Now, this is what I say is theultimate can of worms, and I
wish I had a really easy way oftelling you what you could and
couldn't trust.
(07:51):
I will say the TGA products canonly contain ingredients that
are approved by the TGA and onlylist claims that are from a set
of claims the TGA allows you toselect from, so that's a good
thing.
However, not every singleproduct is detailed reviewed by
the TGA allows you to selectfrom, so that's a good thing.
However, not every singleproduct is detailed reviewed by
the TGA before it goes to market.
You sort of apply for it, youget a number and then they may
(08:13):
check you afterwards.
So there may be some claimsthat are exaggerated, but it's
less likely for the therapeuticgood.
So this is my kind of pragmaticway of how you should check
this, based on what I've seenLook at the label, which is
usually really compliant becauseit's highly regulated and if
the label is completelydifferent to what's on the
Instagram page and the website,that's a red flag.
(08:35):
So the label says it maysupport energy levels.
If the Instagram page saysyou're going to go from one to
10 out of 10 energy levels intwo days, well, that sounds a
little bit exaggerated.
So that to me, is a red flagthat you may want to choose a
different brand in that case,just because you can't be
confident that's truthfulinformation, because it's
exaggerated.
Sonya (08:55):
I think that's a really good point to dwell on for a
moment and that is thatexaggeration of claims in
marketing.
And I've actually seen a fewexamples of these recently crop
up in my social media feeds ofparticular products.
And there was one recently thatcaught my eye.
I'm not going to name what theproduct was, although I don't
know.
Sometimes I am tempted to nameand shame, but I'm not going to
(09:16):
today and it had a image of aprobably middle-aged woman and
she was standing side on so thatyou could see her shoulder and
she had like a tank top on.
I think she looked like she wasat the gym, maybe exercising,
and she had her hand up andwritten on her hand with a
(09:36):
marker looked like she'd writtenit on there said frozen
shoulder disappeared in and thisisn't going to be correct, but
it was something like five daysor two weeks it was an actual
time and it was quite from myperspective, very short period
of time and it was anadvertisement for a particularly
well-known menopause related.
(09:58):
It really caught my eye becauseI thought that is hugely
exaggerated, because I know thatyou are not going to fix a
frozen shoulder taking thisparticular product in that
period of time, and I thinkthat's really good to point out
to people because it is a reallyeasy way to identify.
Does this claim that theproduct is making seem
(10:20):
exaggerated?
Does it seem a little likethey're expecting great things
in very short periods of time?
yeah I'm glad you brought thatup, because I think that's
something we need.
Sarah (10:31):
We can easily look for, but we can also really easily
fall prey to yeah, and my commonsaying is and this is in
everything in life, not justthis space if it sounds too good
to be true, it probably is.
And um, but the reason why Ianchor you back to looking at
the label is they are often verycompliant on the label.
So if you see an ad like that,think, oh, I'm not sure if the
(10:52):
label doesn't say it's going toremove your, alleviate your
frozen shoulder in three days,it's probably not something that
they were probably allowed tosay within their claim.
So use the label as your guide.
That's a really kind of youknow less markety type piece
that tells you what it might do,so that hopefully they're
helpful.
The next one is around safety.
(11:13):
So, although this is not howyou can choose one, just being
more conscious when choosing,just because a supplement's
natural or herbal, it doesn'tmean it's 100% safe.
Often can interact with othersupplements, medication, foods,
certain diagnosed medicalconditions.
You shouldn't take them.
So be very careful to read thewarnings or speak to a health
professional and be conscious ofthat.
(11:33):
Don't just think if I can biteso easily, it must be safe.
It's not the case, and we seethings like ashwagandha, a very
commonly used adaptogen herb,which does have its place for
some people, being used really alot at the moment, and then
studies showing that higherlevel doses over extended
periods may actually impact ourliver.
So remember that they are stillactive substances most of the
(11:55):
time, so just bearing that inmind is really important.
Sonya (11:58):
I think that reminder as well of interactions with either
other conditions or othermedications or even sometimes
other supplements that you'retaking, can be really
problematic, which is why Ithink your very, very first
advice, of seeking advice froman expert first, is actually so
beneficial and highly suggested100%.
Sarah (12:21):
And I end with that one again just to kind of double up
on the importance.
But the reason why I end onseek advice at the end is just
check who you're getting theadvice from too.
So is the person.
Not all health professionals dothe same thing.
We all do different things.
So I sort of put the analogylike I wouldn't tell somebody
how to manage a chronic dentalissue, I would refer them to a
dentist.
(12:41):
Or how to manage their frozenshoulder'd probably send them to
a physio and a doctor.
So just be conscious that justbecause you have one
qualification doesn't mean youknow so good things to look for.
Are they sort of pharmaciststhat generally have the
knowledge?
Have they got added like lovelyto hear that you're older.
Where you used to live thepharmacist there was also
nutritionist degree qualifiednaturopaths.
(13:01):
So just checking, they've got adegree.
Lots of the ministry havewonderful health science degrees
now clinical nutritionists andintegrative doctors.
So have they got that expertise?
Because they're more able tosupport you in a more rounded
way as well.
Sonya (13:14):
So yeah, and do you happen to know where GPs would
fall into that?
Obviously, we see our GPs toprescribe medications, but many
women and I think I've probablydone this myself at some point
in time has been having thatconversation with the GP and
what supplements should I takeas well?
My girlfriend's taking creatineshould I?
So are GPs likely to be aseducated in supplements?
Sarah (13:38):
Good question.
It again depends on the GP.
They'd have a very goodknowledge of the things we're
talking about.
Whether or not they're expertsin specific types of supplements
would be another question.
So it really is dependent.
There is also GPs you can findthat have done a lifestyle
medicine degree and you can findthat on the lifestyle medicine
website and also integrativedoctors, through the Australian
(14:00):
Institute of IntegrativeMedicine, I believe.
So you can actually check fordoctors who have done additional
study.
That's more about lifestyle andsupplements.
So that's the case.
But you may also find there's aGP in your area who really has
specialised in this and lookedinto it.
So just look into it, becausethey'll often say, on the hot
doc or wherever you book,they'll say what their specialty
is.
Sonya (14:19):
Yeah, fantastic.
Sarah (14:21):
Then you're more likely to get a sort of more
well-rounded response, I guess.
Sonya (14:25):
Yeah, great advice.
And while we're talking abouthealthcare practitioners, let's
dive into.
One of the most commonquestions that I imagine comes
up is how do I actually knowwhat I need to take?
You touched on earlier likeeveryone at the moment is
talking about creatine, andpersonally I think that's for
good reason.
I think creatine is amazing.
I've been taking creatine dailyfor about five years, but I
(14:47):
just continue to see more andmore studies come out.
Isn't it the most researchedsupplement that's on the market?
So you might be someone that'sheard a lot of buzz about
creatine and so you're thinking,oh, do I need to take creatine
or do I need to take magnesium?
Do I need to take vitamin D?
Like there are so manyquestions around, just because
someone else is taking it orbecause it's getting a lot of
media attention, how do I knowif I need it?
(15:08):
So what's your recommendationin getting to the bottom of that
?
Sarah (15:12):
Yeah, I do agree with you on creatine.
I think it's as wonderful, asyou say as well.
I guess.
A couple of things.
Firstly, we mentioned bloodtests earlier when you and I
were talking before this sessionwas recording.
So blood tests are really great.
Once a year Check for any, or ifthere's any specific symptoms.
First we want to say, well, dowe have any deficiencies or sort
of at-risk areas that mightneed a bit more of
(15:35):
supplementation?
That's the first place, becauseyou want to correct anything
that needs correcting.
The other thing then issymptoms.
So are there specific symptomsthat you can't manage with diet
and lifestyle?
So I have this analogy.
It's about a cake.
I know not all cakes arehealthy, but I love cakes, so I
use the analogy of cake.
So when you've got a cake,you've got the flour, the eggs,
(15:55):
the butter, the base of the cake.
For me, that is if you've gotany symptoms.
You've corrected nutritionaldeficiencies through blood work.
You've got symptoms.
Is your diet optimized?
Is your lifestyle optimized?
Are you doing all those goodthings movement, mindfulness.
Then supplements are kind oflike the carrot and walnuts or
the chalk chips or whatever theflavor is.
It makes the cake taste better.
You don't really need it, butin some cases it makes the cake
(16:17):
better and it actually boosts it.
And then, for me, then, theicing on top, which I know we'll
talk about later, is that hrtor mht, which you know not all
cakes need.
It is that HRT or MHT, whichnot all cakes need it but often
taste better with it and makethem easier to eat.
So it's kind of a weird analogythat I've built up over time to
explain that.
But supplements you need arethings to help you treat
symptoms.
So if you're let's use anexample so when you sit down and
(16:40):
think about what symptomsyou're having, you've corrected
your nutritional deficiencies,let's just say, with blood tests
, so your iron's back to normalif it wasn't, et cetera, but you
still cannot sleep.
That's where we think, okay,what can we do before we go to?
Maybe sleeping tablets?
Or if you are on HRT, we cantalk about that.
But what can we do to try andsupport your body to sleep?
So we look for something like amagnesium glycinate or
(17:03):
bisglycinate, which is arelaxing form of magnesium.
We try that, but we don't justkeep taking that forever.
We try that for three, fourmonths.
Is it making a difference?
No, it's not making adifference, then we might try
something different.
So it's about treating thesymptoms and if they don't work
I often ask this question ifit's not making a difference,
you shouldn't continue taking it.
(17:24):
Some things you can't feel, forexample, caveat with if you're
using certain types of omega-3sto manage your cholesterol
levels and your HDL and LDL,your good and bad cholesterol.
You won't feel that, but youwill know if that's having an
impact when you have that nextblood test, which may be more
frequently than 12 months ifyou're treating a cholesterol
(17:44):
imbalance.
So that's sort of the way Ilook at it.
You know, is it a deficiency ordo you have symptoms?
And the other one would be.
Then I have kind of a set ofgeneral supportive supplements
that are really great for womenin this phase of life.
Creatine is one of them.
Probiotics are another reallygood one.
But again, firstly, have welooked at how you might get some
of those pre and probioticsthrough diet?
Firstly, have we looked at howyou might get some of those pre
(18:06):
and probiotics through diet?
Not possible for everybody, sothere's some that I sort of have
as kind of general supportivesupplements that I'll recommend.
But generally you want to lookat symptoms and see how you can
support somebody.
Sonya (18:13):
Okay, cool, doing some blood panels with your
healthcare practitioner to getan idea of those, the big
identifiable markers.
Like you mentioned, iron, Iknow vitamin D is one of those
ones that you can test on aregular basis, looking at where
those are sitting with yourhealth practitioner, but then
also going through thatsymptomology.
(18:34):
And I loved your suggestion ofjust because you start taking
something doesn't mean you keeptaking it forever, checking in
every 12 weeks, six months,whatever it is, and saying, okay
, but am I actually noticing adifference?
Because of this, I think that'sreally good advice.
Sarah (18:51):
And also what happens is sometimes people layer things on
, layer things, and I'll justgive an example where that
actually might be not great.
So vitamin B6 recently has beenin the media with the TGA.
So if you have too much vitaminB6, it actually can cause
things like tingling or numbnessin your extremities and a range
of symptoms because it cancause kind of nerve sort of type
(19:12):
damage.
But vitamin b6 is actually sortof thrown into a lot of
supplements, like if you'retaking a women's health blend or
a greens or this or that, itcan often be added in.
And what the tga were findingis people were taking lots of
different things, just keptadding and adding and adding oh,
I'm not sleeping, I'll add thegreens, I'm not doing this or
that, and that cumulativeincrease in the b6 was actually
causing almost a toxicity.
(19:33):
So it's not about one's notworking.
Add another, put, put aBand-Aid on that, it's about
well, I don't like recommendingmore than one or two supplements
at a time for someone, becauseif you add five and it's working
, what do you do?
You stay on the five.
Sonya (19:46):
Well, yeah, it's a great point, isn't it?
Like how do you then join thedots of which one is actually
having the most impact?
So I think that's good advicetoo.
Sarah (19:53):
Yeah yeah, that's good advice too.
Sonya (19:54):
Yeah, yeah, that's how I see it.
Awesome.
Now, I did ask my Instagramcommunity for any questions and,
while we're talking on thistopic, I think there's one that
is relevant to this.
I'm going to throw it in rightnow.
So, whilst we're talking aboutdiet as well as supplementing on
top of that, if we looked atthe population in general, how
(20:15):
many of us are actually gettingwhat we need from our diets on a
day-to-day basis without thenthe need for additional
supplements?
Sarah (20:24):
Yeah, and I haven't looked at sort of any evidence
to respond to this one, but interms of like statistical views,
because really our nationalnutrition survey is pretty dated
so we probably don't reallyknow how well people are eating,
I would just say, anecdotally,you'd be surprised like most
people are actually getting alot of what they need.
So if you're eating, you knowyou may not be eating that great
(20:46):
in terms of snacking and thingsin between, but if you're
getting sort of three decentmeals and you're generally
getting most of what you need, Ido find that people who don't
get what they need, they can'teven a buckets, so they might
have a chronic disease wherethere's impact on the way that
they can eat.
If you've got an ulcer orsomething, it may impact the
amount of food you have, ormaybe it's somebody who is
(21:06):
eating more plant-based, sotherefore they're really going
to have trouble with our iron,our B12 and some other things
and creating deficiencies there.
So, without having a statistic,I'd probably say like seven or
eight out of 10 people that Isee I generally feel pretty
comfortable that they're gettingthe right type of food.
It's just are they getting itin the right quantities to
optimize their health.
(21:27):
So and we'll talk about bloodwork later but you know you get
that range of okay if you getyour iron tested.
It can be from the low range tothe high range and a lot of
people, yes, are in the middleof that average, but many people
sit right at that bottom edge.
So they might be getting enough, but are they getting enough to
actually optimize their energylevels and ensure that they're
(21:48):
in a really optimal range?
So it's that view of you knowthe doctor's view more is it
outside of the range?
It's a traditional view,whereas a more integrative
practitioner might say well,actually towards the bottom end,
so let's actually give you somenow to improve your outcomes
later.
So without a percentage, that'smy kind of best guess at that
one.
Sonya (22:06):
Yeah, that's great, and I think it's also really
encouraging to hear that, fromyour perspective and the
anecdotal evidence that you'rekind of got available to you at
your fingertips, that there is ahigher percentage of people
that are actually getting a lotof what they need from their
diet.
And yeah, which, again, if wego back to that marketing kind
of hype, it can be a trope thatgets rolled out there, isn't it
(22:28):
that you know, like you're notgetting this in your diet, so
therefore, you should, you know,be topping it up with our
wonderful supplement.
Sarah (22:41):
And maybe I have a skewed view of the world because
people come to me want to workon their health.
I don't know, maybe they'realready doing that, so at a
population level I wouldn't know.
But yeah, I do often think, youknow, are we sort of making
people fear they have to havethese powders and things daily
to top up their nutrition, wherethey're probably not doing too
bad a job anyway, yeah, awesome,yeah, if you're really getting
your, your serves of veg andyour fruit and, like you said,
you're dripping your protein outthroughout the day and all
(23:02):
those things.
Sonya (23:03):
I think one of the things you touched on there which is
so important, because it doesn'tjust come down to protein, but
that plant-based diet versus andeven for someone like me who
eats everything that's on offer,except I am not a big seafood
eater and so therefore, I use anomega supplement because I know
(23:23):
that I don't eat anywhere nearas much seafood or fish as I
would need to get that naturally.
So that, for me, has alwaysbeen something I've been really
cognizant of.
Yeah, but I think, yeah,there's many people that perhaps
aren't as aware of how muchthey're eating of certain things
across their day versus theirweek to understand what they
(23:45):
should and shouldn't take.
Sarah (23:46):
Yeah, don't get me wrong.
We do, as a nation, need to eatmore vegetables, but we've
always needed to eat morevegetables ever since I've known
.
So you can always throw in afew extra serves of veg in.
Yeah, but yeah, on the wholepretty good.
Sonya (23:57):
Awesome, fantastic.
Thank you for answering thatquestion and I hope that it
answers the question for thelistener that sent that through.
So let's talk about blood work,because we have touched on it a
few times already.
I am a huge believer and if thegovernment follows through on
their promises, we will begetting a specific Medicare code
(24:18):
for this.
But I'm a big believer thatthere should be a midlife health
check for women that they go inand they have, whether it's
when they turn 40 or when theyturn 45 or somewhere in those
fees that triggers this checkup.
That is really broad.
I firmly believe everybodyshould get a DEXA scan and know
what their bone density is atthat point in time.
(24:39):
But let's focus on blood work.
So what blood work do yourecommend for women that fall
into, let's say, this midlifehealth check?
Sarah (24:49):
Focus in on more is what are those kind of general things
you want to get checked.
When I'm saying, oh, go to thedoctor and get your annual blood
test, well, what do you need?
And if you go to the doctor andask for that, they're probably
just going to give you the basicstuff, which is fine.
But it can be a goodconversation to have with them
about some of the other thingsthat you might like to have
tested as well, and I can giveyou examples of what I usually
(25:09):
recommend.
And the good thing as well is Ihave this other sort of full of
analogies, but full of likesort of analogies, but like we
shouldn't have tunnel vision onthis either, because even though
we're in our midlife phase andwe are likely to be going
through hormonal changes as wetransition into menopause, there
may actually be something elsegoing on too.
So it's important that we don'tjust assume that our brain fog
(25:31):
or our low energy is becausewe're in perimenopause.
That could be things like lowiron or issues with thyroid
levels.
So that's why, also, like Ireally I'd love that idea what
you said there, sonja with thedexa and everything else being
incorporated, because there'sother things at play that you
may just pick up as well um inthis and be able to sort of
treat those.
So then you can treat thehormonal stuff kind of
(25:52):
separately.
So I have a few things Irecommend.
So a full blood count.
What that just means is it'scalled an FPC.
That just means they're goingto look at your red blood cells,
your white blood cells, yourplatelets, checking all your
immune cells.
Already you've got enough redblood cells.
It's a pretty kind of baselinetest that you'll do and most
blood tests would have this.
And the second would be acomprehensive metabolic panel.
So this one looks at thingslike your liver function, your
(26:14):
kidney function, really want toknow how they're operating.
Also, that impacts the types ofmedicines and herbs you can use
, because if it's not optimalsome things won't work as well
or aren't as safe.
They'll also look at yourhydration level, so look at
electrolytes like sodium andpotassium and sort of give you
an idea about that.
So they're the first kind ofalmost like the baseline.
Then the next, most important Ithink, is the lipid profile.
(26:34):
So your doctor will test yourlevels of hgl, your good
cholesterol, which takes thecholesterol out of the body, the
bad cholesterol, triglyceridesand total cholesterol, just four
different ways of talking aboutcholesterol.
The doctor will give you anindication, but essentially you
want more of the good, less ofthe bad, and we especially want
this because estrogen worksreally hard during our lives to
(26:56):
earlier lives to help us controlcholesterol.
And then we're losing thatamount of estrogen, getting to
very low, if none, towards verylow, I should say, in menopause,
and therefore you know yourrisk of heart problems actually
rises, particularly see somedyslipidemia or lipid changes.
The third is around diabetes.
So fasting, blood glucose andwhat we call hba1A1c.
(27:17):
What are we looking at here?
So we know that as wetransition, we can actually see
some women experience what'scalled insulin resistance, which
just means your body doesn'trespond.
You have sugar, your body, yourpancreas, shoots out some
insulin to help you get thatsugar and use it up for energy.
Essentially, in a nutshell, asyou transition into this phase
(27:38):
of life, your body's not asresponsive to insulin for some
people.
So tests like these can helpyou understand.
Is that a problem for me?
And it's not a problem foreverybody.
You might read it is, but itactually may only impact some
people more than others.
So you want to test fasting,which is kind of like random, if
you.
And then hb1c, which actuallylooks at your average blood
(27:59):
sugar control over the past twoto three months.
Then nutritional deficiencies wespoke about a couple of these.
These are where it gets alittle bit, I wouldn't say,
confusing.
But vitamin d great one thatyou brought up before.
So you're really good becauseit's important, especially with
our bone health and immunehealth and a bunch of other
things and things like zinc, youknow and check if you how
you're going with that, becauseit can health and immune health
and a bunch of other things andthings like zinc, you know and
check how you're going with that, because it can impact your
(28:20):
immune system and things likethat.
Then the one that I say isinteresting is magnesium.
So there's lots of studies whenit comes to magnesium For the
example I used earlier to keepthat kind of story going with
magnesium glycinate for sleepthat show that you really get
most benefit out of that forthat particular indication.
If you're deficient inmagnesium, however, the
(28:41):
magnesium blood test isn't asaccurate as we would like, so
we're actually only about onepercent of all the magnesium in
your body is in that blood serumoh, wow yeah.
So even though you want to getit tested to have an idea, I
often recommend with magnesiumthat trial or error kind of
thing that I spoke about before.
So try it for a few with sleep.
It's about a month or two ifyou're not getting any benefits.
Sonya (29:02):
Yeah, and that's a good thing to note with magnesium,
isn't it?
I actually had thisconversation with my husband the
other night.
There is a compounding effectwith taking the magnesium
glycinate to when you are tryingto get it to help for sleep.
And this comes almost into whatyou were saying before about
take something for 12 weeks orbefore you judge whether it's
(29:23):
something you need to continuewith or not.
And I'm going to assume thatmagnesium is not the only
supplement that this is the casewith, where you do need to
build those building blocks tobuild to a level and then
maintain that level, and thatcan take a little bit of time.
It doesn't happen the firstnight that you take your
magnesium.
Sarah (29:41):
That's a really, really great point, sonia, and I've
actually thought of explainingthat.
So thank you for asking thatquestion.
It's not like a Panadol thatyou take two Panadol and your
headache goes.
A lot of these nutrients andsupplements herbal supplements
take time.
Another one is iron, forexample.
You don't just take iron.
It's actually a very slowprocess to use iron supplements
and increase your iron.
But then even things like youcan talk about ashwagandha,
(30:03):
which I recommend for somepeople therapeutically.
You don't necessarily need itevery day in a hot chocolate,
but we can park that.
But the ashwagandha, which isquite an adaptogen helping with
your nervous system response,like even that one system
response, like even that one.
You're not going to just buythe ashwagandha gummies and feel
calm that evening.
It's actually going to have acumulative effect.
So it's actually a great point.
So that was it.
(30:23):
Nutritional deficiencies then.
I know this is a lot, but ifyou just try and bucket them
into I've sort of tried tobucket them into six for us all.
So the fifth is iron studies,which is pretty standard in an
annual blood test as well.
You want to know how your ironstores are going, because iron
is one of those things I'vefound with my clients and over
time it actually can reallymimic that brain fog, energy
(30:46):
level and dizziness that isquite well-known with
perimenopause menopause.
Sonya (30:52):
And really important, and you may be going to touch on
this anyway but specifically inthat perimenopause phase, if you
are having heavier bleedingthan you might normally have or
you're having more regularperiods at some point, then the
iron becomes really important,because we don't always link the
fact that we're bleeding withwe're losing iron 100% and I
(31:16):
think it's something like youonly lose about 80 mils of blood
, so you don't have to lose alot more for it to start to
having that impact on iron.
Sarah (31:26):
That's 100%.
In this age it becomes quitecommon to see iron issues
because of that.
So in that case of course wewant to treat that and you've
got a wonderful episode I justlistened to about heavy periods
and what to do around that aswell, and I often find the brain
fog is really common with irondeficiency anemia.
So that means your iron's gotsuch a low point that the amount
(31:46):
of oxygen that's attached toevery one of your red blood
cells is reduced.
So you've got not as muchoxygen kind of circulating in
the body and that can actuallyreally lead to brain fog.
That's a real big one that Ilike to have checked for people,
and especially plant-based aswell.
So again, it's a bit harder toget the iron absorbed in those
cases.
And then thyroid so a couple ofreasons Like thyroid disorders
(32:08):
are really common in women and alot of us aren't aware we even
have them.
Sonya (32:12):
So first of all, and a lot of the perimenopause
symptoms can mimic thyroidproblems.
Yeah, a hundred percent.
Sarah (32:18):
It's like a kind of double-edged sword.
They can mimic it, but thenchanges to estrogen might alter
the thyroid hormone levels, solike it's really very important.
My tip for this one is, if youcan ask for a full thyroid
function test the whole panelyou want to see your thyroid
stimulating hormones, the onethat normally gets checked and
that's kind of looking at.
It's kind of the opposite.
(32:38):
So a higher level of TSH saysyou're not producing enough
thyroid hormone and a low levelsays you're producing too much.
It's kind of opposite.
But you also want to look at T4and T3, which are the different
types of thyroid hormone.
But then there's some anti uhsort of I should say antibodies,
anti-tpo and anti-thyroidglobulin, being technical.
(32:58):
But just ask the doctor for afull panel if you can, if
they're open to that, becausethey actually give you not just
the tsh, sort of says, okay, youeither got too much thyroid
hormone or not enough.
These other tests on the panelgive you a more specific
diagnosis that make treatment ofthose things just change or
tweak slightly.
So for the panel once a year, Ithink is a reasonable thing to
(33:18):
be asking for.
And then you know they're themain ones.
If you've got other symptomsthe doctor might also want to do
things to look for inflammation, so ESR or CRP, but that's
usually if something's going onand those six are probably
enough anyway.
But they're pretty standard onkind of an annual test to check
that everything's happeningwithin your body the way that
you would like.
Sonya (33:39):
Yeah, great.
So your recommendation, withthese blood panels and all those
pillars that you've just talkedabout ticking off with that,
would be to keep that an annualexercise, at the very least.
Sarah (33:50):
Yeah, it is.
And my other big tip is whenyou get the results, or if you
get told, oh, your results arenormal, you don't need an
appointment, my highrecommendation is that you
please ask them for a copy ofyour blood test results that you
keep for yourself and you mayshare that with your
nutritionists or personaltrainers or other relevantly
qualified health professionals.
(34:11):
I've got a wonderful personaltrainer that has done a bit of
extra training in this as wellto understand it.
So if you have that, then ifyou go and book an appointment
with a naturopath or anutritionist, they've got that
information, which is reallyuseful for them in the way
they're looking at your health,and then you've got a copy of it
for yourself.
My Health Record should makethat easier over time.
Yeah, health, and then you'vegot a copy of it for yourself.
Sonya (34:30):
My health record should make that easier over time.
Yeah, over time.
But not everybody is subscribedinto the my health record, so
that does become a little bitproblematic for some people.
I'm one of those people, butI've always always asked for my
copies of my blood works.
It is actually quite easy, ifyou you do a little bit of
research, to understand what.
And I think the most importantthing and you mentioned this
earlier is that some medicalpractitioners will literally
(34:52):
just look at the baselines thisis what's low, this is what high
, and you fall within those, soyou're okay.
But if you do see a naturopathor a dietician or an integrative
doctor and a lot of GPs now arebecoming more educated on this
is if you are still at thatbottom or even the high.
You need to address that.
It can't just be well, you fallwithin this, so you're okay.
(35:12):
If you are on that low end orthe high end, you need to be
looking at the why behind thoseand is it something that needs
to be addressed?
Sarah (35:19):
100%.
It's certainly very importantto contact the doctor and speak
about it for them to give youthe top level if there is things
that are out of range.
Sonya (35:26):
Oh yeah, always Of course .
Sarah (35:27):
but having it for yourself that means you've got a
copy of that, and usually ifyou go back to the same GP then
we'll get sort of columns of theblood tests that will kind of
show the dates.
Sonya (35:36):
I know I love that.
Sarah (35:38):
Well, you may also may not this day and age.
You may not have a regular GPeither, so make sure, if you've
got it, then you can keep thatyourself.
Sonya (35:47):
Yeah, that's right.
Awesome, that was wonderful.
Thank you so much for coveringoff all of that and questioning
around blood work and pathology,and I think that's awesome
information.
So if we throw hormone therapyinto the mix, just for a moment,
so if somebody is also usingHRT or MHT however they prefer
to refer to it one of the thingsthat I think we need to talk
(36:08):
about consistently is thatthat's not a silver bullet to
anything other than topping upyour hormones.
So, on top of that, you need tostill always be addressing your
nutrition.
You need to be looking at yourexercise.
You need to be looking at sleepand stress management, that
lifestyle medicine degree thatyou talked about before, which I
love so much.
I have a friend who's doing hermaster's in it at the moment
(36:30):
and I think it's just amazing.
I'm tempted.
Yeah, I know, don't worry, itcrossed my mind too, and then I
was like no, sonia, you don'tneed to do anything else right
now.
But so if we consider hormonetherapy in that same kind of
like holistic approach, where dosupplements sit within that?
Sarah (36:50):
yeah, I love that question.
It's sort of my cake that Ispoke about.
But you know, hrt, or mht asyou mentioned, tops up the
hormones and should mitigatemost of the hormonal symptoms
you've got and then does areally great job, as you would
know too, sonia of sort ofpreventing that kind of helping
prevent the longer term kind ofrisks of heart disease and bone
osteoporosis etc.
But first I would say, ifyou're taking HRT and it's not
(37:13):
really making things better, thefirst thing I would do is go
back to speak to the doctor orspecialist because it might not
be the right dose, like Iactually was writing an article
the other day about the types ofHRT and I can't, even as a
pharmacist, keep up with thedifferent formats, types that
come out all the time.
So there's different ones youcan try.
Sonya (37:30):
And it is very much something that, like we were
talking about with supplementsbefore, needs to be tweaked,
takes a little while to kind ofget into your system and start
working on that compounding kindof effect.
Yeah, but yeah, and you know, Ithink that's so important that
you must always remember that itis a therapy that is going to
be unique to you 100%.
(37:51):
It's got to be tweaked and youshould be going in and having
regular checks, particularly inthose early few months when you
start on it, to make sure thatyou are getting the right dosage
that you are absorbing.
There are so many differentlittle nuances with it.
So supplements, absolutely thesame.
Sarah (38:08):
Yeah, so if the tick box is go check, everything is good
with that, then you may actuallyneed some supplements, as you
mentioned, sonia, like HRT isnot going to solve everything.
So back to that kind of ironexample if you're deficient in
iron, hrt is not going to fixthat, you will need an iron
supplement.
Or if you want to try creatinefor the muscle, health and other
benefits, that's not reallygoing to be something that HRT
(38:30):
is going to do for you.
So you again look at thosesymptoms or things you want to
prevent or support and you mayadd them on.
The other thing that I alsofind interesting is something
that remember at the start I wassaying take off the pharmacist
hat, throw on the nutritionisthat, but now I think I wear both
hats is there's some nutrientdepletions that drugs can cause
(38:50):
as well.
So I just wanted to touch onthat briefly.
I do want to caveat with itdoesn't happen for everybody,
but it is a possibility thatsome of our hormone replacement
therapy medicines might actuallyimpact us and deplete our body
of certain nutrients.
So just something to bear inmind.
Give some specific exampleshere Estrogen therapy therapy
and I believe this is similarfor bio body identical and
(39:12):
synthetic estrogen, again beingquite the same possible in the
literature.
So it means it could happen mayactually deplete your magnesium
levels, which, if we know wespoke about before, it's kind of
hard to know what yourmagnesium level is, so again, we
might be compounded by havingless magnesium.
So trying some might be a goodchoice.
Again, the right format.
So I spoke about glycinate, butthere's lots of other formats
(39:35):
for different things.
Then vitamin B6, another onewe've spoken about.
It can impact that metabolism,either making you more likely to
have low or high levels.
So again, that's something else.
If you're having sort of weirdkind of neural symptoms, it
could be you've got too much B6.
So I find that superinteresting.
The B6, I should caveat to saythat's more so with the oral
(39:56):
contraceptive pill.
It often has more syntheticforms but also a lot higher dose
than HRT.
So that's, if you put on anoral contraceptive pill which
generally I see happen, as wementioned before, to help with
those heavy periods and forcontraception, that can actually
have a depleting effect on theB6.
Increased calcium needs in thisage of life I think it's 1,300
(40:16):
milligrams a day for a lady inmenopause and so therefore you
know the fact that it mightimpact.
That makes it even moreimportant to get your regular
tests around your vitamin D, butalso making sure your calcium
levels are being topped up,dietary as well.
Your doctor or nutritionist canhelp you navigate that if you
think or want to ask questionsabout that for your personal
(40:36):
situation.
Sonya (40:36):
Yeah, brilliant.
Thank you.
That was some really goodinformation.
Okay, I want to end on apositive note.
My first question is if you hada magic wand, what would you
change about the supplementindustry?
Sarah (40:47):
Yeah, yeah, I think this will be positive.
I would like there to be aworld and we're imagining it's
just complete free reign herethat there's a world where every
single supplement that comes tomarket has gone through a
rigorous process of being testedDoes it actually work, are the
claims right?
Is it suitable for all thethings it says it's going to do?
It's all checked thoroughly.
(41:08):
And then we see really hugesort of restrictions, which
exist, but like huge penaltiesthat happen really fast when
they do the wrong thing.
There are things that TGA aretrying to do about this, but
there are only so many peopleand there's so many things
happening.
And I will say, in a positivenote, we are really lucky in
Australia.
So we might think that thesethings frustrate us, that we see
(41:31):
these claims they can't make,but compared to other countries,
we've actually got a prettygood handle on this stuff and
the TGR are doing a really goodjob.
The magic one give them moreresources, time and money to be
able to make it even better, sopeople get what they need, it
works and they're not wastingtheir money.
That's the bit I hate.
Sonya (41:55):
These things are expensive, so that would be a
perfect world, in my opinion,amazing.
All right, we talked about itright at the very beginning and
I think it's a really hot topicright now.
But what makes creatine such agreat supplement?
Not looking at athletes,necessarily, but specifically
for women in this midlife phase?
Sarah (42:09):
I was actually hoping this question would come up, I
just think because it has theevidence that supports so many
different things, which is andyou mentioned before it's so
well researched.
I feel like it's having itstime in the sun, but I've been
talking about ages, I'm sure youhave been too.
So if we think about, yes, ithelps with your muscle mass and
(42:31):
strength, which is a huge thingin this phase of life, we're
losing our muscle tone, ourmuscle strength.
We want to make sure we dostrength training and all that
sort of stuff to do that.
I personally love strengthtraining, optimizing that.
But the thing that I love aboutit is what's coming out around
how it can actually improve moodand actually really help with
that.
Some of those hormonal thingsand for me, also very, very
(42:53):
minimal side effects I'llmention one shortly but and also
really only if you've gotsevere kidney problems, you
can't take it.
So it's pretty great for most,most of us in this phase of life
and it helps with our muscles,it helps with our hormone
balance, it helps with our mood.
So really it does a lot ofthings with one scoop and often
it's unflavored, so you can addit to things or add a few
(43:14):
electrolytes or add it towhatever you can you can add it
to your coffee yeah, add it towhatever the brand suggests you
can on the back of the pack,because they'll know whether
it's heat tolerant, whicheverone.
That it is right.
But what a great thing.
And look, if you hear that itmay cause weight gain I'm sure
you've heard this sonia like.
It pulls water in, which is oneof the things it does.
So at the start you might feela bit more sort of bloated or
(43:35):
puffy.
That will go away and I canguarantee I think you may have
seen all these things on socialtake it every day for 30 days.
That's three to five grams, andthen you make it.
You make a decision andremember we're saying don't take
things if you don't notice adifference.
You will notice a difference, Ithink, with this, and most
people tell me they do.
So I love that it actually doeswhat it says it's going to do
(43:57):
yep yeah, and, as I mentionedearlier, there's just so much
research.
Sonya (44:02):
even though it's already so well researched, there is so
much research consistentlycoming out about it.
The one one that blew me awayrecently is I think I've
mentioned on here I've had COVIDrecently for the first time.
One of my biggest fears isgetting long COVID and I
definitely want to do everythingI can to avoid that the way I'm
feeling right now.
I'm pretty sure I've managed todo that.
(44:22):
But a lovely friend, angeliqueClark, who is a dietician and
nutritionist, she sent me someresearch whilst I was ill
showing that four grams ofcreatine taken daily for six
months was showing wasresearched evidence that it was
helping prevent or helping torecover from long COVID.
(44:46):
I'll send you the researchpaper and for anyone listening,
I'll also link it in the shownotes because it is quite a new
piece of research and it justreally shows the breadth of the
supplement.
Sarah (44:58):
Sometimes it can be a bit .
You get a bit stuck in thesocial media and think these
things are being recommended,but this is one that makes me
smile, I think.
Oh, it's having its time in thesun and it should be having it,
so it's a good thing of socialimpact.
Sonya (45:10):
Yeah.
Sarah (45:10):
This one really is the one that you can get on board.
Sonya (45:13):
Awesome.
I'll link through in the shownotes just some general
information on creatineWonderful From great
evidence-based sources, as wellas that paper that we just
talked about, and I'm going tolink through to your website as
well so that if anybody that'slistening is as intrigued as I
am by all of this conversationand they want to know more about
you and perhaps potentiallylook at how they could work with
(45:34):
you, they'll have all theinformation they need in today's
show notes.
Sarah (45:36):
Very kind, thank you.
Sonya (45:38):
Absolute pleasure, Sarah.
Thank you for being my guesttoday.
Popular Podcasts
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Special Summer Offer: Exclusively on Apple Podcasts, try our Dateline Premium subscription completely free for one month! With Dateline Premium, you get every episode ad-free plus exclusive bonus content.
The Breakfast Club
The World's Most Dangerous Morning Show, The Breakfast Club, With DJ Envy, Jess Hilarious, And Charlamagne Tha God!
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.