It could be your hormones - treating common issues holistically
In my last blog I explored how important time is when it comes to seeing your GP – and how the current funding model for Medicare does not allow for this time.
This means appointments are usually rushed – centred around one single symptom, with very little space to ask questions, dive into complex issues or explore the big picture of a patient’s life and experience.
Because of this, it can take a lot longer to get to the heart of an issue and create a sustainable, long-term plan to resolve it.
So what sorts of issues need more time? Probably everything, I’d argue.
To show you why, I’ll be writing a series of short emails exploring some of the most common presentations that have possibly complex issues.
“I’m tired all the time.”
It’s probably not just your iron levels.
Fatigue is one of the most common presentations to primary care. It is a feeling of constant tiredness that does not seem to get better with rest.
Many people feel tired all the time. If you jump on Google or social media, you’ll find lots of explanations – iron deficiency, low levels of thyroid, toxic chemicals.
However, fatigue is more complex than that.
Sure, it could be your thyroid,
It could be that you're low in iron.
It could be that your sleep architecture is way off because of alcohol or marijuana use.
Or because you are on edge, stuck in fight or flight mode and cannot relax.
The point is – usually, it is not just one thing.
It is likely a complex interplay of many different things.
You might be a bit low in iron.
You might be a bit low in iron because you’re bleeding heavily each month.
You might be overworked.
You might have young children and some strain in your relationship.
You might be having hot flashes and you’re waking multiple times during the night, so much so that you wake up exhausted.
You might be having an existential crisis and feeling like there is more to life than what it is.
It might be all of those things.
Yet if you have two 15-minute appointments – just enough time to have a blood test and get a result of iron deficiency, then arrange replacement with oral iron or an iron infusion – only one of these problems will be fixed. You may not get a chance to fully understand the issue, have time to have your questions answered or consider all of the options in this time frame.
It will take multiple appointments and multiple months to sort out the rest.
“My mood is all over the place, could it be my hormones?”
Sure, it could be your hormones. Though usually, it’s not just your hormones, it’s a complex interplay of many things!
If you are a cis-woman, and you are not taking or supplementing with hormones, your body is cyclical.
Oestrogen rises as eggs are maturing and falls pretty dramatically when they are not fertilised.
There is a mid-cycle surge of a testosterone-like substance called luteinizing hormone that tells the ovaries to release an egg into the fallopian tubes.
Progesterone rises after ovulation and stays high for about two weeks – being produced by the leftover follicle that grew the egg and released it into the uterus.
This dramatically drops when no embryo implants in the uterus.
The follicle degrades and the cycle begins again.
These hormones influence the entire body and the brain, not just the reproductive tract. This changes our experience of the world, our emotions and our bodies on different days throughout the month.
And they are not the only hormones that exist.
We have stress hormones such as cortisol and adrenaline, which are produced by our adrenal glands in response to threat.
We have thyroid hormones produced by our thyroid gland – primarily involved in the metabolism and use of energy.
We have insulin – a hormone produced by the pancreas that allows us to use glucose to produce energy.
So when we think ‘is it my hormones?’ It’s useful to have the time to consider which hormones and how, as well as the bigger picture.
It’s also important to recognise that our hormones are a complex system (and these are simple descriptions). They are influenced a lot by external factors, such as:
Activity levels.
Sleep.
Nutrition.
What is happening at work.
What is happening at home.
What is happening in relationships.
Age.
The time of the month.
The amount of toxic stress we’ve dealt with in our lives – where we have gone beyond the point of being able to manage and we are now out of equilibrium.
So when we look at hormones as a possible reason for the issues you are facing, we can do a blood test. And that blood test might offer some insight.
But sometimes – frustratingly – it might come back “within normal ranges”.
This is because we are not taking into account the wider concept of how our bodies adapt.
Often when we see a problem or an abnormal blood test, our adaptation has come out of balance.
To find out how to come back into balance, we can examine the foundations for a healthy mind and body and how they relate to us/our experience.
These are what I call ‘the Five Pillars’ – the foundations for feeling good in your mind and body in every season of life. They are:
Nourishing your body
Developing clarity of mind
Supporting connections
Finding meaning and purpose
Cultivating sensuality
Exploring the Five Pillars (and how they work with your specific needs) will take more than a 15-minute appointment.
That’s why I am now offering extended, four-session, 1:1 packages to holistically assess your lifestyle, sexual, reproductive or women’s health issues.
So we can explore. Dive deep. Reflect. Consider. Question.
And find a clear path forward that works for you.
“I’m scared of getting cancer” (and other chronic health conditions ).
It’s normal to be fearful of a disease that can be so devastating, especially when it is relatively common. This fear can often prompt us to take action – to go to the GP to get tests or scans to reassure us.
As a GP, it is part of preventative medicine to arrange screening for preventable cancers. Like bowel, breast and cervix.
The thing is, a negative screening test, scan or blood result just tells us you are unlikely to have cancer now.
It does not look at your personal health history or the things you are doing now that could increase your risk of cancer.
It also doesn’t consider the most common chronic health issues for people your age – issues that are just as important to reduce the risk of.
For many women in perimenopausal or menopausal years, this is heart disease and diabetes.
We are living longer and our bodies are finite. As we get older, things start to happen and we will develop health issues. It’s inevitable.
So, what can you do personally to reduce the risk of preventable chronic illnesses?
So what adjustments do you need to make to ensure you have the best quality of life for as long as you would like to live?
How can you embrace the Five Pillars to build a strong foundation for supporting your mind and body?
These are:
Nourishing your body
Developing clarity of mind
Supporting connections
Finding meaning and purpose
Cultivating sensuality
From a GP’s point of view – as well as doing those tests to ensure that we are detecting preventable cancers and illnesses early – we can also discuss lifestyle factors that can contribute to illness.
The problem is, in a 15-minute appointment, it is tough to have enough time to discuss this in specific details. Often, there’s only time for a general conversation with general suggestions – and then we’d refer you to an allied health clinician or credible online sources such as Healthy Bones.
Many GPs are interested in lifestyle medicine and preventative care – and many do this really well in the current system. Still, we all wish we had more time than the system allows for these deeper discussions and individualised treatment plans.
That’s because making changes has bigger implications and impacts on your life.
For example, increasing your vegetable intake sounds like simple advice. But practically, it is much more complex than that. Many things need to change.
How do you structure your time? What do you buy in the supermarket? Is it affordable? How do you change your recipe routine? Can you learn to experiment with cooking and enjoy different foods? Do you have space in the day for this? What happens to your lifestyle changes when you feel stressed? Tired? Need time out?
For example, I know that when I feel I need nurturing, I get a sugar craving. I have started to tune in and question – do I need a sense of nurturing OR am I actually hungry? What nourishment have I given myself today? In the form of care for myself or nutrition? Am I seeking a Kit-Kat because I saw it in the shop next door, because I didn’t have enough carbs at lunch or because I need a hug?
When you and your healthcare provider have more time, you can ask these deeper questions, reflect on your answers, consider more options and map a path forward that suits your personal circumstances – taking into account your lifestyle, work, health, history and preferences.
That’s why I’m offering a new holistic health and wellbeing package for this very purpose.
It’s a tailored four-session package to assess your lifestyle, sexual, reproductive or women’s health issues holistically, get more 1:1 time with a Specialist GP and gain clear next steps.
If you’d like to know more, you can get all the details here.