Histamine Well Podcast: Exploring Histamine, Methylation & Holistic Health

Practitioner's Perspective- Managing SIBO and Hormonal Imbalances Without Testing: A Practical Approach

• Joanne Kennedy • Episode 5

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In this episode of the Histamine Well Podcast, Joanne is joined by naturopath Bridget Greenall to discuss Small Intestinal Bacterial Overgrowth (SIBO), particularly focusing on how to diagnose and treat it without testing. 

They explore the intertwined issues of SIBO, inflammation, and blood sugar dysregulation and their impact on hormonal health, including PMS and hot flushes. 

The conversation provides practical insights for practitioners, students, and patients on managing SIBO, especially under financial or geographical constraints that prevent testing. 

Additionally, they touch upon the significance of methylation in addressing hormonal imbalances and introduce an at-home saliva methylation test. 

The episode wraps up with detailed case studies, addressing facets of SIBO treatment and related hormonal symptoms.

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Disclaimer: For educational purposes only.

Joanne Kennedy:

Welcome back to the show today. I'm excited to have naturopath Bridget Greenall back with us. This episode is all about SIBO. Small intestinal bacterial overgrowth. And what to do if you suspect you have it, but aren't able to test. We also discussed how the inflammation caused by SIBO and blood sugar dysregulation can cause havoc with your hormones, leading to PMS and hot flushes. This conversation will be especially valuable for practitioners looking to deepen their understanding of SIBO and learn practical approaches for supporting clients when testing isn't an option. Students, this is a fantastic opportunity to expand your knowledge of functional gut health and gain insights into addressing SIBO from a clinical perspective. And for our listeners dealing with SIBO and fluctuating hormones, this episode will provide actionable insights and help you better understand your next steps. Welcome to the Histamine Well podcast. Designed for practitioners and patients alike. This is your trusted source for insights on histamine intolerance, methylation, gut health, women's hormones, and much more. I'm Joanne Kennedy. Your host, naturopath, author, and educator, passionate about breaking down complex science into clear, accessible knowledge. Whether you're a health professional or navigating your personal wellness journey, the Histamine Well podcast bridges the gap between cutting edge research and practical understanding to empower you with the tools to thrive. Hi, it's Joanne. Before I start this show, I want to talk to you about the at home saliva methylation test that I mentioned in this episode. As I've mentioned it in so many upcoming episodes. I'm talking about it on guest podcasts that I'm on. I'm getting a lot of my patients to do this test. So essentially, it's like a, it's a like a covid test. It's a at home saliva swab test. So you can do it from home. You do the test and it shows you where your methylation status is in real time. Because the thing with methylation, it changes. It changes with your diet, sleep, exercise. It changes throughout the menstrual cycle in women, amongst other things. So, we need to be looking at it at a day-to-day basis to understand how it's changing. And it's very fascinating as I'm seeing a lot of my women with PMDD actually are severely over methylating, not under. Which has been a real eye-opener for me. So I've been using this test now for several months. I'm really happy with the results. The company, they recommend supplements to reduce methyl or increase methyl, which I agree with what they say. I agree with the products that they're prescribing. It's sort of telling you, you know, this is what they think you should take. They link through to the actual supplement so you can purchase it from iHerb, I think. So game changing. I absolutely love this test. So I reached out to them and said, Hey guys, can I secure a discount for my listeners? And they said, absolutely. So I've secured a 10% discount for the methylation test. So you can find it on my website under methylation test, and you can use discount code HISTAMINEWELL10 to enjoy 10% off your first order and each subsequent order. Hi, Bridget. Welcome back to the show. Thanks, Jo. Okay. So Bridget and I were just having a chat before we jumped on and she's had a patient recently who's just unable to test for SIBO. And we always have to remember this in clinical practice that some of our patients who just don't have the funding available to do SIBO testing, they need to see us. They need to test. They need to get the medications. And some people are living in countries where the testing is just not actually available. And we're going to chat today about how we can work with that. Because the thing about SIBO, it is so obvious when someone has SIBO due to signs and symptoms. And once we get the right treatment protocol in place for them, within a couple of weeks their symptoms will significantly improve. Which is why we don't have to test if there are hindrances. I love to test. It's great to be able to see the test results and to retest to make sure it's gone. So this is one of the conditions that I think we can rely on signs and symptoms and how our treatment is working to ascertain whether this is what is going on with our patients. So Bridget, so do you want to give me a rundown on this patient who you highly suspect has SIBO. What are their symptoms?

Bridget Greenall:

I had a female present to the clinic. 48 years old. And her presenting complaint was bloating and gas daily. It was really significant that distention certainly towards, after lunch, through the afternoon and evening, and it was really quite painful. So to me, that's a big red flag. She does have regular bowel motions, but a lot of diarrhea. Certain foods will trigger diarrhea.

Joanne Kennedy:

Do you remember what foods they are?

Bridget Greenall:

Well, fruit gives her diarrhea. So she has stopped eating that. And anything fatty. So if she has any takeaway, which she's learned to avoid. But if she was to go out and have a hamburger and chips, it would not end well for her. Another thing that was relevant, she started having hot flashes as well. That's just started as well.

Joanne Kennedy:

Okay. So how old is she?

Bridget Greenall:

48.

Joanne Kennedy:

Okay. Does she have a regular menstrual cycle?

Bridget Greenall:

That started to be inconsistent. Sort of in the last six months she's noticed. So up until this point, yes. And now she started, it's kind of coming every six weeks or it comes on time. And then it might be 8 weeks and then it comes on time. So now we're getting that inconsistency.

Joanne Kennedy:

Okay. Okay.

Bridget Greenall:

So definitely. You look at that intestinal permeability. It's not great. And then the knock on effect that's going to have to everything else. To hormones, immune function, hormone function, everything. Now, we did speak about SIBO and we talked about what it was and how it could possibly be affecting her. And as you had mentioned at the beginning, I think it's more of a time thing for her like that. She, you look at that process and she's like, I have time for that. She works shift work and,

Joanne Kennedy:

Oh, okay. This is an interesting one.

Bridget Greenall:

Yeah.

Joanne Kennedy:

This is a good case guys. So shift workers, nurses, and flight attendants. It's difficult. You know guys, I want to first just go back to, just why this is so obviously SIBO. Having a disrupted circadian rhythm is a major cause of SIBO. Okay. Simple. Bloating and distention, it's just absolute classic. You know, the bloat, I mean, it is the gases that are causing so much of the bloating. And the loose stools, depending on what foods. It can point to hydrogen SIBO, but if she was getting diarrhea from fruit, she could have also have fructose malabsorption, which is common with SIBO. And, you know, eating of fatty foods can do that to anybody, right?

Bridget Greenall:

Yeah.

Joanne Kennedy:

But what we also need to understand about SIBO is that it deconjugates your bile acids, doesn't it? So sometimes people are not being able to digest fats. Not necessarily because they've got gallbladder issues, but because the SIBO bacteria break the bile acids. Rendering them unavailable. I'd be really happy with a case like this, to talk to them about, Hey, we can do a SIBO diet. It is restrictive,. But if you did a SIBO diet for a couple of weeks with some digestive enzymes and herbs for SIBO. And if that improves your symptoms out of sight within two weeks, then it's like, Hey, I reckon you got SIBO. Like it's pretty, it's pretty obvious.

Bridget Greenall:

Yeah. And that's exactly what I did. Yeah. So we looked at some digestive enzymes. I looked at some, Phellodendron forte and the Alimax.

Joanne Kennedy:

That's exactly what I would have done Bridget. So listeners, the thing with SIBO, the easy thing is that you can have hydrogen SIBO. And what is really good for reducing the bacteria that create hydrogen is berberine. And it's. Bridget said Phellodendron is actually a plant that's highly, it's the plant that has the highest concentration of berberine, so it's the strongest. Phellodendron and allicin. Allimax is allicin, which is an active constituent of garlic, which is specific for methane. So if you don't know if she's got hydrogen or methane, you give both. And then you get the digestive enzymes in and make sure her bowels are moving well and she should definitely see improvements.

Bridget Greenall:

Yeah. And we did. We saw a huge improvement, huge.

Joanne Kennedy:

Now, the thing with this is that if she didn't want to continue doing that and she wanted to go down the allopathic route, that's going to be very costly. Most GPs don't know about it. They won't prescribe you the Rifaximin. And then you have to go to an integrative doctor and pay for that. And then you'll have to pay for rifaximin, which is, it's not covered by the government. It's something like$400 a pop.

Bridget Greenall:

Yeah.

Joanne Kennedy:

That's the thing with SIBO is that the allopathic treatment is actually really expensive. I'm not saying that it's not warranted in some instances. But it is costly. So Bridget, if she came back and she wasn't doing well at all, right? What I wouldn't presume straight away that she didn't have SIBO. What I'd be thinking about is Issues with migrating motor complex. I had a lovely English girl here. She's moved out here from the UK living here. Her distension is beyond uncomfortable. We tested SIBO absolutely through the roof. And before I saw her for a follow up, I got her to do the diet and she did it. And she did it religiously and she came back with no improvement. But her SIBO is really high. She's got massive issues with the migrating motor complex.

Bridget Greenall:

And then what can trigger that?

Joanne Kennedy:

Oh, it's usually caused from food poisoning. There's other causes, but it's majorly caused from food poisoning. And the thing with the migrating motor complex, it kicks in 90 minutes after you eat and it sweeps out undigested food and bad bacteria. So when the bloating is still there on that bland diet with no fun and it's positive for SIBO. It's just not moving. Now it was so severe with her. I sent her off to the integrative doctor to get low dose naltrexone, which is a prokinetic medication that is going to help with getting that migrating motor complex reset. She will also do the antibiotics because she's gone into allopathy. But that's fine because if you do the antibiotics for SIBO and if you make sure your bowels are moving and you've got the low dose naltrexone, the prokinetic medication in place, so everything's going to move. If you hit it for two weeks with antibiotics, it can really clear it out. But if you do antibiotics without knowing you've got a migrating motor complex issue. It's for no. It's a complete waste of time and money and you're killing a good bacteria at the same time. So I've seen that a lot with patients. They take Rifaximin and Neomycin or the other antibiotic for it couple of weeks and they feel amazing. And then they stop and within a day, Bridget, it just comes back. So that's a classic sign of, you need, there's massive issues with migrating motor complex. There are natural prokinetics, like Iberigas and ginger. I just don't see them being strong enough in most instances.

Bridget Greenall:

No, no, I agree.

Joanne Kennedy:

I don't find them strong enough either.

Bridget Greenall:

No, I don't, definitely not.

Joanne Kennedy:

I think people will benefit from them because they're like they're lovely liver herbs. Like they support liver and bowel flow. But they're not strong prokinetics.

Bridget Greenall:

No. I mean, it's a drop dose as well. Also, I wouldn't see it, I don't generally see it would be efficacious in that way for that function.

Joanne Kennedy:

Yeah. Interesting. No, perfect. Like, that's exactly what I'd do. And so she's come back and no bloating.

Bridget Greenall:

There is still some bloating. However, It's a huge reduction. So she noticed that we did the two week SIBO diet. And then she noticed in almost instant relief with that. And then when we kind of got off that and we looked at moving into a more regular diet that we can sustain. I maintained no gluten at this point still. now I don't know if I mentioned it before, but also I think it's important to mention that she does have type 2 diabetes. So another concern, I guess was more from that Metabolic endotoxemia, which can affect insulin if we've already got type two diabetes. That then can create more issues for this patient as well. But yeah, so yes, a huge reduction in gas and bloating. So that was fantastic. She noticed when she slipped up and didn't eat foods that she knew she should eat. She experienced pain and discomfort again. But not to the extent that she had in the beginning. So yes, overall, there was huge improvement.

Joanne Kennedy:

Yeah. Yeah. Fantastic.

Bridget Greenall:

You look at someone, you know, she's 48 and this has happened very slowly over a long period of time. Yes, there's an improvement in. I think it was I didn't get to see her after two weeks. But I saw her after about three weeks just to initially see, hey, what's happening. Check in. What do we need to fix here? it's going to take, a period of time to really manage that for the long term.

Joanne Kennedy:

Yeah, I see SIBO taking at least three or four months.

Bridget Greenall:

Yeah.

Joanne Kennedy:

It's not. It's not easy. It's not easy. And I take my hat off to my patients that have done it. Because it's a hard slog. But I tell you what. It's so well worth it because if you treat it naturally, you understand the root cause and you are dealing with the root cause at the same time. And usually it doesn't come back. I've had many patients. Start. Stop. Go away. Do antibiotics. Come. And then two years later they're like, Jo, I'm back. I'm ready to do it properly now.

Bridget Greenall:

I t's all about expectation management, isn't it? And I feel a really big part of our job is it's really easy for me to sit here and educate someone or explain a concept to somebody. Which all the time I think people don't even want to hear. They're just like, give me a solution. Right? But it's how do I motivate this person to be able to change their behavior or their attitudes to be able to follow this for quite a long period of time and that's where it's quite challenging.

Joanne Kennedy:

Yeah. So this is where we should start talking about the major causes of SIBO and we have everything in the medical literature, like surgery and food poisoning. Celiac disease, endometriosis, antibiotic use. Excessive antibiotic use. Proton pump inhibitors. But what I see that's just not in the literature is stress. Major. Eating at your computer. Your brain's just not kicking in to get your digestive enzymes going. Yeah. And people that graze. I had a patient once. God, we, she would eat rice crackers with tuna and cottage cheese over like four hours. She just constantly grave. And we test and, and I know, and it's just like, it's just SIBO through the roof. Because you're just not allowing that migrating motor complex to kick in. So it's just what I've found clinically with patients that are just really unresponsive and it's so, it's like. Oh my God. Like they'd said, I'd just snack because they wouldn't do it in their form Bridget. They'd tell me breakfast, lunch, and dinner. They didn't tell me about the actual grazing of it all day. And then they're migrating. I think it's somehow slowed down the migrating motor complex. Where it just was lazy or something. Yeah. Yeah. Interesting. Cause it's the grazes and um, stress will absolutely do it.

Bridget Greenall:

And then also I think certainly what I see a lot of, cause I really see, as I mentioned before, women in their forties, and and early fifties is that shift in hormones and that fluctuation. The reduction in progesterone and that fluctuation of estrogen is also going to impact your gut microbiome. It can certainly, influence intestinal permeability and then it can start there. So a lot of these patients are saying to me, never had gut issues ever.

Joanne Kennedy:

Yeah, yeah, yeah.

Bridget Greenall:

And then all of a sudden I hit 40 and I don't know what's happened.

Joanne Kennedy:

Yeah. Yeah. That metabolic syndrome causes massive issues with inflammation, disruption to the microbiome. So interestingly to talk about this lady in the hot flushes. Cause it's like, I'm 49 now. And I'm taking estrodiol. I went to, I got my hormones tested on day two and my oestrogen wasn't low. But I'm not having hot flushes. But I start spotting on day like eight, nine, 10 and I, cause I'm a naturopath and I know what's going on. Like my oestrogen is not high. So I got oestogen gel and I lather it on myself and I love it. It just gives me, it's just like a shot of coffee. It gives me so much energy. So it's like, does she need oestrogen? But do you know what? With her case picture. Insulin. So SIBO is highly inflammatory and insulin is highly inflammatory. And she could just have inflammation pulsing up and down her hormones.

Bridget Greenall:

Yes.

Joanne Kennedy:

The oestrogen, she's potentially histamine gets involved as well. It's like the estrogens pulsing and causing hot flushes. Like that would be my instinct on that.

Bridget Greenall:

Yeah.

Joanne Kennedy:

Do you do you agree?

Bridget Greenall:

I agree.

Joanne Kennedy:

Yeah She might not need oestrogen yet. Like it's interesting oestrogen. Because you I'm so pro taking it but Sometimes it's literally the systemic in as you're saying leaky gut and all that systemic inflammation. Histamine for sure can cause hot flushes.

Bridget Greenall:

Oh very much so. I wonder though, certainly, this is why I wanted to go and get her insulin monitored. Because if we can support that intestinal permeability because there's definitely something there. We've had a great response with the SIBO diet and some of the supplementation to support that. Would that then as you said, would that then effect have an ongoing effect downstream and effect reduce hot flushes in that regard because we're reducing the inflammation.

Joanne Kennedy:

I'd Be surprised if it didn't. Yeah. Absolutely. So surprised if it didn't. Before we go any further, I want to speak directly to the practitioners and students listening. If you're intrigued by histamine intolerance and eager to expand your knowledge, particularly around methylation and how to apply this understanding in clinical practice, we offer the Histamine and Methylation online group coaching course. The only program of its kind. It covers everything you need to know about histamine and methylation, providing both the theory and guidance you need to treat these issues effectively in clinical practice. To learn more and apply, visit joannekennedynaturopathy.Com

Bridget Greenall:

And then also another point that I definitely have thought about with this case is then how is this then influencing the metabolism of her oestrogen and then how do we support that?

Joanne Kennedy:

Yeah. So interesting. So, the only way you can really look at each of the metabolites is with the Dutch hormone test.

Bridget Greenall:

Yeah.

Joanne Kennedy:

It's always interesting. And then we've also got the methylation test. The somaticode mood sense methylation test that with the home test. We can also do that.

Bridget Greenall:

I'm definitely going to try that one.

Joanne Kennedy:

So again guys. Listeners, practitioners, students. You can now do methylation testing as a saliva swab test from home. So you can actually test it every day for like a month and see what your methylation status is. And you'll be surprised cause we've actually, I've been doing this in my patients and many of them are severely over methylated. Not under.. So be careful about giving out B vitamins like candy. I remember at college, everyone gets B vitamins. Well, not everyone. Yeah. so somatic code it's a company in the US. And when I spoke to the owners of it, Amanda, she was messaging me. Cause she's 49 and perimenopausal like me. And she has hot flushes. She does the methylation test and it tells her what to take. She's an under methylator. Yeah. And she takes some trimethylglycine and it stops the hot flushes.

Bridget Greenall:

Wow.

Joanne Kennedy:

Well, for her it's just balancing out our oestrogen. Yeah. It's pretty fascinating stuff. So look, methylation is so complex because it's dealing with what's dealing with many enzymes, but it's definitely dealing with histamine. It's definitely dealing with your oestrogen.

Bridget Greenall:

Yeah.

Joanne Kennedy:

And It's complex, but you can test now and understand what you need to do to tweak your methylation, which can really impact your hormones.

Bridget Greenall:

Yeah, definitely.

Joanne Kennedy:

Yeah, so Bridget. You could do a Dutch hormones test. And then you can also look at a methylation test. The girls that I'm doing this test on are like perfect diets. They've been with me for a couple of years.

Bridget Greenall:

Yeah.

Joanne Kennedy:

They're not overweight. They don't have insulin resistance. They've been in perfect diets. They've been, they're really good health. And this is just the one thing like the PMDD is just that mood stuff is. It comes and goes each cycle. But sometimes as they're getting older, it can get worse.

Bridget Greenall:

Yeah.

Joanne Kennedy:

And clinically I've found SamE helped a lot of women with PMDD. But then sometimes it doesn't. And why? Because they're severely over methylating. What I found. This is just anecdotal from the patients that I've been seeing is that this group of women that I could only get so far, they didn't even feel good on B vitamins. They had such signs and symptoms. They had high homocysteine. They were high oestrogen, fibroids. They seemed like such a candidate for methyl, for Sam E. They didn't do well on B, so I never gave them Sam e and they were way better than they were when they saw me with their PMDD. But they were still struggling with mood.

Bridget Greenall:

Yeah.

Joanne Kennedy:

And when I tested it and they're over methylating, it's like wow. Like severely over methylating. And they take niacinamide and vitamin C to reduce the methyls. Absolutely, their mood goes from terrible to really stable.

Bridget Greenall:

That's unbelievable.

Joanne Kennedy:

So it's great. It's really interesting to see. So however, with your patient now, if this is we don't want to jump the gun, like what you're doing is what you need to do.

Bridget Greenall:

Yeah.

Joanne Kennedy:

So we don't want to jump the gun and go, Oh, we need to look at methylation when the gut stuff has to be worked on and the, obviously the weight and the insulin and the inflammation.

Bridget Greenall:

Yeah, that's right. Definitely.

Joanne Kennedy:

Because those things disrupt methylation. They disrupt methylation significantly. So potentially if a woman like that did a test, it could be all over the methylation test. It could be under, over, it could be all over the place.

Bridget Greenall:

Now, that's really interesting to know. I'm definitely going to start looking into that and start utilizing those.

Joanne Kennedy:

Yeah. Good. So any other symptoms? Is any other interesting symptoms this patient had?

Bridget Greenall:

No. So other than she is a shift worker, as I mentioned before. Which I did think was really quite significant. She doesn't seem to have any issues when she sleeps, when she does get to sleep. She doesn't do night shift all the time. But, I think it's something like five or six days a month where she'll do a night shift. So certainly looking at circadian rhythm and how to support that was a big part of our treatment plan. She does grind her teeth and she mouth breathes. So again, she's not sleeping properly. So then that's going to have a whole pile of effects on all the different systems in the body. And then when it comes to her cycle. So like I said, her cycle has started to change a little bit but there's lots of irritabilityleading up to her cycle and she can be incredibly emotional leading up to her cycle and then she's having a lot of PMS cramping, as her period starting as well.

Joanne Kennedy:

Yeah. So this is where it's just. The truth ladies, you've got to look after yourself when you're getting older. Because if you have a great gut microbiome and you're eating well. You've got low insulin levels and everything's great. If that was happening with your hormones, then it's just, wow, you seem like you need if you're low in progesterone. You're going to have unopposed estrogen. And so we go in with calcium to glucarate and we detoxify that and we support with progesterone, whether it be trying to improve your ovulation and get your progesterone nutrients up. So progesterone nutrients are. B6, zinc, vitamin D, iodine and iron. We make sure we get that up. Or potentially some women will start needing bioidentical progesterone at that age. But when there's so much inflammation in the body, as I was saying, pulsing the ostrogen to knock them down that could be, she could be like high or low estrogen. It's very difficult. But when a woman is really looking after herself, great diet, low insulin, doing lots of weights, building muscle for insulin resistance and sensitizing insulin, the gut's good. Then that classic picture of 48 years old. Still menstruating, low progesterone, it's usually unopposed estrogen. So it's kind of higher, high ish, and we go in with calcium d glucarate.

Bridget Greenall:

And even going in with calcium d glucarate at that time, because obviously the estrogen, uh, the progesterone is very low, which you're going to see that at that age. But then the estrogen is also going to be on the lower end at that point. And it's still okay to go in with a calcium D glucarate at that point.

Joanne Kennedy:

Great question. Um, I, I would just, for example, if a woman is having say a 28 days, I sort of, okay, if she's not ovulating well, she's probably having like a, Um, and she's, and she's starting to get issues in the luteal phase. Yeah. I would just start from ovulation to start Calcim D glucarate from ovulation. Now if a woman is getting symptoms at ovulation. Right? So mood changes, breast tenderness, high histamine levels at ovulation. Remember estrogen increases histamine. I'd go in with calcium to glucorate around day seven to 10 to get it before ovulation. But I would not be taking it every day because it can drop your estrogen too low.

Bridget Greenall:

And what about NAC? Can you use that interchangeably? Could you use NAC or?

Joanne Kennedy:

I mean, NAC is nowhere near as strong as Calcium Deglucorate for oestrogen detoxification. What I use NAC for is to support follicle quality and corpus luteum quality. So follicles and the corpus luteum in particular are highly reactive to oxidative stress. Also, I find NAC is not as strong as calcium d glucarate when it comes to estrogen detoxification, but I use NAC to support follicle quality and corpus luteum. So where I find NAC shine Is in women, um sort of from 40, you know, in the early forties where they're still cycling. And sometimes this is when you can get lots of really hectic symptoms because your estrogen is so high and then your progesterone is dropping. And you get like breast tenderness, bloating and fluid retention, bad mood. And you're like an estrogen bucket. Yeah. Right. You're so high in estrogen because for the first time, like your progesterone is really dropping out.

Bridget Greenall:

Yeah.

Joanne Kennedy:

And so that can be really helpful. And at the same time, N acetylcysteine is going to help with follicle quality, healthier follicles, healthier ovulation, healthier corpus luteum. Listeners, the follicle, when it, um, releases the egg, it then has another role. It forms a tissue called the corpus luteum that secretes progesterone. And so we need a healthy corpus luteum for progesterone and N acetylcysteine or glutathione is really, really helpful for that. Yeah. And this is why I see women with the really chronic things that are causing inflammation in our patients, like oxalates and mold and insulin, um, and bad, really bad diet. They have terrible PMS because they're just the quality of the follicle, the quality of the corpus luteum just, just not there.

Bridget Greenall:

No.

Joanne Kennedy:

It's just all that inflammation, oxidative stress. Yeah. Yeah. Interesting. But the whole, the whole, um, oestrogen conversations is an interesting one. I'm really pro taking oestrogen when you need it. And like progesterone, you can't take progesterone until you need it. I've had a lot of women be put on progesterone just because they've got PMS, but they've got PMS because of inflammation and high estrogen. They take progesterone and until it's low, When you take bioidentical progesterone, it can cause, uh, it slows down the motility of the bowel. It causes massive issues with breasts, like really sore boobs. It can throw your menstrual cycle out. So it's not really great to use until you really, you actually test and you're low.

Bridget Greenall:

You know, and that's a really good, um, point to make. And also I think there's a similar argument you can make around stress. If you're incredibly stressed and You start shoving in the progesterone, where, where's that progesterone going to go? Is it going to go where it needs to go or is it going to go, uh, is it going to be used to help make..

Joanne Kennedy:

Cortisol?

Bridget Greenall:

Yeah, exactly. Create more stress.

Joanne Kennedy:

Yeah. That's exactly right. So that's a really good, because I just have women go, Oh, Joe, like I'm on this Facebook group and women love progesterone and I just feel terrible on it.

Bridget Greenall:

Then start taking it.

Joanne Kennedy:

Yeah. So some women just don't necessarily feel that great on it. Um, so I just want listeners to know that, um, your hormones are like your report card each month, giving you insight into your overall health and it gets more strict as you get older. I think. And it just does. And we need to be doing all the lifestyle. The diet and lifestyle stuff and the exercise to help us through that transition. Because you can't just, it's, yeah, it's we really, really do this. Look, I'm jealous of women. I've had some women say to me, I had this woman in the shop the other day. We were just chatting and she was only 45. She goes, Oh God, she's. I don't know why. I think I must have been complaining about my hormones. I don't know. I talked to her about it. She goes, Oh, I started getting hot flushes and like low libido and then I just went to the doctor and I had really low hormones and then they put me on hormones and I'm better. She was just, in my mind, lucky. She just went into menopause really quickly. Yeah. And her, she was in menopause and her hormones were dropped. They were down, and then she got onto her HRT and she felt great. So she didn't go through that rollercoaster that most of us other women have too. Um, but as naturopaths, we are here to, to lessen that, to soften that ride in perimenopause.

Bridget Greenall:

And it, it's, it's such an individual, um, case by case, isn't it? Um. And then that then triggers the question for you as naturopaths for us to think about, well, what else is happening here? Right. So if that's quite black and white for that individual, well, that's great. Um, and it's generally not like that for a lot of people. So what else? And this is something that I know that you've always said is you really need to kind of look at that root cause and figure out what that is and then address that because otherwise it's Yeah, exactly. It's a bandana.

Joanne Kennedy:

Yeah, it is. It is. And you know, as I was saying, all for oestrogen and progesterone. But ladies, if it hasn't worked for you especially if you, when you're done, when you're in menopause, you're not menstruating, usually it's just really well tolerated. But if you're still cycling and these synthetic or bioidentical hormones are causing you problems. Then there's a lot we can do naturally to help. Like get your cycle better and get your symptoms under control. Until the time that you actually do need to take them. And when you do need to take them, they should be beneficial. So it's usually, if they're not benefiting you, you don't actually need to take them yet.

Bridget Greenall:

That's a good point to make Jo.

Joanne Kennedy:

Cool Bridget. Well, interesting case. Thank you so much.

Bridget Greenall:

Thank you. My pleasure.

Joanne Kennedy:

We'll have, we'll definitely have you on the show again.

Bridget Greenall:

Thanks Jo.

Joanne Kennedy:

You're welcome. If you've enjoyed this episode, be sure to subscribe to the Histamine Well Podcast. Leave a review or share it with someone who could benefit. If you have any questions you'd like answered or have a topic that you'd like me to discuss on future episodes, please go to my website. It's joannekennedynaturopathy.com where you can provide us with that information. I'll see you next time. Until then. Take care and be well.