Females Hormones & Blood Sugar Control

As someone with type 1 diabetes, and coaching many with diabetes, we have to consider over 50 things that are non-food related that can affect our blood sugar control, and one of the most common moving variables include the female cycle.

In fact, I have to change my daily basal weekly, if not more, to coincide with my cycle and insulin sensitivity.  Along with this tweaking, I have been collecting data and savvy tips in a notebook on this topic and have organized the insights below.

Wellness for a female is different and is achieved differently than for a male. There needs to much a bigger component of emotional health and support, which is why it’s important to understand our moving hormones.

OUR PERIOD
The benefit of being a female (among many!) is we have a period. Wait, how is that a benefit? Well, our cycle is termed as a 5th vital sign per the American College of Obstetricians and Gynecologists (ACOG) Committee Opinion and this vital sign offers insight into our health, each month.

First and foremost, when assessing your period, understand our body will always choose survival over making babies. In fact, the period you have this month reflects your life 2-3 months ago. As well, if you are taking savvy hormone balancing supplements like maca, chaste tree, vitex, evening primrose oil, to name a few, give it 3-4 months to take effect.

Balanced/Balancing Hormones Involves the Combo of:

  • Daily bowel movements. If you don’t poop every day – you can’t remove the digested estrogen out of your system. Gut health is super important.
  • Modulating toxins in our life. Most environmental toxins will come from the practices women take within hours of waking up – deodorant, makeup, toiletries.
  • Sleep. If you are not sleeping 7 hours a night, you are not going to have balanced hormones. Research even shows that the liver can’t detox with sleep deprivation and liver needs to be optimal to metabolize our hormones as well.
  • Diet. Eat regular and balanced meals, emphasizing the importance to eat healthy fats. Avocado, olive oil, and organic animal fat are great sources, to name a few. The research on broccoli is so strong for detoxing estrogen and this is crucial for hormone balance. If a female is not having a bowel movement daily, the estrogen is sitting in the intestines and can be reabsorbed. We want it to move along as it should daily, and if this is not happening, consider tweaking the diet to include more vegetable fiber, remove grains in the diet and add a magnesium supplement to get things moving. Overall, lots of leafy green vegetables are key to a nourished body and healthy, fertile hormones.
  • Blood sugar stability. This is one of the most crucial things for hormone balance. Do the best you can to reduce blood sugar swings and variability. If blood sugars are too high they can structurally change the ovaries.
  • Movement. Most of our hormones won’t work unless we are moving. This is esp true w/ inactive thyroid to active thyroid.
  • Happiness: Plan a girls night and go have some fun. Or find a good book. Whatever helps you live a little and un(wine)d.
  • Sex. Yes, sex, intimacy and orgasm can help naturally balance hormones.

MONTHLY CYCLE:

While PMS is not normal it is natural to feel a shift in energy throughout the month, and that’s why it’s important to vary the amount and type of exercises you are doing and cycling your food/carbs throughout the month.

(Visual from ontrackdiabetes.com)

Week 1 (on period): MENSTRUAL

Day 1-10 females are most like males. Progesterone and estrogen are the lowest, and the first half of the cycle is called the follicular phase.

Insulin – many women may experience high blood sugars on the first day of their cycle, but it levels out the remainder of the days of bleeding. Personally, (bc I am sure you want to know), I am more insulin resistant on the first and last day of my cycle/bleeding, so therefore I may have a basal of let’s say 10 units on Day 1, drop down to 9 units, and then on the 6th day of bleeding I go back to 10 units.

Diet – Aim to eat higher fat and protein-rich meals, which means to ease up on carbs (fruit, legumes, grains, starchy veg), but do not restrict as much as you did before you started to bleed.

Protein helps to replenish lost iron. If a period is heavy – eat iron-rich foods with a focus on vitamin C. A citrus, spinach salad with some steak? Other good foods to source: seafood or seaweed, and low carb vegetables.

Exercise – slow movement pilates or yoga, stretching, walking or light hiking. A few days after the onset of your period you may feel energized and ready to pick back up your exercise routine. Movement this week can be variable from girl to girl, and from month to month. Listen to your body and what it needs.

Agenda – This is a good week to ground yourself, relax more physically and construct or address personal goals. Pull out a journal and reap the benefits of writing out your thoughts.

Seed cycling: 1T of pumpkin seeds and 1T of flax meal per day. 

Week 2: FOLLICULAR

Diet – highest carb week, lowest calorie.

Persist including protein and fat in each meal, but bring down the total fat, and increase carbs. Typically, meals will be smaller than the 2 weeks before your period/bleeding. Females are most insulin sensitive around this time of their cycle and they can tolerate more carbs without blood sugar spikes. Since the onset of your period, your estrogen will gradually rise until ovulation (which starts at the end of this week). Keep in mind estrogen has an inverse relationship to appetite. When estrogen is highest, you may notice less hunger.

Exercise – a great time to do HIIT training, challenging and longer workouts.

Agenda – it’s common to be restless and able to tackle projects and goals, including batch cooking for the week ahead when willpower is less. Right before ovulation, you may notice you feel your best, sexiest and most social. Make the most of it.

Seed cycling: 1T of pumpkin seeds and 1T of flax meal per day. 

Week 3: OVULATORY

Insulin – blood sugars can seem less seamless (to put it nicely). For 2-3 days blood sugars will run higher, and I view this as a mini period. What I do to manage my blood sugars and insulin here, I do more aggressively, and for more days, prior to bleeding.

Diet – Wind down the carbs, and begin increasing fat and fiber. You may notice some cravings for chocolate as well. Increase magnesium-rich foods, including cocoa. Five days after ovulation, you might find benefit and emotional/energy relief in eating ~30 grams of carbs at dinner (assuming you are eating a lower carb diet; less than 100 grams). This bolus of carbs (like half of a sweet potato) can support serotonin levels and improve sleep, sense of calm.

It’s not uncommon to have constipation post ovulation. Find use of chia seeds, and high fiber veggies. Focus on hydration aggressively until end of week 4.

Agenda – Ovulation is a great time to enjoy raw foods, raw salads, high-quality protein, and foods high in zinc. During ovulation, you may notice slight cramps. Your body is preparing to release 1 of 500 eggs (which is a fraction of the eggs you were born with). Ovulation is on average 10-16 days before a period. After Ovulation, this is when progesterone and estrogen increase and progesterone release a lot of sodium and holds onto a lot of water. This can lead to bloating. Your body temperature may be a degree higher as well. You want to salt (NOT table salt, sea salt please) your food here. Listen to your body needs.

The second half of a female cycle is called the Luteal phase.

Seed cycling: 1T of sesame seeds and 1T of sunflower seeds per day. I use tahini and sunbutter often during this half of the month. 

Week 4: (right before period) LUTEAL

Insulin: the 7-10 days leading up to your period, insulin demands will be the highest and trickiest. This is where I take notes on what basal totals I am taking days leading up to my period and what cravings I had and how I treated them. I personally take these notes in my calendar on my phone – and happen to miss a few months, but I always have some notes to fall back on. It’s also common to see a need to increase basal insulin the most the day before your period (thanks progesterone!). If on an insulin pump, it can be a great idea to have a separate basal pattern to switch to for these days.

Diet – Lowest carb. Eat more cruciferous vegetables, more root vegetables. Limit booze AND caffeine (even though we may be craving them more).

Start increasing fats and lowering carbs or being more strategic with carbs (aka plan out your meals).  Roasted foods are really good right now as they bring out the sweetness of vegetables. Note, however, this is a good time to eat more food period. If you limit food to amounts from prior weeks, you will indeed crave more sweets, as your body merely needs more calories. Many females deny themselves of this and end up with larger cravings. Days leading up to a female’s period, serotonin production is less. Eat high tryptophan foods (turkey, bananas, buckwheat, oily fish, flaxseed).

Studies have shown women who have a high intake of oily-fish (omega 3 fatty acids) including sardines, salmon, and mackerel, tend to have milder PMS. EFAs are also hormone regulators.

Leafy greens right before your period is helpful in calming your nervous system (due to calcium, magnesium and potassium). Even consider a green powder here, such as those sold by Organifi.

Overall understand your desires for food when it’s this time of the month. Just understanding what is going on with your body can help resolve overeating or poorer food choices. “This too shall pass.”

Exercise – step back and understand what your body needs. It could be stretching or it could be a long hard workout. This week is often a wild card.

Agenda – This is the best week to have pre-planned meals as your energy and interest in making meals will be low.

Supplements – Magnesium supplementation is important for cravings, energy, mood and blood sugar control, especially 7 days before the period. Additionally, fish oil, B vitamins, and tryptophan are recommended to help with PMS and can be used starting with ovulation (if not all month).

Seed cycling: 1T of sesame seeds and 1T of sunflower seeds per day. I use tahini and sunbutter often during this half of the month. 

Related Reading:

Inspiring Others with Type 1 – My Interview with Hanna

Hanna first caught my eye on Instagram, under the name @HannaDiabetesExpert, as she seemed like an eager soul to help others across the world. She has an unconventional approach to managing her type 1 diabetes and I believe her story is not only inspiring others but helping make bold changes too. I am excited to share this interview with you, and please let us know your thoughts on Hanna’s story. Thank you, Hanna!

  • Tell us a little about yourself!

I’m a public speaker, writer, and advocate who loves to help fellow people with diabetes to feel healthier and happier with their own care. I’m passionate to find motivational and inspiring ways to bring about a change in diabetes management, and I’ve developed a profound understanding of how things like nutrition and lifestyle choices can balance diabetes. I also co-organise Europe’s first 100% low carb events, called The Low Carb Universe.   

How long have you had diabetes?

I’ve had Type 1 Diabetes for 33 years, since 1985.

What eating style have you found to be most helpful in managing blood sugars? What hasn’t worked?

I was eating a “normal diabetic diet” for the first 26 years after diagnosis, including skimmed milk with meals and extra points for fruits as dessert, not to forget the 45-60% other carbs on my plate. Throughout these years, I could never manage my diabetes like I was expected to, my A1c was always way too high, too many fluctuations in my blood sugar, I was overweight and using insulin like it was water. I quickly got the label of “brittle diabetic” in my file. When I did my education to become a nutrition coach, my teacher, who is not a medical professional, but has more common sense than most, saved my life. When we were learning about carbs, insulin and how they work in the body, he pointed me out in front of the class and said “Hanna, you don’t even make any insulin. If I were you, I’d think once and twice about what I was eating”. That was my aha-moment, and I started cutting down on carbs soon after that. Today I eat very low carb, protein-rich and healthy fat, as I’ve found it works the absolute best for me, my diabetes and my lifestyle.

What type insulin do you use and what insulin dosage method work best for you and your lifestyle?

I went through a lifestyle transformation when I finally said yes to the pump 5 years ago. It’s vastly improved my life, and I love that I can be so spontaneous with it, for example with basal rates. I use Novorapid (Novolog) and have gone from taking about 100 units a day to 15-25.

How do you treat a low blood sugar?

Always, always, always with glucose tablets. I treat them like medicine and they are the most exact way to get to a safe, healthy range again without overshooting. Treating hypos with food never worked for me.

Do you exercise? What do you like to do for exercise? How do you handle activity with controlling your blood sugar? 

I hate exercise, but I love movement! I do a lot of walking, yoga, and body weight exercises, for example. For these movement forms, I don’t feel any pressure, like having the right gear paying expensive memberships, which is also good because I travel quite often. I personally rarely have problems with blood sugar and activity, and if I do, I can quickly correct it back into range again as I don’t have masses of active insulin. But I do know it is a huge struggle for many others.

What tips would you rattle off for someone who is trying to improve their blood sugar control? Or even for someone who is newly diagnosed with type 1 diabetes?

There is always a way! You need to find YOUR way of managing diabetes, which takes some researching. And it definitely doesn’t have to look like anyone else’s or what your healthcare professionals tell you. That being said, with great freedom comes great responsibility. If you want to change your health, you need to be ready and willing to take it into your own hands.

What does a typical day of food look like to you? 

I get up, have a few glasses of water, as well as a giant cup of herbal tea to rehydrate my body after a long nights sleep. I very rarely have breakfast, as I’m generally not hungry then and don’t see the point of stressing my body with food if it doesn’t signal for it. It also gives my blood sugar a chance to stay stable for a few more hours. I wait with eating until lunchtime, 12-1pm, when I have vegetables, protein and fat, such as an omelet with vegetables and ham, smoked salmon and avocado, or just the leftovers from dinner the night before. I don’t typically snack unless my body tells me to. Then, around 7-8pm, I have dinner, which is again vegetables, protein, and fats, like a burger patty with spinach sautéed in bacon fat, chicken with cauliflower rice or salmon with pesto and broccoli.

To some, eating like this might sound boring. To me it means freedom not to feel constant hunger, being able to push meals around according to my schedule, as well as stable blood sugars.

What is the hardest part of being diabetic? What is the best part?

The hardest part for me is worrying about the future, possible complications, and limitations in life diabetes may bring me. Even if I’ve found my way of dealing well with the emotional and mental part of living with a chronic illness, it still gets to me sometimes.

The best part is that I know my body so much better than many others and can tell quickly if something isn’t right somewhere.

Any closing thoughts?

Dare to go out there and find what works for you and your diabetes management. It’s a difficult illness to handle, but it’s entirely possible to live and thrive with it on a daily basis.

This is one of the hopefully many interviews I will be showcasing on my site. If you have type 1 diabetes and are interested in sharing your story and strategies, please send me an email at [email protected]

Gut Health + Multiple Autoimmune Diseases

Just recently, I had an “ah-ha” moment when tuning-in to a podcast hearing Dr. Sarah Ballantyne discusses the risk of getting additional autoimmune diseases for those who already have an existing one. As if 1 disease wasn’t enough, right?! Thankfully, there is something we can do to halt this from happening, but a little information first.

Autoimmune disease affects over 50 million Americans, and if you have an autoimmune disease, you have genetic predisposition to have an overactive immune system. With this, the risk of getting an additional autoimmune disease, according to Sarah Ballantyne’s literature review, is 1 every decade.

Hitting close to home, I felt it in my gut when I read how type 1 diabetes (T1D) is associated with autoimmune thyroid disease (AIT), celiac disease (CD), Addison’s disease (AD), and other autoimmune diseases.

Looking back on my 26+ years of having type 1 diabetes I sense a relationship with this research. In 2009, my life changed when I did a gluten-free experiment. Multiple endocrinologists thought I was wasting my time, as I had proved multiple celiac disease tests negative. Yet, my A1C and blood sugar control were immediately improved and continue to be more predictable and better than ever. Not to mention, my eczema, insomnia and female hormones are better off. Just last July I did a food sensitivity test on myself, and my reaction to wheat was off the charts, followed by gluten. An allergy (celiac) is very different than a sensitivity, and taking my food sensitivity results seriously is improving my overall well-being and are helping to reduce my risk of acquiring more diagnoses. In the last 2 years, I’ve experimented more with my diet, and am now working to wean down or off my thyroid medication (my thyroid tanked with the onset of pregnancy with my second child). It will be a slow process, but things are moving in the right direction. No doubt, food is powerful. Slower than medicine, but powerful.

In the least, it’s a good thing the progression of an autoimmune disease is not entirely determined by genetics. Reseach concludes there are 3 parts:

  1. genetics,
  2. environmental factors (from everything from a heavy metal toxicity, to a stressful emotional event), and
  3. a leaky gut. (Here Dr. Axe does a good job defining Leaky Gut, and below I highlight how to take care of your gut).

It’s valuable to understand that an autoimmune disease can sit brewing in the body for years before a diagnosis occurs and the great news is we can do a lot to prevent the last “straw” from reaching the camels back.

While there is not a one-size-fits-all approach, the best way to be your healthiest and prevent any further autoimmune diseases from occurring or progressing is to focus on 1) what we eat, 2) what we absorb and 3) how we take care of our body/lifestyle. 

Diet/What We Eat:

  1. The AIP is a good starting point for anyone dealing with one or more autoimmune diseases. Not only does it exclude grains, dairy, and legumes like the basic paleo template, it also eliminates nightshades, nuts, seeds, eggs, alcohol, and sugar, leaving a pure and basic diet of meats, seafood, certain vegetables, certain fruits, healthy fats and spices that help to promote anti-inflammatory reactions within the body. Upfront, I want to highlight that while this diet can be a very low-carb diet, it can also be a high carb diet sourcing healthy foods including plantains, sweet potatoes, yams, fruit, yucca, taro, etc. This approach can be tough. Thankfully there are great resources, from books to websites and podcasts. Pheonix Helix is a leader in communicating effective ways of living this lifestyle. Her website is a wealth of information as is her podcasts and guests.
  2. A few other paths to take to make sure someone is eating the right things for their gut is they can do an elimination diet, removing the biggest offenders: gluten, wheat, sugar, eggs, soy, dairy, seed/man-made oils (think corn, canola, soy, safflower seed oils) and corn. Like I did in 2009, begin avoiding one or all of these food groups and take notes on how you feel.
  3. Increasing vegetables and fruit in the diet,
  4. Diversify meals,
  5. Incorporate good spices and herbs,

Gut/What We Absorb:

  1. First REMOVE inflammatory foods and chronic stressors, REPLACE the problem foods with healing foods, such as items listed below, REPAIR the gut with specific supplements, and REBALANCE and nurture the gut, ongoing with probiotics. This is known as the 4 R Protocol.
  2. Research suggests the gut can take on average 2-12 weeks to heal, and likely longer for this of us with an autoimmune disease. For anyone with an autoimmune disease who is also sensitive to gluten and consuming it, it can take closer to 6 months for the gut to heal. And there is little benefit in a “gluten-light” diet. A fraction of a crumb can inflame the body, and I know this first handed when the cook in a cafe I used to work in, would cut my chicken breast with the same knife he was cutting chicken sandwiches with, I’d get ill. I also think of my mother who has osteoporosis, Hashimoto’s and rheumatoid arthritis, but still gets non-gluten free communion at church every weekend. Bottom line, it’s important to be 100% gluten-free when experimenting and if implementing when results are positive.
  3. Increase fermented foods in the diet along with coconut products, bone broth, and collagen,
  4. Avoid food sensitivities – do an elimination diet, tracking your intake and symptoms, or do a blood test to cut to the chase. Feel free to email me if you want help doing a blood test like this.
  5. Moderate saturated fat as it can impair the microbiota,
  6. Replenish nutrient stores with potent supplements, and ask for advice from a health professional to find a high-quality product and the right product for your needs and background.

Lifestyle/How We Take Care of Ourselves:

  1. Prioritize sleep, both quantity, and quality, Did you know in 1965 we got on average of an hour and a half more of sleep per night than compared to today? That’s a big difference, and females need more sleep than males. Here is a list of how to tweak your environment to improve the quality
  2. Engage in adventure and hobbies. If you don’t have the time, shift things around so you do.
  3. Not that you don’t know already, but prioritize blood sugar control. The swings cause inflammation and disturb the peace in our gut.
  4. React better to stress. It’s common to say,  “Reduce stress,” but that thought only makes me a little more strung out. Instead, I put my energy on my response to challenges and tough tasks.
  5. Work on communication so you can be heard and respected.

 

Resources/References:

  • 5 At Home Test Gut: https://www.thepaleomom.com/5-gut-health-tests-you-can-do-at-home/
  • https://academic.oup.com/jcem/article/91/4/1210/2843240
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4971288/
  • https://www.healthcentral.com/article/type-1-diabetes-and-autoimmune-diseases
  • https://www.mindbodygreen.com/0-28154/what-to-eat-to-have-a-great-poop.html

Winning with Diabetes

When I say “winning,” please don’t think it means I have perfect blood sugars, or I am skipping through this journey with bliss. Hella no. This disease is hard BUT in the last 26 years, I have unknowingly grown to love it.

You see, I was diagnosed in second grade, which is also where most of my memories begin, and I have always expressed, written and stated we need to live life to the fullest. I believe with every single one of my doctor’s appointments, shots, blood sugar tests/pricks, I fear death, and with that fear, I want to live and appreciate every minute I have in my life.

Am I alone with this thought? I don’t think so. Last month at the Weekend for Women, Diabetes Sister’s conference I attended in DC, the keynote came from Shawn Shepheard, who happened to also have type 1 diabetes. He shared that on Christmas, many moons ago, when he was diagnosed with type 1 diabetes, he needed to immediately “squeeze every minute out of life.” What an honest thought, and I recognized that he too doesn’t want to downplay the health statistics that are not in our favor, but rather he wants to use this fuel to seek happiness.

Like Shawn – I am “winning with diabetes” because it has given me the opportunity to be more connected to my soul, my purpose, my passion and serves as a reminder to seek happiness and adventure.

I have accepted my limitations and I continue to push beyond them and I thank gratitude for the solution.

How are you winning in life?

National Apple Pie Day

This past weekend wasn’t only Mother’s Day, but it was also National Apple Pie Day. On this very day, May 13th, I had the pleasure of demonstrating an allergen-friendly recipe on the local Columbus, OH 10TV News. 

Allergen Friendly Apple Pie

Ingredients:
• 2 Wholly Wholesome 9″ Gluten Free Pie Shell
• 6 medium sized granny smith apples, sliced
• 1/2 cup coconut sugar – or reduce total amount and use maple syrup
• 1 Tbsp. cinnamon
• 2 Tbsp coconut oil, melted
Directions:
1. Mix sugar and cinnamon together in a large bowl. Peel, core, and slice apples, and place in a Wholly Wholesome Gluten Free Pie Shell. The apples will be piled high but will cook down in the oven. Sprinkle sugar/cinnamon mixture over apples.
2. Spoon coconut oil and place on top of apples. Add second pie shell over apples and crimp pie edges. Poke a hole in top crust to allow air to escape during baking. Place pie on a sheet pan and bake in a preheated oven at 375° for 30 minutes or until top is browned. You will know the pie is done when a paring knife can be easily inserted into the center and the apples are tender.