Ep 31 - Feeling irritated, moody and fatigued? Maybe it’s not in your head. With Dr Miranda Myles
Dr Miranda Myles is a naturopath, acupuncturist, homeopath, herbalist and nutritional medicine lecturer. She's also the founder of The Fertile Project, a clinic in Albert Park that I have the pleasure of working from when not in a pandemic!
Listen to the full episode on Apple Podcasts, Spotify, Google Podcast and more.
Broadcast: October 1, 2021
Here is a snippit of our conversation…
Amy: Miranda and I had a really great conversation recently. I'm sure many women listening have had that experience where you've gotten some results back from the doctor and the doctor has said ‘You’re fine, it's all within normal range – what you’re feeling is in your head.’ Those of us who have felt that may walk away feeling really deflated and frustrated because we’re anxious, fatigued, our moods fluctuating, we’ve no get up and go. Maybe there's no libido and we start questioning, is it the pandemic, is it just because of the enormity of what I'm dealing with or is it something else?
Miranda: So firstly, it's not all in your head. That's number one. And number two, the pandemic on top is just on top of what can be happening for us in our age group. So from your mid-forties, your hormones naturally start to drop. The first hormone to drop is progesterone. And progesterone is associated with dopamine and GABA, which are two of our neurotransmitters. And dopamine is like our hormone of reward and satisfaction. And GABA is our calming hormone. So if you imagine progesterone's up, GABA's up here, dopamine's up here. But as we start to go into that peri-menopausal stage, or just basic hormone changes, progesterone drops, and what goes with it is dopamine and GABA. And so our sense of calm and our sense of relaxation and enjoyment drops as our progesterone drops, which is all naturally what's happening as we get older. And then what happens with that is that we get this imbalance between progesterone and oestrogen. And we've all heard about oestrogen dominance - it's a term that's bandied around all the time and oestrogen is associated with serotonin. Serotonin is our happy hormone. And we would naturally think ‘Cool, oestrogen’s high so then serotonin's high, so we’re going to be really, really happy.’ But it's an imbalance, right? If you've got too much oestrogen and too much serotonin, that presents as anxiety if it's not balanced against the dopamine.
We may no longer feel like Wonder Woman…
We talk about the balance between oestrogen and progesterone all the time. That's one of the big hormonal things we talk about. But deeper than that is the connection with the serotonin, the dopamine and the GABA. So suddenly as the progesterone drops, dopamine's dropped, GABA's dropped. So GABA is our calming neurotransmitter. So suddenly we're not calm. Dopamine is our home of satisfaction. So suddenly we're not satisfied sexually, emotionally, physically. We're unhappy with everything and we're stressed and anxious and irritable and frustrated. We tend to think about oestrogen as this beautiful hormone, which it is, and serotonin is our happy hormone. And that's what makes us able to take on the world and run a business and be a mum. But if there's too much oestrogen and too much serotonin in balance with the progesterone and dopamine then we no longer feel like Wonder Woman.
Amy: But when the results come back and when a doctor says that the results are in range, what are they missing?
Miranda: So what happens is when you go and get your thyroid tested is they're testing TSH, which is Thyroid Stimulating Hormone. And that's the hormone that comes from your brain. So it's actually not testing your thyroid, it's testing your brain. So TSH comes from the pituitary gland in your brain and TSH then comes to the thyroid to tell the thyroid what to do. So TSH from the brain, when they measure TSH, they're measuring your brain's communication with your thyroid. We then want to know, what's happening to the thyroid - is the thyroid then producing T3 and T4, which are the actual two thyroid hormones. But if TSH is in range, they don't test the thyroid hormones because the TSH is seen to be the regulator of all of those thyroid hormones. So the thought is if TSH is in range, then T3 and T4 will be fine. But it's just not the case. And the range for TSH is really, really big and you can be at the lower end, lower normal, or upper normal. And you're still told that your thyroid's fine.
The good news is this: It’s not in your head.
Amy: And so can that test be done through GPs?
Miranda: It can, but most of them don't do it. A lot of the functional practitioners, an Integrative GP, naturopaths will do it. And it comes up often that there's a thyroid thing and women literally sit there, opposite me at my desk and just burst into tears because suddenly it's like 'Oh my God, it's not all in my head'. It really is so problematic because it is just so confusing to be experiencing all of these symptoms.
Amy: And certainly like the irritability and the low mood, the lack of libido, let alone the weight gain, but it makes you question what else is going on, you start blaming other things in your life and questioning your relationship, questioning the direction of your business and questioning all of these things, when actually it could just be your hormones.
Miranda: I think, I think the cool thing to know is that your thyroid, your stress hormones and your sex hormones are all interfering with each other. They're all impacting each other, and they all impact each other because they're all regulated by the same gland. And when that gland, is trying to do its job, it's trying to make sure everything is balanced, but stress puts so much pressure on the pituitary glands that cortisol goes ‘I can’t, I've only got enough energy now to focus over here because the stress has gone up.’
You know your body best.
Amy: So there's obviously not a one size fits all approach to helping somebody here, but what are some of the crucial things women should do from here?
Miranda: There's a couple of things, a couple of approaches that I would take. So the first thing is I would sit with someone and just say ‘Okay, you know your body best. You know that there's something that feels different independent of what blood tests say.’ And there's a lot of educated guesses. You can make some really good educated guesses and just go, all right, this is what I think is going on - as some women are telling me their hair's falling out, if they've got three of the myriad of thyroid hormone symptoms, that's enough for me to go 'Okay, I think we better just give your thyroid a bit of a tweak'. Those three are common - hair is dry or thinning or falling out, constant fatigue, and unexplained weight gain, or difficulty losing weight. Those three things are enough for me to go you know what? Let's see. Give your thyroid a bit of a tweak, but really if we want to get down to the nitty gritty of it, then I would be doing a proper extensive thyroid panel and seeing what's going on there.
Amy: Can acupuncture help?
Miranda: So acupuncture can help enormously, lifestyle and dietary changes, but I use a lot of herbs and a lot of nutrients to support the pathways. Alcohol would be problematic, because alcohol makes your stress hormones worse, and then that all feeds back again … and you know, for some people to have a glass of wine once a week, that's not a game changer. It's more about, I think women feeling like ‘Oh my God, it's not all in my head’ because that's literally, how many of my patients tell me that they feel until we actually sit down and have this conversation and I can draw it for them.
Getting back in balance...
Amy: If somebody is experiencing a number of these symptoms, how long can it take for them to feel a sense of balance?
Miranda: It's a hard question. So there's immediate therapeutic value in knowing that it's understood right? That someone gets it. The knowing that something can actually change it, it doesn't have to be like this forever. And then when we start treatment, we start addressing some of the stuff. I'd be wanting to see something different in six weeks. Now having said that, depending on what's going on with the thyroid and hormonally, it can be longer – it can be up to six months, and if it's extending beyond six months, then I would be feeling like we're missing something, there's something else at play.
Amy: You can find Miranda’s wonderful work at www.mirandamyles.com.au.