Stress is — no joke — a killer.

The toll it takes on our bodies and psyches is enormous. When stressed we don't sleep well (check out our reviews for the Hush blanket and Embr wave to help with sleep), eat well, exercise well, or play well with others. Stress causes or contributes to hormonal headaches in menopause, stomach upset, fatigue or no energy, muscle pain, anxiety and depression symptoms, and a host of issues that can really erode your quality of life.

Adaptogens are herbs and mushrooms that help your body deal with stress. As the name implies, these plants many actually adapt to give your body exactly what it needs where it needs it.

But do they really help your body deal with stress? And if so, what are they, where do we get them, and how do we take them?

Given that (peri)menopause can be such a stressful time, we thought we'd invite in some expertise on the subject.

Webinar with Wendy Ellis

In this webinar, Gennev's Director of Health Coaching Stasi Kasianchuk speaks with Naturopathic Physician Dr. Wendy Ellis on adaptogens and the particular advantages they may have for women in menopause.

Watch the video of their conversation on YouTube.

 

How do you deal with stress? Do you meditate, go for a walk, make lists, to manage it, or do you mostly power through and hope it goes away? Whatever you do, we'd love for you to share it in our Gennev Community. Come join the conversation!

TRANSCRIPT

Stasi, Gennev Director of Health Coaching

So, thank you all for joining. I am Stasi Kasianchuk, Gennev’s, director of health coaching. I'm a registered dietician and exercise physiologist, and we are joined here with Dr. Wendy Ellis. One of our naturopathic physicians. And Wendy, can you introduce yourself to the group and tell us everyone a little bit more about yourself?

Dr. Wendy Ellis, Gennev Naturopathic Physician

Yeah, absolutely., as Stacy mentioned, my name is Wendy Ellis and I'm a naturopathic doctor here in Seattle, and I've been predominantly doing a hormone related type practice since 2005 and adrenal dysfunction comes up a lot. And so, what I really love about it is that it's not just a quick fix. It's something that involves a lot of self-care and there's a lot of misinformation out there. So, I'm really looking forward to having an honest conversation about the adrenals and how they serve us and how they sometimes don't serve us.

Stasi Kasianchuk, Gennev Director of Health Coaching

Excellent. I'm excited for this topic as well, working with my clients through Gennev, this has come up several times. Clients asking about adaptogens specifically, what are they, how can they use them?  and what the purpose of, of it is. And, and in talking with Wendy and her knowledge and information, we really realized we have to take a step back here and help people understand more about what adaptogens are, what they're targeting and looking at stress in general. And this time right now that we're facing between pandemics and looking at the country in terms of our problems and challenges with racism coming to a pinnacle point here. there's a lot of stress out there and then you add menopause in it, and that can be a lot for a lot of women.

Dr. Wendy Ellis, Gennev Naturopathic Physician

We've all had to become teachers.

Stasi Kasianchuk, Gennev Director of Health Coaching

Exactly. Yeah. Right. Homeschooling, home working from home, you name it. There's plenty of stress to be had. Yeah. So, let's jump right in and start with just a basic information. And can you describe for our participants, Wendy, in terms of what are the adrenal glands and what is their role in the body? Why do we have them?

Dr. Wendy Ellis, Gennev Naturopathic Physician

 Adrenal gland, there are, they're like teeny pyramid shaped glands that sit top from our kidneys. And even though they're not directly related to kidney function, they do have a role in sodium potassium and our blood pressure. The adrenal glands are mainly to respond to stress and that can be any sort of stress that could be physiologic stress that could be, you know, stress from all the things that Stacy just mentioned. And so, the adrenal glands produce predominantly two hormones.

They produce cortisol and DHEA and cortisol and DHEA. Cortisol is our stress response and most people, when they think about cortisol, they think that that's a bad thing but it's necessary for life. And when it comes to cortisol, it works in a diurnal rhythm, meaning it's highest in the morning. And then it declines over the day because we need cortisol for energy and for living. And, so it, it peaks usually around five to seven in the morning, and then it should decline over the day because, if we have too high cortisol levels at nighttime, it makes it really hard to sleep. And then DHEA is the other most important hormone produced by the adrenal glands and DHEA actually is it's in its highest peak before we're born. And then, it sort of peaks at the age and then it sort of declines at birth.

And then at the age of 25, it makes us slow decline. So, we think about cortisol and DHEA as having an inverse relationship, meaning that as we age cortisol tends to rise and then DHEA tends to fall and if we think about adrenal dysfunction, there's two major health conditions that are: Cushing's disease, which is where your body produces way too much cortisol and how that presents clinically is generally a really puffy face. We think about truncal obesity, like a barrel shaped body, and this is a, you know, a medical condition that needs to be treated. We can have cushingoid syndrome associated with people who have chronically high cortisol levels. And then Addison's disease is basically the opposite where your body's not able to produce cortisol. And this is a life threatening. You can't live without cortisol.

And so, patients who have Addison's disease are actually on 100% cortisol hormone replacement, generally from 20 to 40 milligrams per day, depending on the amount of exercise or stress or activity they have, or whether it's a male or a female. Male bodies tend to have more cortisol than female bodies because of body mass index. So, the adrenals, they work to not only help us respond to stress, but also, they're an anti-inflammatory and so cortisol is really essential to life. so, having healthy adrenal function is really critical to so many components of our health, including blood sugar regulation as well.

Stasi Kasianchuk, Gennev Director of Health Coaching

Yeah, a lot of work that those little glands, do on a regular basis and so important for health and physiological function. And it sounds like there's extremes where there can be you know, true medical conditions where there needs to be treatment. Like you mentioned, the cushingoid disease and Addison's disease. And then there's the existence in between. I hear clients asking and mentioning this term adrenal fatigue, you use adrenal dysfunction. Can you distinguish between the two or give an explanation of what these are and maybe dispel any misconceptions?

Dr. Wendy Ellis, Gennev Naturopathic Physician

Yeah, it's I know it's interesting because as a, as a naturopathic doctor, you know, adrenal dysfunction or adrenal fatigue is something that is a term that's used for me a little too loosely. I think that, you know, when it comes to adrenal dysfunction, generally, what this means is that either the cortisol is way too high. And so, you're getting the negative effects of having too much cortisol, which we can discuss, or you have an altered circadian rhythm of your cortisol. And so, there are certain tests that you can do to check adrenal function. And as a naturopath, sort of the test that's used most frequently is really a cortisol salivary test where you actually can check your cortisol. And it's really, you just spit in a tube four times throughout the day, starting at like seven in the morning and finishing at like midnight.

And what you're assessing is to see if you have a healthy, cortisol rhythm, meaning is it high in the morning and is it declining over the day? And so when we think about adrenal dysfunction, we're thinking not only how much cortisol are you producing, but do you have that natural cortisol rhythm where you have high cortisol in the morning and then it's declining at night, so you can go to sleep?, I think adrenal fatigue is a little bit of a misnomer. I don't really like to use that term because beyond Addison's disease, adrenals are always going to make cortisol. You know, if you can't make cortisol, like I said earlier, it's not compatible with living but I do think that in our current society, we are on this sort of burning the candle at both ends. And so, I think a lot of people who really find themselves for saying, yes, I definitely feel that adrenal fatigue.

It generally means that they're just tired. They're burnt out. They have low blood pressure; they just lose that vitality. And that is not as common as the other condition, which is too much cortisol. And I would say that too much cortisol is a chronic problem across the board with our society. And we see high cortisol associated with diabetes, heart disease., we see it correlated with, you know, just obesity. And so, there's a whole spectrum of adrenal dysfunction. So, you could feel like you had low cortisol levels and then you could also have high cortisol levels.

That's a great point. Again, coming back to that spectrum so important to recognize that individuals may exist on different areas of that spectrum and perhaps different areas during their life. One you mentioned is that there are times when cortisol is necessary to live. Sometimes I, when talking with clients, they've wanted to get their cortisol as low as possible. They think low cortisol is optimal because there's this maybe misconception that cortisol is bad., can you talk a little bit more about when cortisol can be detrimental or when it may be more harmful or when it's too high or too high too long?

Yes, so there's this sort of, instead of thinking about cortisol, DHA is having an inverse relationship, cortisol and insulin are correlated together. Meaning that generally speaking, when you have high cortisol, you tend to have high, high insulin as well. So if we go back to, you know, sort of Hunter gatherer ages, when, you know, let's say you haven't eaten and you're really hungry, and your body's pumping out, you know, you know, cortisol because you're stressed. Basically, you start running after that Buffalo or whatever. And then, you know, your cortisol goes up to help you respond to stress. But in this day and age, we're living in this chronic stress and we're eating a lot of processed food, a lot of carbohydrates, a lot of sugar, a lot of food, that's actually not really food. And so, when that insulin rises secondary to eating all that processed food, because it's kind of a biochemistry lesson.

So, when we eat, let's say I eat a piece of bread and I, you know, eat a piece of bread and I put jam on it. My blood sugar is going to rise. And then my insulin is going to rise to help get that blood sugar into the cell. But when that insulin rises, your cortisol generally rises too. And so, a chronic diet of having too much processed food and food that doesn't have a lot of nutrient value that has very little fiber or very little you know, complex carbohydrates like beans or proteins. Those diets tend to really raise that insulin level, which raises the cortisol level. And so, your body is basically suffering the effects of that high cortisol. And we tend to put that weight on, around the middle. So, it's like that cushingoid syndrome where that chronic stress gives us high cortisol throughout the entire day.

And so, you're not getting this natural cortisol rhythm. You're basically having cortisol. That's sort of sits like this. Obviously it goes down a little bit at nighttime, but when it comes to being able to sleep, if you have those high cortisol levels secondary to your lifestyle habits during the day, then what happens is that you just have the sustained problems of having too much cortisol, which is really diabetes, heart disease. It basically as, instead of cortisol being an anti-inflammatory, which it be on a daily basis, it becomes pro-inflammatory. So, I think that as a population, we tend to have this high cortisol fraction instead of low cortisol. And so, it's just creates breakdown of our body isn't breakdown of tissues instead of being you know, helpful. And anti-inflammatory,

Stasi

so, it's the, the rhythmic, the, the rhythm, the rhythmic effect of cortisol or that's high in the morning, and then decreasing throughout the day is beneficial but when it's chronically high, that's where we can see some of these detrimental effects.

Exactly. And so, when people come in and they talk about the fact that they can't sleep cortisol is definitely one of the things that we address. And as I mentioned, you can do those four points, salivary, cortisol tests, traditionally to check for actual adrenal fatigue or, you know, Addison's disease. It's a clinical test that you do where you inject the precursor, which is act H, which is Metairie hormone. So, you inject that in an Ivy. Before that time, you do a 24-hour urine collection for cortisol, and then they inject that ACTE age, and then they do a urine test after to see if your body's actually able to produce cortisol secondary to giving the stimulant. So, when we think about adrenal testing, salivary testing is something that actually even lab core is doing now. And so, I think that people are asking for it, there is a blood test for cortisol, but there have actually been clinical studies that a lot of people don't like having their blood drawn, or they feel very stressed. And so, the test is not that great because you know, the cortisol can rise just in response to thinking about the fact that you're having a blood draw really good point.

Stasi

Well, with the you mentioned the diet can definitely play a role in keeping those I was being a stressor and keeping the elevated cortisol, what are some other lifestyle things that can implement that can impact cortisol, elevate those levels that we may be exposed to on a day to day basis?

Dr. Wendy

You know, we live in this go go go 20th century and the stress of Go go go going definitely increases that and then exercise. So it's interesting because exercise, we need cortisol to exercise and when you're acutely exercising, so let's say I'm going to go for a run. My cortisol will actually rise in response to that active exercise. And so, you have a bump in cortisol, but that exercise and that bump in cortisol and that regular exercise actually gives you a lower baseline cortisol throughout the course of your lifetime. So, if you want to actually improve your cortisol levels and not have high cortisol levels, you have to eat a clean diet. That's not full of refined carbohydrates. You have to exercise regularly. So, you have like lower cortisol levels over the course of time. And then you also need to have a daily regimen that correlates with your cortisol rhythm. And as we live in this time in life, where, you know, a lot of us are living in cities and you know, where we have all this sort of light pollution that comes in the, the light, dark rhythm is something that really plays a role in our cortisol levels.

And so, if we are staying up late in front of our computers, if we're eating really late at nighttime, even if it's seemingly healthy food, all of those things are going to negatively impact your cortisol in the evening. And so when we talk about how to lower your cortisol levels, do you want to eat earlier in the day, you want to exercise earlier in the day, you want to have some period of time when you get home after work and you need to sort of ramp down and bring that stress level down. So that could be stretching that could be walking that could be reading or knitting, but it's really important at the end of a stressful day to do something that's going to bring more harmony and more relaxation. So, your cortisol levels can therefore, you know, respond to that.

Stasi

Yeah, that's a great point of that. Just having that rhythm in our day and versus that elevation, and I think we've all experienced where we, we noticed when we are at a high level of stress for an extended period of time and it starts to wear on us. Some of us may notice that's when our immune system gets depressed. So many times, I've gotten sick once, once I'd had an extended period of stress and then there's that let down and all of a sudden you get a cold, or you get the flu. and at a time right now, no one wants to get sick. So, it's important to figure out how we can manage stress.

Dr. Ellis

Exactly.

Stasi

Well, let's talk about where adaptogens play a role here and how they fit in and, and we're going to come back to some of the lifestyle things, cause based on what you said, it doesn't sound like adaptogens are going to be the answer, but certainly they're out there. So, let's talk about what they are first and how do they play a role in supporting the body's stress response.

Dr. Ellis

Yeah. And adaptogens it's, you know, it's a tricky one because there's a lot of definitions for adaptogens and actually in preparation for this, I actually pulled up, a pretty good definition of adaptogens and I'm just going to read it to you. Basically, said it was, they were initially defined as substances that enhance the state of nonspecific resistance to stress. It's and this stress is linked with various disorders that involves not only our endocrine system, but in the way we think and process information and also in our immunity. And so, when we think about adaptogens, we're thinking about things that are supporting our, you know, our cognitive function, our physical function, as far as how we can respond to stress, how we can go out and exercise but also how we sustain a healthy immune system, which of course, in this state of COVID where we have this virus that we really don't have anything to protect ourselves against having a strong immune system and doing everything we can to support our immune system, which means managing your stress appropriately is really important.

And, and adaptogens are, it's interesting. Cause when we think of adaptogens, it's, it's two different ways. It's basically a substance that's given to you that is meant to help you in the way that your body needs it. The most, which sounds like a little, you know, it sounds a little foo foo, but at the same time, you know, I, when I was doing a lot of research into the various herbs and new trends that are considered adaptogens, which, you know, we'll mention the ones that are most common. So ashwagandha is probably the most common adaptogen Rhodiola and then adaptogenic cordyceps, which is a type of mushroom is considered an adaptogen Maca is even considered an adaptogen. And those are, you know, they all can be used to support the immune system, but they all can be used to support stress.

And there's actually even clinical studies in, in rats that were fed a high fat diet that when they were given adaptogens that actually improved their protection against obesity. And so it's really interesting because adaptogens, you know, and most herbs actually, if we think about herbs, I think a lot of, a lot of issues happen when we talk about herbs because there's not a lot of money to be made in herbs and you can't patent a natural substance. And so, unfortunately there's not a lot of great clinical studies on herbs, but they're, you know, with the demand, there are more and more clinical studies and, and the ones mentioned actually have pretty great safety profiles. And you know, that being said, we want to make sure that we're using a supplement that's from a reputable company. And so, it's really important. Like if I bought an arm from China, I don't know if that's contaminated with lead or pesticides. And so, when you do buy these products, it's important that you take a look at that and you know, whether it's from a reputable company, but adaptogens are meant to support you in the way that your body needs the most.  it's kind of a simplified answer but that's the definition. So, if I need more immune support, it's supposed to be helping my immune system. If I have high stress, it's supposed to help high cortisol. And if I actually feel like I have low adrenal function and I have reduced cortisol response, or I have that it's, it's supposed to help both high and low cortisol. So adaptogens just basically means that it's supposed to help you in the way that your body needs. The most

Stasi

Sounds like the title of it, basically adapts to what you need as an adaptogen. Oh, interesting. That's fascinating and glad to hear that there are some more research going into these, these herbs that are out there. And the few that you mentioned that are safe and as long as you're getting them from a reputable source. When we think about menopause, so that's an additional stress on the body, a natural stress that comes during this time of life. How does that connect to let's talk about how that impacts the body's stress or stress response first what's the, how does that impact that?

Dr. Wendy Ellis

There's actually, I actually found quite a few clinical studies that looked at cortisol response and menopause. And, you know, for, for, for those of you who don't know, menopause is really associated with an increased weight around the middle. And that when we think about when I see a patient and they're carrying a lot of weight around the middle; I automatically think about cortisol because generally those people have a higher cortisol value. And so, when we approach menopause, actually as our bodies create that fat around the middle that make more estrone, which is a really potent estrogen. And, and yesterday we were talking about its protective because our bodies want to put more fat around the middle so that fat can produce estrogen as we go through menopause. But as that estrogen is produced, it actually creates more cortisol. And the more cortisol you produce, unfortunately, it's going to propagate that weight around the middle and not only does cortisol increase weight around the middle, it also increases hot flashes. And so, menopause being a stress is generally associated with higher cortisol production, which also just makes hot flashes worse.

Stasi

Okay. So, there's a little bit of a cycle here I'm hearing. And what about with, so with these adaptogens, can they be effective during menopause or is there research on this, in this population? Or what do you see?

Dr. Wendy Ellis

Yeah, there, there actually is. And ashwagandha's probably the one that has the most research. And I would say ashwagandha can be helpful for a number of things. So, there are studies showing that ashwagandha can really help with sleep. And so, people who have sleep latency, meaning they have a hard time getting to sleep. Ashwagandha can actually help lower that cortisol in the evening and to help them sleep. And then the other thing that a lot of women complain about around perimenopause and, you know, in that menopausal transition to post-menopause is that brain fog where they start sort of missing words and searching for words. And, you know, in perimenopause myself, I'm experiencing that where you're like, I see that thing. I know what it is. I can describe it, but you're just grasping for that word. And actually, ashwagandha has been shown to actually improve brain plasticity and cognitive function around menopause. And so, brain plasticity, just to describe that, I, you know, it seems backwards. I think with plastic is being hard that festivity in the brain means that information can travel like rapidly and freely between the different components of our cognitive function. And so ashwagandha has been really shown to, to help with cognitive function and being able to think more fluidly and clearly at menopause.

Stasi

 Oh, wow. That's great to hear that there's some benefits there and with some of these with ashwagandha specifically, would this be something that would be anyone should take this, or does it depend on the individual are, or does the response depend on the individual?

Dr. Wendy Ellis

You know both men and women can take ashwagandha.  it's not just for menopause.  and it's not just for people with low cortisol or high cortisol because it can actually help it. There are clinical studies that show that it actually improves perceived stress. And so, if I feel like I can take off Rhonda and be able to handle my stress better, then that stress is going to be, you know, not having all those sort of cumulative downstream effects. And so ashwagandha, sorry about that. Working in my office to fit your life from your office and that's the front door. So ashwagandha can be taken for people who are just fatigued because they're not sleeping. But also, those people who do have high cortisol at night-time who need help, you know, getting to sleep, but it could also be taken in the morning and not make you sleepy, but improve your ability to respond to stress. When you have to get up after a night of not sleeping and you need to go to work and respond to all the stressors that, that don't take a break with menopause, they just seem to accumulate at menopause. Cause I feel like, you know, generally when women hit menopause, we're also in this sort of peak in careers, right? Where everything is really busy, and the stress is pretty high. And if, if anything, you need more support to help you get through that stress secondary to, you know, the, the place you are in your life, but also with menopause, just adding an additional stress.

Stasi

Yes. I have several clients too that have adolescent children right now where they're in perimenopause and they talk about actually feeling the hormonal mix that's happening in their house at that time, when you have a child that's has changed your hormones and then your hormones are changing, there's a cumulative effect.

Dr. Wendy Ellis

Absolutely, absolutely. Having that.  I think the kids in my house are creating a little more cortisol production for me. I love them, but they're ever present,

Stasi

Well, we got a question around what is the best way to take ashwagandha?

Dr. Wendy Ellis

It depends.  so, one of my favorites one of my favorite ashwagandha is out there is called cortisol manager. And I'm not at all correlated with this company, integrative therapeutics, but cortisol manager has a number of different ingredients in it, including ashwagandha. And if people take that, I generally have them take it at night because for the most part, most people do have high cortisol. And so, Laura and then low cortisol, we're trying to treat the effects of high cortisol, especially in this specific group of peri and post-menopause. And so most adaptogens are generally taken at nighttime, but they can be helpful in the morning as well.

Stasi

Okay, good too. And is that in a capsule form then?

Dr. Wendy Ellis

It is in a capsule form and actually I did pull up some pretty typical doses for ashwagandha. And it's about like, let's say it's funny just to see me writing it's about 500 milligrams. So, I'd say for most adaptogens it's four to 500 milligrams of the dried herbs.

Stasi

Well, let's you mentioned some other one’s rodeo, I think was another one. What does that one help with?

Dr. Wendy Ellis

Actually, the same thing. So Rhodiola has been shown specifically to support not only the immune system, but also to help reduce cortisol levels and actually to improve your response to stress. Okay. So, and the other one that's is a pretty common adaptogen is actually ginseng and there's lots of different things.  but that one we tend to take earlier in the morning because that one does tend to be pretty stimulating.  but I'd say Rhodiola ashwagandha are more typically taken in the evening because they do tend to be more for people who do that high evening cortisol.

Stasi

Okay. And would there be a reason that you would prescribe one versus the other for someone?

Dr. Wendy Ellis

I would say that ashwagandha probably has more history and more research than Rhodiola. And so, I tend to start with ashwagandha just because I've had better clinical success with that one, but at the same time, oftentimes when it comes to adrenal supplements, that kind of throw everything in together. And so, I know we're talking about herbs right now, but there are certain nutrients that are really important in adrenal function.  and one of them is actually vitamin C. And if you actually took a, an adrenal gland and sort of broke it open you would see higher concentrations of vitamin C, B vitamins, specifically B6and B5. And those are important in cortisol production. And also, boron. Boron is a nutrient. That's also important in bone density and immune system, but boron is important and adrenal function as well.

And so, you know, I think one of the most important things is that when people are feeling stressed and they're having mood disturbances, we generally add B vitamins in there because they're important in adrenal function. And so those tend to be taken earlier in the morning because B vitamins can be very stimulating, and you want to eat them with food. And so generally we're trying to discourage the late-night eating because we don't want that rise in cortisol. And so, adrenal supplements that have B vitamins in them are better taken earlier in the morning and herbs adrenal sort of herbs tend to be taken in the evening.

Stasi

Okay and we have a question here. If a patient has a history of CVA, is it safe to take any of these adaptogens?

Dr. Wendy Ellis

Did you say CVA?

Stasi

Let's see. Cardiovascular stroke.

Dr. Wendy Ellis

Oh.  Without looking at that, without specifically looking for that I can't say 100%, however, you know, if we think about all that, I don't, I don't think about those herbs having any potential for increased clotting.

Stasi

Okay. Should be fine. Okay. Maybe something that's still check with your physician if you are thinking about it.

Dr. Wendy Ellis

Yeah. And the other thing is with any herbs, there's a lot of herb drug interactions. And so it's really important to note that if you do start some sort of herbs herbal treatment that you check with your physician to make sure that there's no interactions, because some of them can actually decrease the actions of medications, but some can potentiate the action. It can make it more potent. So, we certainly don't want to affect someone's drug regimen with an herb.

Stasi

 Okay. Any other things that people should be aware of as potential risks or dosing reasons to stay? Definitely in that four to 500 milligrams. 

Dr. Wendy Ellis

You know, when we look at safety studies, if we think about, you know, if we think about Mako, we haven't talked about Maka yet.  but my ashwagandha Rhodiola, they generally have pretty, pretty good safety studies. And if we look at toxicity studies, we're talking about 20 and 30 times the amount of that specific herb.

And so, it's really, you know, I would say for the most part, they're pretty safe herbs when taken in that four to 500 milligram doses. One thing we haven't talked touched on, which I think is really important is DHEA. Let's talk about DHEA cause it's a really hot topic. And it's available over the counter unless you're in Canada and then it's not available over the counter. But DHA is in the same family as testosterone. It's an androgen. So, if you think about cortisol as too much cortisol is breaking tissues down. So, it has sort of a catabolic state DHEA is an anabolic steroid. So, all hormones are steroids.  estrogen, progesterone, testosterone, DHEA and DHEA is one of these things that has amazing potential, but it can metabolize to testosterone, to estrogen, to progesterone, and most DHEA supplements come in 25 milligram capsules. And when you swallow that capsule, you have no idea what your body is going to do with that. So, in the case of someone who carries a lot of weight around the middle, that DHA tends to robotize to estrogen. So, if you have a man that's taking DHEA thinking, I'm going to prove my testosterone. If you carry all this extra weight around the middle, it's going to go straight to estrogen.

Yeah. And then when it comes to women, if I have there's something called the five alpha reductase enzyme, which is basically the enzyme that converts testosterone to dihydrotestosterone. And I like to think about so if you think about guys that are like super hairy bodies and they have bald heads, they have a lot of that enzyme. So, they have a lot of the most active testosterone women who tend to be athletic-y, lean sort of women who build muscle mass pretty easily when they take DHEA, it's less likely to go to estrogen, but it's heavily likely to go to testosterone. And when that happens, you can create hair loss, you can get acne, you can have increased body hair, and we don't want too much testosterone. You know, you want to, you want a healthy ratio between estrogen and testosterone. So DHEA also because it's over the counter, it's not regulated by the FDA.

And the FDA actually did a study that I read about years ago where they took 25 different DHEAs off the counter. And then they measure their DHEA and something like 75% of them didn't have the DGA dose that was mentioned on the label. Some had 0% and someone had some, one of them had like a thousand percent of the DHA that was mentioned. So DHEA is one of these things that seems harmless, but because you just don't know how it's metabolized and you know, if I had breast cancer and it was a hormone sensitive breast cancer, and I went and grabbed some DHEA and I took it because I was tired that could have negative impacts on that. So, you just, it's one of those things that you still be talk to your doctor about before taking.

Stasi

Still highlights the challenges with so many supplements out there and the lack of regulation and importance of choosing supplements that are regulated are not regulated, but there are fights through third party verification or the practitioner that is providing it knows,

Dr. Wendy Ellis

We do have we do have a blog about how to determine if something is a good supplement, so you're set up.

Stasi

Yeah, good reminder to check out that learning library and just, with a pretty robust search engine. So just putting supplements and it should pop up. And we can also include that in the link and in the follow-up to this webinar. Well, let's talk about Maka, cause that's another one that has come up and especially with women in menopause, there are some claims that can help with hot flashes. I have some clients that swear by it. Some clients that say it tastes awful and they're not noticing a difference, but they'll do anything to feel better right now.

Yes.  and Maka is one of those herbs that I found it's either gonna work or it's not. And when Monica is taken, it has been shown to help with hot flashes.

But I'd say that more women I've found take Maka because it just makes them feel more levelheaded. And in this perimenopause menopausal transition or post-menopause, I feel like moods are more difficult to manage. And so, anything that can help women feel more, you know, sort of levelheaded can be really helpful. And the Maka I'd say 500 milligrams is usually the amount that it comes in, but generally women take somewhere between 500 and a thousand milligrams of Maka. And again, it's considered an adaptogen. And so, if you feel like you have adrenal, you know, adrenals, that just don't respond to stress as well. Maka can help that. But if you're also one of these women who have really high cortisol, it can help with that as well. It can help offset that, those issues with thinking and those issues with stress response and it can help hot flashes. And so, it's one of those herbs that has a lot of benefit in many different ways.

Stasi

Okay. Multipurpose it's sounds like an adapting to what the individual may need.

Dr. Wendy Ellis

Exactly, exactly.

Stasi

And with Maka this might play into even what you mentioned around other forms of the ashwagandha Rhodiola are there, if I've seen it in powder form and to include in say smoothies or oatmeal, something like that. And then I've also seen it in capsules. Does it matter the delivery mechanism?

Dr. Wendy Ellis

Well, what you're going to get in the capsule is generally just a powder anyway. And so, it's less on the delivery and more on the total milligram dosage. And there are, you know, just like Jen saying there's different types of Maka as well.  I'd say there's probably more research in the feminessence is probably the Maka that is most known in the clinical world.  and that is a 500-milligram capsule taking one capsule twice a day generally.

Stasti

And how about the cordyceps? You mentioned those as in the mushroom family what's are those used for, is that similar in terms of the stress?

Dr. Wendy Ellis

You know, it's interesting.  it was interesting for me to read about cordyceps being an adaptogen and sort of thrown in the same category because when I think of cordyceps, I think more about cordyceps and it's in you and enhancing properties. And so, when I use cordyceps or, you know, reishi mushrooms, I generally use them for people who just have poor immune tolerance and they just feel like they are getting sick more easily. And so, the Rhodiola ashwagandha Maka tend to be the more like clinical symptoms that you feel as far as, you know, stress or memory or hot flashes or mood. Whereas the cordyceps I use, I don't tend to use those for that so much as I use them for people who just feel like their resistance resilience is down and they're like, I get sick all the time, or I go through stress. And like you mentioned, you go through a big stress and immediately when it's over, you know, you tend to get sick. And so, I tend to use more of the mushrooms when I'm thinking about trying to improve the overall immune response.

Stasi

Okay,

Excellent. Yeah. It seems like they, there's still a stress connection. We know immune function can be connected to the stress and we know though the body's connected but that there might be some nuances in each of these that might be used for different things depending on the individual.

Dr. Wendy Ellis

Yes, exactly. Exactly. But again, you know, mushrooms are, are a really safe thing to take.  again, you don't want to take too much of them.  but you know, for the core steps, I'd say there's plenty of research on cordyceps being safe for you to take, assuming you get them from a reputable company.

Stasi

Yes. You're going to keep putting that out there.  and how about in terms of, you know, thinking about food, what about cooking with mushrooms and, and getting, do you get the same benefits in that way?

Dr. Wendy Ellis

I would say yes, but you probably, you know, when you're thinking about chorus ups or you're thinking about an extract, I'm probably going to have to eat a lot more than you would, you know, as far as the cat to equal what's in a capsule form because it's generally dried and pulverized, versus when we eat mushrooms, we tend to eat the fresh mushrooms. And so that's a, that's a lot of mushrooms.  I, you know, the longer I'm in practice, the more I am getting away from supplements and focusing on the lifestyle, because you can't supplement your way out of an unhealthy lifestyle. I feel like that's going to be the tagline on my, I'm not going to have great stone, but if I did, if you would license plate somehow, lastly but I do, I do feel like, you know, I feel like we've missed the Mark when it comes to adrenal dysfunction that it's not that our adrenals are just, you know, with, with thyroid, for example, you know, it's not like our thyroids wear out and then we're going to have to do take thyroid hormone replacement.

Generally, it's an autoimmune thing. Or, you know, there's, there's many reasons for thyroid, but you know, when your thyroid is low, you take thyroid hormone replacement. When your adrenals are low, you generally don't take cortisol. I mean, there are some circumstances where women have really low blood pressures and they have, you know, really low cortisol levels when you're checking, even in the blood. And sometimes, you know, those women, they get sick really easily. And so, you know, it's very controversial, but sometimes taking a small amount of cortisol can be really helpful.  but I'd say that's an extremely rare event when that occurs. But I would say that adrenal dysfunction generally happens because we're doing too much and we're not taking care of ourselves. And so, when it comes to adrenal fatigue, it generally means that our self-care is lacking and we're not sleeping enough and we're not eating the proper food to fuel our bodies effectively. And we are not finding a way to manage our stress and we're staying up too late or over-exercising, you know, there are so many things. And so when it really comes down to improving adrenal function, B vitamins, vitamin C ashwagandha, those things can help you feel better, but unless you go back and you really take a hard look at what am I doing in my life, that's putting me in this exhaustive state. And I think that, you know, at the end of the day, adrenal fatigue, isn't an adrenal function. It's a lifestyle issue.

So, it's not like, I don't believe in adrenal fatigue. I do believe our adrenals take a hit from not taking care of ourselves. And yeah. So, I think that's where the controversy lies.

 

Stasi

Yeah. And I think it Briggs just such a great reminder that it is this holistic approach and that yes, there are these options out here. Their adaptogens are more popular. They're getting more attention, but it's not, we still have to come back to a, it's not a quick fix. And many of these things do lie in where the stress is coming from. So, it's getting to the root of it. And perhaps the adaptogens may be appropriate to provide additional support. But if you don't, if you don't address the cause, it's not gonna really get you to where the optimal state might be.

Dr. Wendy Ellis

Exactly. And, you know, as we talked about before, cortisol does rise over time and we can't stop menopause from happening. It happens to everybody.  and so, if we know that cortisol does rise and response to stress, and it does rise in response to time. Like there's nothing lifestyle-wise you can do about menopause. I mean, obviously there's a lot, but there's, you know, that, that lowering of estrogen and that increase of the fat estrogen that our bodies make. I mean, that is something that, you know, we really can't avoid. And so, by taking ashwagandha or Rhodiola to help us think better and to help us go to sleep and to help us respond to the stress that we can't avoid better, it was could be huge, helpful AIDS along with all the lifestyle things.

Stasi

Yeah. Well, let's finish up by talking about some of those so that our listeners can definitely take away, you know, maybe a, a checklist of things that they could think about in their life of implementing. And just as we're having this discussion, if there's any other questions, feel free to add them into the chat.  we'll, we'll be finishing up here, but happy to address those. so when you're talking with your patients, Wendy, do you, or do you find things that are come up as most common stressors, or do you have a checklist of things to go through in terms of how, how women can look at their life right now and find areas they might be able to reduce stress?

Dr. Wendy Ellis

Yeah. I had a patient yesterday and it was just really interesting because I feel like a lot of people are in this place where she's working full time. She's got one, you know, two kids one's in high school, one's in college.  she's taking two classes to get her accounting, like associate's in accounting and she's like being a mom and she's trying to, she's a little bit type a, so she likes to clean house, but she's working, she comes home, she makes dinner and then she just, you know, we'll go do homework. And so, she doesn't have any time for exercise. And she's just like, oh my gosh, I'm gaining all this weight around the middle. And I think that movement and exercise and making time for yourself is one thing that women around menopause are terrible at doing. We're really terrible at self-care because we don't want to drop the ball anywhere. And she also said, I feel like I'm becoming OCD where I just like, want the house perfectly clean. And like, I just don't know where there's room for self-care. And she said, and then I finished my homework and I just want to sit on the couch and like have a glass of wine. And in the morning, I get up and I just want a couple of minutes, so I'm not getting any exercise. I just want to sit on the couch and like, watch the news and drink my coffee. And I'm like, okay. So, all these things are happening. Like if you don't move your body, it's going to be really hard to get better. Because again, yes, cortisol can rise secondary to the immediate effects of exercise, but it's long-term effect is having that maintain low cortisol.

So, if you can lower your cortisol by exercising over the course of time, having that low cortisol, it's probably the one most impactful thing you can do.  and then the other thing is diet. So, a lot of people get home and they eat meals really late and eating meals really late is not a good thing to do. And so, if you can make time for exercise and you can make time to eat earlier or have your larger meal at lunchtime and eat a smaller meal at dinnertime and try to eat at least three hours before you go to bed. I think those are the two really important things that we're not doing. And then the other thing is, you know, having some outlet for your stress, whether it be using an app, like call the comb app or a Headspace app, because you don't have to go anywhere. You know, you can do it anywhere. You are, you can just close your eyes, put your earphones in and just let your body relax. And they do the work for you. And so those are the most important things. And then, you know, a lot of people will drink too much.  you know, because we were stressed, and we want to just like drink some wine at the end of the evening. And that is a big that, that raises your cortisol level. And it also increases to that weight around the middle, which adds to more stress. So, we're just propagating this, you know, this thing. And so, I know that not having enough time is one of the biggest complaints, but if you don't make time for exercise and self-care, you're not going to be able to take care of everything else. You know, you're just, it just makes time for disease.

Stasi

It's counter intuitive, where we are in a culture that really promotes doing more and being the best at everything. And you have to show up and be the, the students, the mom, the worker and that that's a lot. And so, it's counterintuitive to take a step back to care for yourself to realize that that actually could get you more steps forward.

Dr. Wendy Ellis

You know, I think one thing that's a little bit shocking and horrifying is looking at your phone to see how much time you've spent on your phone.  and you know, a lot of people are on their phones, like, you know, mindlessly scrolling through things. And, you know, you figure if you spend two or three hours a day looking at your phone, playing words with friends or on Facebook or reading Twitter or whatever people do on their phones, like if we have time for that, then we can definitely take from that. And I feel like some of the things that we, the idle time we could use a lot more effectively and people say, but I'm so tired. I can't exercise, but exercise actually gives you more energy. And so, and again, it will lower that cortisol level. And so it's just something that, you know, I see a lot of patients over the course of their, you know, I've had some patients that I've had since 2005 and it's been really great because I generally start with menopause and now they're in their seventies. And the ones that do best are the ones that move their bodies every day. And you can't take that in a supplement.

Stasi

Yeah,

No, that's one of just how our bodies are meant to move.  and I like how you preface to the movement piece. It doesn't have to be structured exercise. It doesn't have to be miserable, but can you move and maybe start, if you are really fatigued, can you start with a walk on the block, see where that takes you, maybe then you have a little bit more energy and then if you're still fatigued, okay. Maybe the next day, it's two, it's two laps around the block, but you've started to move your body in that way. And that's the most important thing you're moving forward in some way shape or form

Dr. Wendy Ellis

Yes, exactly. And I think the hardest part of exercise is making yourself do it once you're at the door or, you know, once you put your shoes on, like you're committed. And I feel like, you know, my, my mother is a good example of, I was never really, always really active, but never really an exerciser. And probably 10 or 15 years ago, I started walking with her friends like three miles a day. And it's just amazing because my father is in this place where he's been the opposite. He's, de-compensated, he watches a lot of golf and my, you know, it's just really interesting to see how I used to see my parents like this. And now my mom was exercising so much energy and fit and, you know, not on any medications and my dad, you know, just isn't getting enough exercise. Cause then I do see that high cortisol and that weight around the middle. And it's just, it just is propagated by, you know, I don't feel good. I'm tired. I don't have enough time in my day. I'm too stressed. I don't want to add one more thing.  and so, you know, it's, it's, it's some, you have to sacrifice something somewhere.  and so, you know, for me, I'm like, Oh, you know, I need to move my exercise to the morning. Cause otherwise the day just get swallowed up and other people's things. Yeah. So.

Stasi

Oh, great. There you go. That's true too. I'll say I have a; almost 10-month-old puppy and that dog does need to get out multiple times per day and it's not able to do it on its own.

Dr Wendy Ellis

I'll add some stress, a dog that hasn't had enough exercise.

Stasi

Exactly.

Well, we have one other question here to finish up with. I'm just asking about. Let's see, is ashwagandha safe to take if you've had ovarian cancer and then can ashwagandha help to raise depleted DHEA levels

Dr, Wendy Ellis

Ashwagandha to will not improve your DHEA level. and so, I have not seen, I, I did take a quick look at that. and again, DHEA will increase with DHA supplementation but I have not seen any studies on astronomic increasing DHEA levels and as far as ashwagandha and was it ovarian cancer?

Stasi

Ovarian cancer.

Dr. Wendy Ellis

So, it should be fine.  definitely something I will check into for sure.  and so maybe you can connect me in some way or get that person's information and I can, I can circle back on that.

Okay. That sounds good. We can work to connect on that piece. All right. Well, thank you so much, Wendy.  any closing thoughts on this topic?  if they get you hit the exercise piece pretty good. So, I think that's a good closing message, but any other information you want to share with our listeners?

Dr. Wendy Ellis

Yeah.  hold on, I put a couple stars next to this. Let's see, just, you know, if you, if you don't work on lowering your cortisol levels, it's associated with a lot of negative things meaning it can raise your fast, your glucose levels. It can decrease your ability to, to heal tissues in the body. It can increase inflammation. And so, there's a lot of negative side effects to having high cortisol levels. And I would say that even though adrenal fatigue is sort of the phrase that's thrown around a lot, I feel like the, you know, adrenal dysfunction really as what I see it in practice tends to be more high cortisol than low cortisol, and it's definitely associated with lifestyle. And so, we can take things to help us, but at the end of the day, we really need to get enough sleep.

If you're getting hot flashes, treat those hot flashes, whether it be with herbs or botanicals if you're eating poorly or you're eating too late or you're drinking too much wine in the evening, those are all behavioral things. And, you know, obviously sleep is one of the most important things that cortisol affects. And so if you're, you know, not sleeping well, and then cortisol is one of the most important things you can look at to try to help improve your sleep because sleep medications, you know, even the over the counter ones, they have detrimental effects on our cognition, cognitive function in the long run and with a lot of women worried about Alzheimer's because it's so much more prevalent in women. I think it's just really important that we stop taking things to try to treat things that should be treated with behavioral changes.

Stasi

Okay, excellent. And Wendy, in any of our panelists or participants want to get in touch with you, how would they be able to work with you?

Dr. Wendy Ellis

 So, I am the telemedicine provider for genetics. And so, you can make an appointment with me, it'd be a genetic and that you can find me on the list of telemedicine providers. And if you are in the state of Washington and Oregon, I do have a private practice and you can email me at info@ drWendyellis.com. And it's my website is just drwendyellis.com and you can always send me a message via my website as well.

Stasi

All right. Awesome. Well, thank you so much for your time today and thank you everyone for participating for your questions and for listening to this topic.  just also a reminder for through Jeanette, we offer our health fix program, and that gives you an opportunity to work with a coach like myself or other coaches, And you're able to learn again, more of those lifestyle things that we talked about is really being factors in terms of stress management. So, what's appropriate exercise, nutrition, sleep, stress management, really, and help to have that personalized strategy for you based on your current lifestyle and your goals. And then finally, just to let you know, our next webinar will be on Monday the 22nd of June, I believe and that we are going to be talking with representatives from Uqorea and they are a company that has a treatment. They use treatment approaches for urinary tract infections. So, we'll be talking about that as it relates to menopause. So that's coming up on Monday at 3:00 PM. So, thank you all for participating, and we look forward to seeing you all soon.

Dr. Wendy Ellis

Thanks, Stacy.

 

 

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