Sarah Greenfield on Your Gut, Hormones and Learning From Your Poop


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Katie: Hello and welcome to “The Wellness Mama Podcast.” I’m Katie from and, that’s Wellnesse with an E on the end. This episode is all about the gut-hormone connection and what you can learn from your poop. I’m here with Sarah Greenfield, who is a functional dietitian and founder of the “Fearless Fig”. She helps high-achieving women cut through the noise and find what works for their body specifically using labs, functional testing, biohacking, and much more. This episode was a lot of fun because we got to go deep on the gut-hormone connection and why it’s so important, the gut markers that give insight into hormones, how cortisol comes into play, the blood-sugar connection, how undereating can cause hormone issues for many women, the importance of magnesium for your hormones, and how do you add it up a bit it in your diet, what to do about the supplements, how to handle if your estrogen is high, the benefits of removing certain foods, and how to optimize sleep. We also talk about how willpower is often overestimated as a tool especially when it comes to hormones and better ways to solve their problem using good habits versus willpower and depleted decision-making resources. She’s a wealth of knowledge. This was a fun, fun conversation. And I know you’ll learn a lot, so let’s jump in. Sarah, welcome, and thanks for being here.

Sarah: Yeah. Thank you for having me. I’m so excited.

Katie: I’m excited to chat with you. This will be such a fun conversation, but before we jump into so many directions I wanna go, I have a note in my show notes that you recently started playing the drums. And I’m so curious. I have to know what led to that.

Sarah: Good question. I have been in this nutrition world. It’s been my career and my passion. It’s so interconnected into who I am and I really wanted to step outside of that and do something that wasn’t physically related or nutrition-related, and just, like, break out of that world. And I always wanted to play the drums. Like, it’s been on my heart for so long. I remember even when I was a little kid, they were like, girls play the flute and boys play the drums. And I was like, okay, I guess I’ll play the stinky flute. And the drums have been on my heart and I was just like, “I’m ready. I’m stepping into this, it’s time, let’s do it.” So, that’s kind of how it happened.

Katie: I love that. I love hearing about adults taking on a new project or especially like a creative or, like, something out of your comfort zone. That’s something that I saw the value in a long time ago and started having yearly, like, every year I have to do something that scares me or that’s new or hard because I think it helps us grow so much as people. And so, for me, it was voice lessons and this year standup comedy, but it’s just been so fun to get a challenge. I love that you’re doing that. And also I know in your work world, you talk a whole lot about the gut and hormone connection. And I think this is a topic that seems to be increasingly important right now because we are seeing a rise in so many issues. And I hear from so many women who have various types of hormone struggles. And I don’t feel like this is being talked about enough in the mainstream medical model and even, I feel like it’s just starting to be understood even in integrative models. So, to start broad, kind of give us an overview of what you mean by the gut and hormone connection and kind of the pieces that come into play.

Sarah: Yeah. So, I spent a lot of time thinking about the gut, doing stool testing, really getting into the microbiome. So, the bacterial balance that we have in our gut, which is our mouth to our butt is essentially our gut. And really just trying to understand what is going on there and how is it impacting the rest of the body. Because when we look at hormones, that’s typically downstream of a gut imbalance. And I find that everything that we start to play around with, or every symptom is really correlated back to the health of the microbiome. And when I start digging into that and asking different questions and, you know, having people look at their poop or having them poop in a French fry container, which is, you know, this is how we do the stool test and ship it off to a lab and we start to look at the types of bacteria, it really starts to open up and allow us to see what’s going on in the body. And there’s different markers, something like beta-glucuronidase is one that I look at that is a big kind of insight factor into how the body is re-circulating estrogen. So, when that is out of whack, typically I’ll see people with more, like, estrogen dominance type symptoms. So, it’s really crazy when you start to put the pieces together and just start honing into the gut what you can find about the rest of the body and how it’s functioning.

Katie: Absolutely. And I think estrogen dominance seems to be very much on the rise right now. I’m hearing from a lot of people and we know there’s a connection there with things like, I believe PCOS and endometriosis, we see some estrogen issues. I’m sure many others as well and I know from the statistics I’ve read, even infertility seems to be on the rise and there’s an obvious hormone connection there. So, you mentioned that one lab, are there other labs you look at as well? Or how can someone get a picture of what’s going on in their gut that might be affecting their hormones?

Sarah: Yeah, so I started with the gut. I also look at, cortisol levels. That’s another really big one that can show us just how stress is being managed. I often talk to my clients a lot about, well, how do you feel from a stress perspective? And they’re like, “Oh, I’m pretty good.” But I think we’ve learned as a society to really kind of exist with a high level of stress and normalize that. So, when I look physiologically at how the body is actually responding to stress, oftentimes I’ll see a different picture. So, we’re looking at adrenal function, we’re looking at that cortisol output. Are you making enough? Are you not making enough or is it deactivating to cortisone? So, there’s a lot of little clues that our body leaves us into that stress world, and getting a better picture of that. So, yeah, that’s another way.

I also look at blood sugar regulation. That’s a huge one. I think oftentimes we forget that insulin is a hormone and so our blood sugar fluctuations are going to be impacted by our hormone status as well. When we are stressed out, if cortisol is high, that up-regulates our blood sugar. So, we just get this whole imbalanced picture and you mentioned PCOS and that can have insulin dysregulation component to it as well. But really kind of digging back into that, my whole question is where is this coming from? What is the root cause? What is going on here? And a lot of times it’s in the gut and it’s inflammation and figuring out, all right, how do we really start to pull these apart and understand where these imbalances are starting from.

Katie: And I love that you brought up stress because I think this is another topic it’s no secret, especially in the past couple of years, that stress is on the rise. But I think often stress gets put in this box of feeling mentally stressed or overwhelmed. And in my experience, that’s just one tiny piece of the pie when it comes to stress. And often, we don’t realize that other things like the food that we’re eating, if it’s causing inflammation is a stress in the body’s mind. And it doesn’t differentiate. Like, we may not feel stressed, but if our body is dealing with that, we are operating in a state of stress. Same thing with, for me, unresolved trauma was a big part of it. I was constantly in fight or flight, so it didn’t matter how perfect my diet was or how many supplements I took. Until I was able to feel safe in my body, I was always operating in a state of stress and fight or flight versus rest and digest. I feel like this could be a series of books all on its own, but just starting with the stress component, what are some tips for starting to dismantle and unpack where the stress from the body’s perspective is coming from?

Sarah: Yeah. So, I always think about it in a couple of ways. Like you mentioned, there’s our perception of stress. There’s what we are kind of seeing in our day-to-day that elicits stress like an email, a confrontation, our emotional status, like, that is stress. But also you mentioned the food we’re eating can create inflammation that can create burden on the body. That is stressful. If we’re not eating enough, that’s another form of stress. So, oftentimes I’ll work with women and they’re like, “Oh, I’m doing all the right things to lose weight. I’ve cut my calories. I started exercising more and I feel awful and I’m just holding onto weight.” Well, our bodies are stressed out from the jobs that we do, the parenting that we do, showing up as mothers. There’s so many things that stress us out baseline, and then we’re gonna cut our calories and up our exercise. Those are two more forms of stress and then along with toxic burden. So, that’s another one that kind of ties back into that hormone conversation as well. We really have to be aware of what we’re coming in contact with on a day-to-day basis, because all of these different chemicals can really change the way our body’s interacting, producing hormones. And that can also burden our bodies, especially if we have an imbalanced gut and then we’re not detoxifying and taking those things out, it just creates more metabolic chaos in the body.

Katie: I’m so glad you brought up the issue of, like the kind of the chronic dieting and women not eating enough because I don’t think this is talked about enough either. And even with a background in nutrition, this was a blind spot for me for a long time after having had Hashimoto’s, I have had six kids. There was a lot of weight gain that came with that. And so, I had been in this kind of chronic dieting mindset for a long time. And when I actually started tracking, I realized I was drastically undereating. So, my body thought it was starving all the time. I was not getting enough protein or enough micronutrients. And so, I had to break that mindset and even understanding the science of it. It was hard to get myself to start eating enough calories and protein and everything at first. And it was actually, like, I had to track to eat more, and I had to remind myself to eat more. Do you see that with a lot of women, especially with hormone imbalances?

Sarah: Oh yeah. That’s probably one of the core components is we’re afraid to eat because we’ve been told that food leads to weight gain, and then we’re afraid of fat and carbs, mainly carbs. I think fat we’ve kind of gotten over that one a little bit more, but there’s still this really intense carb fear. Maybe things like the keto diet have kind of sparked this idea of like, no, carbs are bad, but when you look at getting adequate calories, feeding your microbiome, this is a huge one that I always look at. It’s like, we need really complex carbohydrates, beans, and red rice, brown rice, quinoa like, all of these different carbs are really important. They have polyphenols that feed our microbiome and also these carbohydrates fuel our adrenals. And that’s a big conversation in the stress world and also sleep regulation. So, like, that’s so, so important. Because maybe you experienced this, when you cut your calories, when you’re in this chronic dieting, when you’re depleted your sleep is also impacted, which then makes it hard to recover from stress. And it’s just this whole domino effect. So, I think we really have to…I spend a lot of times kind of reminding my clients that food is okay. We have to really heal our relationship with that because as women we’ve been told that food is not our friend.

Katie: Yeah, absolutely. I know for me, that was, life-changing just the energy and the mental clarity and everything that came with actually surprisingly fueling my body the right way. But like you said, this is, I feel like a very tough mindset to break for a lot of women because we have been told for so long that food leads to weight gain. So, any tips for, I know we’re also individualized, but for each of us figuring out our own metrics of what we need to be consuming without gaining a lot of weight because that is so scary for a lot of women, are there ways to kind of experiment and dial that in?

Sarah: Yeah, I mean, I always like to kind of take it back to the body. So, one of the things that I work on really deeply with my clients is empowering them in their own bodies to feel like, okay, I got this, I don’t have to be reading the newest articles that are coming out and feeling like I’m not doing enough or I’m not taking the right supplements, but really getting back to what works for each individual person because it is very individualized. But the first thing, I mean, I always take it back to, like, let’s start with looking at your poop and really getting clear on how things are being processed in your body because you are what you eat, but you’re also more importantly what you absorb. So, if you start looking at your poop and noticing, wow, okay, like it’s really hard, it’s really loose. I see pieces of food in there, I’m not going enough, I’m going too much, like, really dialing into what that looks like can give you that internal report card and really show you what’s happening on the inside.

Because we don’t get a lot of data from our internal body, but we do poop quite often. And it’s so fascinating to really look into that and say, what is this telling me? What can I start to uncover and learn? And there’s so much, so much learning that can happen when you just look at your poop. And I’m not saying, like, you have to, like, shove your face in the toilet and dig around in there, but, like, glancing at it, connecting to your body that’s so, so, so important. I think that’s really where I usually guide most of my clients to start.

Katie: Yeah. So, let’s delve in there a little bit because you’re right. I feel like often we think, oh, I need to get labs, it’s hard to pinpoint what’s going on in the body, but we all go to the bathroom. So, that’s an area that we can get information from. And I also often am so grateful and think like as women, we also have hormone fluctuations and so our monthly cycle can be such a great teacher of what’s going on in the body. There’s also now things like continuous glucose monitors. So, you mentioned blood sugar and insulin, we actually have the ability get that data now. But when we’re talking about poop specifically, what are some things that you have people, like, pay attention to and look for and what can we learn from maybe if something’s off in those areas?

Sarah: Yeah. So, I think one of the more obvious ones is, like, looking and seeing if there’s undigested pieces of food in there. So, that can sometimes signify there’s an enzyme issue. Maybe you’re not making enough stomach acid, which can lead to bloating that can lead to not absorbing everything from your food properly. So, that’s a real big clue. Like, if you’re seeing a piece of lettuce or pieces of rice, then it’s like, okay, why is this not being broken down? Things like corn, quinoa, sesame seeds, those don’t always get broken down, that’s okay. But like carrots, those should be pretty much broken down. That’s kind of first clue. And then looking at the consistency, if it’s loose, then I always think about all right, are you eating things that are irritating the lining of your gut that are causing maybe some underlying inflammation that you’re not seeing externally, but it’s it’s happening internally? If you’re constipated, the other side of it, what is going on? Are you eating enough blend of complex carbohydrates, soluble fiber, insoluble fiber, drinking enough water, getting enough minerals. Like, those are things that you can start to kind of ask yourself as you’re looking at your poop.

So, those are kind of the places that I would start. Color can fluctuate. If you have beets, it’s gonna be red. If you eat a ton of spinach, it’s gonna be green. Like, that can fluctuate. But really getting clear on, like, texture, consistency, and then you can also do simple transit time tests to really see how long are things staying in your body, how quickly are they moving out? And you can do that with the things that I mentioned that are non-digestible like corn, eat some corn, document when you ate it and then just look at your poop and see, when does that come out again. And that can give you more clarity on transit time. If you have a slow transit time, then that’s things you have to look into. Like, is there a magnesium imbalance? What type of bacteria do you have in there? So, again, just so many different, really cool insights that you can learn from literally just looking in the toilet. It’s something that we all are like, so grossed out about it. We’re like, oh, flush. And it’s like, no, just glance at it. It’s gonna tell you so much.

Katie: What is a good transit time, if someone’s going to start paying attention to that?

Sarah: Yeah. So, a good transit time for a woman is about 12 to 48 hours in that time range. Sometimes people can be, you know, there’s variations to normal, but anything quicker than 12 hours, you really wanna be like, okay, did that actually stay in there enough time to be processed and digested and broken down? And then I always pair it with symptoms. Like, what are you experiencing? How are you feeling? Is there an actual imbalance that’s happening that you’re like, okay, something feels off and then transit time can give you a little bit more clarity.

Katie: And you also mentioned endocrine disruptors and I’ve seen a lot of data. I’ve talked about this a little bit before, but about how so many of the things we interact with on a daily basis have basically chemicals in them that mimic hormones that confuse our body. And we know from the data we are exposed to these in much, much higher amounts than previous generations were. I would guess there’s a connection here with why we’re seeing, you know, men have a third of the testosterone their grandfathers did, women are having so much more estrogen than our grandmothers did. But how big of a role does that play, the endocrine disruptors that we’re coming in contact with on a daily basis? Because often I feel like I run into that roadblock with people of will start to acknowledge, okay, when I eat certain things, I feel a certain way. We can get that connection, but it’s harder to understand that, like, when I put certain things on my skin, for instance, and women do this more than men, it’s affecting my hormones. Because it’s not as much of a, short-term feedback loop, but how much are these affecting our hormones?

Sarah: I always look at health and it’s so complex in nature that it’s layered and it’s often like a bucket. You can burden your body and our bodies are extremely resilient. I often look at our bodies and I’m like, “Wow, our bodies are incredible, they wanna stay in balance, they wanna keep us regulated, they wanna maintain the right pH.” Our bodies are really good at this. It’s just when things become too much and then the bucket overflows. So, if you’re eating the wrong foods, if you have high stress, if you’re not eating enough, if you’re also exposing yourself to a bunch of toxins, eventually that’s gonna fill up your bucket and you’re not gonna be able to engage with that anymore. So, I think it’s just as important as really dialing in what are the right foods for you? How is your microbiome working? Like, really getting those toxins out of your system is only gonna be beneficial. Even though you might not feel it right away, it’s just a critical part in thinking about long-term sustainable health.

Especially for women, like, I work a lot with women that want to get pregnant or, you know, a baby is on their five-year plan, but they’re in this space where they’re like, “I don’t know if I can do that. I don’t really trust my body.” And anything that we can do to reduce burden on the body to help balance out nutrients is going to be beneficial. So, I just look at it as like a big part of the overall puzzle when it comes to optimizing wellness.

Katie: And you also mentioned magnesium which it seems like a lot of us in the modern world are deficient in magnesium which we can trace back to our food supply being depleted of magnesium, us also just not consuming enough of the foods that are natural sources of magnesium. We know our vegetable consumption is down for instance. But how do you typically guide women on replenishing magnesium and getting that in balance?

Sarah: Yeah, so I mean, I am a dietician at my core and that was my main training. So, I always like to go back to food and seeing how are some easy ways that we can get dark leafy greens, magnesium-rich foods back into the diet, whether that’s a smoothie or eating more cooked greens or using an Instant Pot, which is like literally my favorite kitchen item ever. So, how can we start to integrate that back in? And then also I’m a big fan of supplements. I do blood work on a lot of my clients to look at RBC magnesium and really see what is the actual level in the cell. And then utilizing different types of magnesium, maybe some that are more absorbable, some that aren’t to get that level back up. Because like I mentioned, magnesium has a huge impact on our digestion, especially with motility. So, for people that are tending towards constipation, I always think about, all right, well, what is your magnesium status and how do we get some in there that can pull water into the intestines to make you poop, but also make motility more effective overall.

Katie: And let’s talk a little bit more about other supplements as well because, if there’s one lesson I’ve learned the last few years over and over, it’s just how individualized and personalized we each are. So, I’m hesitant to ever give a blueprint or I don’t answer the question directly ever of what supplements do you take because my thing is I don’t take anything every day. It rotates based on my body, based on blood test, based on my goals at the moment. But I’ve also seen firsthand how magnesium for instance is life-changing, especially if you’re deficient and how, for me, I have a whole bunch of choline-deficient genes and I was off eggs for a long time because of an intolerance. And so, I was super deficient in choline without realizing it. And when I started supplementing that it was like a light went on in my brain and I felt amazing, but that wouldn’t be necessarily a common one that someone would think to take. So, how do you help guide people in figuring out what supplements to take and kind of knowing how to work with their own bodies?

Sarah: Yeah. So, I often get people coming into my world that have a supplement graveyard is what I like to term it, where they have this cabinet full of things that they’ve tried, they don’t know what they do, somebody told them to get it. And that’s where I go back to individualized testing. I’m a huge proponent of let’s look at the data of your body to make better-informed decisions versus guessing and trying to say like, “All right, what is this gonna do? What is this gonna do?” But really getting clear on, like, but what is it that your body actually needs? Because there’s so many levels, there’s so many layers and you can do a simple blood test to assess magnesium status. We can look at the microbiome to see what types of probiotics are going to be most beneficial. So, I also am kind of in your world where I really like to understand who is this person in front of me? What do they need and how do we really see from a physiological perspective what’s going on in their body? Like, our bodies are so beautifully complex, and having just some tools to get some insight into internally what’s going on is the biggest game-changer.

Katie: Agreed. And you mentioned estrogen being high for a lot of women. And this seems to be a pretty common thing and it seems to be on the rise, at least from the studies that I’m seeing. When you have someone come to you who has all these kind of things of high estrogen, what are some of the ways that you start addressing that?

Sarah: Yeah. So, first I look and see, like, what’s actually going on. I look at it from a genetic perspective. So, how are their genes set up to actually metabolize and convert estrogen, that gives us one clue into what’s happening. Like I said, I do a toxin analysis looking at, like, all right, what are you being exposed to on a day-to-day basis from skincare to what you’re washing your clothes in, all of that. And then I also look at it in the, I like to use a test called the Dutch test, which allows me to also see how it’s metabolized. So, different phases of estrogen metabolism can give us insights into whether or not the estrogen that you have is in fact in high levels, and then what your body’s doing with it. Is it actually making more toxic forms of estrogen or is it shuttling it into our 2OH pathway, which is less toxic, more protective? So, I look at that, put that together. If I do find that there are elevated levels of estrogen, then I think about, okay, well, how do we support the body in clearing that out more effectively? I mentioned stool testing and that beta-glucuronidase marker. If that’s elevated, that’s just gonna recycle estrogen throughout the body. So, we got to get that down.

And then also just looking at different foods, things like broccoli that has indole-3-carbinol, which can help break down estrogen levels and trying to say, all right, from a food source, can we integrate some more of these or then, you know, sometimes doing supplements like dim, you can supplement with indole-3-carbinol and just really kind of bring that level down overall. But at the core, you know, going back to the foundations and just saying like, okay, gut status environment, how can we set your body up so it can actually handle this and process these things on its own.

Katie: From the hormone perspective, are there things women can notice about their cycles that can be kind of enlightening as far as what’s going on with hormones? Like, would women see like shorter or longer cycles based on certain hormones potentially being off or like heavier versus lighter? Is that a reliable clue?

Sarah: That’s a great question. And it’s hard to say, like, generally that there’s a one size fits all or this is what’s happening. because again, it’s all about the gut for me, the way I approach it. I’m like, well, if your gut is imbalanced, if you have dysbiosis, if you have more inflammatory pathogens, that’s going to impact your cycle in a way that it’s just gonna impact it in a bigger way. So, I always, like, thinking about how do we get into the microbiome and start there? So, yeah, that’s always where I start. And then once we start working on the microbiome, oftentimes I’ll see women actually start to have irregular cycles because as we’re clearing out bacteria, all of a sudden they’ll be like, “Oh, you know, like I haven’t gotten my period, I’m two weeks late or I’m spotting.” So that can really happen. And that just shows me again the power of the microbiome in regulating a period or a menstrual cycle.

Katie: Yeah. I feel like the more we learn, the more it goes back to the gut.

Sarah: Everything. It’s like, we try and get away from it. This is what I love about this space is like you try and do all this really extensive research. And you’re like, “Oh, but there’s got to be this one correlation.” And then it comes back to, like, what’s your stress level? Like, are you eating fruits and vegetables? How are you sleeping? And are you pooping? And you’re like, that’s so simple and beautiful. I wanted to get like really deep into this, but yeah, it does kind of go back to those foundations all the time.

Katie: Yeah. As much as we wish for a silver bullet or a perfect supplement, I think it’s realizing it’s those core things that we do every day, like, the more common I have it, the more of an impact it’s gonna have.

Sarah: Exactly. And even with, like, nutrient genetics, that’s a big, like, emerging field in the dietician space. So, looking at how our genes are actually impacting the way we’re processing carbohydrates, the way we’re metabolizing fat, the way we’re activating vitamin D, that has a lot of really interesting learning pieces within it. But still our environment is switching those genes on and off. So, if we have a chaotic environment, then it’s gonna turn on these genes. But if our environment is better managed, then we’re still gonna be able to interact in a way that’s totally balanced and healthy. So, it’s still like back to the foundations.

Katie: Yeah, exactly. And that’s why I also like I said, I don’t share the supplements I take as a list and I don’t even share the diet I follow as a list. Because I’m like, we’ll actually do a disservice. At the end of the day we’re all so individualized, we’re constantly also changing. And so it’s learning how to manage our own bodies as the most effective machine possible. When it comes to gut stuff, do you have any at least commonalities that are a good starting point either with trigger foods that you have people pull out for a little while or, obviously magnesium can help a whole lot with gut, same thing with probiotics. But are there kind of like common, negative and positive starting points that you look at with people?

Sarah: Yeah. If I’m gonna do, like, a very generalized approach, I do a lot of food sensitivity testing and I definitely see patterns in there with people and the most reactive things that come up time and time again are the ones we’re probably familiar with, but wheat, dairy, soy and corn are across the board the most reactive. I would say, at least all of my clients have at least one of those that comes up as reactive. So, even if you’re in a place, and I don’t love doing, like, broad eliminations, because I think if we eliminate certain things, we can really kind of throw off the diversity of our gut. Because I really believe in, like, eating lots of different foods, lots of different variety. But when I’m looking at corn, wheat, soy and dairy, I’m like, you know what? Those can come out and not cause a lot of potential for imbalances in the microbiome because they’re just everywhere and we just got to get those out. So, that can be a really good starting place, even though it can be kind of overwhelming for some people to say, oh my gosh, that’s, like, everything that I eat, but it can just be so helpful in starting to reduce that burden, reduce that immune system response, reduce inflammation. So, that would be if I’m, like, generalizing it saying, like, all right, I would start in that world.

Katie: Yeah. And I wonder if you’ve seen this in your practice as well, especially tying in the gut and the hormone connection. I realized for me with auto-immune disease, I did have to be careful about certain foods for a while. And thankfully that was not a long-term thing. So, I always mention that of, like, there’s very often hope, you very often will get to reincorporate at least some of these things once you address the gut. But another thing that came as a surprise to me, because I also come from the nutrition world is that I was chronically undereating for a long time. And this has a really drastic hormone implication. And I don’t think women are told this part enough. We’re, like, kind of it’s drilled in through societal messaging that eating too much leads to weight gain. And so, a lot of us get in this mindset of avoiding food and carbs and enough variety of food because we don’t wanna gain weight. But it turns out hormonally that undereating can be just as damaging and even more so long-term than eating in a surplus. So, I’m curious if you have noticed those kinds of patterns with women and some tips for addressing that. I had to, like, consciously learn to actually eat enough to fuel my body and that ironically helped me lose weight.

Sarah: Yeah. I know. It’s so counterintuitive to everything that we’ve been taught to think about. Oh, like sometimes I literally tell people move less and eat more and they’re like, “Wait, what?” Because it’s really, yeah, it’s kind of just like a mind-bender where we’re like, that’s not right. So, I think just getting into that empowerment in your body and trusting your body and kind of breaking some of those rules that we have and allowing yourself to see how you feel. That’s so important. Like, when I tell women to do this, they’ll be like, “Oh my gosh, my energy levels changed or I could make it through a workout or I felt that I slept better.” So, these are like little key things that you can tune into where it’s like, all right, let’s give yourself a week. You don’t have to make it this huge, massive change because it’s uncomfortable when we had these food rules or these food ideals and somebody is like, okay, do everything you’re doing, but the opposite. And it’s like, and I think just, you know, breaking it down into something that’s achievable saying like, all right, give yourself a week of eating complex carbs and just kind of diversifying your diet as much as you can.

I always like to look at the plate as, all right, is half your plate vegetables, a quarter of it a good source of protein, two tablespoons of fat, maybe like a half a cup of complex carbohydrates, a quarter cup if you’ve been restricting them for awhile. Start there, see how you feel. Just really start to listen, look at your poop, see if it changes. Like, there’s just ways where we kind of have to get back into our intuition and learning to trust our bodies when we’ve been told, like, don’t trust your body, override all of the things that it’s doing. But, like, getting back into that can be really helpful.

And I think another piece just with the gut hormone connection and also this undereating, a big one that we have to be aware of as well is cholesterol. So, cholesterol often gets demonized, but this is the backbone of how we make every single hormone in our body. So, if we are undereating, if we are cutting fat, if we’re like eggs are full of cholesterol, I won’t eat them, shrimp are high, like, whatever these, you know, rules that we have in our brain and now all of a sudden our cholesterol is low, that’s gonna be a huge problem for creating hormones. So, that’s another one that I think has been a misinterpretation in our educational landscape of nutrition is, like, cholesterol is bad. It’s like, no, it’s not. It’s the components of it we have to understand. But, like, getting that cholesterol to an adequate level is so important in the hormone conversation.

Katie: I’m so glad you brought that up because this is an area that has driven me crazy for a little while is just when you actually look at the data, like, we hear the mainstream narrative about cholesterol and they oversimplify that cholesterol is bad. And I always look at well, first of all, if you actually look at long-term data, super low cholesterol is correlated with early death. And ironically, especially in women, higher cholesterol, as long as you have a couple of other markers in range is actually correlated with longevity. So, we’ve been avoiding these vital things that our bodies need and our hormones need because we demonize this one part of it. And my thing is always, it would be actually much more beneficial to focus more on triglycerides, for instance, or some of these other easily available markers that we have, and not worry about the cholesterol, as long as we’re not seeing any abnormal patterns in kind of those ratios that we pay attention to.

Sarah: Exactly.

Katie: That’s a huge component for a lot of women and we’ve been taught wrong about that. And it’s definitely creating long-term problems now that we’ve seen several decades of people making these changes and we’re starting to see how that’s expressing.

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Any guidelines for their, from what I’ve seen in my own labs, I track pretty carefully. It’s like if I eat processed food will mess up your ratios very quickly. Vegetable oils also seem to have a negative effect because they’re fats that our body is still not very used to. They’re pretty new. Any other things that come into play with that cholesterol equation?

Sarah: Yeah, sugar. Sugar is probably the biggest one because, you know, oftentimes as women, we have a sweet tooth, we like our chocolate and if we’re eating higher levels of sugar, that is just gonna go right into the liver and convert into triglycerides. And yeah, our body’s just not gonna process that as effectively. So, that’s another one to really hone in on and understand, like, where are you getting added sugar? How much of this added sugar are you eating? Are you snacking on it? Like, and that also is, like, okay, well what’s going on blood sugar-wise, sleep-wise. You know, it all comes back to the same question if you’re having these intense cravings, what’s at the core of that? So, yeah, just getting clear on sugar intake is just a big tie-in in the cholesterol picture.

Katie: Yeah. And for women, especially, like you said, separating out and not demonizing carbs because we need those for hormones, but there’s a huge difference between natural forms of carbohydrates and processed sugar and processed refined flours, which is what makes up most of people’s carbohydrate consumption these days, sadly. People will find and I’m sure you see this as well as a dietician but, like, it’s very difficult to overeat natural sources like quinoa or sweet potatoes or fruit. Your body has a natural cut-off mechanism. You’re not gonna eat 12 apples most likely, but it’s very easy to drastically over-consume processed sugar because it’s a survival mechanism. Our body’s not betraying us. It’s that it was wired this way for survival for a long history. But now we have wide availability of these foods, and so it’s not that our body is betraying us. We have to understand the role of these foods. And at least I’ve seen when you fuel efficiently and you get enough protein and you get enough complex carbs, you don’t crave the processed stuff as much. Your body definitely adapts over time. Do you see that as well?

Sarah: Yeah. And I think it’s also too about, like, just kind of getting some key learning insights. So, if you do have sweets, if it’s something that you want, how can you do it in a way that is actually healthy for your body or at least maintaining your blood sugar balance. So, like, instead of having all your sweets at nighttime right before bed, which can totally impact your circadian rhythm, can you do it maybe earlier in the afternoon. Most people don’t often want it then, but you know, how do we start to kind of biohack our blood sugars so it’s more stabilized and our body can actually handle it better. And so, playing around with that, it’s really important. Or if you have a huge meal going for a walk afterwards can help just stabilize blood sugar.

Like, these simple things that if you look back in history when we didn’t necessarily have the scientific means like, oh yeah, my grandpa always went for a walk after dinner, like, that’s just like what he did. And there’s so much like benefit in that or like eating soups and stews. Those are really blood sugar-stabilizing. It’s just kind of going back to some of those things that maybe we don’t always understand, but were just, like, part of our culture or history. Like, I’m Jewish. I ate a lot of, like, stews and soups and that was such a big part of, like, our food. And there’s so much, like, chicken soup, there’s so much healing and nurturing within that, that maybe wasn’t understood from a scientific perspective that we’re seeing now that has such a huge implication on the health.

Katie: Yeah. It’s so funny, the more we learn the more we spend millions of dollars researching, we realize maybe our grandparents intuitively had a lot of these things figured out and we get back to the basics. You’ve also mentioned sleep a lot, and I know this is a really important key when we’re talking about gut health and also hormones. But I mean, really anything we’re talking about related to the body, sleep is gonna be a huge puzzle piece. I’ve seen data that just even one night of interrupted sleep can give you the blood sugar levels of a pre-diabetic. We know that over time it really affects hormones. I feel like this is often also a very tough piece to dial in, especially for moms because we have so many factors that can disrupt our sleep. So, any guidelines that you give women as starting points for improving that? Like, I know on a personal level, I do better if I don’t eat too close to bedtime, if my room is dark and cold, but just starting points for optimizing sleep?

Sarah: Yes. All of those, I think the sugar piece that we talked about, really making sure that you’re not eating a bunch of chocolate right before bed, really important. If you have a sensitivity to caffeine, dialing that in and not having any caffeine after noon or even 10:00 a.m. can really be helpful. And I think one of the things that I see most commonly in most of my clients, especially moms, is by the end of the day, we’re just exhausted, we wanna zone out. We spend a lot of time potentially on our phone. So, really dialing in blue light exposure that can really mess with circadian rhythm. And it might not seem like something like you’re like, oh yeah, I look at my phone, and then I’m totally energized. Like, we don’t necessarily feel it right away, but it does have an impact on circadian rhythm. So, I think that’s a big one that I spend a lot of time working on my clients with is like, can we put the phone somewhere else? Can we get back to reading a book before bedtime, doing a crossword puzzle, something where we’re not just exposed to blue light, but that’s still giving us that sense of, or source of dopamine.

Because you know, we’re going after a dopamine, a pleasure response, like, oh my day was just so insane, I just wanna feel good right in this moment. And we will, like, scrolling through Instagram is like dopamine, dopamine, dopamine. But you have to think long-term how has that been impacting circadian rhythm and it’s having a negative impact. So, how can we just, again, like, simplify, go back to the book reading or the talking with our partner or whatever it is to really just kind of disassociate from that technology and that dopamine hit over and over again.

Katie: Yeah. Again, those things our grandparents knew and it’s another area I feel like exactly, like you said, we often underestimate because we don’t see that immediate effect as we do with food. But this is another drastic change over the last 100 years. And certainly, in the last 30 years, we just haven’t had blue light exposure directly to our retina at night before. And the studies keep coming out more and more about how this really, really changes hormones. So, I think that’s a really important, valid starting point for people.

One tip I always give based on our previous podcast guests is that I have windows open and bright light during the day and even, like, daylight bulbs above, because the body’s used to getting blue light during the day from up high. But then after sunset, I turn on only lamps that have only orange hues and not blue light because the body is used to getting that thing of, like, red light coming from more like eye level, so fires or sunset or…And so, it’s not even just the light itself, but the direction and that one change, you can even put them all on timers so lamps go on at sunset. That alone, I’ve seen people have drastic sleep changes, even if they don’t change anything else. So, I love that you brought that up. I think this is an area I think we’re gonna see so much more research on, but we’re just really starting to see in the mainstream a little bit.

Sarah: Yeah. And I think something like, I love, like we’ve talked about, I love testing, I love data. I love biohacking and something like the Oura Ring is a really cool device as well to just kind of understand like, all right, what does your REM look like? Your REM cycle, what is sleep latency? How long has it taken you to fall asleep? If you meditate before bed, if you decrease blue light exposure, do you then see a better performance score the next day? That can also be really helpful because a lot of times when we start to get into wellness and health and sleep, it’s very gray. We don’t really have a lot of, like, markers. It’s, like, I slept well, I think, my energy is okay, I think. But when you start to put numbers to it and give it more data, it just helps us really understand it a little bit better. So, that’s something that I find to be helpful when we’re trying to get into a better sleep pattern to really see, oh yeah, when I do that, it has a pretty strong impact on how I feel the next day or how my numbers are saying I’m set up for the day. So, that’s just another, like, fun for the data nerds out there, a fun piece to incorporate.

Katie: Big fan of my Oura Ring as well, and especially paying attention to, I love deep sleep and heart rate variability. And also as women, it tracks body temperature, not in, like, an exact sense, but in a relative sense, which is another cool, just helpful tip is if you can watch that trend of lower body temperatures pre-ovulaton, higher body temperatures post-ovulation, that’s a good window into your hormones. It also tells you when you’re fertile, when you’re not.

And I also, like I said, I pay attention to deep sleep and I’ve noticed the trend seems to be kind of universal with humans is when we get enough deep sleep, especially over two to two and a half hours because that’s the time when our brain is flushing amyloid plaques and hormones are being created, that, that seems to have a really big impact on, how you feel the next day and on focus and also in time on hormones, that also you talked about cortisol earlier it comes into play there. So, this is a tool that we can get and use at home that gives us such a good window into those changes on a micro level daily, also heart rate variability I’ve talked about on here before. But trackers that track that they show you basically how your body’s responding to stress. So, back to our stress conversation, that’s an a window you can have without a ton of testing and watch over time. And unfortunately, I’ve learned some things like my body doesn’t really like alcohol, especially at night and it will mess with my HRV and it’ll go from 140 to 40. And so, maybe I just don’t drink alcohol very much. But it just is so helpful to have that personalized data. Is Oura your favorite for tracking?

Sarah: Yeah. I love that. I think that’s great. You mentioned heart rate variability. If you don’t want to go into the Oura Ring, something like HeartMath, that’s a really cool biohacking device to really assess, like, okay, how is my heart variability in relation to stress and how I feel and how do I start to regulate that? Because we can, we can regulate our emotions, we can regulate our feelings to an extent, and that can help us just kind of uncover and get deeper into stress management, which is such a…stress management is probably the most challenging area that I work on with all of my clients, because it’s like, well, I can’t stop being a mom, which is, you know, it brings up many levels of stress. I can’t stop going to my job, which is a level of, so it’s like, how do we start to really get into more self-regulation and, and understanding. And that’s what I think that the key is to going from overwhelm in your health which is so easy in this day and age. Like, there’s so much information even potentially somebody listening to this might be overwhelmed by all of the different nuances and things we’ve talked about with health. But really getting that data can help you go from overwhelmed into empowered.

Katie: Exactly. Yeah. That mindset piece of data is a good thing and positive steps and not the guilt or, like, feeling bad when you don’t get it right. Because we’re all in this journey and it’s all consistent habits over time.

Sarah: Having willpower, like, willpower is my least favorite word because it’s like, no, it’s not. The willpower conversation is so dated to me because there’s so many different things. And then what that does is it sets us up for, I failed. And it’s not an I failed thing, it’s an exposure. It’s the environment, like, there’s so many elements that go into the choices that we can make in our success that it’s like, oh, my willpower just wasn’t there. And it’s like, no, you just didn’t set yourself up in the right way. It’s not a personal loss or failure. It’s just, you didn’t have the right information.

Katie: I’m so glad you brought that up. You’re right. Because we have to acknowledge as humans decision-making and willpower are limited resources and we’re existing in a time that tests them on a much wider scale than we’ve ever seen. And so, it’s not at all, I think, especially people with health problems, it’s often painted with a brush of like you said, lack of willpower or being lazy. And it absolutely is not. It’s that we are fighting bigger battles than we fought before. And we haven’t always had the best tools to be able to fight those battles well. And so, I think all these things you’re talking about having data and having small habits that can build over time. And then certainly I’m sure you see this drastically in your work is as you change the gut, that changes your cravings, that changes your sleep, that makes willpower less important. But I think you’re right. It’s horrible that we’re kind of putting that burden on people and telling them it’s their fault when they’ve got so much working against them.

Sarah: Yes. Oh, it’s like my, ooh, it’s a little pet peeve, or it’s like you just didn’t have the willpower. I’m like, no, it’s not your problem. It’s yeah, there’s so much that we’re exposed to. Like, if you’re in an office setting, it’s so challenging when there’s all those snacks laid out in front of you or someone brings cupcakes and you’re like, “I just didn’t have the willpower.” It’s like, no, you just had crappy exposure over and over and over again. And eventually, you know, we only have that limited capacity of decision-making and then we get into decision fatigue and we’re like, “Well, screw it. I just wanna feel good and I wanna do the path of least resistance.

So, yeah, it’s, it’s a big mind journey and a mindset game to go on wellness. And that’s why like, the journey is not linear, it’s not like you get into this space and you’re like, “Cool, I’m gonna work with someone, I’m gonna get this information and I’m just gonna keep improving every single day.” It’s like, no, we’re humans, we deal with emotions, we deal with trauma, we deal with disappointment and that’s part of health and that’s okay. We deal with sickness. Like, sickness is also part of health and that’s okay. Like, so yeah, it’s never a linear journey. And I think the more we can be kind to ourselves in that process and give ourselves that space to explore and I don’t even wanna say make mistakes, but just, you know, find what works and what doesn’t, then it’s gonna be such a different journey than having the expectation must be perfect all the time.

Katie: Yeah, absolutely. And you’re absolutely not going to guilt and shame yourself healthy, it will directly work against you. And also when we’re talking about the gut and hormones, I guarantee you long-term in the battle of hormones versus willpower, hormones will win because they’re there literally for our survival. So, if we’re just trying to willpower our way through hormones, that’s a losing battle from the get-go.

Sarah: Yes. Yeah, exactly. I mean, yes, perfectly said.

Katie: And as we get closer to the end of our time, a couple of questions I love to ask, the first being are there any often misunderstood or misinterpreted areas when it comes to your area of expertise that we haven’t already touched on today?

Sarah: The one thing that pops into my mind for some reason is anxiety. And I think oftentimes people, that’s another one we’re just talking about willpower, we’re talking about, you know, so many things. And anxiety, I think sometimes can be, the gut connection to anxiety can also be overlooked. So, when we have an imbalanced gut, we have potentially a lot more gram-negative bacteria that have more, LPS or lipopolysaccharides, which are endotoxins. Those are, they’re natural, but they’re endotoxins.

So, in higher levels, when we have this big release of endotoxins, that makes us anxious. And so, I think the anxiety conversation is again, not just it’s your stress management isn’t good enough, your movement isn’t good enough. Like, no, we also have to think what’s the physiological response that’s happening. What’s going on in your gut too that’s keeping that perpetuated and that cycle upregulated. So, I think that’s often another area that I see kind of overlooked because maybe when you’re anxious, you’re not thinking about your poop or you’re not really, you know, I sometimes anxiety can create diarrhea, but you’re not maybe in this, like, I have digestive issue space, but it still is a big part of that cycle. So, that was just something that popped into my mind. I was like, “Oh, I got it. I got to at least say that.”

Katie: Yeah. And anxiety seems to be definitely a big thing for a lot of women. So, I’m glad you brought that up as well. Is there a book or a number of books that have had a profound impact on your life? And if so, what are they and why?

Sarah: The biggest one, honestly, this might be a little bit kind of not what you would expect, but “Omnivore’s Dilemma” is like one of my favorite books just because it’s such a, I love Michael Pollan. I love the way that he writes. I love just kind of the factual approach he takes and the experiential approach. And I just thought that was such a beautiful exploration of our food sources. And again, like, I think about how do we go back to foundations and simplify our eating? Because, I mean, food, we have to interact with that every single day and going back to, how do we kind of find the healthiest food in the best format. Like, I love that book. I think it’s just so well done. And there’s a chapter in there called Corn Sex. And I’m like, this is just a brilliant way to communicate this information, but really just understanding more of our food source and the importance that that has on our health. I just love that book.

Katie: Me too. I will put a link to that in the show notes for you guys listening at, along with some notes. I’ve been taking notes while we’ve been talking and some more posts on all of these topics. I know Sarah, you have a wealth of information available as well. Where can people find you if they want to work with you on hormones or learn more from you directly?

Sarah: Yeah, so I’m on Instagram @fearlessfig. That’s a great place I do tons of education. I also have, I know I mentioned a lot of times, like, looking at your poop. I have a whole guide on how to look at your poop, what it means, the different lab values that I had mentioned kind of throughout. So, that’s on my website, And you can grab that poop guide just to get a little bit more of an insight into like, what is your body actually telling you.

Katie: Love it. I’ll make sure to link to that as well. And lastly, any parting advice you would leave with all the listeners today?

Sarah: I mean, I think it’s really like we mentioned, getting back to the foundations, trying not to beat yourself up in this journey, getting clarity to get over overwhelmed. Like, that’s such a big thing trying to not be like, oh my gosh, I have to do this all on my own, I have to figure all these things out, like, my body is broken. But really kind of just calming down the noise, calming down even what’s going on in your own mind about your health and knowing that there are answers, there are ways to connect back to your health and you don’t have to feel like you’re broken. You don’t have to feel like you’re crazy because you’ve gone to the doctor and they’re like, we don’t know, your labs are fine. It’s, like, if it doesn’t feel right, if something is out of alignment in your body and you have that knowing like, even though they’re saying I’m normal, I just feel like something’s off. Then keep exploring and reaching out and coming into this world of functional wellness. I think this is such a cool way to really optimize the body, not just look at disease. So, there are people in this space, don’t feel like you have to do this on your own. That’s the biggest thing that I would say.

Katie: Oh, and that resonates so deeply with me. I’ve heard that from doctors when I was trying to figure out my health struggles of, oh, your labs are fine, this is all in your head or that’s just normal. And I think many people have had that experience. I love that you brought that up. I think that’s a perfect reminder. And that there always are resources, just sometimes you have to think outside the conventional first approach. It took me eight tries to find practitioners who knew what was going on and it was life-changing. So, I love that we’re ending in a place of hope, especially for women. I think the gut and hormone connection can not be overstated. And I think we got some great starting points today and I’ll make sure there are links for people to find you and keep learning more. but thank you so much for your time. This was so much fun.

Sarah: Yeah. Thank you so much for having me and for guiding this conversation into so many different fun avenues and your wealth of information as well. Like, it’s such a, feels like a very nourishing space that you’ve created for people to learn more about their health and not feel defeated.

Katie: Oh, thank you. And thanks as always to all of you guys for listening and sharing your most valuable assets, your time, energy, and attention with us today. We’re both so grateful that you did, and I hope that you will join me again on the next episode of the “Wellness Mama Podcast.”

If you’re enjoying these interviews, would you please take two minutes to leave a rating or review on iTunes for me? Doing this helps more people to find the podcast, which means even more moms and families could benefit from the information. I really appreciate your time, and thanks as always for listening.


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