Feel Better, Live More with Dr Rangan Chatterjee - #8 Optimising Hormonal Health with Angelique Panagos

Episode Date: March 7, 2018

Dr Rangan Chatterjee talks to Angelique Panagos, nutritional therapist and author of The Balance Plan: Six Steps to Optimize Your Hormonal Health. They discuss why modern life is attacking us and how Angelique discovered practical lifestyle changes that can improve female hormonal health. Show notes available at drchatterjee.com/angeliquepanagos Follow me on instagram.com/drchatterjee/ Follow me on facebook.com/DrChatterjee/ Follow me on twitter.com/drchatterjeeuk Hosted on Acast. See acast.com/privacy for more information.

Hi, my name is Dr. Rangan Chatterjee, medical doctor, author of The Four Pillar Plan and BBC television presenter. I believe that all of us have the ability to feel better than we currently do, but getting healthy has become far too complicated. With this podcast, I aim to simplify it. I'm going to be having conversations with some of the most interesting and exciting people, both within as well as outside the health space, to hopefully inspire you, as well as empower you with simple tips that you can put into practice immediately to transform the way that you feel. I believe that when we are healthier, we are happier, because when we feel better, we live more.

I'm very excited about today's guest on the podcast. It's someone who I have been following on social media for quite some time and it's very clear from looking at what she posts out there that her ethos and her viewpoint on health is pretty similar to mine. It is someone who is a nutritional therapist. She is author of The Balance Plan. It's an absolutely fantastic book, a book that basically is giving you six steps to optimize your hormonal health. And she specializes in female health, stress, and digestion. It's Angelique Panagos. Angelique, welcome to the podcast. Hi, thanks so much for having me. It's my absolute pleasure. As I say, I have been a big

fan of what you are putting out there, a big fan of your book. And actually, the things you specialise in are actually the sort of things that a lot of my followers ask me about. Female health, stress, digestion. Can you tell me how did you get into being a specialist in this area? Yeah, absolutely. And before I say that, if I can just say that I'm a huge fan of your work as well. And I just feel that where we're headed with health care at the moment is just amazing. We've got so many new ideas coming in and we're all talking about very similar things where lifestyle is concerned.

And I think that really leads on really well into my own journey into becoming a specialist in this area. I needed to fix myself. to becoming a specialist in this area, I needed to fix myself. I am a Greek-Italian girl born and bred in sunny South Africa. And that meant I had the license to eat. And I ate a lot. I grew up with a mom that was always into naturopathy and homeopathy and nutrition. So I had this foundation of what healthy eating was. But in my 18, 19, 20s, I lost my way and I partied like a rock star. I was up all night. I was then up all day. I was eating badly. I drank a lot of alcohol and I was really stressed. And my hormones just took a turn for the worst. I was in men's training for 90 days at a time. I developed Hashimoto's and then which led into hypothyroidism. I developed eating

disorders, anorexia, bulimia, obsessive compulsive, overeating. And I just felt absolutely wiped out, terrible, irritable, and continuously feeling like I had PMS. And I feel that it was that journey going through it myself that actually led me to a point where I thought up to here and no further I need to make changes in my own lifestyle to make a difference to my own health. And how did you realise that you had to make changes in your lifestyle? So what I mean by that is did you go and see doctors for those problems because one of the problems that you mentioned about not menstruating for 90 days that that is very common. That's a common issue that comes into general practice all the time. So what had the doctors told you? Absolutely. I felt like I was bouncing from doctor to doctor because I just felt like something was not right, especially with regards to my weight. I think

at that stage in my early 20s, I understood that not menstruating for 90 days at a time was possibly not right and not how the body was not functioning optimally. But more concerning for me was the fact that my weight was yo-yoing and that I couldn't shift the weight in my late 20s. And I was always cold the whole time and I just didn't feel right within myself. So I kept going back to the doctor and they kept running blood tests. So for example, thyroid, they were looking at my TSH levels. And then for not menstruating for 90 days at a time, we did a scan as well. So they looked at the ovaries and they told me there's cysts on the ovaries and there's nothing really we can do about it was the answer that I got a lot. And I was also encouraged to go to CBT

to learn to live with my symptoms. And that to me was the turning point. Like I thought, I don't want to live with these symptoms. There has to be something else that's going on. And luckily for me, I stumbled across a nutritional therapist who did extensive blood work. And we looked at stool function. We looked at full thyroid panel. And with those test results, I went back to my doctor armed with more information saying, but look at these results. What do these mean? And that's when I got the diagnosis of, oh, hang on.

Actually, it looks like Hashimoto's. It's now hypothyroidism. It's PCOS. So that's how it all came about. For those people listening, Hashimoto's is an autoimmune thyroid condition where your body is attacking your thyroid gland and often leads to people having underactive thyroid. And PCOS, we're talking about polycystic ovarian syndrome. Ashley, did you ever get prescribed things such as levothyroxine, the thyroid hormone, or even the oral contraceptive pill to help you with those symptoms?

Yes, absolutely. I was given the pill to start with so that it would regulate my period. That's what I was told. And at that time, I took it. And yes, I bled. I had a period for three months. I remember taking it for three months and also remember crying solidly for three months. It just completely made me so weepy at everything. And from what I know now is that yes,

I had a period, but it wasn't my body doing what it was meant to be doing. It was the fact that I was taking the pill. And so when I came off of the pill, I was right back to where I started with menstruating every 90 days, even sometimes more than that. And I was also put on thyroid replacement hormone, which I'm actually really grateful for because I'm still on it and I feel that I'm a completely different person now to what I was 15 years ago when I was in the thick of it,

where I couldn't string a sentence together. I was losing all the hair on my head. I was cold continuously. People were hot in the summer. I was wearing a jersey. My body just wasn't functioning as it should. A lot of other work needed to be done as well, like looking at the autoimmune condition and seeing why my immune system was attacking the thyroid. But I think of all the things that I had taken and of all the medication that I had taken, I think the thyroid replacement worked the best for me personally. The levothyroxine. The levothyroxine, yeah. I mean, I think what's really interesting for me is that you were just getting on with your life. were you know partying in your 20s like many of us do certainly i was doing that in my 20s and you know your health was just bit by bit

deteriorating to the point where actually you couldn't go on like that you went to see people to help you your doctors and it sounds like you weren't really satisfied with the answers you were given because they weren't actually helping you when you took the pill yes it helped you menstruate or you know you're right it's not technically a proper period it's it's a withdrawal bleed so yes it sort of fixed that problem by by one way of looking at it but your mood went off so you know arguably you're not much better because you're actually your mood's gone down and you're crying a lot. And what's interesting to me is that you had a problem. You weren't satisfied with what you were being told.

And then you took matters into your own hands to get better. And that's a story I see a lot, both with myself, whether it's myself or a family member, but lots of other healthcare professionals who I think have got, you know, a story to share. They've got a mission. They really want to help empower people. I find often there is that personal story there. And so what happened? What changes did you make?

And how do you feel since you made those changes? And I think the changes are so important because in order to see a change, you have to make a change. And you can't keep doing the same thing over and over again. And that's exactly what I was doing. I was still eating truckloads of sugar and chocolate on a daily basis and refined carbohydrates and not thinking about the amount of caffeine and the amount of alcohol that I was putting into my body on a daily basis. You know, not thinking about how little sleep I was getting. When I started making changes in all of those areas, reducing the amount of sugar,

reducing the amount of refined carbohydrates, bringing in the right amounts of vegetables, dark green leafy vegetables, getting some sleep, saying, hey guys, I went out with you last night. I'm going to stay home tonight and get some rest. That was a major thing to do because you have major FOMO, fear of missing out. You just want to keep, you want to keep living that lifestyle. But if you keep living that lifestyle, you're going to keep feeling as rotten as what you were before. And I think that was a major shift. And it happened quite early on, I think for me, because I mean, I was mid twenties. I was probably around 25, 26 at that stage where the penny already dropped. And I thought, for me, because I mean, I was mid-20s. I was probably around 25, 26 at that stage where

the penny already dropped. And I thought, I can't possibly be carrying on this way because I want to have children one day. And if I'm not menstruating every month, then my dream of becoming a parent one day may not materialize. And these are things that I have control over. And I think that's really an important thing to note. And an important thing that I like to empower my clients with is that we have the power to make the changes in our own lifestyle. We have the ability to look at what we've done in the last six months and a year to see what changes can we make on a daily basis, consistent changes that are going to help us reach our goals. Yeah, thanks for that. I mean, one thing that comes to mind there is that you had problems with the way that you felt, you had hormonal problems. Did a part of you think,

well, what's my lifestyle and nutrition got to do with my hormones? Absolutely. Absolutely. Because not once in my consultations with these doctors, and they were doing the best that they could because, I mean, they had like seven minutes to see me, but not once did they look at my belly fat and think, hang on, you know, why is there so much fat around the middle? You know, what's going on with this adipose tissue? Let's look at a hip to waist ratio. What's going on there? Like looking at that is a simple tool that I use in clinic a lot is let's look at what's happening around your middle. Is the weight accumulating around the middle?

And that can give us indications of a lot of things happening within the body. And with PCOS in particular, we're looking at it. We know that it's an insulin driven condition. And if we're talking about an insulin driven condition, that goes back to what your diet is. we're talking about an insulin-driven condition, that goes back to what your diet is. So with insulin, we understand that if we're eating a lot of sugary foods and high refined carbohydrate foods, it gives us this insulin spike or hyperinsulinemia, where we have this continuous elevated insulin. And what's happening there within the body is that actually stimulates more testosterone from the ovaries.

And in PCOS, your testosterone can be elevated. Yeah, which is why some of the women who have issues with polycystic ovaries have sort of features such as what we call hirsutism, you know, hair on the face, you know, typically what we would call male characteristics often are there because of this raised androgen or raised testosterone level. I think, actually, you really touched on an interesting point for me. And maybe eight, nine years ago when I was seeing patients with hormonal problems,

I don't think I really understood as a doctor how much lifestyle and nutrition plays a role in your hormonal health because i think people feel that you know if i think that's a lot of the consultations i've had with women in their 20s with hormonal issues i don't think there is a a connection made between our lifestyle and our hormones and it's something i try and touch on in my recent book, The Four Pillar Plan. I start off actually with the relaxation pillar, the whole stress component. And I go into details to try and explain to people how actually, you know, your hormones are, you know, it's a delicate balance between all the hormones. And once you are getting stressed, for example, you change that whole balance. You know, you drive more cortisol to be made.

And that means that there's less, you know, less resource there, let's say, to make things like estrogen and testosterone and the whole balance shifts. And you can impact that with your nutrition and your lifestyle. Absolutely. And do you find with your clients these days that they're surprised when you explain to them how lifestyle and nutrition can affect your hormones? Absolutely. And I think we're still really understanding. I love the fact that we keep learning. But what we definitely know at the moment is that stress has a major impact on every aspect of health, but especially on hormones, because we're either making stress hormone or we're making sex hormone. And it's really simply put, but stress hormone is made so that you can get out of the lion's way. It's come through the door. It's about to eat you. You

have to make a split second decision. Are you going to stay and fight or are you going to turn around and run? We're not faced with a wild animal anymore. That lion is not actually standing in front of us, excepting we've replaced that with email stress. And that's a thing. We're getting inundated with things pinging at us continuously as well. Social media, if it's Facebook, Twitter, Instagram, we've got so many things coming at us at once that we're actually living in the state of chronic stress as opposed to what stress was meant to be is acute stress. There's danger, you deal with the danger, and then all your stress hormones actually settle. So what we're

not allowing is our bodies that time to rest, that time to recuperate, that time to restore. And this is having a major effect on hormones. Yeah, you're so right. And it's something you just said echoes a line that I put in my book, actually, where I say we're not being attacked by a lion. We're being attacked by our lives. Yes, absolutely. And this is the problem. Modern life is kind of for many of us attacking us. And, you know, even simple things like, you know, 10 years ago, there was a switch off between our work life and our personal life.

But that's gone. You know, we don't have that you know to arrange this podcast i contacted you on social media on a sunday right do you know what i mean i mean yes it's leading us to being here now talking but actually that's quite invasive on one level you know and i don't think many of us realize the impact that is having and you know i i often talk to people and i say, well, you know, 10, 15 years ago, I'd like to think that the majority of the working world would, you know, they finish work, they'd come home, they might see their children, they would, you know, maybe put the

kids to bed, have some dinner, and that they'd switch off. They might be watching television with a partner and, you know, communally sharing that experience, not being individuals on their own devices, looking at their own personalisation of everything that they want, whether it's social media or it's Netflix. And there was that kind of shared communal relaxation that is going out of society. And that's actually the reason for me that actually I started my book with the whole relaxation pillar. I think it's the one that we undervalue the most. I wonder if you could share with the listeners, in terms of stress and modern stress, what are some of your best tips that you have found that have helped your clients reduce their stress levels and therefore improve their hormonal health?

There's so many, and I've actually put that in the book. I have my pillar of nurture where we're actually really looking at the adrenal glands and then also restore. We're taking a moment, I call it me time, you know, get lost, get lost in a book, get lost in a walk in the park, you know, get lost with laughing with your friends. Take a moment to eat your food without being chased by that lion. It's like we've taken this wild lion and we've put a lead around its neck and said, you're my pet. And I'm going to have you there next to me, but I'm going to jump every two seconds because you are a wild animal.

So we need to take that lion, put him back in the wild, and we need to start relaxing while we eat. Take 20, take 30, take 40 minutes to actually eat your meal. We eat our meal over the laptop while we're working. Get up from your desk, go for a walk, sit somewhere quietly and eat your meal. You are allowed a lunch break. Let's take that. Let's take that lunch break back.

And then I also talk about 4-7 breathing. So there's a lot of different breathing techniques. And we're looking at stimulating the parasympathetic nervous system. So the part of the nervous system that actually helps us to relax it's the calm nervous system it's where hormones happen it's where digestion happens and the breathing technique that i really love to use is four seven so it's breathing in for the count of four really deep belly breathing and for all the ladies you know we we're so concerned with sticking our stomach in and making sure that it's not poking out in any way. I really just want you to let it all out. Push out your belly, breathe in from the belly, and then breathe out for the count of seven. You might not get there the first few goes. That's okay. It's not in judgmental breathing at all.

And do that for about 10 rounds, morning, evening, and any time that you feel stressed. You can do it in the tube with your eyes open. You can sit on the tube with your eyes closed. There's no real excuse not to be able to do it. And it's something that I think it was the Dalai Lama that said, meditate for 20 minutes each day. Unless you don't have time, then do it for an hour. Yeah, it's so true.

And so that's what we need to be doing. And it doesn't mean that you have to be sitting there omming for 10 hours of the day, but it's about bringing in these little things that you can do. It's amazing hearing you talk, Angelica. There's such synergy between what you stand for, what you're promoting to your readers, to your clients and what I stand for. It's just amazing. I tell you that an interesting study I read was, you know, we talk about this hormonal balance in the body. And what a lot of people don't realise is that, you know, the precursor for all these hormones is LDL cholesterol.

And, you know, it really is amazing that we need cholesterol in our bodies to make hormones. But there's a very key intersection point. So cholesterol is right at the top. And then lots of additional things start to get made on our way to making our hormones. And there's a key intersection point where you can either go down, as you well know, towards cortisol, one of our primary stress response hormones, or you can go across to making things like testosterone and estrogen and you know when we're stressed we drive ourselves as you've already mentioned on the podcast more towards making those stress response hormones but I wrote this study that showed that actually meditation

sends you the other way so there's a hormone called 17-20 liase which actually stress helps to switch off and push us towards cortisol but but actually meditation helps to get 17, 20 liars active to get us away from that stress response and making more of the sex steroid hormones. I found that remarkable. So yeah, meditation and switching off, critical for our hormonal health. But one thing I'd love you to share with the listeners is, you know, it goes in line with your philosophy.

They know that my philosophy is on four pillars, food, movement, sleep, and relaxation. But what are your six pillars to optimize your hormonal health? These are, honestly, all the things that I had to change for myself and that I use in clinic with my clients and I've seen the best results for. And so I'm looking at nourishing. So nourishing, so nourishing

the body with the right food. So going back to the pathway of the hormones, starting with fat right at the top, leading into your mother hormone, pregnenolone. If we don't have enough fat in our diet, we have a rate limiting step right at the top. And what happens at the top filters through this whole pathway, this whole hormonal pathway. So taking in enough fats, good fats to make pregnenolone, which then gets shifted down, as we said, into cortisol or into estrogen and testosterone and progesterone. So that's a key one that I really want to talk about as well, is that we need that Zen master. We need progesterone because that progesterone is what actually helps us to stay pregnant as well. So if we're talking about fertility,

it's really important. We're looking at getting enough protein. And it's not just a couple of pieces of ham in a sandwich that you've bought at M&S on your way to work. It's about getting good quality protein in. And it's not obliques just eating a wild boar. It's about getting different variety of protein in and also vegetarian sources of protein as well. And then getting in enough vegetables and dare I say it, carbohydrates. We need carbohydrates. And I think I see this a lot in clinic as well. Ladies in particular are scared of fat and scared of carbs. And if we really expand our definition of what carbohydrates are, every single vegetable you eat is a carbohydrate.

It's about getting the right carbohydrates into the diet and on a daily basis. So that's pillar one. So that's nourish. Pillar on that, actually, I'm just going to just jump in there. I know you're describing those six pillars to me, but I think it's a really key point for people listening

in that there's a lot of extremes out there in the dietary world. And certainly in my own experience, a lot of people promote now a low-carb diet, which, again, I've never been a huge fan of the term. I do believe that actually diets low in refined and processed carbohydrates have a very useful role to play with many, many patients. But I've got to say, my female patients with hormonal issues, my own experience has been that they do better with a moderate amount of carbohydrates. But it's the right kind. It's the right kind, exactly. And I find they do great with things like sweet potatoes, parsnips, carrots, all these starchy vegetables, which nourish our gut microbiome. I find, particularly with women, I don't know if you've found that or not.

And I think exactly what you said there. It's also about nourishing the microbiome. And I've got that in my pillar too, which is balance. You know, I'm looking at blood sugar balance and the gut. The gut is so essential. You know, we say that disease begins in the guts. If that's where disease begins, that's where health has to begin as well. And we need to be feeding the good guys.

I call them my eco-warriors. And these are the microbiome, the gut flora, the good bacteria. These eco-warriors are essential for so many different functions. And one of those functions is absorption of nutrients. many different functions. And one of those functions is absorption of nutrients. And these nutrients are key because they are the cofactors for us to be able to synthesize. So to be able to make our hormones, to be able to use the hormones, to be able to convert the hormones into what we need at that time. So again, if we don't have a good microbiome, if we don't have good eco-warriors, we have another rate-limiting step.

So there's so many different things that we can fix in our own environment that we can take control of. And this low-carb, high-fat, I call it right-carb, good fats. So it's about getting the right carbohydrates in and getting the good fats in. The reality is, I think, for, you know, and this is where, you know, doing things that get sensationalized or in the media gets quite tricky, really, is how preaching a very similar message, which is it's about getting rid of the bad carbs, the refined and highly processed modern carbs that... That are everywhere. That are everywhere, that damage our health, that damage our gut bugs, and putting in lots of nice healthy natural fats. So one of the frustrations I have in general with health messaging is that a lot of us are actually saying 80 90 of the same

thing but we're we amplify the 10 where maybe people disagree and and you know and try and create these these these different camps because the reality is you know i don't think any group no matter what their dietary preference is i don't think any group says we should limit how many healthy vegetables we're eating. You know, well, maybe, you know, or tell me, do they? I've tried every single diet under the sun. I've boiled cabbage for breakfast and I've done crazy things in my day

to try and keep my weight under control. And the only time that I actually got it right, and I've been the same weight now for going on 12 years was when I changed my lifestyle. But I tried every fad diet out there. And I know that the two that spring to mind now, that I actually was scared to eat vegetables after that, because I thought, oh, no, I've lost the weight. And it was very high protein, very high fat. And the vegetable content was really low. And I actually started to fear veg. Really?

And I think this is, I just want to say this out loud, and I almost feel like I want to go stand on Oxford Street Corner like shout and say, stop the fad dieting because it's not doing our hormones any favors and it's not helping our health either. And I think that's where both of our approach to diet and lifestyle is about that balance. And it's about doing things consistently as opposed to becoming a perfectionist about it. Yeah, I think that's key, isn't it? Is, you know, we can put a bit too much pressure on ourselves to have the perfect diet,

the perfect workout regime. And actually and actually for many of us it's just making them good enough you know and one thing i you know and i probably evolved my thinking on this over the past few years you know because i've realized that a lot of patients who come in and see me now actually the diet is pretty good and instead of stressing out about an extra five ten percent improvement in their diet i think they're better off focusing on another pillar and actually getting bigger results quickly by going to sleep half an hour earlier each night, for example. Is sleep one of your pillars?

Absolutely. So it comes under restore. And as a new mum, so I'm going to call myself a new mum until she's 18, I'm sure. She's almost a year. And I still feel like I'm a a new mum until she's 18, I'm sure. She's a year, she's almost a year. And I still feel like I'm a new, very new mum. And I've been sleep deprived for 12 months. So it's really reminded me of how I was before in my party days. And then, oh, I didn't actually mention that I developed extreme insomnia as well. So I wasn't sleeping at all. And your brain just doesn't fire on all cylinders.

Like you just, there's, as we know, when we sleep, we restore and our brain actually detoxes as we sleep. And we're able to absorb new information and we're able to access little boxes with old information stored. And lack of sleep leads to poor food choices as well and doesn't allow you the space to be able to plan ahead because you're exhausted and you're trying to like catch up on that five minutes extra in the morning as opposed to going to bed a few minutes or half an hour extra in the evening and it's having a knock-on effect on our health. So have you noticed then you healed yourself, you got better, you felt great and then you become a mother? Yeah. And I think a lot of people who are listening to this are mothers, a lot of people will probably

echo that and really resonate with that. Has your hormonal health therefore declined a little bit over the past year? Absolutely. But I'm looking at it as a positive because I'm like, oh, yeah, now I remember how terrible I felt. Now I remember all those things. So I struggled to get pregnant. We had two miscarriages, unfortunately. And the last miscarriage was two months before I actually fell pregnant with Isabella. And I've got polycystic ovaries, as I said, and hypothyroidism. I had a history of eating disorders, low progesterone and adenomyosis as

well, which is just, it's a type of endometriosis. So it's also known as uterine endometriosis. So there's quite a few hormonal conditions that were happening. So I did struggle to fall pregnant. And when I was pregnant, I was also extremely anemic. So I was really tired. So I did struggle to fall pregnant. And when I was pregnant, I was also extremely anemic. So I was really tired. So I was not able to keep my energy up. And then once that postpartum period hits, I feel like I'm in fourth trimester right now. Your hormones are in the storm. Everything's happening.

I'm still breastfeeding. So, you know, the hormones are not able to settle. And I'm back in that period where I was before where I'm exhausted. I'm craving foods, energy, high energy foods. And sometimes I have absolute baby brains. I apologize to anyone that I thought maybe baby brain isn't real. I feel like it's totally real. I feel like my hippocampus, my memory center has absolutely shrunk.

And it has an effect. But it's interesting hearing that because that is real life, right? Because lots of parents, particularly mothers, will say, well, what am I meant to do? I've got a young child. And you know what? The reality is, it is hard. It's hard. It is hard.

And as you say, it's almost like a re-education for you, a remembrance that, hey, this is the impact it has. But hopefully when this period ends, you will be able to reprioritise that sleep. And, you know, just probably remind you of how important it is. You know, I stayed in London overnight last night. I was in a hotel next to St. Paul's Cathedral. I've never stayed there before. Do the bells go off all night? No.

All night. I wouldn't be able to. And I kept waking up and then I looked it up this morning on Google and said every 15 minutes the bell chimes and you know what? I'm feeling exhausted this morning I'm certainly not craving fruit and vegetables let's put it like that

and it's incredibly hard and then if you expand that out across the population many of us are sleep deprived now how many of the choices that we make, how much of how we feel, our hormonal health, our mood is down to the fact that we've just simply not slept. We've not slept and we're living at 100 miles an hour and we just have to keep go, go, go all the time. And we need to find that balance somewhere, somewhere something has to give because if we're feeling this exhausted and then we're not getting any movement either, or we're feeling this exhausted and we're pounding the treadmill at the gym, again, we're throwing that balance out.

Absolutely. problems. My menstruation's fine. But when we talk about hormonal health, it's not just sex hormones that we're talking about. We're talking about your stress hormones, as we said. We're talking about keeping that insulin balance. We're talking about your thyroid hormone, which is a peptide hormone, which I call my queen of metabolism. It's so important for brain function as well. And we're talking about your ghrelin and your leptin so your hunger and your satiety hormones all of these get muddled up if we haven't slept and we're not eating right and if we're not actually giving our body the nutrients it needs to go through the act of detoxification optimally or to ensure that you're having a poop a day yeah absolutely it's incredible and it's you know, what's

fascinating for me as I've been on this journey to understand the science of lifestyle and nutrition and how much, you know, how much biology it changes in our body. One phrase I have that I sort of came up with when I was writing this book, and it's, you know, consciously change your lifestyle to unconsciously change your biology. I love that. And I just don't think we realise as a society how important these things are, how many different conditions. Your book is directed around hormonal health, right? Yep.

But one of the reasons I didn't put my book around a particular area is because I'm thinking and I'm seeing more and more now how many different conditions or symptoms actually have the same root causes. And it's remarkable. Hormones, but also your weight, also your blood sugar, also your mood. Headaches, it's incredible. And as you are trying to spread this message to women about hormonal problems, which you're doing a fantastic job of doing, you know, I'm trying to raise awareness that actually a lot of these seemingly separate conditions are actually when you when you go upstream and you look at the root cause, they're actually similar driving factors behind all of them. actually similar driving factors behind all of them. And, you know, instead of, you know, as we were saying earlier, instead of people seeing hormones and lifestyle as separate, yeah, you know, well, what's, you know, what's the food I got to eat got to do with whether I'm having periods or not? You know, I think there is a disconnect. Absolutely. And sorry to interrupt you there, but I think we also need to move away from

this mentality of a quick fix pill. And I was definitely there. That replacement model, you're not menstruating, take the pill, you'll menstruate. As we know, it's the pill breakthrough bleed that's actually causing the bleed. You have a headache, take a pill, it's going to make it better. We need to move away from that. We need to move into this more functional model where we're looking at, okay, this is what's happening, but we need to move away from that we need to move into this more functional model where we're looking at okay this is what's happening but we need to look at the root cause if you think of it as a tree and we've got the fruit at the top and the fruit is rotting why is the fruit rotting well there's something going on with the roots and that's the same with health care we need to look at the root cause and what we know about genes and epigenetics at the moment is so exciting because

we have the ability to change what's going on in the body. And I'm not talking about it's going to cure you if you're going to eat a plate of kale, it's going to cure you of all your ailments. What I'm talking about is giving the body the tools that it needs to function optimally. I think it's such a great point you bring up. And, you know, I really would encourage anyone listening to this, if you're a female and you're struggling with your hormones and you've been going to see your doctor and you're not satisfied with how you're feeling despite treatment or despite that advice,

or if you're a male listening and your wife, your partner, your mother, your daughter is having issues, what I would encourage you to do is share some of the messaging in this podcast with them. Apply some is is you know share some of the messaging in this podcast with them apply some of my principles apply some of the principles that angelique is talking about and see where you get to it doesn't mean you don't need ever any hormones as you said you're taking a thyroid hormone which is helping you feel good absolutely and i i've got genetically low progesterone it's And I used a progesterone cream

right through my pregnancy as well. So these things are needed. But I think it's such a good point that you said there, because it's something that I mentioned in the book as well. Like following this 28-day plan does not mean that suddenly you don't have PCOS or suddenly you don't have endometriosis. What it will show you is that one, you're either going to feel so much better on it or two, we need to do further investigation to see what's going on. But by following the plan and following your principles and adopting what I call the 80-20,

the 80% of the time and where it's in your control, really sticking to these principles and 20% of the time where it's not in your control, let your hair down, have a pina colada. You know, it's not in your control, let your hair down, have a pina colada. It's about following a lifestyle 80% of the time. It's that 80-20 rule. So 80% of the time where you can,

and especially where it's in your control, really sticking and taking from these pillars that we both talk about. And 20% of the time, and where it's not in your control, letting your hair down and going with the flow. So it's not about forming these rigid rules around it either. But we need to make these changes because if we don't make the change, then taking a replacement model, taking a pill, I still had to make a lot of lifestyle changes and really actually look at my gut and my immune system to help with the Hashimoto's, the autoimmune condition, to reduce those antibodies

which are elevated in autoimmune so that my thyroid could function optimally on the replacement model. I think it's remarkable you share that. And I've got a patient of mine who came on to BBC Breakfast News with me recently to share her story. And this is a lady who has got an underactive thyroid. And she was on 75 micrograms of levothyroxine a day to replace it. So basically her body is attacking her thyroid. Her thyroid is not able to make enough thyroid hormone to give her the function that she needs to feel good in a nutshell and despite taking the replacement hormone and despite her blood tests all looking fantastic she was feeling dreadful

yeah exhausted couldn't function as a mother couldn't function as a wife she couldn't really function in her everyday life as she wanted to yeah and i think many women can relate to that and remarkably you know, again, her doctors were trying to do the best that they could for her with the knowledge that they had. But she was told, no, there's nothing you can do in your nutritional lifestyle. This is the condition you've got

and your blood tests look fine. Yeah, but doc, I still don't feel good. Well, you know, that's your condition. And I saw her in the National Health Service with a 10-minute consultation because I appreciate 10 minutes is not ideal, but there's a lot you can do in 10 minutes if you tune into it. And I helped her understand how the food choices that she makes will impact her immune system. And she has a problem with her immune system attacking her thyroid. She was like, okay.

So she changed her diet. immune system attacking her thyroid she was like okay so she changed her diet she went on to a much more whole food diet and she eliminated foods that i thought might be driving her problems including gluten actually because i i strongly was suspicious from what she was saying that gluten might have been an issue for her and in many cases with thyroid and especially if there's autoimmune yeah it can be it can be i mean we're all biochemically individual and we're not saying that one thing works for for everyone but it can be it can be and so i said we went with a trial with her like a 21 day trial you know instead of going for a load of testing and loads of blood tests was like okay i'll tell you what let's try this 21 days let's see how you feel and then we'll figure out what to do after those 21 days and by changing her diet okay by me teaching her how to meditate

and i taught her in my consultation how to meditate and then pointed her towards apps that would help her over two years not only does she feel better than she's ever felt before she's reduced her thyroid medication from 75 micrograms down to 25 micrograms a day. That's brilliant. So her condition's not been cured. She's still got it, but she feels good. She's thriving now and she's taking less medication. And the reason I'm mentioning this is we're not claiming to anyone that you're necessarily going to cure everything that you've got. We're just saying, I think, communally that lifestyle and nutrition

play a significant role in your hormonal issues. And it is worth trying to make some small changes in key areas and see where you get to. I absolutely love that. And I totally agree. And it's about just trialing it. Because let's look what you've done for the last six months, year, two years, three years. Okay, that obviously hasn't worked for you. Let's try another avenue and see if that works. And I just want to add that with the thyroid. So we take the replacement T4, so the liver thyroxine, that still has to be converted in the liver into your active form T3, which is what gets sent out to all the cells. So what you still need is your cofactors. And so you need your iodine, your B vitamins, your vitamin C, all of these nutrients that you get from your vegetables.

So it's really about getting in your vegetables on a daily basis. I call them my detox warriors in the book, and I've actually got a pillar called Cleanse. And I'm not talking about going on a strict detox. What I'm talking about is bringing in the cofactors and the nutrients that we need to help our body detox on a daily basis. So we're looking at your dark green leafy vegetables, your cruciferous vegetables, which are your broccolis, your cabbage, your kales. These actually help us to detoxify spent hormones in the body. So hormones that have been used up. Hormones that have been used up. And we need to get rid of.

Need to get rid of them. And they also help us, the fiber in these veg help us to fluff out the stool so that we're actually able to pass a better stool. And they feed our eco-warriors, so the good bugs in the gut. So it's win, win, win for everything involved. So I really encourage everyone to eat more vegetables. And I'm talking seven portions of vegetables a day here. But if you're only eating a couple of tomato slices a day that's okay start where you are and start building on that yeah that's what I talk about when I mean a lifestyle change because you're going to start bringing foods in on a daily basis that are going to help your health yeah they're going to help your

hormones and many other aspects of your health as well so I think we're coming towards the end but we've not quite got through your six pillars of balance yet I know we So I think we're coming towards the end, but we've not quite got through your six pillars of balance yet. I know we've, I think we've done restore. I think we've done nourish. We've done nourish. I think we've done cleanse.

Just done cleanse. Did we do? We haven't done balance. Balance, nurture and move. Have we done? We haven't got to them yet. Well, can you touch on those briefly? What those are?

So pillar balance is all about blood sugar balance, as well as balancing our microbiome, so looking after our gut function. And when we talk about balancing our blood sugar, I mean, that word gets bounded around a lot. We're all talking about blood sugar balance. But the reason why it's the cornerstone and the foundation really of hormonal balance is it helps to keep our insulin in check. So insulin is the peptide hormones or protein hormone that actually helps to keep our blood sugar levels stable. So we don't want too high blood sugar levels and things that can cause high blood sugar would be refined carbohydrates, refined sugars, and possibly even having far too much coffee and caffeine in the diet. And what happens when we have this elevated insulin

and these peaks of elevation of insulin, we get more testosterone being produced from the ovaries. Wow, it's amazing that, isn't it? Just by the foods that you eat can impact the hormones in such a big way. And if we're looking in particular for polycystic ovaries, we are often met with a clinical picture of elevated testosterone absolutely yeah absolutely that's incredible that's um one of your pillars is move now what kind of movement do you recommend for improving our hormonal health um i recommend getting movement

in on a daily basis and it doesn't have to be a gym session or Lycra and a sweat band every day. It can just be going for a walk. So we're reclaiming lunch break. During your lunch break, get your trainers on and go for a walk. Get some fresh air. It can be a yoga session, Pilates. It can be putting on YouTube in your living room and doing a Zumba class and dancing like nobody's watching. Whatever you want, hey? Whatever you want. But it's just getting that daily movement in. And I would say, especially where hormones are concerned, we don't want to overdo it. And I think as human nature, we can take things too far and we want to become and do it in excess. But what we need to do is we need to still keep that moderation. And I would say,

ensuring that you get weight training in as well yeah very important for women isn't it yeah and i think as women we think oh no it's cardio cardio cardio but no we need to be doing weights we need to be doing lunges we need to be doing squats these are the type of things that will actually help your hormonal health yeah it's a huge take home for me and actually a significant way that my practice has changed in the past, I'd say two to three years as I am prioritising strength training with women a lot. In fact, any of my patients who are listening will know that I taught them a lot about how they can start strength training. And yeah, of course, I can be in a gym doing squats and deadlifts, of course. I talk about something called a five minute kitchen workout that I detail in my book.

And there's a video on my website about this five minute kitchen workout. This idea that actually you can do strength training in your house, in your own clothes without any fancy equipment. Sure, if you want to go to the gym, that's fine as well. And what's the final pillar? And then we're looking at restore. Can I just say one thing on exercise? I use Isabella, my daughter, as weight. So I hold her and I squat with her and then I hold her and I do dumbbell press. That is fantastic.

You know, you can just get some movement in. And what I'm hoping that will also show her is how important movement is. As she gets older, we'll be doing things together. And I've noticed that's something that you do with your kids as well I do absolutely I do that I do you know when when the dinner's on if we're waiting for the spinach to steam or the sweet potatoes come out the oven I am there doing star jumps or squats with my son with my daughter it's a game why do I do it a it keeps me fit b it models that behavior that I would love you know I would love my kids to grow up you know I'm like every parent I'm trying to do the best that I would love, you know, I would love my kids to grow up. You know,

I'm like every parent, I'm trying to do the best that I can. I don't know if what I'm doing will lead to the results that I hope for them. You know, I don't know. I don't think any parent does. We do the best that we can. And that's what I certainly try and do is incorporate it into our daily lives. And I think movement for me, especially, I strongly believe that it's been a major part of my whole fertility journey because when I went through the first miscarriage, exercise wasn't a very big part of my life. It was more sporadic. I was doing it here and there. By the time I got to falling pregnant with my second pregnancy, I was exercising three times a week and going to with a personal trainer. I was really fortunate to have one down the road and we were exercising. Oh, wow.

And then I fell pregnant so soon again after and I exercised through my whole pregnancy. And as a PCOS sufferer, I truly believe that was one of the factors that really helped me carry full term. Oh, fantastic. That's incredible to hear and hopefully inspiring for people listening. We are coming towards the end. So I just wonder if you could briefly touch on your final pillar and then we'll do the conclusion. Okay, perfect. I talk so much.

But let's talk about Restore. So Restore is about giving you that me time back. It's about allowing your body to relax. It's about allowing yourself some head space. So I tell you to get lost, but that's within a book, you know, read something that gives you joy. Stop looking at your phone screen. That's something we haven't touched on. But, you know, something my husband said to me the other day, which I was horrified when he said, he's like, oh, let's watch, I think it was Dragon's Den. Let's watch Dragon's Den so

I can get excited about the program and you can stare at your phone. And I was like, oh my God. Something like a home truth sometimes is there and i was just thinking and that's why and you know like be kind to yourself as well but it's about losing that screen time because that in itself affects our melatonin production so our sleep production and just allowing that that time to restore and relax so self-care iscare is a necessity, not a luxury. And I think we've moved away from that in our fast-paced modern life. Yeah, I agree. And I think the thing you said that was really important for people listening,

I think, is that your husband called you out on your phone use. And I know in my own life, my kids often, you know, your kids can tell when you're not present, when you're in the same room but thinking about something else you know my daughter recently said daddy you're not listening to me are you and you know that we need that you know we we're here to promote health I try and live by the principles that I talk about but we're not perfect and I think it's really important for us to listen to that we're not perfect it's a constant battle we're trying in this fast-paced modern world to actually live these principles because we felt

the benefit ourselves we felt you know we've experienced the benefits with me through my patients with you through your clients um so you know it ain't easy um look angelique i i think there's so much more that we could have covered today and i know there's a lot you've gone into real detail on female hormones in your book the The Balance Plan, which, you know, I've recently found out not only is it published here in the UK, but it's also now, it's coming out in Germany soon. It's out in the United States, so people can go and get the book there now, I'm assuming, as well on Amazon and wherever else they choose. One thing I do right at the end of each podcast is to try and lead the listener with four simple tips that they can apply in their everyday life immediately to improve the way that they feel.

Have you got four quick tips for them? Absolutely. And I think the first one would be, let's get those blood sugar levels balanced. And that would be protein with every meal or snack, taking time to eat your meal, and getting rid of the refined carbohydrates and sugars. Great. Sleep. Prioritize sleep. If you need to get up earlier in the morning, get to bed earlier the night before. The best way to prepare for your day ahead is to get a good night's sleep the night before.

Great. head is to get a good night's sleep the night before. Great. Get some movement in. Make a plan. Meet a friend for a walk. Go for a walk instead of a tea and coffee date. That's a great one. And just get out there and get moving. Get some fresh air. Fantastic. And finally, pile those plates high with vegetables. We're talking dark green leafy vegetables, sweet potatoes, asparagus, whatever your favorite veg is, plus others that you're not eating. We want to get that fiber in to feed the eco-warriors. We want to get that, they're part of your detox warriors. So they're helping your body to detox, helping you poop because it's really important. And if I think about hormones,

I think of it as this beautiful Viennese waltz. And if you're currently walking around, we're feeling like your hormones are doing the hokey pokey, using the wrong feet, then you need to start making these lifestyle changes and do it consistently instead of trying to be a perfectionist about it. These are great tips. I'm sure the listeners are going to find those incredibly useful and hopefully can start applying them immediately into their everyday lives. But actually, I've got to say thank you for sparing some time in your busy schedule. You're a mother. I really appreciate you coming in today to actually talk to me, and I hope you manage to spread the word as far and wide as you possibly can.

And perhaps one day I can get you back on the podcast to talk about some new developments. I would love that. And thank you so much for having me. And once again, I am just so happy that you are spreading this message so far and wide. And I'm just so thrilled that I could come and talk to you today and actually just to sit here having a chat with you has been amazing. So thank you. Thanks. That's the end of this week's Feel Better, Live More podcast. Thank you so much for listening and I really hope you found the conversation useful but also enjoyable. If you're not already, I'd highly recommend that you subscribe to this podcast so that you can be notified when the latest episode of my podcast comes out. I'd also

be incredibly grateful if you consider going onto iTunes and giving this a five-star rating so that I can get this information out and reach more people. It really does make a difference. And if you have any suggestions for people you'd like to see me have conversations with on this podcast, I'd encourage you to get in touch with me on social media using the hashtag feelbetterlivemore. You can find me on Facebook and Instagram using the handle at DrChatterjee and on Twitter using the handle at Dr Chatterjee UK.