Menopausal Weight Gain

In my practice as a naturopathic physician, I often see women in their 40s and 50s who are doing everything right—eating well, staying active—yet still struggling with unwanted weight gain and declining energy. What they’re experiencing isn’t a failure of willpower. It’s a reflection of the profound hormonal changes that accompany perimenopause and menopause, changes that affect metabolism, fat storage, sleep, mood, and appetite regulation.

Weight gain during this life stage is common, but it isn’t inevitable. The key is understanding the “why.” As estrogen, progesterone, and testosterone begin their often erratic fluctuations and eventual decline, the body undergoes significant shifts in its fundamental processes. These hormonal shifts make the body less efficient at managing blood sugar, preserving lean muscle mass, and regulating cortisol, our primary stress hormone. Specifically, declining estrogen levels can lead to increased insulin resistance, making it harder for cells to absorb glucose, contributing to higher blood sugar and increased fat storage, particularly around the abdomen.

Furthermore, the decrease in these hormones, especially testosterone and estrogen, directly impacts muscle protein synthesis and maintenance, leading to an accelerated loss of lean muscle mass – a process known as sarcopenia. This reduction in metabolically active tissue further slows metabolism. Concurrently, the fluctuating and declining levels of estrogen and progesterone can disrupt the delicate balance of the HPA (hypothalamic-pituitary-adrenal) axis, impairing the body’s ability to effectively manage stress and often leading to higher or more erratic cortisol levels. This hormonal interplay often leads to increased abdominal fat, a propensity for insulin resistance, and a frustrating sense of metabolic slowdown, even for those with disciplined lifestyles.

Unfortunately, conventional weight loss advice like eating less and exercising more can make things worse. Restrictive diets and excessive cardio elevate cortisol levels, which further disrupts metabolism and encourages the body to store fat. What’s needed is not more discipline, but a more intelligent and personalized approach.

That’s where naturopathic medicine shines. When I work with women navigating midlife weight changes, the process begins with comprehensive lab testing. We assess thyroid function, insulin sensitivity, cortisol patterns, and sometimes a detailed sex hormone panel to understand where the imbalances lie. These results guide every step of the treatment plan.

From there, we craft an individualized strategy that may include:

  • Bioidentical hormone replacement therapy (BHRT), tailored to each woman’s unique needs and stage of life to restore hormonal balance and support energy, sleep, and metabolism.
  • Targeted natural medicines to help balance hormones and to support insulin sensitivity, adrenal function, and liver detoxification.
  • Nutritional guidance that supports metabolism without deprivation, with an emphasis on protein intake, blood sugar balance, and anti-inflammatory foods.
  • Movement recommendations that respect the body’s changing physiology, focusing on strength, stability, and nervous system regulation.
  • Support for stress and sleep, both of which directly influence hormone balance and weight.

This is not a one-size-fits-all approach. It’s a partnership grounded in physiology, clinical data, and the lived experience of each woman. When we address the underlying hormonal and metabolic shifts of perimenopause and menopause, the results go far beyond weight loss. Women report better mood, clearer thinking, deeper sleep, and a renewed sense of vitality.

If you’re approaching or moving through midlife and feel frustrated by changes in your body, know that you can reclaim your health with strategies that are rooted in science and personalized to suit you.

Dr. Deidre Macdonald is a naturopathic physician who has practiced in Courtenay since 1997. (250) 897-0235 or www.getwellhere.com

Dr. Deidre Macdonald

Naturopathic Physician

250 897-0235

www.getwellhere.com

Cortisol Myths

As a naturopathic doctor, I often hear cortisol talked about like a comic book villain, always wreaking havoc and stealing our health. But cortisol is far more complex than that. It’s a vital hormone that helps us survive and adapt to challenges. The real issue lies not in cortisol itself, but in the common misconceptions that surround it. Here are five of the most persistent myths I hear in my practice.

The first myth: cortisol is simply bad. In truth, it’s essential for life, regulating blood sugar, pressure, inflammation, and energy. Problems arise when cortisol is chronically high or low, often due to long-term stress or health conditions. It’s often blamed for abdominal weight gain because cortisol receptors are dense in visceral fat, promoting midsection storage. This metabolically active fat can contribute to further imbalances. The issue isn’t cortisol, but what throws it out of balance, often a sign your body is constantly alarmed or struggling for equilibrium.

Another common myth: high cortisol always means you’re just too stressed. While emotional stress elevates cortisol, it’s not the only cause. Sleep deprivation, blood sugar instability, chronic infections, overtraining, and inflammation can all increase levels. I’ve seen patients doing everything right, eating well, exercising, meditating, still have elevated cortisol due to physical, not necessarily emotional, stress.

The third myth: low cortisol only occurs in serious diseases like Addison’s. While Addison’s is a rare autoimmune condition where adrenal glands stop producing cortisol, many experience functional low cortisol. This often develops after long periods of stress, when the body downregulates production to protect itself. People frequently wake up tired, feel flat in the afternoon, and get a second wind at night. Their quality of life suffers. Adaptogens like Rhodiola and Ginseng are helpful, regulating the stress response. Licorice root also supports cortisol by extending its availability. Naturopathic strategies also focus on optimizing sleep, gentle movement, and nutrient-dense dietary support to restore adrenal balance.

 

Another misconception: cortisol can be tested accurately at any time of day. In reality, cortisol follows a daily rhythm, highest in the morning and lowest at night. A single random blood test isn’t useful. Comprehensive testing, using saliva or urine samples taken at several points, reveals healthy, blunted, or reversed patterns, often aligning with how people feel and guiding treatment.

 

Lastly, there’s the belief that relaxing more is all you need to fix cortisol issues. While calming practices like meditation and deep breathing are valuable, they’re only part of the picture. Cortisol regulation also depends on sleep quality, stable blood sugar, digestive health, and inflammation control. Natural medicines can also jump start the healing process. A comprehensive approach works best for this complex hormone.

Cortisol is not the enemy. It’s a survival tool our bodies rely on, especially in times of change. By understanding how it truly works, we can better support our energy, focus, mood, and long-term health.

Dr. Deidre Macdonald is a naturopathic physician who has practiced in Courtenay since 1997. Contact at 250 897-0235 or via www.getwellhere.com

ADHD in Adults

Attention Deficit Hyperactivity Disorder, or ADHD, is a condition we normally associate with children. But it is estimated that one in twenty adults meets the criteria for Adult ADHD. Most of these people likely showed symptoms as children; a study that tracked children with ADHD into adulthood found that only 10% completely grew out of it. In recent years, many well-known and accomplished people have shared that they have ADHD, including actor/singer Justin Timberlake, Olympic swimmer Michael Phelps, and Olympic gymnast Simone Biles. There are many tools available to help adults with ADHD to make the most of their unique neurological style. But the first step is to recognize the patterns. 

Having a brain with ADHD can be challenging. The disorder is characterized by a persistent pattern of inattention and/or hyperactivity/impulsivity that interferes with daily functioning. Some people struggle to pay attention in various aspects of their life. They might make careless mistakes, not seem to listen when spoken to directly, fail to follow through on tasks and instructions, show poor organization, avoid tasks requiring sustained mental effort, and get easily distracted (including by their own thoughts). These people are more likely to fly under the radar than hyperactive people. Hyperactivity in adults takes the form of fidgeting, tapping or squirming, restlessness, difficulty engaging in quiet activities, talking excessively, and interrupting others. While many adults with ADHD are high-functioning, creative, dynamic people, the lack of organizational skills may impact work performance, and the lack of emotional regulation may impact relationships. The result is often anxiety and low self-esteem.

Since there can be significant overlap with other issues, particularly anxiety, post-traumatic stress disorder (PTSD), and depression, it’s important to determine which came first, or which is the primary condition. It can be hard to focus when your mind is racing with anxiety or consumed by depression. Insomnia can be related to ADHD and exacerbated by ADHD medication, but it can also significantly worsen symptoms. Addressing underlying sleep issues is one of the best ways to improve focus, impulse control, and problem-solving. Post-concussion syndrome should also be ruled out as symptoms can be very similar. 

Because this disorder is often misunderstood, many people who have it do not receive appropriate treatment. But it can be quite liberating to realize that ADHD is just one type of neurodiversity, and there are ways to make the best of it. As a naturopathic physician, I look at each person as an individual and develop a plan to optimize their brain function. That plan may include addressing the profound gut-brain connection; I have seen many children with a history of ear infections and repeated antibiotic use, for instance, who later manifest symptoms of ADHD. Studies now show a link between changes in the gut microbiome and ADHD. Nutrition can play a significant role in brain health. Adequate levels of iron, B12, and Vitamin D, as well as balanced blood sugar levels, are all crucial. Fish oils can help the brain. Balancing the nervous system through natural medicine can help focus the mind and calm the body. Perimenopause or PMS can also exasserbate ADHD and there are excellent strategies for both. I help my patients to work on reducing stress, improving sleep, and getting regular exercise. Mindfulness techniques can help develop the capacity for prolonged attention and self-regulation, and to dial down stress and restlessness. Moreover, organizational skills that may come naturally to some people can be learned, just like you would learn a sport or instrument. Although medications can be helpful for some people with ADHD, the best way forward for optimal functioning is to combine medication with a brain-supportive lifestyle, natural medicines, and skills development. 

Dr. Deidre Macdonald is a naturopathic physician practicing in downtown Courtenay. Contact at www.getwellhere or 250 897-0235.  and 

Protein Power: Your Ally in Aging Gracefully and Staying Strong

When it comes to healthy aging, protein is like the unsung hero of nutrition—always there, quietly working behind the scenes to keep your muscles strong, your brain sharp, and your body resilient. But how much protein do you really need, and is it possible to have too much of a good thing? As a naturopathic physician with a focus on nutrition and healthy aging, these are questions I commonly get from my patients. So, let’s dive into the science and myths of protein and how it can help you stay fit and vibrant at any age.

First, let’s get the numbers straight. The science says that most adults benefit from consuming 1.2 to 1.6 grams of protein per kilogram of body weight daily. Calculate your protein requirements using your estimated lean body weight. For a person whose lean weight is 150 pounds or 68 kg, that’s an average of 26-36 grams of protein three times a day. Considering that one chicken breast has about 50g of protein, those numbers aren’t out of reach for most people. 

Dietary protein supports maintaining and building muscle, which plays a vital role in balance, strength, blood sugar regulation, metabolic health, and more. After 50, we typically lose 1% of our muscle mass per year; after 70, that number goes up to 4%. However,  exercise and protein intake can reverse that trend. And if you’re trying to build or maintain muscle, a post-workout protein shake isn’t just trendy—it’s genuinely effective. While there’s no need to obsess over a narrow “anabolic window” after exercise, having protein before or after a workout gives your muscles the building blocks they need. 

Not all proteins are created equal, though. Animal proteins like chicken, eggs, and dairy tend to pack the biggest punch when it comes to essential amino acids, especially leucine—the star amino acid that triggers muscle growth. But if you’re vegetarian or vegan, don’t fret. By consuming a variety of plant-based proteins, like beans, soy, quinoa, and lentils, and perhaps adding a plant-based protein powder, you can absolutely meet your needs. 

What about concerns that high-protein diets might harm your kidneys or speed up aging? For most healthy people, these fears are more myth than fact. Research shows that regular exercise changes how the body processes protein, directing its benefits to where they’re needed most—your muscles and brain. Staying active essentially turns protein into a tool for health, not harm.

Now, let’s tackle a common concern: IGF-1, a hormone that spikes with higher protein intake. Some studies suggest this could increase cancer risk, but here’s the nuance: exercise flips the script. Physical activity directs IGF-1 to muscle repair and brain health while limiting its availability to potential problem areas. Simply put, a balanced diet paired with regular movement lets protein do its job without unintended consequences.

Ultimately, the magic of protein lies not just in what you eat, but in how you live. Pairing a thoughtful protein intake with resistance training or even a daily brisk walk can help keep your body strong and your mind sharp. After all, isn’t that the goal of healthy aging—staying active, independent, and ready for life’s adventures?

So, whether you’re whipping up a protein-packed smoothie, enjoying a hearty lentil soup, or indulging in a grilled salmon dinner, remember every bite is an investment in your future. Protein isn’t just for athletes or bodybuilders; it’s for anyone who wants to age gracefully, stay fit, and feel amazing in their skin. Cheers to that.

Top 4 Hormone Replacement Myths

Hormone Replacement Therapy (HRT) has long been a topic of debate and confusion, especially for menopausal women exploring their treatment options. Despite its potential to offer significant relief from menopausal symptoms and more, several myths persist, often deterring women from seeking the benefits it can provide. With 27 years of experience as a naturopathic doctor who prescribes HRT, I’ve witnessed substantial advancements in our understanding of this important treatment. Let’s clarify these common misconceptions.

Myth 1: HRT Causes Cancer

One of the most pervasive myths about HRT is its association with cancer, particularly breast cancer. This concern primarily stems from findings of the Women’s Health Initiative (WHI) study in 2002, which reported a slight increased risk of breast cancer in women using combined estrogen-progestin therapy. However, subsequent analyses and studies have shown that the risk is more nuanced. The study used outdated forms of HRT, such as horse estrogen and synthetic progesterone. Now we use bioidentical hormones, which have been shown to be much safer. Also, the study participants had an average age of 65 when they started HRT. Now, we know that the safest window for starting HRT is withing 10 years of a woman’s menopause or before age 60. A family history of breast cancer is not a contraindication.

Myth 2: HRT is Only for Severe Symptoms

Another common misconception is that HRT is only necessary for women with severe menopausal symptoms. While it is true that HRT can provide substantial relief for those experiencing significant symptoms like hot flashes, night sweats, vaginal dryness and mood swings and insomnia, it can also benefit women with mild to moderate symptoms. Additionally, HRT has been shown to offer long-term health benefits, such as reducing the risk of osteoporosis and age related cognitive decline, if started early.

Myth 3: HRT Will Make You Gain Weight

A widespread concern among menopausal women is that HRT will lead to significant weight gain. However, research does not support this claim. While menopause itself is associated with changes in body composition and fat distribution, HRT has not been definitively linked to weight gain. In fact, some studies suggest that HRT may help mitigate the abdominal fat accumulation often seen during menopause.

Myth 4: HRT is Risky for Women with a History of Blood Clots

Many women with a history of blood clots or a family history of clotting disorders believe they cannot safely use estrogen therapy. While it is true that traditional oral estrogen HRT can increase the risk of blood clots, there are alternative delivery methods that pose less risk. Transdermal estrogen, which is delivered through the skin via patches, gels, or creams, has been shown to have a lower risk of blood clots compared to oral formulations. As always, it is crucial for women to discuss their medical history and individual risk factors with their healthcare provider to determine the safest and most effective form of HRT for their needs.

While myths and misconceptions about HRT persist, it is important for women to seek accurate information and consult with their healthcare providers. HRT can be a valuable tool in managing menopausal symptoms and improving quality of life in the long term. By dispelling these myths, we can empower women to make informed decisions about their health during menopause.

 

Dr. Deidre Macdonald is a naturopathic physician practicing in downtown Courtenay. www.getwellhere.com  250 897-0235

 

New Cervical Cancer Screening

As a naturopathic physician, I am deeply committed to keeping my patients informed about the latest advancements in women’s health. Recently, during a trip to Tanzania, I met with a local female doctor who shared the stark reality faced by the many women she sees who battle advanced cervical cancer—at a rate of one in 200 women. In Canada, thanks to aggressive screening and early detection, the occurrence of cervical cancer is relatively low, affecting only about one in 10,000 women. Now, with pioneering changes in cervical cancer screening, including a transition from Pap smears to self-administered vaginal swabs, British Columbia is spearheading a monumental shift toward improved accessibility, convenience, and efficiency in detecting precancerous changes in cervical cells.

The rationale behind this transformative shift lies in the efficacy of vaginal swabs in detecting the human papillomavirus (HPV), the primary culprit behind cervical cancer. Compared to Pap smears, testing for HPV through vaginal swabs offers a more accurate and sensitive method for identifying high-risk HPV strains, empowering individuals to take proactive control of their health in the comfort of their own homes. It’s important to note that being HPV positive doesn’t inherently signify the development of cervical cancer, and not all HPV strains pose the same level of risk. Most women will have the HPV at some point in there lives. It can appear years after the time of infection and it can go away on its own.

However, a positive HPV test, especially for high-risk strains, may prompt further evaluation through a Pap smear, which I will continue to offer in my naturopathic clinic.  A gynecologist can take a closer look at the cervix and do a more targeted biopsy with a procedure called a colposcopy.

The test will still be done every three years for women ages 25-69. You can stop cervix screening at age 69 if you’ve always had normal Pap tests. Talk to a health care provider if you’ve had treatment for pre-cancer cells in the past.

 

To learn more about the new HPV screening swab: http://www.bccancer.bc.ca/screening/cervix

The test is done AT HOME! Every three years, you can order a kit, do the test at home, and mail it in.

To order your test kit:

https://submit.healthcarebc.ca/bccancer/cervix-screening-kit

or call 1-877-702-6566

Hormone Health For Women – Naturally

Hormones are an integral part of a woman’s health and vitality, influencing everything from mood and energy levels to reproductive function and overall well-being. As a naturopathic doctor with a focus on women’s health, I emphasize the importance of maintaining healthy hormones throughout a woman’s lifespan. In this article, we’ll explore practical tips to support hormone balance.

During early life, hormones promote growth and maturation. Proper nutrition, care, and a nurturing environment are crucial to foster healthy hormonal development in these formative years. During adolescence, hormones play a key role in puberty, influencing emotional well-being, skin health, and of course, menstruation. Many young women are told that it is just normal to experience PMS, painful periods and excessive flow. But these can be signs of hormone imbalances that can be corrected with natural methods. My favorite herb for teens with period problems is Chaste Tree, or Vitex Agnus Castus. This remarkable herb aids the pituitary gland in balancing hormones and has been proven to safely help some menstrual cycle problems.

In adulthood, hormones like estrogen and progesterone regulate the menstrual cycle, fertility, and libido. Hormone balance is essential for reproductive health during these years. In an age where more women are choosing to delay pregnancy, fertility challenges have become increasingly common. I guide my patients in understanding their body’s rhythms and how to optimize their fertility if that is their goal.

Of course, balanced hormones are critical for a healthy pregnancy, and particularly in the postpartum period. Nutritional support and stress management are vital, and naturopathic physicians can provide guidance to women on the safe use of natural medicines during and after pregnancy.

As women approach middle age, menstrual issues and PMS can become more pronounced as the hormone glands struggle to regulate the cycle during perimenopause. This is when active intervention with naturopathic approaches can be pivotal. For instance, natural anti-inflammatory herbs like ginger have been shown to significantly reduce blood flow in menstruating women. Menopause can be a relief or a challenge as rapid hormone changes can give rise to a range of symptoms, including hot flashes, mood swings, and insomnia. There is so much conflicting information out there about hormone replacement therapy, but the most recent scientific findings indicates that it can be used safely long term, and it can help prevent some diseases of aging like cognitive decline and osteoporosis. If it is done right. (See my detailed blog post for more information.)

As women age, we need to keep in mind other hormones that can affect our health and wellbeing. Cortisol, the primary stress hormone, when imbalance, can contribute to lowered immunity, abdominal weight gain, blood sugar imbalance and more. Maintaining blood sugar with the hormone insulin can be more challenging but is critical for disease prevention. Hypothyroidism affects up to one in six women in their lifetime, and the risk increases with age. So just because you were “fine” five years ago, doesn’t mean that your fatigue, depression and weight gain aren’t attributable to low thyroid hormone now.

The body’s hormones are all interconnected and are influenced by our immune system, our digestion (think microbiome) and our lifestyle. Key lifestyle factors that can improve your hormone health include moderating caffeine and alcohol intake, embracing whole food nutrition, regular exercise, ensuring adequate sleep, effective stress management, and maintaining a healthy weight. As a naturopathic physician I often recommend natural medicines and bioidentical hormone prescriptions to help women optimize their hormones.

Empower yourself with knowledge. Stay well-informed about hormonal health and its impact throughout the lifespan. A naturopathic physician with a focus on women’s health can serve as an invaluable resource for guidance and education.

 

Early Cancer Testing You Should Know About

Part of being a health-conscious person is being aware of the early signs of cancer and taking advantage of cancer screening. Cancers caught early are often treatable. An estimated two in five Canadians will be diagnosed with cancer in their lifetime and about one in four will die from cancer, making it the leading cause of death in Canada. Having a relationship with a doctor who can provide regular checkups, blood work, and cancer screening simply saves lives. But because fewer people in the Comox Valley have a family doctor, these non-urgent conversations happen less often. People without a family doctor often only use the walk-in clinics for urgent concerns and miss out on regular screening. And what woman wants to go to a stranger at a walk-in clinic for intimate exams? As a naturopathic physician, more of my patients are accessing my services for basic medical screening tests and exams and I’m glad they have options. Here I’ll remind you of the key symptoms you should watch for and tests you should do regularly to screen for cancer. 

Paying attention to changes in your body and not ignoring them is important. It’s better to have a symptom checked out and found to be normal than ignore it and have it progress into overt issues. Symptoms that warrant investigation include unexplained: fatigue or weight loss, persistent lymph node enlargement, persistent hoarseness or coughing, bladder changes, any vaginal bleeding after menopause, easy bleeding or bruising, difficulty swallowing, unusual lumps, digestive issues, night sweats, neurological symptoms, changes to moles, white areas in the mouth and more.

Regular testing offers the chance to pick up cancer before it becomes serious. For women, PAP smears test the cervix for abnormal cells that can be or become cervical cancer. Current guidelines are for women aged 25-69 to do a PAP smear every three years. MDs or NDs can offer this service. Only about 75% of eligible Canadian women are up to date on this important test. 

Mammograms save lives. Women can just call the Comox Valley North Island Hospital. They can use an MD or an ND as the doctor who receives the results. Since one in five cases of breast cancer is found in women under 50, I agree that women in their 40s should be screened every two years.

The FIT test is a simple stool test that picks up invisible blood in the stool, which can be a sign of colon cancer. About one in 17 Canadians will get colon cancer, so it makes sense to regularly screen for it. Your MD or ND can provide the requisition for this test.

Prostate cancer screening is controversial because the harms associated with testing for and treating prostate cancer can outweigh the benefits. That said, research shows that screening blood tests do save lives, especially for high-risk populations.

I regularly provide skin cancer checks as part of a yearly physical exam, especially a patient has light-coloured skin, eyes and hair, has many moles or freckles, or report having had several blistering sunburns as a child. MDs can refer patients to dermatologists or skin specialists for diligent tracking or treatment of suspicious spots. 

I also recommend an annual full basic blood work-up, physical exam and discussion of any health issues that may be cropping up. It’s not possible to do good cancer screening when patients can only bring up one symptom, since it is often the constellation of symptoms that provides the clues needed to suspect cancer. Plus we want to be discussing healthy lifestyle practices to increase the chances of living long and well.

Dr. Deidre Macdonald is a naturopathic physician who has practiced in downtown Courtenay since 1997. 250 897-0235 or www.getwellhere.com

PCOS – Androgen Excess

I’m a naturopathic physician, but I’m also a woman who had a hormonal imbalance called Polycystic Ovarian Syndrome, and who comes from a family of women with PCOS. I’ve spent decades learning about this hormonal imbalance and treating women who have it. If women want to really turn PCOS around there are strategies that can improve symptoms, improve fertility, and set them up for better mental and physical health long term. There have been three major breakthroughs in our understanding of PCOS that have come about since I was diagnosed 30 years ago. Naturopathic physicians are leading the way to find real solutions to this issue, which is the number one cause of infertility in North America. 

Firstly, I have to say that the name Polycystic Ovarian Syndrome is a lousy name.  Women with PCOS don’t even have to have cysts on their ovaries to get a diagnosis! A better name being proposed by experts in the field is Anovulatory Androgen Excess, meaning that these women have too many of the “male” hormones, or androgens, which can hijack the menstrual cycle so that it slows or stops, and ovulation is less likely. There are also receptors for androgens in the skin, which can result in acne and excess hair growth on the face and body. Lesser-known symptoms of PCOS are anxiety, depression, brain fog and increased risk for cardiovascular disease and certain cancers.

Secondly, there are several different types of women that can have these symptoms which we call PCOS, depending on what’s driving the issues. In women who may be slim and have inherited the issue the root of the problem is in the pituitary gland.  These women tend to have normal blood sugar metabolism. In contrast, for some women, PCOS is very closely related to adult-onset or type 2 diabetes in that they have high insulin levels which drive up testosterone.  The good news for these women is that normalizing body weight, eating a low-carb diet, and having regular exercise can make a real difference in their hormones. 

The third breakthrough is that we’ve expanded the ideas around treating PCOS. It used to be that the only treatment was oral contraceptives.  Yes, “the pill” can help control some symptoms.  But it does nothing to restore fertility, reverse dark hair growth or teach women how to balance their hormones in a real and lasting way.  My goal in working with women with PCOS is to engage them in a program that can do all those things and set them up for good long-term health.   Firstly, I run blood tests to dig deeply into their hormones and blood sugar to see which type of PCOS they may have. Then we create an individualized program with diet, exercise, and stress management at its core.  There are also herbs and natural medicines shown in clinical studies to balance hormones, reduce symptoms and help fertility.  There are times when pharmaceuticals can help, especially when excess dark hair growth is the issue. When women with PCOS go off “the pill”, their symptoms come back. But with these other medications, the positive effects can remain after the pills have been stopped. I am so grateful that a naturopathic physician helped me get a handle on my PCOS 30 years ago and I have learned so much in helping my own daughter and many other women manage their PCOS with the help of our modern understanding of this complex condition. 

Long COVID and the Brain

Most people who get COVID, especially if they are vaccinated, will recover without residual symptoms. But for some people, COVID infection can result in long-term health issues. So-called “long COVID” sufferers can experience many symptoms including crushing fatigue, dizziness upon standing up or standing too long, exercise intolerance, anxiety, headaches, heart palpitations, shortness of breath, brain fog, and more. Similar post-viral syndromes can result from other viruses too, and a very similar phenomenon can happen after concussions. The common thread is that when the brain suffers a blow, either literally or via the inflammation associated with a virus, the nervous system that runs almost every process in the body can be knocked off its axis. Across Canada, researchers and physicians are scrambling to try to understand how to help this new wave of people afflicted with a condition that is untestable and for which there are no simple drug solutions. Patients often feel frustrated and isolated. A greater understanding of what’s going on can help us target solutions for symptoms and speed the healing of the brain and nervous system. 

A patient I’ll call Emily had previously been in good health, so when she contracted COVID as an unvaccinated person ten months ago, she thought she would recover well. She did get over the acute symptoms of cough and congestion but was left with a mysterious assortment of symptoms that derailed her life. She has profound fatigue, dizziness when she stands up or stands for more than ten minutes in one place, and daily headaches; in addition, her mental processing and memory are impaired. When she tries to exercise, she crashes and is exhausted for two days. She has nausea and IBS. Her fingers go white when she gets cold, and her skin can be blotchy. Her periods are irregular for the first time. Anxiety seems to hit randomly, day or night, and depression is creeping in. 

Emily’s symptoms indicate that the nerves in her brain have been damaged. The brain governs the autonomic nervous system, which runs all the automatic processes in the body such as blood pressure, heart rate, circulation, balance, energy production, hormones, adrenalin release, sleep cycles, digestion, and more. When this critical system isn’t working right, we refer to this disorder as dysautonomia.  As a naturopathic physician, I treat people with complex, chronic conditions every day, so I have seen similar symptoms before triggered by both viruses and concussions. 

There are strategies to manage symptoms, such as wearing compression stockings to prevent blood from pooling in the legs while standing. Since the nervous system is intimately involved in digestive processes, such as motility of the intestines and secretion of digestive juices, in people with dysautonomia, we often see irritable bowel syndrome symptoms such as bloating, gas, diarrhea, or constipation. Without proper motility, food ferments in the small intestine, causing an overgrowth of bacteria where it shouldn’t be. Small intestine bacterial overgrowth (SIBO) can cause bloating, constipation or loose stools, as well as brain fog. There are excellent ways to test and treat SIBO through a naturopathic physician trained in this area. 

Brain healing requires a more comprehensive approach because the brain is highly sensitive to what is happening in the rest of the body. Emily started naturopathic medical protocols for dysautonomia include addressing the gut-brain connection through avoiding inflammatory foods, enhancing nutrition, and balancing the microbiome. She took natural medicines to target the mechanisms needed to heal the brain, including enhancing energy production (mitochondrial health), reducing inflammation and oxidative stress, promoting nerve healing, and helping the brain filter toxins. After three months she is feeling much better. Programs can also include hormone balance, stress-reduction training, physical therapy, and visual therapy can all also help address dysautonomia. 

Like most viruses, most people who get COVID make a full recovery. But for those whose lives have been turned upside down after this infection, it’s important for them to understand that there are strategies that can help.