Whether you’re approaching your 30s, 40s, 50s, or are well into your later years, you’re likely experiencing big and little health changes that may make your life seem messy and out of balance. Yet all too often, we don’t get the caring medical attention we deserve and need. This can have a huge impact on everything from your body image and moods to your physical health and relationships. And if you add perimenopause and menopause into the mix, life can get even trickier and more challenging. Could paying attention to stress and healthy food be the key?

Today, I’m joined by a wise and wonderful functional medical practitioner, Carrie Levine, who knows how messy health and life can be. Author of the fabulous book “Whole Woman Health: A Guide to Creating Wellness for Any Age and Stage,” Carrie offers powerful tools to help you be your best self at every age and stage of life. Topics discussed include stress, work-life balance, sleep, whole foods, healthy foods, relationships, relaxation, self-care, vegetables, vagal nerve, cortisol, biochemistry, gut health, women’s issues, HRT, hormones, and sex drive.

Please note that this episode may contain sensitive material; listener discretion is advised.

Emergency Assistance Note: If you or someone you know needs immediate support, please call your emergency services. In the US, 24/7 help is available by calling “911” or “988” (Suicide and Crisis Hotline). Support/informational links are in the show notes.

IMPORTANT DISCLAIMER: No expert in this (or any episode) is offering medical or psychological direction; the content is purely informational in nature. Please consult your physician or healthcare provider before undertaking any new regimen or procedure.

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Connect with Dr. Carla Manly:

Website: https://www.drcarlamanly.com

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Books by Dr. Carla Manly:

Joy From Fear: Create the Life of Your Dreams by Making Fear Your Friend 

Date Smart: Transform Your Relationships and Love Fearlessly

Aging Joyfully: A Woman’s Guide to Optimal Health, Relationships, and Fulfillment for Her 50s and Beyond

The Joy of Imperfect Love: The Art of Creating Healthy, Securely Attached Relationships

Imperfect Love Relationship & Oracle Card Deck by Dr. Carla Manly:

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Connect with Carrie Levine:

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LinkedIn: https://www.linkedin.com/in/carrie-levine-cnm/

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The HUGE Health Benefits of Reducing Stress and Eating Well!

Create a Healthy Body, Mind and Spirit by Reducing Stress and Eating Well!

Whether you’re approaching your 30s, 40s, 50s, or are well into your later years, you are likely experiencing big and little health changes that may make your life seem messy and out of balance. Yet, all too often, we don’t get the caring medical attention we deserve and need. This can have a huge impact on everything from body image and mood to physical health and relationships. If you add perimenopause and menopause into the mix, things can get tricky and even more challenging.

I’m joined by a wise and wonderful functional medical practitioner who knows how messy life and health can be. This very special guest offers uplifting, practical solutions to help you be your best self at every age and life stage. For this episode, we’ll focus on this reader’s real-life question.

“I’m 34 and dealing with perimenopause already. It affects everything from my focus at work to my sex drive. It’s killing my relationship with my fiancé. I can’t get into sex at all. Not to be dramatic, but my skin is sagging more every day. It’s not just my face, but it’s my arms, legs, neck, thighs, all of me. I’ve never been overweight, but I’ve added a few pounds in the last year.

The worst part is the mood swings, but the hot flashes aren’t pretty either. My doctor said it’ll get better, but that’s no help. My friends don’t understand because it hasn’t hit them yet. My self-confidence is in the toilet. Do you have any feel-good tips?” With that question as the focus of this episode, this is Imperfect Love. Please note. As this episode may contain sensitive information, reader discretion is advised.

I’m joined by a wonderful special guest, Carrie Levine. Carrie is a functional medicine practitioner and the author of Whole Woman Health: A Guide to Creating Wellness for Any Age and Stage. Welcome to the show, Carrie. It’s such a joy to have you with us.

It’s a joy to be here. Thank you for having me.

Carrie’s Contemplative And Quiet Way Of Being With People

Before we launch into the topic of the episode, a big subject matter, which is interesting and broad, could you tell our readers a little bit about what makes you you?

It is probably my serious, contemplative, quiet way of being with others and with myself.

Healing The Body Through Functional Medicine

I love that. Serious, contemplative, and quiet. That’s beautiful. Contemplative is something that we can certainly use more in the realm of health and wellness. Thank you for that beautiful backdrop. As we move into this reader’s question, I love it, and I chose it and paired it with you because it addresses so many issues. Regardless of whatever age bracket somebody is in, there are pieces of it that we can all learn something from.

There’s the idea of skin not doing what we want it to do, sex drive not doing what we hope it will do or wish it would do, or a partner wishes it would do, and weight gain. There are all of these issues, as well as mood swings. There’s a lot to unpack here. Before we jump into that piece, you are a functional medicine practitioner. Could you explain to readers what that means? It is so that they can absorb what a great approach it is and how it gets to the root of things, rather than looking at the superficial elements that somebody might see or feel.

Functional medicine is a systems biology approach to chronic disease and illness. What that means is that people who practice functional medicine are looking at the ways in which things are interconnected. There’s a great meme that says everything is connected to everything, as opposed to a conventional medical model. Instead of looking at symptoms in silos the way conventional medicine silos health issues, like if you have a mood issue, you might see a psychologist, if you have a weight issue, you might see an endocrinologist, or if you have a digestive issue, you might see a gastroenterologist, from a systems approach, all of those symptoms may have a common thread that’s rooted in biochemistry.

My job, or people who practice functional medicine’s job, is to find the underlying physiology that’s driving the symptoms, with the understanding that everything is connected to everything. An example of that is skin eruptions like eczema or psoriasis often have a gut-related component because the home of the immune system happens to be in the gut.

People don’t necessarily think that what they eat or the health of their gut microbiome has anything to do with their skin. There’s a little example of how functional medicine connects seemingly unrelated symptoms and can work to help rebalance physiology, so people have relief as opposed to prescribing one medication for that symptom and another medication for that symptom.

There are a couple of pieces that I love about functional medicine, but one is that, in general, functional medicine practitioners lean heavily on nutrition and lifestyle. There’s a lot of talk about how people are living, how they are sleeping, how they are moving, and how their relationships are. That is part of the dialogue. At the core of the model is the mind, body, and spirit. There’s a little bit of room in the room for that aspect of health, which is dear to my heart.

Addressing The Root Cause By Listening To Your Gut

I’m all in. It sounds fabulous. Being a body, mind, spirit person myself, this is an episode I’m going to thoroughly enjoy and learn from. You’re already saying things that I’m saying, “Tell me more,” but I will try and stay on topic. When we look at the gut, that enteric nervous system, everything that’s in the gut and how important that is, could you explain more about that? We often think of the gut as the stomach and the intestines.

Maybe you have eczema on your face. I have a friend who has a skin issue, and they’re giving him a cream to put on it. The cream is the regular drugstore type of cream that you’ll get with a prescription. I’m not going to go into that piece except to say it’s creating a topical treatment. When he stops using that medication, it flares up again. From what you are saying, which is right up my alley, there’s something going on in his system that would need to be adjusted to clear it up and give him relief in the short-term and, more importantly, long-term. Did I get that right?

Yeah, 100%. You’re speaking to another meme within functional medicine, which is that functional medicine is root cause medicine. I might say root causes because very rarely is there one thing that’s driving somebody’s health issue. I talk about the gut as Grand Central Station. If the gut is not functioning optimally, it’s not possible to have health at all because it is the home of inflammation, the immune system, and neurotransmitter production, neurotransmitters being hormones that affect mood like serotonin and GABA.

Inflammation is something that drives many health issues. Inflammation may drive muscle pain, joint pain, fatigue, and depression. It might not just be gas, bloating, constipation, or diarrhea, but it’s there as well. It can be itching, skin issues, or a hormone imbalance. There are over 100 trillion organisms that live in our intestines, and they are supposed to be there. The fact that they’re there isn’t necessarily the problem. The problem arises when the environment is such that some of those organisms that are potentially disease-producing can proliferate, or there’s not enough good bacteria to keep the offensive line of the immune system strong. It’s fascinating to me.

Let me give readers some context. I have a very small practice in Midcoast Maine. I take care of only women, and I am primarily cash. Already, people who see me, for the most part, are self-selected. Their baseline level of health is above average. Many people find me because they haven’t gotten the help that they have wanted.

Still, when they do a stool test and we look at the bacterial colonization in their gut microbiome, the good bacteria are low. It’s not something I understand because, in general, the women that I take care of, it’s not their first rodeo. They’re largely engaged with their health. They’re doing what they can to the best of their ability. That does not mean being perfect, but they know vegetables are probably good for them and that too much sugar probably isn’t awesome for them. They bring some understanding of nutrition and overall health to the table, and still, the beneficial bacterial colonization is low. The clinical term for that is insufficiency dysbiosis. I am stymied. I don’t know what’s driving that.

The things that generally would compromise our gut microbiome are eating food that’s inflammatory for us. That could be things that are good for us. It could be chicken, kale, and almonds. Once we eliminate processed food, eating too much of even foods that are good for us can be too much. It could be medications. Any pharmaceutical is going to affect the health of the gut microbiome. Lipopolysaccharides, which are chemicals that are present when there are high levels of potentially disease-producing bacteria.

The wild card that I am most fascinated with is stress because of the two-lane highway between the brain and the gut called the vagus nerve. That highway is bidirectional. Meaning, stress can be real or perceived. That will affect the gut microbiome, and/or the gut microbiome will affect our depression, anxiety, energy, those kinds of things. Finding this prevalence of insufficiency dysbiosis at this time in this population makes me wonder what the impact of stress is on our physiology and our health. That was more than what you were asking.

It’s such a perfect place to start. We’re seeing so much stress in elementary school, kids, teens, and people in their 20s, 30s, 40s, 50s, and 60s. It tends to drop off a little bit more for people in their 60s and 70s. We’re seeing so much stress, whether it’s about politics, environment, relationships, disconnection, loneliness, or whatever is causing somebody stress, whatever is contributing to that.

People think that all of the anxiety that’s swelling up in the world is normal, and it’s not. We have this heightened stress response. Our stress response is intended atavistically to be something that arises when we are threatened by a lion, tiger, bear, or intruder. We address the threat, and then we go on and live our normal life. The parasympathetic nervous system comes on board. We chug along. We’re doing great. There is no stress in general until there is another intruder alert like that.

People are feeling stressed from every direction, whether it’s the greater world, their relationships, or posts they’re seeing on social media that are scaring them, or they’re comparing themselves. There are all of these stressors. It makes sense that even as many privileges we may have in many areas, we have a lot of stressors coming from not just the internal world, but the external world.

Achieving Better Physical And Mental Health Through Stress Management

My sense, too, is that there’s a lack of community. We no longer have Mom living in the house next door or around the corner. We no longer have Grandmother to watch the kids. We no longer have one parent at home who can focus on what the kiddo might need. I’m not saying that a parent should be at home, but the point is, many people are alone and isolated. All of this can raise our levels of cortisol, and cortisol is not good for our systems in the long-term. Before we get to the reader’s question, could you talk about that piece about the stress response and why it works against physical health and mental health as well?

Yeah. I alluded to it already in that of real or perceived stress. It’s important to identify that the stress can be the tiger, or it can be thinking about the tiger if that’s stressful for you to think about. There’s a real calling to do what we can cognitively to keep our thoughts quiet or peaceful so that we’re not contributing to what’s happening in the world around us.

That message is going to travel through the vagus nerve to our gut microbiome and change the colonization of who’s there, who’s growing, and who’s not. That becomes part of the physiologic basis for an endless number of things. Whether that’s irritable bowel, chronic fatigue, fibromyalgia, joint pain, muscle pain, eczema, depression, or anxiety, that vagus nerve highway is central to our overall well-being.

The other part that I find many women are not aware of is the HPA or HPG axis. The way in which our brain, our thyroid, our ovaries, and our adrenals, the primary producers of cortisol, other stress hormones like epinephrine and norepinephrine, and another hormone called DHEA, which is the precursor to testosterone, which is the precursor to estrogen, all of those organs are interrelated. What’s happening in one affects the whole loop.

When I talk with women about stress, particularly when we’re talking about hormone balance, which will segue us into your reader’s question, that axis is crucial and always in communication. There’s a natural shift that happens with midlife. When ovarian hormone production starts to slow down, then there’s going to be a preferential burden to the thyroid and the adrenals. That is part of why there’s so much hypothyroidism that pops up midlife for women, because that whole axis is trying to adapt to what’s happening. Also, this is why our resilience in terms of rebounding from stress declines. It’s because that shift in ovarian hormones is already putting a lot on the adrenals.

Typically, by midlife, when that ovarian hormone production starts to shift and change, women haven’t necessarily been super awesome to their adrenals and managing stress. We typically have been growing careers, caring for families, or not taking the best care of ourselves for whatever reason. When that ovarian hormone production starts to shift, the system can’t always adapt, or there’s a lot of turbulence that happens as the system tries to adapt.

It’s so important in my mind that women understand the intersection of stress and hormone balance. I have seen women not unlike your reader be in perimenopause, and then as they have tended to their lives and the stress in their lives and taken slightly better care of themselves, some of the symptoms abate. They abate because the whole loop is not pressed and stressed.

That makes perfect sense. You’re looking at the whole system, not just saying, “It’s the onset of perimenopause.” It sounds like this person’s doctor said, “Wait it out,” or, “It’ll get better. Don’t worry.” You are saying that if we learn to soothe or calm down the system and start to work with the full circle of what’s happening, then some of this person’s symptoms may naturally abate.

Slow Down And Focus On What You Are Doing

Let’s look at this individual. I know you can’t give medical advice to a specific person, so we’re looking globally. What would you say about what they’re experiencing? I know there’s a lot to address, but it sounds like there are mood and focus issues, sagging skin, a little bit of weight gain, and low sex drive. What would you offer as several key tips that they could look at and begin to make changes in their life, other than lowering stress? Feel free to focus on that issue as well.

For this particular reader, the first thing that caught my attention was her age of 34. That age of onset requires a thorough medical evaluation to make sure that there’s not something else endocrinologically going on. The guidelines are any hormone shifting that happens after the age of 35 is thought to be “normal.” Prior to that is a little bit of a, “Do we need to rule out some other things here?” My first qualifier would be a full medical workup to make sure that there’s nothing else going on.

Once we are sure that all of that was normal, the starting base for conversation for me all the time is stress, 100%. How are you living? What does work look like? How many hours a week are you working? Does that feel good in your body? Does it feel too much? Does it feel like you have to because you need to for the money? Do you have enough time off? Do you have enough time in a day to take care of yourself?

Some people leave for work at 6:00 and get home at 6:00. Where on that workday is somebody exercising, goofing off, relaxing, having time for food preparation, or seeing the light of day even? That is part of the conversation. What is the situation at home? What does that look like? Do you want to be there? Do you not want to be there? Does it feel like a healthy environment?

Can I pause right here? That is so rich already. If they’re working, whether it’s 6:00 to 6:00, 7:00 to 7:00, 8:00 to 6:00, or whatever it might be, I love how you said, “How does that feel to you?” There are certain people for whom working twelve-hour days feels good. They don’t feel stressed from it. They have different needs. They may get exactly what they need in the evening, and they may sleep well. Maybe they don’t need a ton of sleep. They may have great relaxation on the weekends.

For them, that will work. Yet, for somebody else, working from 7:00 to 5:00 or 7:00 to 4:00 may feel like far too much. Maybe they have little ones at home. Maybe they’re caring for a parent or grandparent.You said this as well. Maybe home life isn’t good, or it’s too stressful, so they put in whatever their workday is.

We don’t know about this reader, but in their relationship, especially because of the sex drive issue, sometimes, that can create a cycle of big disconnection. Maybe work doesn’t feel good. It sounds like they’re not feeling connected to their friends because the friends don’t get them. The primary relationship, the romantic relationship, isn’t feeling good.

That sounds to me like this person is not feeling supported and is having some stress in their romantic relationship. At work, if they’re losing focus, that wouldn’t feel very good. It may be that during their waking hours, they’re not getting a reprieve. If they don’t get a reprieve, then that stress keeps carrying on. Thank you for asking us and the readers to slow down and focus on not what other people are doing, but what we are doing, what areas feel good and healthy, and what areas feel stress-inducing. Thank you. That’s incredible. It’s so rich.

You’re welcome.

We’re ready for more.

These are the foundations. If that doesn’t work for someone, why would they feel good on a super fundamental level? One of my favorite things to do is pull women out of work for three months because it’s even hard to know what’s what. If you’re zooming along every day, where is there time for reflection? How do you know how you even feel if you’re constantly charging along?

Find Better Ways To Eat Healthy

Once we talk about stress, the next place I go to is nutrition. Food is our first medicine. Junk in, junk out. What is somebody eating? Are they meal-skipping? Are they eating one meal a day? Are they eating a lot of processed food? Are they eating a lot of sugar? Are they eating a ton of carbohydrates? Are they drinking a lot of alcohol?

What does it look like? Are they eating vegetables? Are they getting protein? Are they getting healthy fats? These foods provide the biochemical substrate for the substances that we make in our bodies that make our bodies work. We’re either going to work well mechanically or not well. Are we supporting good function, or are we stressing good function?

There is also a lot about hormone balance and the importance of fiber as being crucial for healthy hormone detoxification. Is this woman pooping? Pooping is primary for estrogen detoxification. If somebody’s constipated, first of all, why? Second of all, what’s going on in their gut microbiome? Third of all, are they drinking enough water and moving their body enough? How might not eliminating be contributing to hormone imbalance? It’s because estrogen is detoxed in the stool. If the stool is sitting in our body, that estrogen is going to be resorbed back into the bloodstream. By the nature of not pooping, we are contributing to a hormone imbalance.

To anybody reading, no matter your gender, if you’re not pooping right, pay attention. I didn’t know. I know it’s so important to have our regular bowel movements for overall health. I had no idea what you’re talking about with the reabsorption of hormones. It makes sense. It’s still sitting in your system. I have a question. Let’s say there are toxins in your food or processed food that you’ve been eating. For somebody who might have a fast-food kind of diet, would they also be reabsorbing some of those toxins if they don’t have regular bowel movements?

That makes sense to me.

Readers, that is another reason to make sure you’re pooping. Great conversation.

I talk about poop a lot because I talk about gut health and digestion a lot for all of the reasons already stated. I do want to mention one more juicy tidbit that not a lot of people are aware of. When there is bacterial overgrowth in our intestines, there can be elevations of an enzyme called beta-glucuronidase. Beta-glucuronidase can also bind estrogen and circulate it back into the bloodstream. This is a gut hormone intersection. When there’s an overgrowth of bacteria in the intestines, it can contribute to a hormone imbalance. Another reason why gut health is essential for everything.

How To Get The Right Amount Of Fiber While On The Go

You are doing a great job of emphasizing how important our gut is. I knew it was important, but I didn’t quite have this level of understanding that I’m already getting, so thank you. Let’s talk about fiber for a minute because it’s so important. I’m a vegetarian, so I tend to get plenty of fiber. For people who aren’t vegetarians or people who may be vegetarians but maybe not getting a whole lot of fresh fruits and vegetables, what might you point them to?

I have a garden. Some people don’t have a pot where they can grow some fresh herbs. What would you recommend? I know there’s a lot of talk about teens and up taking fiber supplements like Metamucil. What would you suggest as a primary source of fiber for somebody who’s a bit on the go or not inclined to go to the store and purchase good, fresh fruits and vegetables? Maybe they don’t have access to them.

I am always encouraging people to eat food first before going to supplementation. A lot of the reason that people don’t go to food first is because they’re too busy, which is part of the conversation, or because they don’t know how to cook some of these foods because they weren’t foods that they grew up with. We talk about that.

In food groups, particularly for women, I’m always stressing the brassicas, which are broccoli, kale, Brussels sprouts, and collards. These are foods that not a lot of people necessarily have a lot of experience or palate with. Our local health food store takes SNAP, which I love. People on assistance can go to the health food store and buy. A lot of our local farmers will also take food stamps. I appreciate that where I live is probably a little bit unique in that way. There is access here. Then, there’s whether you have the time to cook it, and then what you do with it if you don’t know how. There are resources for all of that.

I do recommend food first. As many vegetables as anybody can get in. In fact, that’s part of the nutrition advice or guidance that I often will give people. If we never meet again and you walk away with one pearl from this encounter, my hope is that you will walk away and understand the importance of eating as many vegetables as you can possibly get in your body on any given day.

For someone who’s on the fly, that’s an interesting question. I would probably recommend the vegetables that you can eat raw that require no preparation. I would be looking at the little baby cucumbers that you can grab and eat. It could be baby carrots, radish, or snow peas that you can grab and eat raw, and you don’t have to prepare in any way.

I’m trying to think of the rest stops. At the rest stops, you can get a hard-boiled egg. You can get a little hummus and cheese. I know the rest stops are trying. I’m trying to think of what I have seen at the rest stops for vegetables other than pickles, which is not the worst choice. It’s better than nothing. Sometimes, you have to do what you can do and let it be enough. Maybe it’s pickles. I’m not sure.

What I would recommend would be something like a grocery store chia pudding. You can buy chia pudding that’s already made in some grocery stores. Chia seeds are very high in fiber. It’s also high in Omega-3 fatty acids, which are super anti-inflammatory. I would probably steer people toward chia pudding. I would also steer them toward pumpkin seeds and sunflower seeds, which are not vegetables, but are going to be high in fiber. Seeds are going to be high in fiber.

Thank you for pausing with that. I’ve heard about chia seeds before. They are those little gelatinous things. I’ll give them a 2nd or a 3rd chance. I love how you paused to help readers think. Think about when you see a smorgasbord of vegetables. When you go to the grocery store, think, “Would I like to try a little bit of cilantro? Would I like that red bell pepper? How would that taste cut up?” Give things a try. Find out what feels portable to you or not.

This is the first year I’ve grown kale. I wanted to grow it because I’m aware that if you’re not buying it organic, there can be a lot of pesticides in it. Readers, if you haven’t heard of the Dirty Dozen, every year, there’s a Dirty Dozen that’s published that tells you what top fruits and vegetables you need to buy organic. The ones on that list are the ones that have the most pesticides, herbicides, fungicides, and that sort of thing.

People often think that if you’re buying organic, it’s necessarily more expensive. That’s simply not true. I know that when I shop sometimes, and I buy organic carrots, they are exactly the same price as regular carrots. I love how you invited that sense of playfulness. Look and play. I know in the grocery store I like to go to, I ask often, “What’s your freshest vegetable?” or, “Could you tell me more about this one?” If it’s a small community market, they often have good employees who can tell you a lot about what something is high in or not. Ask questions. Get curious.

I love how you said food is our first medicine. Many people were raised because that’s what life offered for many decades. It’s only recently that we’re coming back to the awareness of whole foods. There’s no blame or shame here, but if you are raised on processed cereals, processed lunch, and processed meats, this will sound new. It is easy to get a box of mac and cheese, a can of whatever it is, or a microwave meal, but if you can start working in 1 meal a day or 1 meal a week, even that’s whole foods, it’s a lot less complicated than you might think if you find the right recipes. What do you think?

100%. It’s wise to take baby steps to find one food that you’re curious about and let that be the only new thing that you do that week. Sustainable change doesn’t happen in leaps and bounds. It happens one tiny moment at a time, and it often involves a lot of failure. You might buy collared and be like, “That was terrible.” It might take another week, two, or three before you have the courage to be like, “Fine. I’m going to try kale and see what I can do with it.” This is how change is made. It’s work.

Understanding The Many Benefits Of Eating Whole Foods

We make it playful work if we enter into it. I love how you brought up collard and kale. If you have a neighbor that you’re close to, you can say, “Do you want to split some kale with me?” That way, if you don’t like it, you give it to them or something. You find playful ways of bringing in whole foods. I’m assuming that readers know what I’m saying when I say whole foods. Would you please explain what that means?

Yeah. I like to talk about whole foods as foods that we could hunt or gather. If we were left to our own resources, there are foods that we could get from the natural world that don’t need to be packaged in any way. The other guidance is to shop the perimeter of the grocery store, primarily. It’s not that you never have another tortilla chip or cracker. That’s not what we’re talking about here. We’re talking about shifting the balance of some of that, where the tortilla chip is the exception and the fresh avocado is the norm, or whatever the case may be.

The other tip that can be helpful for people in terms of fiber or nutrition is this concept called Eat the Rainbow, which was coined by a woman named Deanna Minich. I believe she was the one who coined it. She has a website with all kinds of resources on it about what is eating the rainbow and what foods are in each category.

It’s this concept of trying to make sure that every day, we eat some red foods, some orange foods, some yellow foods, some green foods, and some blue foods. I’m not talking about M&M’s. I’m talking about whole foods, like blueberries, purple potatoes, purple kale, collard greens, oranges, lemons, clementines, cherries, berries, red peppers, yellow peppers, green peppers, summer squash, zucchini, winter squash, acorn, butternut, and kabocha. It’s not that the skin on the squash matters.

The point is, eating foods that have diverse colors exposes us to diverse phytonutrients, and that enhances our nutrition. It’s harder to get that and harder to assimilate it through a supplement. It’s possible, but still, these nutrients were designed and evolved to be taken in within a complex, not necessarily isolated in a supplement form.

It is deciding that nutrition is medicine, deciding that it is worthy of some money and is worthy of some time, and restructuring a week so that there is some time for food preparation. It doesn’t have to be complicated. When I talk to people, I’m like, “Get yourself a rotisserie chicken and salad in a bag. There you go.” It’s like fast food, but not quite. Sometimes, that’s the starting point. That’s going to be better than a frozen dinner that’s probably got chemicals, a lot of carbohydrates, probably some sugar, and some not-awesome oils. It is trying to be realistic.

The other thing that I talk to people about is double and triple recipes. Nobody wants to cook every night. I should rephrase that. Not many people want to cook. Most modern people’s schedules preclude that from even being an option, whether it’s meetings, involvement, or because we want to get to the gym and there’s no time for both. It could be whatever it is. Double and triple recipes so there are leftovers for a lunch or two and another dinner or two. You’re only cooking two or three things, and you’ve got the week.

It’s wonderfully put. I was working with a client who has a busy lifestyle. Some of this would apply to this person because they are fitting in so much, and then by the time the end of the day comes, they end up eating something sugary, packaged, or whatever. I’m trying to address a few of the components you’re talking about with a no-blame, no-shame, baby-stepping kind of approach.

This individual could, on a Sunday, set out some time to create a nice batch of chili or something. It could be vegetarian. It could have meat in it. Chili is something that’s great to freeze and put in the refrigerator. It could be a prepackaged salad. It could maybe be a lasagna or something that is easy to create. It’s done in an hour or two on a Sunday.

If they’re able to do this toward the end of the day or even in the morning, 1 or 2 days a week, they can use that as meditative time. If they’re not rushing and they see it as time to slow down, cook for themselves, and make space for that, it could shift the game a little bit. For somebody who’s high-powered, maybe they’re better off going to the grocery store and getting a pre-done chicken or something. It is realizing there are lots of ways to play with it.

The end game, if I’m hearing you right, is to take baby steps and not call yourself a failure. If something’s not working out, try something else. Start making these changes in your diet. I love how you said to eat the rainbow. I’d never heard of that. That’s fabulous. There’s a lot of playfulness to that. Take some play.

You talk a lot about messiness. It’s okay for it to be a little bit messy and not to work. Find out what works for you. Look at your entire life as far as your work, your sleep, your stress levels, and your relationships to get a sense of not judging yourself, but finding out, “What’s going well? What’s not going well? Where can I start making these little shifts?”

Do Prebiotics And Probiotics Really Work?

Many times, people say, “I take a probiotic,” or, “I take a prebiotic,” and they think that that will fix everything. I haven’t found this out. I’m going to ask you. I’ve read that a lot of times, the prebiotics and probiotics, whether they’re being taken in pill form or in a drink, are destroyed by the acids in the stomach before they’re even absorbed. Is that accurate?

There is controversy around the benefit of a daily probiotic. When I dive into it, I land on still advising people to take a probiotic. I spoke about the insufficiency dysbiosis that I see on testing, the prevalence of that, and the remedy for that. This brings us full circle back to the vegetables. Eating vegetables is going to be our best source of fiber. That fiber becomes the fuel for the cells in our colon. That fiber gets digested and fermented by our microbiome into what are called short-chain fatty acids. Those fatty acids are crucial for digestive wellness overall.

Good bacterial colonization. That probiotic, to me, is a little bit of insurance. It’s like doing a little bit of the work for us. Maybe that’s because we’re stressed, or because we had a cocktail or two, or because we had a piece of cake or ice cream, or we take pharmaceuticals or any of the things that might diminish that good bacterial colonization. That is the basis on which I make that recommendation. I feel a little bit like it’s a low-hanging fruit in terms of insurance that we’ve got some good bacteria going on, trying to keep things balanced.

Are Smoothies Really Good For Your Body?

That sounds fabulous. I have another question. It came to me. I’m not a big smoothie person, but I know a lot of people who are smoothie fans. They take their protein, and they put the kale, spinach, and blueberries in. Does that make a difference to the body, whether it’s something that we chew or something that’s already blended for us?

It’s an interesting question. It is true. Our digestion, some would say, starts with our eyes and our nose. Looking and smelling food can begin our mouths to produce some of the enzymes that we need to begin to digest food. Then, there’s the action of chewing food as opposed to having it pureed for us. What happens when we chew? What happens to the enzymes in our mouths? What happens to our central nervous system in terms of the primitive brain being like, “Here it comes. I’m so happy I’m going to get fed.” How does all of that mind and body affect digestion? It stands to reason in my mind that eating and chewing food is optimal.

I will also make smoothies in the warm months. I’m not anti-smoothie. It can be an amazing and tasty way to get nutrient density that takes work otherwise. If you can put your coconut milk, protein powder, nut butter, seed, green vegetable, and a few berries, you’re done. To put all of that on a plate and make it tasty would probably take more time and energy than zooming it through the smoothie or zooming it through the blender.

I’m not anti-smoothie by any stretch, but I say this to people. A part of nutrition guidance is that you don’t want to be eating the same thing every day, even if it’s healthy. People come in and say, “I have this every day,” even if it’s eggs. They’re like, “Eggs and veggies, I have it every day.” It’s not ideal. I encourage people to have 3 or 4 different breakfasts, lunches, and dinners that they can then loop and rotate through.

That makes perfect sense. Ages ago, somebody had talked to me about how our ancestors had the seasons of the year, and they were often moving, so they weren’t getting our systems. Our systems are still pretty much based on more ancient biology. Our bodies are not used to having the same food. Our ancestors had winter, spring, and summer vegetables available.

When You Should Get A Hormone Replacement Therapy

There were different crops throughout the year. They had different meats that were more plentiful at certain times of the year. I agree with you. Having a lot of rotation as much as possible is probably good for the body. That makes perfect sense to me. As we prepare to wind up, I love how you’ve addressed this reader’s question in a way that I hadn’t anticipated. I thought you were going to go into hormone replacement therapy.

I’m happy to do that, but we would need more time. We can have a conversation, too.

We’ll have to have you back. I was so interested in that, but what you offered us is something that is so much more relevant to people of every gender. What you’re saying makes so much sense.

I work with people to try and shore up their foundation first to the extent that they feel able. Once they’ve done what they can in that regard, if they’re still not where they want to be, then we talk about hormone therapy. Plenty of women come in and are like, “This is what I want,” which is completely fine. I’m about supporting people taking care of themselves the way they want, but I am very sure to tell them if they’re living a bonkers life and they’re not taking care of themself in any way, it is unlikely that the hormone therapy is going to get them entirely where they want to go.

Thank you. One of my big takeaways, and I hope that the reader who wrote in and all the other readers take away, too, is you’ve given me a huge reminder of the importance of looking at your life, body, mind, spirit, paying attention to where stress is leaking into your life, and focusing on how stress is one of the biggest enemies to emotional health, mental health, physical health, and overall health. Thank you for that reminder or that wake-up call.

To the reader who wrote in, I love how you were saying to start looking at the foundation. Check your relationships. Check your work. Pay attention to your food. Pay attention to your stress level. They should also check in with their doctor to have a full workup done. By starting with having a healthy foundation of healthy living, then maybe they can see what symptoms disappear, if their focus gets better, or if their sex drive gets better. I don’t know about the skin, but skin is affected by what we eat, for sure. It makes sense. Thank you.

You’re welcome. I do want to also be clear and say that some women feel so terrible that addressing their lives is not possible. Sometimes, starting with hormone therapy and taking the edge off, so to speak, gives them the leg up. I don’t know how else to talk about it. Let’s say, for example, someone isn’t sleeping right. It is hard to exercise if you are tired because you’re not sleeping. That’s a good example of starting with hormone therapy so that someone can sleep. They have better energy, and they can then deal with their food and move their body.

It’s not always linear. It’s very rarely a linear process. I want to emphasize how much our life influences our hormone balance and how we feel increasingly so with age. I will use hormone therapy as a tool to help someone take the edge off so that they can then look at their life and figure out, “Where can I modify here? What can I do? How can I support myself?” It’s not necessarily an either-or scenario.

Thank you for emphasizing that. A piece that we didn’t have time to talk about is the importance of sleep and progesterone in particular at bedtime. I’m not giving medical advice here. I’m following what you’re saying, particularly before bedtime, that people can do such. That alone can be a game-changer.

We don’t know what the individual’s sleep routine is like because it wasn’t mentioned. When we have a deficit of sleep, it does affect sex drive, cognition, and our bowels. It affects everything, so sleep is so critical here. You have so much information to offer. I’m going to have to read this episode a few times to take it in. I’ll have to have you back to discuss HRT with us. That would be lovely.

Let’s do it. I can talk about that, too, for sure.

Get In Touch With Carrie

Thank you. Where can our readers find you?

Instagram, Facebook, the World Wide Web, and LinkedIn. It’s @CarrieLevine.cnm on all those channels. I’m not on TikTok and Threads.

Thank you so much for sharing your time and wisdom with us. It’s been such a delight.

Thank you.

You are welcome. To our readers, thank you, as always, for sharing your time, energy, and journey with us. It’s such a pleasure.

Important Links

• Carrie Levine
• Resources – Carrie Levine
• Carrie Levine CNM on Facebook
• Carrie Levine CNM on Instagram
• Carrie Levine CNM on LinkedIn
• Whole Woman Health: A Guide to Creating Wellness for Any Age and Stage
• Dr. Deanna Minich
• NAMI HelpLine
• Mental Health and Relationships – MyHealthfinder
• Chronic Stress and the HPA Axis: Clinical Assessment and Therapeutic Considerations
• Stress and Inflammation – The need to address the gap in the transition between acute and chronic stress effects
• Dr. Carla Manly’s Website
• Dr. Carla Manly on Instagram
• Dr. Carla Manly on X
• Dr. Carla Manly on Facebook
• Dr. Carla Manly on LinkedIn
• Dr. Carla Manly on YouTube
• Dr. Carla Manly on TikTok

About Carrie Levine

Carrie E. Levine, CNM, IFMCP is the founder of Whole Woman Health, and author of Whole Woman Health: A Guide to Creating Wellness for Any Age and Stage. As a certified nurse midwife and an Institute for Functional Medicine Certified Practitioner, Carrie evaluates and treats most common women’s health concerns, incorporating gynecology and functional medicine.

Previously, Carrie practiced gynecology and functional medicine at the world-renowned Women to Women health care clinic in Maine from 2006 to 2014. Prior to that, she practiced full-scope midwifery at Miles Memorial Hospital, now LincolnHealth, in the beautiful mid-coast Maine town of Damariscotta.

Carrie is known for her ability to listen to and relate to women. For more than twenty years, she has been working with her clients to identify personal health goals and then to break those goals down into attainable steps. She looks for the underlying causes of illness, seeking to connect the dots of seemingly unrelated symptoms and emotions. By supporting women in setting and achieving their own health goals, Carrie helps her patients thrive emotionally, spiritually, and physically.

Carrie earned a Bachelor of Science degree in Public Relations and Women’s Studies from Syracuse University. She went on to earn her RN and MSN from Case Western Reserve University. Her certificate in Nurse-Midwifery is from the Frontier School of Midwifery and Family Nursing.

She is a member of the Maine chapter of the American College of Nurse Midwives, the Maine Nurse Practitioners Association, and the Institute for Functional Medicine.