July 29, 2025 • 31 mins
In this episode, Dr. Alfred Alessi and Matt Tack delve into women's health, focusing on hormones and perimenopause. They differentiate between perimenopause and menopause, emphasizing the impact of hormonal disruptors. The discussion highlights the functional medicine approach to hormone testing, alongside gut health, metabolic, and toxic burden assessments. They explore protocols for achieving hormonal balance, including lifestyle and dietary modifications. The episode concludes with special offers and encouragement for listener engagement, providing a comprehensive guide to navigating hormonal health challenges.
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Episode Transcript
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(00:00):
Here's the thing.
(00:00):
You know, most of the suffering that peopleexperience with old menopause is actually in
perimenopause.
And women are told to wait until it gets badenough to consider, you know, hormone therapy
or addressing it.
And really, that's backwards.
We believe in catching it early, supporting thebody naturally, you know, with lifestyle,
nutrition, activity levels to mitigate anddampen, if not fully get rid of those symptoms
(00:27):
that you would feel.
And if that is possible.
Welcome to Health Decode, your number onesource for real health information with your
host, doctor Alessi and Matt Tack.
Hey, Health Decoded listeners.
Doctor Alessi here.
Let me ask you a serious question.
Are you tired of waiting until something goeswrong to finally see a doctor?
(00:51):
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We believe true health care isn't about chasingsymptoms.
It's about preventing them in the first place.
That's why we created the Alessi Total CareProgram.
This is a functional medicine based membershipthat gives you proactive, personalized care
(01:12):
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(01:32):
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As a Health Decoded listener, you'll get yourfirst three months completely free when you
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(01:53):
Head on over to alessifunctionalhealth.com,click on our services tab, and go to Total
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Learn more about this program and claim yourexclusive podcast listener offer.
Your health is your greatest asset.
Let's protect it proactively.
Welcome back to another episode of HealthDecoded.
(02:13):
I'm your host, doctor Alessi.
I'm excited to get into another episode heretoday.
Today's episode is gonna be a little bit morefocused and a little bit more specific towards
women's health and hormones, but this is gonnabe a powerful one.
These are things we see all the time in ourclinic and, honestly, has just been something
(02:34):
that's been a little bit more prevalent lately.
Not sure why that is, but it was something thatI noticed I was getting a lot of questions
about.
We were seeing a lot of these types of casesand so we said, hey, why don't we dig into
this, give a little bit of information topeople, and ultimately try to provide some
education.
So again, today is gonna be all about women'shealth and hormone one zero one.
(02:55):
And really, you know, to to get into it,women's health isn't really just about
reproduction.
So your hormones are really an orchestra.
It's delicate, it's complex, it's a dynamicsystem that influences nearly every part of a
woman's body.
Obviously, this pertains to women and men inthat regard.
However, this episode is going to bespecifically about women's hormone and those
(03:19):
impacts.
So your hormones influence everything.
Really, they affect your brain, your mood,focus, memory, your metabolism, how your body
is burning fat and building muscle, the storageof energy, your immune system, inflammation,
autoimmunity, resilience to infection, as wellas things like heart health, bone density, your
(03:41):
skin elasticity and your gut function.
All of these are driven by the balance of yourhormones.
So, you know, many women that we see in theclinic come in and they say they have these
symptoms, yet they've been told that, oh, thisis just your aging, you're getting older, or
oh, it's just it's in your head.
(04:01):
Or the worst one I've heard is that literally apatient said that the doctor she saw told her
your symptoms are normal.
That's not medicine.
That's gaslighting really because symptoms withhormones are not normal.
Your body should be able to have balance and beable to age, I air quote that normally without
(04:24):
having symptoms.
So it's all about understanding the rhythm.
So let's start.
We're going to have basically a few segments ofthis episode.
The first segment is going to be basicallyunderstanding hormones.
Then we'll get into kind of what symptoms youmight notice if there's imbalance, how to test
for hormonal imbalances, and what tests wewould use, and then what kind of fixes you have
(04:49):
in functional medicine.
So let's get into understanding the hormonalrhythm.
Women's hormones follow a monthly what's calledInfraedian rhythm.
So it's roughly a twenty eight day cycle,although it varies from woman to woman.
But the four phases include phase one is thefollicular phase.
So this is day one to fourteen ish.
(05:10):
Estrogen begins to rise during this phase,you'll feel more energized, maybe clear,
creative.
This is where you have more of that get up andgo.
The ovulation phase, which is around dayfourteen is where estrogen peaks.
Testosterone is going to bump up as well.
This is often where libido is is high andincreasing.
(05:30):
Women feel this effect for sure.
Phase three is is when you get into the lutealphase.
So this is between day fifteen to twenty eightof a cycle.
Your progesterone begins to rise now to balancewith the estrogen.
If there's an imbalance in this, this is wherePMS symptoms will often show up or be
(05:51):
increased.
And so again, these intense symptoms are notnecessarily normal, although they are common.
And then the phase four is the menstrual phase,right?
Which is where we start day one over again,hormones are going to drop.
If you have inflammation or some type ofnutrient deficiency, period symptoms will be
(06:12):
worse, right?
They will be exacerbated by this.
So, you know, there's a great quote here out ofthe Journal of Endocrine Reviews that said
fluctuations in estrogen and progesteronemodulate nearly every physiological symptom
system.
Sorry.
That is awesome.
So basically, you know, what that tells us isthat that balance between estrogen and
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progesterone is critical for your body tofunction as it normally should.
So when there's imbalance, again, symptoms aregoing to be the first sign of that.
So getting into a little bit more of like whatthese hormones are, just talked about like the
cycle there, but estrogen is really a supportfor the brain, bone density, metabolism and
mood.
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If you have too much estrogen, you can getthose PMS symptoms, cramping, maybe more
intense heavy bleeding, breast tenderness.
If you have too little, you might feel veryflat, fatigued, maybe brain foggy, like there's
no energy.
Now, progesterone basically is kind of on theopposite, it calms the nervous system, it's
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going to promote sleep, regulate cycles, andprotect against estrogen dominance.
Chronic stress over time, blood sugar crashesand inflammation can all lower progesterone.
We're going to get more into that.
Now, here's one that many women don't thinkisn't they don't think about, but testosterone
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and DHEA.
These support muscle tone, libido, motivation,mental drive, they're that vitality hormone.
It's the same for men, women just don't have asmuch or require as much, should say.
But they do need them and low levels oftestosterone is actually something I see a lot
and that we work with.
So it's important again, not just to focus onone or the other, but the balance and kind of
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the rhythm of all these working in conjunction.
Now, the next ones that are important thyroidhormones and cortisol.
And so again, these orchestrate the energy,your metabolism and your body's stress
response, and they are deeply connected to sexhormones and must be evaluated together with
them.
If you're looking at one, again, just like wetalked about in previous episodes, you're
(08:23):
getting a snapshot, you're not getting the fullpicture.
A quote here out of the journal The Lancet saidthe interplay between reproductive, adrenal and
thyroid hormones is fundamental to femalehealth, and it often gets overlooked in
conventional care.
Great quote.
I agree with that.
Now, let's talk a little bit about like whyhormones might get hijacked or get thrown off.
(08:45):
So really modern life is anti hormone.
It just is everything we're exposed to thingslike chronic stress, which are spiking our
cortisol, lowering progesterone, environmentaltoxins, things like BPAs and pesticides can
mimic or even block estrogen.
Poor nutrition, which is going to be, you know,probably lead to depleted vitamins and
(09:07):
nutrients, which are required for hormoneproduction.
Sleep deprivation disrupts that hypothalamicpituitary adrenal axis, which can suppress
ovulation.
So even subtle imbalances when gone uncheckedcan spiral into bigger issues.
These can eventually lead to things like PCOS,estrogen dominance, perimenopause, infertility,
(09:34):
even autoimmune thyroid disease, whichobviously we've discussed before in a previous
episode can be very, very detrimental to yourhealth.
So what is perimenopause?
Right?
I always like to clear this up versusmenopause.
So perimenopause typically starts like maybelike late thirties and can last for about five
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to ten years.
This is when on a physiological level, we'reseeing progesterone start to decline.
A woman's cycle may shorten, PMS often worsens,and estrogen just becomes erratic.
Right?
Again, these symptoms, however, are not normal.
It shouldn't be like overly intense.
(10:15):
Menopause is defined as about twelve monthswithout a period.
That's basically like what would be, consideredlike the start of menopause or the concept of
menopause.
By this point, both estrogen and progesteroneare low.
So here's the thing.
Most of the suffering that people experiencewith old menopause is actually in
(10:36):
perimenopause.
And women are told to wait until it gets badenough to consider hormone therapy or
addressing it.
And really, that's backwards.
We believe in catching it early, supporting thebody naturally, you know, with lifestyle,
nutrition, activity levels to mitigate anddampen, if not fully get rid of those symptoms
(10:59):
that you would feel.
And it that is possible.
That is doable.
I just think it's so such a far off conceptthat many people don't consider that an option
because Western medicine hasn't really educatedaround that.
That's just the truth.
Now, let's get into a little bit of like thesymptoms of hormonal imbalance and and what you
(11:20):
could experience.
So, you know, to get real, if you're a womanwho's been told your symptoms are normal, but
you still feel tired all the time, you'regaining weight around your belly, maybe you're
anxious, moody, Something deeper is going on,and it's not normal.
It's not just aging.
It's your body's talking to you, and we have tobe able to listen and take inventory as to what
(11:43):
our body is doing.
So because things that are unchecked oftenbecome worse, not better over time.
That's just the reality of it.
So some cycle related symptoms that are oftenbrushed off.
Many women are told that period issues are justpart of being a woman.
But really the pain, suffering and dysfunctionare not normal.
If you're experiencing intense painful cramps,or you're needing to take pain pillars,
(12:09):
painkillers just to get through your period.
If you have heavier bleeding or clots largerthan say a quarter, if you have PMS mood
swings, anxiety, or you know, get tieredtearfulness before your period, breast
tenderness or intense swelling.
These are signs of either estrogen dominance orprogesterone deficiency.
(12:30):
So again, that imbalance.
There was a study in the Journal of Women'sHealth in 2020, said that premenstrual symptoms
are closely linked to hormonal imbalances andchronic stress induced progesterone
suppression.
So again, the chronic stress loweringprogesterone leading to oestrogen being higher
(12:51):
in that ratio leading to symptoms.
Right?
So some symptoms you would notice inperimenopause, right?
Which they they quote as the invisible years.
Perimenopause can begin about five to ten yearsbefore real menopause.
And most women don't even realize it'shappening.
So here's what it looks like.
You're going to start with the hot flashes,night sweats, sleep trouble, like difficulty
(13:15):
falling or staying asleep, increased anxiety orirritability, especially maybe mid cycle.
Low libido is a big one that we see thatunfortunately, many women are not comfortable
talking about.
Shorter or heavier or irregular cycles, allthese things can be symptoms of that.
(13:36):
So again, this is your brain and your bodystruggling to maintain a hormonal rhythm and
balance.
Estrogen begins to fluctuate where progesteronedrops first, and that imbalance will then
impact everything.
Let's get into the metabolic mood and energysymptoms that you might feel.
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So again, this is where it gets kind of tricky.
Most women don't often connect these tohormones.
And unfortunately, most conventional doctorsdon't either.
So things like unexplained weight gain,especially like around the belly, belly fat,
fatigue, even after eight hours of sleep, bloodsugar crashes or feeling that like hangry
between meals, hair thinning, dry skin,depression, irritability, or basically that
(14:23):
feeling of like, blah, like just don't care.
All of these are hormonal.
And so hormones can affect your mitochondria,which is go back 10 episodes we talked about is
your cellular energy engine, your your thyroidand even your brain chemistry are controlled by
this.
And so estrogen influences a lot of things.
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Influences your serotonin, which is a calminghormone.
Progesterone then also has a calming effect aswell.
And then testosterone affects motivation anddrive.
So if we have that imbalance, again, hormonalfluctuations are going to impact brain energy,
metabolism, neurotransmitter activity, and eveninflammation, which can then contribute to
(15:07):
symptoms.
Again, are not the problem.
Symptoms are the check engine light that thereis a problem.
And so you know, if you're if you're exhausted,inflamed, you feel foggy, but you've been told
that your labs are normal.
The truth is you didn't go deep enough orwhoever was telling you that didn't take a deep
enough look.
(15:27):
And so isolated symptoms are not enough.
They're a message, they're a pattern, but youneed to decode that.
Just not just so that you can feel better, butso that your body can get back to a state of
equilibrium.
So that being said, let's get into a little bitof testing and what to look for.
(15:48):
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Now back to the episode.
Alright, welcome back.
Let's get into kind of the next piece here,which is really functional medicine lab
(17:22):
testing.
And really the labs you need to know whenyou're talking about hormones and possible
hormone imbalance and symptoms associated, anda lot of things that often get under tested,
misdiagnosed or even just missed with otherdoctors.
Again, I'm going to just make sure I state herethat I'm not anti medicine.
(17:43):
I'm not anti doctors.
I just think that across the board, there's notenough of a deeper look into things when it
comes to medicine.
Take a snapshot and then we prescribe a pill.
And that's it.
Versus the functional medicine approach isreally what we're talking about is looking at
the nitty gritty like, is this marker gettingclose to being out of range?
(18:08):
Even if it's not out of range yet, is itgetting close?
And how do we prevent it from becoming aproblem?
Right?
Wouldn't you want to prevent your tire frompopping in the middle of the highway rather
than waiting for that to happen?
Same concept, right?
So, you know, the kind of the gap there is thattypical testing from your primary care doc or
your OBGYN is going to include looking at TSHfor your thyroid.
(18:32):
They're going to run estradiol and then maybelike a lipid panel in a CBC.
It's like that that would be like you read thefirst page of a book and now you're trying to
just give a summary on the book doesn't work.
So, the functional medicine panel andspecifically the one we would run at Alessi
functional health is going to be the fullpicture.
Now let's get into what that would look like.
(18:54):
So, we're going to use these cycle specificlabs, so often via saliva, urine and blood.
And so, we're going to get accurate real timedata.
We're going to look at estradiol, progesterone,testosterone, DHEA.
We like to do a full cortisol, daily cortisol,we call it.
This is going to show you the AMPM and yourtotal daily rhythm of cortisol.
(19:17):
How does your stress response, right?
The Dutch test, which is basically the industrygold standard for mapping estrogen metabolism,
cortisol and your hormone balance.
And then really important, we're going to lookat FSH and LH, which is follicle stimulating
hormone and luteinizing hormone.
These are very important when looking intoovarian function and that that transition into
(19:42):
perimenopause and menopause.
So there's a study out of the Journal ofsteroid biochemistry and molecular biology that
was quoted saying salivary and urine basedtesting provide more accurate measures of
bioavailable sex hormones than serum alone.
We take it a step further, we look at theserum, the urine and the saliva.
(20:02):
I like to just get the full picture.
And so the next thing we're going to definitelylook into is the thyroid panel.
And so we're not just going look at TSH, whichis your thyroid stimulating hormone.
We're going to look at free T3, free T4,reverse T3, which is that inactive.
We're going to look at TPO and thyroglobulinantibodies.
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Does your body have an autoimmune response tothe thyroid?
We're going to look at total T3, and then we'regoing to look at what's called thyroid binding
globulin.
Now, the reason we do this is because ninetypercent of women with low thyroid symptoms have
Hashimoto's, yet they don't get diagnosed withHashimoto's because the conventional medicine
doctors only run TSH.
(20:44):
You can't make a diagnosis there.
And so then you're diagnosing someone as lowthyroid putting them on medication when the
problem is deeper.
The problem is that they have something causingtheir body to mount an autoimmune response to
their thyroid.
You can take all the medicine in the world youwant, you're not going to fix the problem if
you don't get to the bottom of it.
And so additional labs that are going todefinitely play in that we run are things like
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running gut health labs, looking at zonulin andlipopolysaccharide markers for intestinal
permeability, doing a stool test, looking forpathogens, inflammation, dysbiosis.
It's really important with with autoimmunity torun things like food sensitivity panels.
Are there delayed reactions that are missed byan allergy test, right?
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That are causing your body to now mount aninflammatory immune response attacking your
thyroid, attacking your joints.
We're going to look at micronutrient panels,B12, magnesium, zinc, selenium, iodine, iron,
ferritin, which is especially important ifsomeone has heavy bleeding.
Also important to look at toxic burden markers,things like heavy metals, plastics, phthalates,
(21:58):
liver liver detox markers, using something likean organic acids test, which we call an oat
test.
All of this is important because those intensesymptoms during perimenopause and menopause can
often be caused by your body having a toxicburden or toxic overload.
Also important to look at the metabolic andinsulin response, right?
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So blood sugar and inflammation.
So we look at fasting insulin, hemoglobin A1C,leptin, C reactive protein.
These can detect early metabolic or even PCOSpatterns.
Now, know that's a lot.
But again, the concept is, you know, youwouldn't go watch the first ten minutes of a
(22:39):
movie and then go tell everyone how much youlove the movie.
Right?
Or even be able to talk about whether the moviewas good.
You got to see the whole thing.
And that's what functional medicine does.
It gives us the entire picture.
Because every system is connected.
Every system leaves clues.
And when you test the terrain and not just thesymptom, you're going to find the why behind
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the what.
So you don't heal what you don't measure.
Great quote.
If you you can measure it, now you can manageit.
And so let's get into Okay, we talked aboutwhat we can measure, what we can test.
Let's get into some of the protocols that cannow help with these kind of things.
So what happens after the testing?
Once we see what's off, right?
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What's causing dysfunction?
We don't just put a band aid on it or give youa supplement, right?
Because that's the same approach as medicine.
Here's a pill.
We're not just going to be natural band aids,right?
So we want a roadmap.
We want to really create a personalized planbased on the data, based on the symptoms, not
guesswork.
And so this is where functional medicine reallyshines.
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So step one, remove the interference.
So before we can balance hormones, we need toremove what's disrupting them in the first
place.
Again, before you can, you know, fix your tireproblem, you should probably remove the nail
that's in the tire.
So common triggers are going to be things likegluten, dairy, especially seen with autoimmune
or Hashimoto's, refined sugar and alcohol.
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So these can destabilize blood sugar andhormones.
Endocrine disrupting chemicals, again, toxictests.
So BPA, plastics, phthalates, parabens, theseare in beauty products all the time.
Chronic stress and poor sleep patterns.
So in the Journal of Women's Health andFunctional Medicine twenty twenty, there was a
(24:25):
quote saying hormonal balance can only berestored when the root causes like
inflammation, toxin exposure and nutrientdepletion are addressed first.
Fantastic quote.
Again, if you don't fix the cause, you're justgoing to be managing the same symptoms over and
over again.
Now, step two, once we've removed theinterference, rebuilding that hormonal harmony,
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that balance.
So we've gotten rid of the stressors.
Now we use targeted support.
So some of the nutraceuticals that we wouldcommonly use are going to be things like
magnesium glycinate.
This is very great for balancing the nervoussystem and that hormonal stability.
Magnesium is a cofactor with an over 300reactions within the body.
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So if we're deficient in magnesium, there'sgoing to be a lot of things that are off.
B complex vitamins, these are important formethylation and detox energy and the
neurotransmitter production.
Omega threes, anti inflammatories, they theyaid in hormone production, as well as like your
body's ability to create hormones.
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Zinc and selenium are important for thyroid andimmune function.
A great one that we use is called VITACs' chasetree, which is an herb which helps regulate
progesterone.
And we're not using these as much in isolation.
We we we have these protocols that we use thatare, you know, tried and true.
They're tested and they get great resultsbecause we often see that the summation of
(25:53):
multiple things used in conjunction is justgoing to get better results than something used
in isolation.
We'll use things like adaptogens, ashwagandha,and rhodiola, which are going to help balance
that adrenal and that stress resilience.
So we we don't just throw these at you, right?
We are going to dose these and phase thesebased on lab data.
(26:15):
It's not a one size fits all approach.
Every patient is different.
Every person is different.
Body is biologically different.
And so symptoms tell us something, data tellsus more, your response to things tells us more.
And so we're constantly tweaking and finetuning until we get it right.
Step three is then gut, liver and detoxsupport.
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So your hormones don't just exist in yourovaries, they're processed and cleared by your
gut and your liver.
And so it's important to support these.
So supporting the gut lining, using things likecollagen, glutamine, zinc, carnosine, these are
fantastic.
Balancing the microbiome with probiotics andherbal antimicrobials if you need, and then
(26:56):
enhancing those detox pathways with NAC,glutathione, and even things like sauna and
rebounding to get the body moving.
Making sure that we're using the restroomdaily, right?
We're having bowel movements, we're sweatingregularly, because your hormones will stay
recirculating in the body.
And that can lead to symptoms like PMS, acne,mood swings, if the body's not clearing out
(27:20):
those those hormones.
And then step four is what we call cyclesyncing and, you know, using lifestyle
upgrades.
So again, we're not just we're not justtreating, we're teaching throughout this
process.
Functional medicine isn't just about fixingyour body.
It's about helping your body fix itself.
And so we guide women through cycle syncing,which is matching workouts and nutrition to
(27:42):
menstrual phases, right?
Different times of the month require differentthings.
Ideally, when your body is going through thestress of your cycle, probably not best to go
hit a bunch of HIT workouts and be burning itat both ends trying to, you know, build your
business or whatever and overly stressingyourself.
It's good to have that cycle.
So lifestyle strategies that we would implementwould be things like HRV training, breath work,
(28:08):
using cold exposure for the adrenal health andbalance, circadian rhythm alignment, making
sure that our body's, you know, moving with thesun in that proper cycle.
Personalized nutrition plans that are going tosupport hormone and blood sugar balance.
And then fitness protocols, right?
We guide on this kind of stuff, so that you'reworking with your hormones, not against them.
(28:30):
And so there's a great quote out of theAmerican Journal of Lifestyle Medicine 2021
said that lifestyle interventions, includingcircadian hygiene, stress reduction and
nutrition are foundational in long term hormonebalance.
So again, very important that we are managingthe lifestyle, not just throwing pills at it,
(28:50):
trying to cover it up, where functionalmedicine can be bastardized and often just
mimic Western medicine with a natural approachis when that's the case, right?
We see doctors doing this all the time.
They say, Oh, this is functional medicine.
They're really just using supplements insteadof medicine with the same symptom focused
approach.
We're trying to get to the root cause at Alessifunctional health.
(29:13):
We're trying to fix what's leading to theproblem in the first place.
So in summary here, hormonal imbalance isn'tjust about your ovaries.
It's a full system dysfunction.
And so when we remove what's harming, restorewhat's missing and rebuild the body's
intelligence, your hormones don't need to bemanaged.
(29:33):
They self regulate, and that's real healing.
So if you're interested in learning more aboutour functional medicine programs and how we
help to heal reverse and fix hormone imbalance,go to alessifunctionalhealth.com, look into
some of our programs, check out Alessi TotalCare.
It's our flagship primary care functionalmedicine program, where we take people through
(29:57):
blood work, custom protocols, nutraceuticals tofix, and then ultimately educate them to take
ownership of their health.
Listeners of the Health Decoded podcast alwaysget exclusive discounts and price reductions on
all protocols and lab testing, so be sure tomention where you heard about us.
As always, if you found value in today's show,please like, subscribe, and share this with
(30:22):
someone who needs to hear it.
That's the only way we get this message outthere and help change more lives.
If you wanna get in touch with us or befeatured on an episode and share your story,
email us at ask@AlessiFXHealth.com.
You can visit alessifxhealth.com, sign up forour newsletter, check out our resources page to
learn more about our approach to nutrition andsome of the cutting edge therapies that we
(30:47):
offer.
As always, thank you again for tuning in.
I'm doctor Alessi, and I look forward to seeingyou on the next episode.
Thank
you for tuning in to Health Decoded, where webreak down the truth about all things health
and empower you to take charge of yourwell-being.
If you found value in today's episode, pleasesubscribe, leave a review, and share it with
(31:08):
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To hear your questions answered live on theshow, send them to ask@AlessiFXHealth.com.
That's ask@alessifxhealth.com.
(31:29):
Until next time.
Stay curious, stay empowered, and remember,your health is in your hands.
Here's the thing.
(00:00):
You know, most of the suffering that peopleexperience with old menopause is actually in
perimenopause.
And women are told to wait until it gets badenough to consider, you know, hormone therapy
or addressing it.
And really, that's backwards.
We believe in catching it early, supporting thebody naturally, you know, with lifestyle,
nutrition, activity levels to mitigate anddampen, if not fully get rid of those symptoms
(00:27):
that you would feel.
And if that is possible.
Welcome to Health Decode, your number onesource for real health information with your
host, doctor Alessi and Matt Tack.
Hey, Health Decoded listeners.
Doctor Alessi here.
Let me ask you a serious question.
Are you tired of waiting until something goeswrong to finally see a doctor?
(00:51):
At Alessi Functional Health, we take adifferent approach, the right approach.
We believe true health care isn't about chasingsymptoms.
It's about preventing them in the first place.
That's why we created the Alessi Total CareProgram.
This is a functional medicine based membershipthat gives you proactive, personalized care
(01:12):
year round.
You'll get access to comprehensive blood workand functional testing, custom doctor grade
nutraceuticals, deep discounts on labs,protocols, and follow ups, as well as twenty
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(01:32):
And here's the best part.
As a Health Decoded listener, you'll get yourfirst three months completely free when you
sign up for an annual membership.
That's on top of hundreds in savings alreadybuilt into the program.
This is your chance to take responsibility foryour health and join a movement that's
redefining what primary care should look like.
(01:53):
Head on over to alessifunctionalhealth.com,click on our services tab, and go to Total
Care.
Learn more about this program and claim yourexclusive podcast listener offer.
Your health is your greatest asset.
Let's protect it proactively.
Welcome back to another episode of HealthDecoded.
(02:13):
I'm your host, doctor Alessi.
I'm excited to get into another episode heretoday.
Today's episode is gonna be a little bit morefocused and a little bit more specific towards
women's health and hormones, but this is gonnabe a powerful one.
These are things we see all the time in ourclinic and, honestly, has just been something
(02:34):
that's been a little bit more prevalent lately.
Not sure why that is, but it was something thatI noticed I was getting a lot of questions
about.
We were seeing a lot of these types of casesand so we said, hey, why don't we dig into
this, give a little bit of information topeople, and ultimately try to provide some
education.
So again, today is gonna be all about women'shealth and hormone one zero one.
(02:55):
And really, you know, to to get into it,women's health isn't really just about
reproduction.
So your hormones are really an orchestra.
It's delicate, it's complex, it's a dynamicsystem that influences nearly every part of a
woman's body.
Obviously, this pertains to women and men inthat regard.
However, this episode is going to bespecifically about women's hormone and those
(03:19):
impacts.
So your hormones influence everything.
Really, they affect your brain, your mood,focus, memory, your metabolism, how your body
is burning fat and building muscle, the storageof energy, your immune system, inflammation,
autoimmunity, resilience to infection, as wellas things like heart health, bone density, your
(03:41):
skin elasticity and your gut function.
All of these are driven by the balance of yourhormones.
So, you know, many women that we see in theclinic come in and they say they have these
symptoms, yet they've been told that, oh, thisis just your aging, you're getting older, or
oh, it's just it's in your head.
(04:01):
Or the worst one I've heard is that literally apatient said that the doctor she saw told her
your symptoms are normal.
That's not medicine.
That's gaslighting really because symptoms withhormones are not normal.
Your body should be able to have balance and beable to age, I air quote that normally without
(04:24):
having symptoms.
So it's all about understanding the rhythm.
So let's start.
We're going to have basically a few segments ofthis episode.
The first segment is going to be basicallyunderstanding hormones.
Then we'll get into kind of what symptoms youmight notice if there's imbalance, how to test
for hormonal imbalances, and what tests wewould use, and then what kind of fixes you have
(04:49):
in functional medicine.
So let's get into understanding the hormonalrhythm.
Women's hormones follow a monthly what's calledInfraedian rhythm.
So it's roughly a twenty eight day cycle,although it varies from woman to woman.
But the four phases include phase one is thefollicular phase.
So this is day one to fourteen ish.
(05:10):
Estrogen begins to rise during this phase,you'll feel more energized, maybe clear,
creative.
This is where you have more of that get up andgo.
The ovulation phase, which is around dayfourteen is where estrogen peaks.
Testosterone is going to bump up as well.
This is often where libido is is high andincreasing.
(05:30):
Women feel this effect for sure.
Phase three is is when you get into the lutealphase.
So this is between day fifteen to twenty eightof a cycle.
Your progesterone begins to rise now to balancewith the estrogen.
If there's an imbalance in this, this is wherePMS symptoms will often show up or be
(05:51):
increased.
And so again, these intense symptoms are notnecessarily normal, although they are common.
And then the phase four is the menstrual phase,right?
Which is where we start day one over again,hormones are going to drop.
If you have inflammation or some type ofnutrient deficiency, period symptoms will be
(06:12):
worse, right?
They will be exacerbated by this.
So, you know, there's a great quote here out ofthe Journal of Endocrine Reviews that said
fluctuations in estrogen and progesteronemodulate nearly every physiological symptom
system.
Sorry.
That is awesome.
So basically, you know, what that tells us isthat that balance between estrogen and
(06:34):
progesterone is critical for your body tofunction as it normally should.
So when there's imbalance, again, symptoms aregoing to be the first sign of that.
So getting into a little bit more of like whatthese hormones are, just talked about like the
cycle there, but estrogen is really a supportfor the brain, bone density, metabolism and
mood.
(06:54):
If you have too much estrogen, you can getthose PMS symptoms, cramping, maybe more
intense heavy bleeding, breast tenderness.
If you have too little, you might feel veryflat, fatigued, maybe brain foggy, like there's
no energy.
Now, progesterone basically is kind of on theopposite, it calms the nervous system, it's
(07:16):
going to promote sleep, regulate cycles, andprotect against estrogen dominance.
Chronic stress over time, blood sugar crashesand inflammation can all lower progesterone.
We're going to get more into that.
Now, here's one that many women don't thinkisn't they don't think about, but testosterone
(07:36):
and DHEA.
These support muscle tone, libido, motivation,mental drive, they're that vitality hormone.
It's the same for men, women just don't have asmuch or require as much, should say.
But they do need them and low levels oftestosterone is actually something I see a lot
and that we work with.
So it's important again, not just to focus onone or the other, but the balance and kind of
(08:02):
the rhythm of all these working in conjunction.
Now, the next ones that are important thyroidhormones and cortisol.
And so again, these orchestrate the energy,your metabolism and your body's stress
response, and they are deeply connected to sexhormones and must be evaluated together with
them.
If you're looking at one, again, just like wetalked about in previous episodes, you're
(08:23):
getting a snapshot, you're not getting the fullpicture.
A quote here out of the journal The Lancet saidthe interplay between reproductive, adrenal and
thyroid hormones is fundamental to femalehealth, and it often gets overlooked in
conventional care.
Great quote.
I agree with that.
Now, let's talk a little bit about like whyhormones might get hijacked or get thrown off.
(08:45):
So really modern life is anti hormone.
It just is everything we're exposed to thingslike chronic stress, which are spiking our
cortisol, lowering progesterone, environmentaltoxins, things like BPAs and pesticides can
mimic or even block estrogen.
Poor nutrition, which is going to be, you know,probably lead to depleted vitamins and
(09:07):
nutrients, which are required for hormoneproduction.
Sleep deprivation disrupts that hypothalamicpituitary adrenal axis, which can suppress
ovulation.
So even subtle imbalances when gone uncheckedcan spiral into bigger issues.
These can eventually lead to things like PCOS,estrogen dominance, perimenopause, infertility,
(09:34):
even autoimmune thyroid disease, whichobviously we've discussed before in a previous
episode can be very, very detrimental to yourhealth.
So what is perimenopause?
Right?
I always like to clear this up versusmenopause.
So perimenopause typically starts like maybelike late thirties and can last for about five
(09:55):
to ten years.
This is when on a physiological level, we'reseeing progesterone start to decline.
A woman's cycle may shorten, PMS often worsens,and estrogen just becomes erratic.
Right?
Again, these symptoms, however, are not normal.
It shouldn't be like overly intense.
(10:15):
Menopause is defined as about twelve monthswithout a period.
That's basically like what would be, consideredlike the start of menopause or the concept of
menopause.
By this point, both estrogen and progesteroneare low.
So here's the thing.
Most of the suffering that people experiencewith old menopause is actually in
(10:36):
perimenopause.
And women are told to wait until it gets badenough to consider hormone therapy or
addressing it.
And really, that's backwards.
We believe in catching it early, supporting thebody naturally, you know, with lifestyle,
nutrition, activity levels to mitigate anddampen, if not fully get rid of those symptoms
(10:59):
that you would feel.
And it that is possible.
That is doable.
I just think it's so such a far off conceptthat many people don't consider that an option
because Western medicine hasn't really educatedaround that.
That's just the truth.
Now, let's get into a little bit of like thesymptoms of hormonal imbalance and and what you
(11:20):
could experience.
So, you know, to get real, if you're a womanwho's been told your symptoms are normal, but
you still feel tired all the time, you'regaining weight around your belly, maybe you're
anxious, moody, Something deeper is going on,and it's not normal.
It's not just aging.
It's your body's talking to you, and we have tobe able to listen and take inventory as to what
(11:43):
our body is doing.
So because things that are unchecked oftenbecome worse, not better over time.
That's just the reality of it.
So some cycle related symptoms that are oftenbrushed off.
Many women are told that period issues are justpart of being a woman.
But really the pain, suffering and dysfunctionare not normal.
If you're experiencing intense painful cramps,or you're needing to take pain pillars,
(12:09):
painkillers just to get through your period.
If you have heavier bleeding or clots largerthan say a quarter, if you have PMS mood
swings, anxiety, or you know, get tieredtearfulness before your period, breast
tenderness or intense swelling.
These are signs of either estrogen dominance orprogesterone deficiency.
(12:30):
So again, that imbalance.
There was a study in the Journal of Women'sHealth in 2020, said that premenstrual symptoms
are closely linked to hormonal imbalances andchronic stress induced progesterone
suppression.
So again, the chronic stress loweringprogesterone leading to oestrogen being higher
(12:51):
in that ratio leading to symptoms.
Right?
So some symptoms you would notice inperimenopause, right?
Which they they quote as the invisible years.
Perimenopause can begin about five to ten yearsbefore real menopause.
And most women don't even realize it'shappening.
So here's what it looks like.
You're going to start with the hot flashes,night sweats, sleep trouble, like difficulty
(13:15):
falling or staying asleep, increased anxiety orirritability, especially maybe mid cycle.
Low libido is a big one that we see thatunfortunately, many women are not comfortable
talking about.
Shorter or heavier or irregular cycles, allthese things can be symptoms of that.
(13:36):
So again, this is your brain and your bodystruggling to maintain a hormonal rhythm and
balance.
Estrogen begins to fluctuate where progesteronedrops first, and that imbalance will then
impact everything.
Let's get into the metabolic mood and energysymptoms that you might feel.
(13:57):
So again, this is where it gets kind of tricky.
Most women don't often connect these tohormones.
And unfortunately, most conventional doctorsdon't either.
So things like unexplained weight gain,especially like around the belly, belly fat,
fatigue, even after eight hours of sleep, bloodsugar crashes or feeling that like hangry
between meals, hair thinning, dry skin,depression, irritability, or basically that
(14:23):
feeling of like, blah, like just don't care.
All of these are hormonal.
And so hormones can affect your mitochondria,which is go back 10 episodes we talked about is
your cellular energy engine, your your thyroidand even your brain chemistry are controlled by
this.
And so estrogen influences a lot of things.
(14:43):
Influences your serotonin, which is a calminghormone.
Progesterone then also has a calming effect aswell.
And then testosterone affects motivation anddrive.
So if we have that imbalance, again, hormonalfluctuations are going to impact brain energy,
metabolism, neurotransmitter activity, and eveninflammation, which can then contribute to
(15:07):
symptoms.
Again, are not the problem.
Symptoms are the check engine light that thereis a problem.
And so you know, if you're if you're exhausted,inflamed, you feel foggy, but you've been told
that your labs are normal.
The truth is you didn't go deep enough orwhoever was telling you that didn't take a deep
enough look.
(15:27):
And so isolated symptoms are not enough.
They're a message, they're a pattern, but youneed to decode that.
Just not just so that you can feel better, butso that your body can get back to a state of
equilibrium.
So that being said, let's get into a little bitof testing and what to look for.
(15:48):
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Now back to the episode.
Alright, welcome back.
Let's get into kind of the next piece here,which is really functional medicine lab
(17:22):
testing.
And really the labs you need to know whenyou're talking about hormones and possible
hormone imbalance and symptoms associated, anda lot of things that often get under tested,
misdiagnosed or even just missed with otherdoctors.
Again, I'm going to just make sure I state herethat I'm not anti medicine.
(17:43):
I'm not anti doctors.
I just think that across the board, there's notenough of a deeper look into things when it
comes to medicine.
Take a snapshot and then we prescribe a pill.
And that's it.
Versus the functional medicine approach isreally what we're talking about is looking at
the nitty gritty like, is this marker gettingclose to being out of range?
(18:08):
Even if it's not out of range yet, is itgetting close?
And how do we prevent it from becoming aproblem?
Right?
Wouldn't you want to prevent your tire frompopping in the middle of the highway rather
than waiting for that to happen?
Same concept, right?
So, you know, the kind of the gap there is thattypical testing from your primary care doc or
your OBGYN is going to include looking at TSHfor your thyroid.
(18:32):
They're going to run estradiol and then maybelike a lipid panel in a CBC.
It's like that that would be like you read thefirst page of a book and now you're trying to
just give a summary on the book doesn't work.
So, the functional medicine panel andspecifically the one we would run at Alessi
functional health is going to be the fullpicture.
Now let's get into what that would look like.
(18:54):
So, we're going to use these cycle specificlabs, so often via saliva, urine and blood.
And so, we're going to get accurate real timedata.
We're going to look at estradiol, progesterone,testosterone, DHEA.
We like to do a full cortisol, daily cortisol,we call it.
This is going to show you the AMPM and yourtotal daily rhythm of cortisol.
(19:17):
How does your stress response, right?
The Dutch test, which is basically the industrygold standard for mapping estrogen metabolism,
cortisol and your hormone balance.
And then really important, we're going to lookat FSH and LH, which is follicle stimulating
hormone and luteinizing hormone.
These are very important when looking intoovarian function and that that transition into
(19:42):
perimenopause and menopause.
So there's a study out of the Journal ofsteroid biochemistry and molecular biology that
was quoted saying salivary and urine basedtesting provide more accurate measures of
bioavailable sex hormones than serum alone.
We take it a step further, we look at theserum, the urine and the saliva.
(20:02):
I like to just get the full picture.
And so the next thing we're going to definitelylook into is the thyroid panel.
And so we're not just going look at TSH, whichis your thyroid stimulating hormone.
We're going to look at free T3, free T4,reverse T3, which is that inactive.
We're going to look at TPO and thyroglobulinantibodies.
(20:23):
Does your body have an autoimmune response tothe thyroid?
We're going to look at total T3, and then we'regoing to look at what's called thyroid binding
globulin.
Now, the reason we do this is because ninetypercent of women with low thyroid symptoms have
Hashimoto's, yet they don't get diagnosed withHashimoto's because the conventional medicine
doctors only run TSH.
(20:44):
You can't make a diagnosis there.
And so then you're diagnosing someone as lowthyroid putting them on medication when the
problem is deeper.
The problem is that they have something causingtheir body to mount an autoimmune response to
their thyroid.
You can take all the medicine in the world youwant, you're not going to fix the problem if
you don't get to the bottom of it.
And so additional labs that are going todefinitely play in that we run are things like
(21:10):
running gut health labs, looking at zonulin andlipopolysaccharide markers for intestinal
permeability, doing a stool test, looking forpathogens, inflammation, dysbiosis.
It's really important with with autoimmunity torun things like food sensitivity panels.
Are there delayed reactions that are missed byan allergy test, right?
(21:34):
That are causing your body to now mount aninflammatory immune response attacking your
thyroid, attacking your joints.
We're going to look at micronutrient panels,B12, magnesium, zinc, selenium, iodine, iron,
ferritin, which is especially important ifsomeone has heavy bleeding.
Also important to look at toxic burden markers,things like heavy metals, plastics, phthalates,
(21:58):
liver liver detox markers, using something likean organic acids test, which we call an oat
test.
All of this is important because those intensesymptoms during perimenopause and menopause can
often be caused by your body having a toxicburden or toxic overload.
Also important to look at the metabolic andinsulin response, right?
(22:18):
So blood sugar and inflammation.
So we look at fasting insulin, hemoglobin A1C,leptin, C reactive protein.
These can detect early metabolic or even PCOSpatterns.
Now, know that's a lot.
But again, the concept is, you know, youwouldn't go watch the first ten minutes of a
(22:39):
movie and then go tell everyone how much youlove the movie.
Right?
Or even be able to talk about whether the moviewas good.
You got to see the whole thing.
And that's what functional medicine does.
It gives us the entire picture.
Because every system is connected.
Every system leaves clues.
And when you test the terrain and not just thesymptom, you're going to find the why behind
(22:59):
the what.
So you don't heal what you don't measure.
Great quote.
If you you can measure it, now you can manageit.
And so let's get into Okay, we talked aboutwhat we can measure, what we can test.
Let's get into some of the protocols that cannow help with these kind of things.
So what happens after the testing?
Once we see what's off, right?
(23:21):
What's causing dysfunction?
We don't just put a band aid on it or give youa supplement, right?
Because that's the same approach as medicine.
Here's a pill.
We're not just going to be natural band aids,right?
So we want a roadmap.
We want to really create a personalized planbased on the data, based on the symptoms, not
guesswork.
And so this is where functional medicine reallyshines.
(23:41):
So step one, remove the interference.
So before we can balance hormones, we need toremove what's disrupting them in the first
place.
Again, before you can, you know, fix your tireproblem, you should probably remove the nail
that's in the tire.
So common triggers are going to be things likegluten, dairy, especially seen with autoimmune
or Hashimoto's, refined sugar and alcohol.
(24:05):
So these can destabilize blood sugar andhormones.
Endocrine disrupting chemicals, again, toxictests.
So BPA, plastics, phthalates, parabens, theseare in beauty products all the time.
Chronic stress and poor sleep patterns.
So in the Journal of Women's Health andFunctional Medicine twenty twenty, there was a
(24:25):
quote saying hormonal balance can only berestored when the root causes like
inflammation, toxin exposure and nutrientdepletion are addressed first.
Fantastic quote.
Again, if you don't fix the cause, you're justgoing to be managing the same symptoms over and
over again.
Now, step two, once we've removed theinterference, rebuilding that hormonal harmony,
(24:48):
that balance.
So we've gotten rid of the stressors.
Now we use targeted support.
So some of the nutraceuticals that we wouldcommonly use are going to be things like
magnesium glycinate.
This is very great for balancing the nervoussystem and that hormonal stability.
Magnesium is a cofactor with an over 300reactions within the body.
(25:11):
So if we're deficient in magnesium, there'sgoing to be a lot of things that are off.
B complex vitamins, these are important formethylation and detox energy and the
neurotransmitter production.
Omega threes, anti inflammatories, they theyaid in hormone production, as well as like your
body's ability to create hormones.
(25:32):
Zinc and selenium are important for thyroid andimmune function.
A great one that we use is called VITACs' chasetree, which is an herb which helps regulate
progesterone.
And we're not using these as much in isolation.
We we we have these protocols that we use thatare, you know, tried and true.
They're tested and they get great resultsbecause we often see that the summation of
(25:53):
multiple things used in conjunction is justgoing to get better results than something used
in isolation.
We'll use things like adaptogens, ashwagandha,and rhodiola, which are going to help balance
that adrenal and that stress resilience.
So we we don't just throw these at you, right?
We are going to dose these and phase thesebased on lab data.
(26:15):
It's not a one size fits all approach.
Every patient is different.
Every person is different.
Body is biologically different.
And so symptoms tell us something, data tellsus more, your response to things tells us more.
And so we're constantly tweaking and finetuning until we get it right.
Step three is then gut, liver and detoxsupport.
(26:36):
So your hormones don't just exist in yourovaries, they're processed and cleared by your
gut and your liver.
And so it's important to support these.
So supporting the gut lining, using things likecollagen, glutamine, zinc, carnosine, these are
fantastic.
Balancing the microbiome with probiotics andherbal antimicrobials if you need, and then
(26:56):
enhancing those detox pathways with NAC,glutathione, and even things like sauna and
rebounding to get the body moving.
Making sure that we're using the restroomdaily, right?
We're having bowel movements, we're sweatingregularly, because your hormones will stay
recirculating in the body.
And that can lead to symptoms like PMS, acne,mood swings, if the body's not clearing out
(27:20):
those those hormones.
And then step four is what we call cyclesyncing and, you know, using lifestyle
upgrades.
So again, we're not just we're not justtreating, we're teaching throughout this
process.
Functional medicine isn't just about fixingyour body.
It's about helping your body fix itself.
And so we guide women through cycle syncing,which is matching workouts and nutrition to
(27:42):
menstrual phases, right?
Different times of the month require differentthings.
Ideally, when your body is going through thestress of your cycle, probably not best to go
hit a bunch of HIT workouts and be burning itat both ends trying to, you know, build your
business or whatever and overly stressingyourself.
It's good to have that cycle.
So lifestyle strategies that we would implementwould be things like HRV training, breath work,
(28:08):
using cold exposure for the adrenal health andbalance, circadian rhythm alignment, making
sure that our body's, you know, moving with thesun in that proper cycle.
Personalized nutrition plans that are going tosupport hormone and blood sugar balance.
And then fitness protocols, right?
We guide on this kind of stuff, so that you'reworking with your hormones, not against them.
(28:30):
And so there's a great quote out of theAmerican Journal of Lifestyle Medicine 2021
said that lifestyle interventions, includingcircadian hygiene, stress reduction and
nutrition are foundational in long term hormonebalance.
So again, very important that we are managingthe lifestyle, not just throwing pills at it,
(28:50):
trying to cover it up, where functionalmedicine can be bastardized and often just
mimic Western medicine with a natural approachis when that's the case, right?
We see doctors doing this all the time.
They say, Oh, this is functional medicine.
They're really just using supplements insteadof medicine with the same symptom focused
approach.
We're trying to get to the root cause at Alessifunctional health.
(29:13):
We're trying to fix what's leading to theproblem in the first place.
So in summary here, hormonal imbalance isn'tjust about your ovaries.
It's a full system dysfunction.
And so when we remove what's harming, restorewhat's missing and rebuild the body's
intelligence, your hormones don't need to bemanaged.
(29:33):
They self regulate, and that's real healing.
So if you're interested in learning more aboutour functional medicine programs and how we
help to heal reverse and fix hormone imbalance,go to alessifunctionalhealth.com, look into
some of our programs, check out Alessi TotalCare.
It's our flagship primary care functionalmedicine program, where we take people through
(29:57):
blood work, custom protocols, nutraceuticals tofix, and then ultimately educate them to take
ownership of their health.
Listeners of the Health Decoded podcast alwaysget exclusive discounts and price reductions on
all protocols and lab testing, so be sure tomention where you heard about us.
As always, if you found value in today's show,please like, subscribe, and share this with
(30:22):
someone who needs to hear it.
That's the only way we get this message outthere and help change more lives.
If you wanna get in touch with us or befeatured on an episode and share your story,
email us at ask@AlessiFXHealth.com.
You can visit alessifxhealth.com, sign up forour newsletter, check out our resources page to
learn more about our approach to nutrition andsome of the cutting edge therapies that we
(30:47):
offer.
As always, thank you again for tuning in.
I'm doctor Alessi, and I look forward to seeingyou on the next episode.
Thank
you for tuning in to Health Decoded, where webreak down the truth about all things health
and empower you to take charge of yourwell-being.
If you found value in today's episode, pleasesubscribe, leave a review, and share it with
(31:08):
someone who needs to hear this.
For more resources and personalized support,visit us at alessifunctionalhealth.com and sign
up for our newsletter.
To hear your questions answered live on theshow, send them to ask@AlessiFXHealth.com.
That's ask@alessifxhealth.com.
(31:29):
Until next time.
Stay curious, stay empowered, and remember,your health is in your hands.
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