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Conception Pregnancy Feb 26, 2020
13 Minutes

Ask the expert: how your cycle is the fifth vital sign….

We are big believers in knowledge of your own body as power. Sometimes, you just need to know where to look. We spoke to Dr Antoinette Falco an expert in female hormone health. She talks to us about her own journey with an undetected Thyroid condition and autoimmunity. She also talks to us about the importance of proper testing, listening to your body plus how to get your hormones in balance as well as some every day things that can throw them off. Finally we discuss how as women we should be better informed about the contraceptive pill and most importantly how we can rebalance our bodies as we get ready for pregnancy. Phew! 

To listen to the full conversation with Dr Falco click to hear our podcast here. Otherwise read on for the key highlights from our discussion!

It all started with my own experience…  

I practise as a naturopathic doctor and fertility awareness educator. However, my journey into a specialism around hormone health really started from personal experience. Something that started back in my early 20s. I had no major symptoms (or so I thought), but I went for a routine test as I had a family history of Thyroid issues. Frankly, I was blindsided by what I learnt subsequently and it really kick started my entire journey into hormones. 

What quickly became clear is how powerful our hormones can be disrupting our bodies: 

The results showed I had elevated TSH (Thyroid Stimulating Hormone) and Hypothyroidism. I was put on medication straight away which took time to get right. During this time, I had a load of symptoms flare up as we tried to get the correct dose: tiredness, weight gain and acne. What became very clear is how vital the thyroid is and how involved it is with so many processes in the body. 

I did not have what I deemed to be major symptoms: which isn’t uncommon…they were in fact ‘normal’ to me: 

Into this diagnosis, I was not having the alarming symptoms that are traditionally associated with a thyroid condition. Something that is actually quite common. The trouble is, a lot of the symptoms of a thyroid condition can masquerade as other things. For example, if you have a lot of stress or if you’re working hard (as I was while studying) being tired and run down can feel ‘normal’. I thought this was also behind my heavy, painful, irregular periods.  

The big thing that was missed… 

It wasn’t until I was in medical school that I learnt the importance of getting  COMPLETE thyroid testing. Including testing for Thyroid antibodies. When I got mine tested I was shocked.

I have never seen antibodies as high as mine were…. 

And I have seen a lot of thyroid blood work! When I saw mine, I was in complete shock. So, not only was I dealing with hypothyroidism, it was now undiagnosed Hashimoto’s. This is an autoimmune condition (essentially where the body attacks itself). The trouble is most clinicians will deal with the autoimmune part in the same way that they will deal with a thyroid issue. Essentially just trying to manage your symptoms. Often the antibody part doesn’t get addressed despite the fact it is completely different. 

An important lesson I learnt: 

From my own experience, I could see first hand the big difference between a regular Thyroid test vs a full panel. The reality is that a regular thyroid/TSH test captures just a very small piece of the puzzle and ended up missing a big part for me.

The trouble is, as a diagnostic tool this is now outdated: 

In many cases (including Canada where I practise) a TSH test is the first test that is done. However, the research that is behind this as a diagnostic marker for the Thyroid is pretty outdated. With it we are only looking at such a small piece of the thyroid puzzle. I always encourage my patients to advocate for a full panel. However, because of the way that healthcare works in certain places and the fact it costs money can make it tricky.

It’s not so simple: 

However, the reason it is so important is because you need to know. Are you dealing with an autoimmune condition? Are you dealing with a conversion issue? (By that we mean the conversion from the inactive form T4 to the active form T3). The active form is what goes into all cells in the body, so if you cannot convert to that form you will have a problem. Something that won’t be picked up from TSH alone. 

Finding the root cause: knowledge is power: 

The reality is that the autoimmune condition: for me Hashimoto’s can come on first. This can be an issue before you get a signal from TSH. In fact, it can be the reason for a worsening thyroid (as your body is attacking it). The sad part is that if people knew this and treated it, it could even potentially prevent the thyroid deteriorating.

Some of the things I think are behind the rise in autoimmunity… 

Ultimately we live in quite a toxic world. Food is not grown how it used to be, we are genetically modifying foods, chemicals and antibiotics are everywhere. I definitely think this is contributing to more issues for our immune systems. 

The power of the gut microbiome:

I discovered that my own journey was linked to leaky gut. My own sensitivities (which were not displaying symptoms) were gluten and dairy. I removed both from my diet and within three months the antibodies were down by half.

With food sensitivities you don’t always feel major symptoms: 

I never struggled with what I thought were digestive issues, but the sensitivities were clearly contributing to an autoimmune condition. If I had symptoms, perhaps I would have done more about it.

The link between the gut and immunity: 

In medical school because our approach was more holistic we talked in detail about the immune system and how fundamental it is for all aspects of our bodies. Gut health is linked to this. As is hormone and mental health. We know that 70% of our immunity starts in the gut.

Your body will tell you what you need to know: you just need to know how to listen to it: 

Frankly, if I had not had my own first hand experience, and the first hand difference it made I may not have thought to look into gut health and other causes of autoimmunity/thyroid. I was lucky to have been supported by the right practitioners.

Find someone who will listen to you and your what your body is telling you: 

Patients know when something is off. You need to find someone who will listen and to get the right testing done in order to get the full picture. If the person you have is not doing that then find someone else. 

Healing my hormonal balance: 

The first step for me was to look at my triggers: stress and adrenal health was playing a big part, particularly for my Thyroid. So I had to get on top of my self care practises and building adequate time for this. Adaptogens were a big part of this too – these are herbs that help support adrenal and hormone health. Ashwagandha/Withania not only helps with adrenals but helps with T4 to T3 conversion. Click here for more. 

Probiotics were also important. However, I learnt I couldn’t introduce them until I had removed the triggers (for me were dairy and gluten). It is important to do this first and also to go step by step. 

Food as medicine:

I am a food is medicine kind of practitioner. You are eating multiple times a day. What you put in can be really powerful. For me fermented foods, prebiotics and all the crucial vitamins and minerals can go a long way. 

Stress: our ‘new normal’: not good for our hormones: 

This chronic low level anxiety absolutely contributes to hormonal imbalance.

You can have all the supplements you want, but if you’re not dealing with the underlying….

I always say that we can throw all the supplements you can think of at you, however, if you’re not finding a way to cope and manage the stress in your life you will constantly hit a wall and you won’t see much benefit. 

Developing coping skills and strategies for stress is the hard work. You have to make a conscious effort to do it. However, it is the deep root for your health. High cortisol or constant low levels will impact your body’s ability to make reproductive hormones and can cause an imbalance. 

Other common things that I see play a role from our modern lifestyles:  

Our modern diets are certainly contributing to insulin resistance. Too much particularly refined  sugar – they create a physical stress on the body. We know that inflammation drives hormonal imbalance. It is all interlinked. 

Estrogen Dominance: 

There are definitely more components in our environment that make this more of an issues. Xenoestrogens: are chemicals that the body registers as estrogen and will react to that. However, because they are not actually estrogen it creates a hormonal cascade. This can include things like BPA in plastic or till recipes. In packaging and Tupperware. It is everywhere and can be hard to avoid.  

Time to clean out your beauty cabinet: 

They are also rife in our beauty and personal care products. The reality is we are exposed to thousands of hormone disruptors even before we leave the house. Phthalates and Parabens are well researched and documented as disrupting your hormones. Click here for more. They are rife within our personal care products however.

Take a look at the ingredients on the back. If there are a lot, particularly full of names you cannot pronounce then just put it back, as it’s likely to contain potential hormone disruptors. The good news is that we now have the Environmental Working Group’s resource: ‘Skin Deep’. You can type any product in and it will give you a rating. Click here.

The contraceptive pill: nothing is for ‘free’ when it comes to your hormones: 

I always start this conversation saying that I am not anti birth control. At the time it was created, it gave women choice. Options that we would not necessarily otherwise have had. That was huge. However, what I am against is the not having ‘informed consent’ this is where I feel we have hit a wall. 

It is all about knowing what you’re dealing with: informed consent: 

The reality is that as many as 70% of women are being put on birth control for reasons other than pregnancy prevention. It is being given as a ‘solution’ for an imbalance. That is where I have a problem. The pill is not ’fixing’ or regulating. In fact, it is further disrupting your natural hormone rhythm and patterns. It is a band aid over symptoms. To the point where when you decide to come off it your body will have a transition period. 

It can take up to a year to rebalance your hormones post the pill: 

I say that if you’re on hormonal birth control and you’re planning on having kids in the near future this is something you need to be really mindful of. It can take a while for your body to regulate and women are not always made aware of this.

The drivers behind this: 

It’s good to actually understand what the contraceptive pill does from a hormonal standpoint. Generally the pill uses Progestin which is a synthetic hormone that effectively shuts down the communication between your pituitary gland and your ovaries. That means you aren’t getting the hormones that trigger ovulation.

So, when you come off the pill the body is trying to reestablish this communication to start the production of progesterone. This is the hormone you produce post ovulation.

The reality is when you take the birth control pill you are not taking something naturally produced in the body. That’s important to understand. Progestin is used in fact to terminate a pregnancy vs. Progesterone which actually helps thicken your lining and prepare your body for pregnancy. 

How to help your body after coming off the pill…. 

I have a ‘post pill’ guide up on my website. Click here.  However, in a nutshell there are many things you can do to support your body’s adjustment.

Phase One is the release phase: this is releasing toxins, detoxing the body. This involves you five major detox organs: that being liver, gut, kidneys, skin and lungs. That phase is really foundational. We need to make sure organs like the liver which is crucial for metabolising and producing hormones is at it’s best.

Phase Two: awareness: its about using your body and cycle as a diagnostic tool. Your menstrual cycle is a vital sign. It gives so much information. As women we are so lucky to have this extra tool to understand more what is going on in your bodies. Then you can learn your cycle and understand birth control better without synthetic hormones.

Phase Three: replenish: we go into a deep dive in what your body needs to replace the nutrients which may have been eroded during long term use of synthetic contraceptives. 

The liver is super important for our hormones and balance: 

When it comes to liver detox, a compound found in cruciferous vegetables helps in allowing phase II detoxification in the liver. Starting your day with a smoothie full of things like Kale, Broccoli is a great start or a mixed greens. Making sure you’re drinking enough water and making sure your bowels are excreting excess hormones. So regular bowel movements will help with this. 

An extra helping hand to consider…. 

When it comes to the liver I also like to recommend Castor Oil packs – you can put it over the liver. This helps with the cellular turnover. If you want to have a stronger effect you can add some heat. You can do this on a regular basis. However, if you put it on your abdomen it can increase the flow of menstruation so be mindful of that.

Cellular regeneration and turnover essentially helps clear away cells that are not metabolically active. Allowing them to be broken down and new ones to emerge. 

Your cycle as a diagnostic tool: 

There are so many things it can tell us. We just need to be listening out. One thing to watch out for is when you have Short Luteal Phase. This is the point from ovulation to your period. On average this stage will be between 12-16 days for most women. However, if it is below 9 you may have Short Luteal Phase which could mean you are not producing the crucial hormone for pregnancy maintenance: Progesterone. In fact not enough of this has been linked to early miscarriage.

Supporting your body for a health pregnancy: the Corpus Luteum: 

Progesterone is produced following Ovulation by the Corpus Luteum. This is what remains as an egg is released from the follicle on ovulation.

The health of your Corpus Lutem us very important for progesterone production. Some key nutrients are Vitamin C, Iodine and Zinc.  We need enough as the Corpus Luteum will produce progesterone for the first twelve weeks of pregnancy. When it is not producing enough, it can lead to miscarriage. 

Things that contribute to a progesterone problem…. 

  • BMI too high/too low
  • Stress
  • Under active Thyroid
  • Extreme exercise
  • Aging
  • High Prolactin

Once again: coping with stress is crucial, but it doesn’t have to be a huge thing: 

It can be something simple, taking a walk. It can even be awareness that you need a bit of space. Even taking two minutes to give yourself some space and relaxation so you are not permanently in the fight or flight response. Make it easy, realistic and enjoyable!

Click here for more on Self Care from expert Suzy Reading. 

Some things I have learnt and do for my own health: 

I learnt to be better at listening to my body. When you have an autoimmune condition you can’t push yourself – or at least I cant. I have to rest when it says rest and especially when it comes to exercise which I love.

My self care is constantly evolving. It doesn‘t always need to be meditating in a dark room. I really struggled at first, but once I lifted that pressure and instead did things I enjoyed like being outside or petting my dog it really helped me get into a meditative state. If you want to meditate it will happen but it can take a while to calm the mind. You need to be a bit patient. 

Much better awareness of my environment: keeping it simple:

I am super conscious of my food, what it comes in and my beauty cabinet. When I first started on this path I got rid of so much and now I keep it simple. We can easily fall into the trap of feeling like we need to buy all these specific products, but you don’t actually need them.

It’s the same when it comes to cleaning products for your home. You can actually make your own – using things like vinegar and essential oils. Generally I keep my lifestyle minimal and simple. Water is another big thing, making sure you’re drinking filtered water. There are a lot of simple things you can do to make your environment better. I am also really particular about plastic of course.

All about the small changes:

 It can be overwhelming to make these changes and it won’t happen overnight but one thing at a time and over time you’ll start to feel good. As parents you are also setting an example for your kids about mindful decisions it can filter to the next generation. 

If you’d like to hear more from Dr Falco check out her website here. 


This article is for informational purposes only. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. The information on this website has been developed following years of personal research and from referenced and sourced medical research. Before making any changes we strongly recommend you consult a healthcare professional before you begin.

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