Lara Briden is a naturopathic doctor originally from Canada. She has been practising for 17 years and over 2000 patients have been under her care. She now practices in Australia as a registered Naturopath. She runs the Healthy Hormone Blog at larabriden.com and runs here practice from the Sensible-Alternative Hormone Clinic in Sydney. Her specialty is working with women’s hormones and thyroid issues.

Transcript:

KUNAL: Today we’re talking with Lara Briden, a naturopathic doctor originally from Canada who has been practicing for 17 years and has treated over 2,000 patients under her care. She now practices in Australia as a registered naturopath. She runs the Healthy Hormone blog at larabriden.com and runs her practice from the Sensible Alternative Hormone Clinic in Sydney. Her specialty is working with women’s hormones and thyroid issues. Hi, Lara.

LARA: Hi. Thank you for having me.

KUNAL: Yeah. Great to have you here; thanks for spending some time with us. Lara, you started off as an evolutionary biologist. Can you share with us how you started down that road to wellness?

LARA: Yeah. Basically, I just loved biology. I was kind of a science geek, and when I discovered that there was such a thing as naturopathic medicine, I saw it as a way to continue studying my love of biology and the human body, and basically it was one of those decisions in university when you’re 21 years old. I just went with it, as a whim at that time, but it turned out to be exactly the right thing for me, I think.

LEON: So in terms of your attitude towards wellness, I saw a pretty awesome quote on your blog when I was having a read of it. It was “brainy Paleo hipster.”

LARA: Yeah. (laughs) I wasn’t necessarily referring to myself, I was just referring to – there’s a lot of great blogs out there, and from my perspective, being in this business for so long, as you say, 17 years, and doing this kind of work for so long, it’s been quite entertaining. Quite, I guess, enlightening to get onto the blog world and see all these people very excited about some of the same ideas now, and putting a lot of their brains behind it. Yeah.

LEON: Yeah, that was awesome. I loved reading that. And I can definitely see it. The whole wellness thing is definitely becoming a status symbol, some types.

KUNAL: Today we’re going to be focusing on antibiotics and the impact on hormonal health. In a previous podcast I did with Jessica Richmond, the CEO of UBiome, she talked about how taking antibiotics can affect your gut flora for up to two years.

LARA: Yes. I heard that podcast. That was a great podcast.

KUNAL: Thank you. There’s obviously a connection there, between the whole gut, brain, and the immune system. The notion that Jessica put to me was that bacteria in the gut manufacture the molecules that eventually feed our brains, and that is essentially the mechanism of action of how everything can go all haywire. What are your thoughts on the subject?

LARA: The intestinal bacteria do that. She’s right about that; they actively produce neurotransmitters that affect our brain chemistry. But that’s just one of many things that they do for us. Their work desk, their in-tray, if you want to put it that way, is huge. They are essential for largely directing the immune system. About 70% of our immune system is all clumped, clustered around the walls of the intestine, taking direction from what the gut bacteria tell it to do. So the gut bacteria are a source of inflammation or a way to reduce inflammation.

Furthermore, they are quite influential in the metabolism of hormones. For example, the intestinal bacteria actively break down estrogen and escort it out of the body. So when they are disrupted or their function is overwhelmed by other things, then they fall down on that job and the partially metabolized estrogens, which are actually a more active estrogen, get reabsorbed into the body. And that’s a source of major hormone disruption that I see again and again.

And that’s just the tip of the iceberg. The field of intestinal bacteria, we are just entering the age of research into this. It’s massive, to put it lightly. (laughs)

KUNAL: In your experience with your patients, can you give us a couple of examples of perhaps conditions people have come in with and how you’ve treated them and what the response has been?

LARA: Sure. A very simple example would be working with some patients on premenstrual tension and premenstrual syndrome, where in the week or two leading up to the period, the body suffers from symptoms essentially from too much estrogen compared to progesterone. Patients will be responding very well to that, using nutrients that help to clear estrogen and calm the body’s response.

And then if they just happen to get a cold and take a course of antibiotics, then the next thing I know they’re sitting in front of me telling me that all their symptoms are back. Their premenstrual headaches are back, their fatigue is back, or their breast tenderness is back. It’s such a common experience that it’s one of my standard questions in a follow-up visit now, in a follow-up appointment with a patient, is to ask them – I can’t even say “Is there anything that’s happened with your health since we met?” I have to be very specific. It’s like, “have you had a course of antibiotics in the last three or four months since we’ve met?” Because I need to know about that, because many times we’re back to square one with hormone balance.

KUNAL: Does it make a difference what type of antibiotic the patient’s taken?

LARA: Oh, good question. I don’t have the answer to that. I’m not aware. I suspect some are more harmful to intestinal bacteria than others, but I don’t have a specific answer for that. Sorry.

KUNAL: What do you recommend people do rather than take antibiotics?

LARA: My experience is most people that take antibiotics – antibiotics are prescribed inappropriately in Australia right now, and this is not just naturopaths saying this. The Australian Medical Association is very concerned. Some of the bodies that govern GPs are very concerned, pleading with GPs to stop prescribing them on patient demand. Basically, patients go to their doctor, they just want to feel a little bit better – and sometimes the antibiotics can deliver that, and it’s not because of their anti-microbial effect but the fact that most antibiotics have a slightly anti-inflammatory effect. So people feel a tiny bit better.

A large part of it is placebo as well. They’ll be of the attitude “I’ve been sick for four or five days; I really just need to get back to work,” and they’re so used to just taking antibiotics for that. Most of the time they do it, I would hazard to say 90% of the time that they do that, they didn’t need the antibiotics. They needed a few more days off work, which is a hard thing for people to accept sometimes. From a natural perspective, in terms of fighting viruses and dealing with shortening the duration of a cold or a flu, the best thing is to remove immune-suppressing foods like sugar and cow’s milk from the diet, supplement Vitamin C and zinc. These are things most people know about already, but just don’t want to do, I find.

KUNAL: In many cases it comes down to stress overload. One of the things I’ve come across recently is you’ve got a few different dimensions of resilience. What I’m getting at is there’s different stresses on your body that come through major lifestyle sources. There can be chemical, emotional, and mental pressures and physical, too much exercise, as well, is another one. All of that combines to the point where the stress compounds and then you get sick. Then people go to the doctor and I think the doctors are just in such a habit now of prescribing the antibiotics themselves.

LARA: They’ve surveyed doctors, they’ve surveyed GPs – because I’ve subscribed to a few GP newsletters, and the majority of GPs feel under pressure from their patients, like basically if they don’t give the script for the antibiotic, the patient’s not going to be happy with them, he’s going to be grumpy or maybe go to another GP.

KUNAL: Lose the business.

LARA: So the message has to be to the patients, I think, primarily. That it is just not appropriate to take antibiotics for every little sniffle. Not only that, in the big picture, it’s creating a very serious problem of antibiotic resistance, so what it’s going to mean is we won’t have the antibiotics to treat the life-threatening conditions that we need them for.

LEON: Most of us have been on a course of antibiotics at one time or another during our lives. That disrupts our gut biome. Is there some way it gets back to normal on its own, after awhile, or are we all just walking around with totally disrupted intestinal systems?

LARA: Yeah. I would. say most of us are walking around with totally disrupted intestinal systems. Kunal mentioned the quote – and it’s the same study I’ve heard, that it takes up to 18 months – after one course of antibiotics, it can take up to two years to return to normal. But sometimes people never go back to normal. They might find a new normal for them.

The reality is, there’s no one normal intestinal flora. Each individual has slightly different. I think at different stages in our life, we move into a different state of intestinal flora. Some are more conducive to health than others. I think as a rule, we want to be minimizing the negative impacts from antibiotics. I think, just to put it in perspective, I think yes, very few of us will get through our lifetime without one or two courses of antibiotics. People still occasionally need them to save their lives.

I’ll just share a personal story: my husband had quite a serious kidney infection a couple years ago, and it progressed very quickly. We did take him in, we got him to the doctor, thank God. She said that if he’d waited another 24 hours, he would’ve had permanent kidney damage, and another two or three days and he would’ve died. I’m just reminding people that those conditions still happen, even in our modern world, and that’s what antibiotics are for.

KUNAL: Meningitis would be another one.

LARA: Yes, exactly. That’s what they’re for, to save lives. They were a miracle 60 or 70 years ago when they were invented, and we’ve lost the miracle now. We’ve just wasted them, basically.

LEON: That’s right. Throwing them [inaudible 00:10:58].

LARA: Yeah. I’m now preempting your question, but the other source of antibiotics is in our food supply, which is a big problem. They give it to livestock to fatten them up, and that actually tells you something about what antibiotics do to our hormonal system, because they’re very good at fattening up an animal, and they fatten up people too, because of what they do to metabolic hormones like leptin and insulin.

KUNAL: Yeah, I think we’ve become very, very keen on grass-fed and [inaudible 00:11:29] meats, and we make sure we buy them from a farm that raises the animals ethically. We’re at the point where we go and meet our farmer before we buy our meat.

LARA: Excellent. I think a priority when it comes to choosing meats and animal products, I think antibiotic-free is the thing that most people should be looking for. There’s so much labeling on meats, organic and free-range. I’m also concerned about how animals are treated ethically, so that’s part of it, but I think knowing that your meat is antibiotic-free is, from a health perspective, one of the most important things you can do. Also that as you say, it’s grass-fed rather than grain-fed.

KUNAL: Yeah, actually, the whole antibiotics in food thing has actually put me off chicken completely. I’m so afraid of buying a chicken that has antibiotics in it now, because they’re all so big and fat.

LARA: And it’s the antibiotics that are doing it. There’s been this idea that chickens are fed hormones. That’s actually, I believe, my understanding is that’s not the case in Australia. It’s not that they’ve been fed hormones, it’s that commercially raised chickens are fed antibiotics, and that has a hormonal effect on them and on us that eat them.

KUNAL: That’s a lot like mercury in fish, isn’t it? It just passes on to us.

LARA: Yeah. Yes, that’s a slightly different issue, but yes.

KUNAL: Cool. Staying with hormonal health, acne. Can you talk a little bit about that?

LARA: Yep. This is something I treat a lot, as you can imagine, in a hormonal clinic. Most women end up using the pill to control it, because the synthetic estrogens in the pill will control it very well.

KUNAL: Interesting.

LARA: But the underlying issue – and I’m very confident to say this – the underlying issue for acne is, in my experience, almost always excess sugar in the diet, because of sugar’s impact on insulin and what that does at the skin and how that feeds the bacteria at the level of the skin. Sugar and, for some people, cow’s milk. Because the protein casein in cow’s milk is immune-disruptive, and one of the ways that manifests in some people is acne. I find clinically, most of the time – especially in a young woman, before she’s tried the pill – if we cut out the milk and the sugar, her skin will clear in three months, and that’s the end of it.

But once the pill has been in place, then there’s the whole issue of trying to withdraw. There’s a pill withdrawal issue that happens at the skin that can be very distressing.

LEON: Yeah, the pill itself seems to have some pretty scary health impacts. A friend of mine decided that because they were stressed out at work and they wanted to take care of themselves, one of the ways they would try and approach that is to take themselves off the pill. What ended up happening was that basically their hair started falling out in clumps in the shower, every day.

It was really unfortunate because it actually made them more stressed out and more worried about this whole thing. Admittedly, they weren’t on a particularly good diet at the time, so they probably weren’t doing the best that they possibly could to support their endocrine system. But yeah, you bring up an interesting point about the pill withdrawal issues.

LARA: Yeah, it’s pill withdrawal. Thank you for bringing up hair loss, because the latest post on my blog is about hormonal hair loss. I blogged about it because it is such a distressing symptom. A big part of what happened to your friend, I believe, and what I commonly see in my practice, is exactly pill withdrawal. The skin and the hair follicles get addicted to a certain level of the synthetic estrogens, which are stronger than our own estrogens. It’s a type of addiction. I don’t use that word lightly; that is what it’s like.

So then when that’s withdrawn, suddenly the physiology of the hair and the skin has to step down, make do with the body’s own hormones. Even though there’s nothing wrong with the body’s own hormones, they are not what the skin and the hair are used to. So there will be a period of withdrawal, and with hair loss, unfortunately, it goes on for a while. I found it’s quite difficult to treat, because the problem will usually start a couple months after going off the pill, and then it might take quite a few months to sort it out. By that point, most women are so upset that they often go back on the pill, just to try to –

LEON: Yeah, that’s what ended up happening. You’re right. It took a good month before her hair started falling out. She decided to battle through it for two or three more months, and then kind of caved and went back on the pill. Yeah, it was even another two months after that before it stabilized.

LARA: There’s a two month delay. Anything with the hair follicle, there’s a two-month time delay, like you need a time machine. So when patients say, “My hair started falling,” I say, “Great. Think back. Count back on your calendar two months. What was happening?” Two months or longer, usually.

LEON: When you’re saying that your body kind of gets used to having a super high level of the hormones available, circulating in your body – is it also an issue of your body shuts down its own production of those kind of hormones?

LARA: Yes. The pill is chemical castration. And again, I don’t use that term lightly. It’s castration. I’ve been practicing so long; I do not understand how women put up with it. It kills their libido; it has quite profound effects on mood, causing depression. Imagine if men were asked to turn off their own testosterone, what that would do to their mood and their libido, obviously, and their ability to gain muscle mass and to have a functioning metabolism. It’s just a tragedy. My practice has been probably a 17-year campaign of getting women off the pill.

LEON: Wow. And grow beards, don’t forget about that. I can’t grow a beard anyway. So what do you think with this friend of mine? I might refer her your way, to have a chat to you. How can she do it better next time around so that she’s taking a bit more of a strategic approach to it?

LARA: What I do with my patients, if that’s been a problem, often to save them grief I will suggest – even though I’m very anti-pill – I might suggest stay on the pill, just temporarily, while we put in place some nutritional structure. Hair follicles need iron and zinc, and we need to test for those minerals and make sure their absorption is happening properly and the body has the nutrients that it needs, and also remove – for some people, they may need to remove inflammatory foods like gluten, which might be affecting the hair follicle, or correct an insulin problem which might be affecting the hair follicle. Once I’m confident that we’ve addressed some of the other issues, then I will coax (laughs) reassure the women into trying to come off the pill again.

But I would never to a patient promise no hair loss, because there’s always going to be this issue of pill withdrawal. I might just say I believe it will be short-lived. It is usually short-lived. If we can get the woman ovulating again and having normal periods again, her own hormones will start to do the job that the pill was doing. The only time for women when hair loss is irreversible is when it’s been going on for months and months or years. At some point, then it will become irreversible. But usually, if it’s just been short-term, it’ll come back.

LEON: So it’s about supporting your body in the right way so that it can shift back to its own endogenous production.

LARA: Yes.

LEON: Can you wean yourself off the pill? Can you take half a pill for a week and then a quarter of one or something like that?

LARA: Someone asked me exactly the same question on my blog. I’m going to say I don’t think that will work. To be truthful, I have never thought to try that, and I’d love to hear from another doctor who has perhaps tried that. I think my approach would be get the woman’s own periods and her own hormones cycling as strongly as possible as soon as possible after coming off the pill.

It’s in the fine print of the medical literature that comes with the pill, that it can take up to two years to get the periods going again. According to the manufacturers of the pill, that’s acceptable and that’s normal. So it’s a bit of a shock for women if they find out that they can’t get their periods going again after coming off the pill. But usually with natural treatment, they can.

LEON: That’s scary.

LARA: Yeah.

KUNAL: I guess one more thing we can cover is cortisol. Could you share a little bit about that with us?

LARA: Cortisol is a complex topic, and I was thinking about it in preparation for our podcast today. The modern term for cortisol disorders, the way most researchers and doctors talk about it now, is what they call HPA axis, so hypothalamic pituitary axis disorder. Why that’s important is that it brings in the brain. This is about the messages that the brain is sending to the adrenal gland to produce stress hormones, and so I do not think it’s possible to treat cortisol without treating neurotransmitters, reducing stress levels. And sometimes, just to be fair, sometimes that means the person finding a way to be happy or to increase their joy and decrease their stress. Improve their sleep.

LEON: It’s commonly called the stress hormone. Is it as simple as that?

LARA: It is our primary stress hormone. For example, it prepares our body for dealing with an intense situation; it increases the amount of blood sugar, it squirts out more blood sugar into the bloodstream, which is why it interferes with insulin metabolism and keeping blood sugar low. It puts energy into the short-term rather than the long-term, so long-term exposure to cortisol will reduce muscle mass, for example. Your body’s stealing energy from some of the organs. Yeah, I think of it in terms of a stress hormone, primarily.

LEON: But it does play some regulatory functions, like your circadian – it’s not – sorry, my simple understanding of it is when it gets dis-regulated, when it’s high all the time rather than going in that circadian cycle –

LARA: Yes, of course. Sorry, Leon. It’s not all bad. Put it this way: we’d die without cortisol. So we do need it, our immune system needs it. Too little cortisol will cause inflammation in the body, so we do need some cortisol. We need cortisol. Absolutely. Not to make it all sound like the bad thing. For example, our thyroid hormone cannot work in the body without adequate cortisol supply. But on the other hand, too much cortisol will suppress thyroid function.

With all hormones, there’s a balance; I’d say the balance with cortisol is one of the most finely-tuned. It largely follows our circadian rhythm; we’re meant to have more cortisol in the morning and almost none at night, which is why if you had to get up and do something, exert yourself at 4 in the morning, it would be very difficult. (laughs) Your body just does not have the resources to do that at that time, when cortisol is supposed to be low.

KUNAL: Does coffee cause a spike in cortisol levels?

LARA: My understanding is coffee increases adrenaline. That can also trigger an increase in cortisol. One of the reasons I think we’re meant to – “meant to,” not that we’re meant to drink coffee, but that we can in a healthy way drink coffee in the morning is that it corresponds with when our cortisol levels are naturally increasing anyway.

KUNAL: Does coffee disrupt production of natural cortisol?

LARA: I can’t speak to that specifically. Because it increases adrenaline and prevents sleep, it would, if used in excess or inappropriately, it would destabilize – yeah, it would interfere with the circadian rhythm.

KUNAL: I guess what I’m getting at is if people are drinking coffee habitually every morning and then they stop, people tend to get a little grumpy. Is that primarily because of the caffeine they’re missing out on?

LARA: Yeah, it’s a caffeine withdrawal. Caffeine’s an addictive drug. I mean, I love coffee, so I’m saying that with full disclosure here. I think the headaches and the jitteriness we get from withdrawing caffeine – I don’t remember the exact physiology of it. I think it’s more to do with neurotransmitters than with cortisol specifically.

LEON: If someone thought that they had a problem with cortisol, how would they figure that out? Is there some kind of test they can do, or is it symptomatic?

LARA: The first symptom I look for in clinic is disrupted sleep. What happens with the disrupted cortisol is the high nighttime cortisol. High when it’s not supposed to be high. Generally, if someone says they are a good sleeper, easy sleeper, they fall asleep and sleep eight hours, then I’m less likely to be considering cortisol as the issue.

But cortisol is one of the hormones that I will test a saliva test for. A saliva test is kind of a controversial testing method. It’s not appropriate for everything, but cortisol is the one hormone where my understanding is most researchers agree, it’s most accurately portrayed on saliva test.

LEON: Is that something you’d want to test in the morning and at night to see if it is cyclical?

LARA: Exactly. The standard test is a three or four point saliva test that you collect at home, so you get four little vials and you spit in the vials. At 6 or 7 in the morning, whenever you’d normally wake up, and then again probably midday, and then around 6 p.m. and then around 10 or 11 p.m. when you’re supposed to be going to bed. That gives what’s called a cortisol curve, and that can be quite helpful, clinically, to understand what’s happening with someone.

KUNAL: Hey Leon, we need to get ourselves a couple of these kits.

LARA: Yeah. (laughs) They’re popular. I mean, they’re not super popular; there’s a few labs in Australia doing them already, but… a lot of labs I think in the U.S. are doing them as home test kits, as well.

KUNAL: That’s great. We’ve actually got Talking20 blood test kits, which let us do in-home blood testing. We do drops of blood on a piece of card and send that away.

LARA: All right. What are they testing?

KUNAL: Leon?

LEON: At the moment, they’ve got a panel of about 20 different things that they’re testing. Vitamins, LDL, HDL, cholesterol, testosterone, estradiol, a few standard things. But they’re a new startup and they’re increasing the coverage of the kind of things that they can test for, the breadth of what they’re testing for. It’s a really cool kind of product. At-home blood testing.

LARA: Yeah, it’s a blood spot, what they call a blood spot test, is that right? People just prick their finger and then they squeeze it? Yep. I’m familiar with some of that for thyroid testing.

LEON: Like a diabetic kind of does, I guess. One good thing about that stuff is it’s just really accessible and cheap. Kunal and I managed to get in at the prelaunch special, but we got three years’ worth of monthly tests, like the full panel of tests every month for $800 bucks.

LARA: Interesting.

KUNAL: Lara, you talked a little bit about antibiotics in food already, in milk and meats. You also mentioned that you tend to prescribe an anti-inflammatory diet and talked about elimination of sugar and gluten, fructose and wheat. Anything else you wanted to add to that, perhaps? What’s your favorite anti-inflammatory food?

LARA: Okay, first I’ll talk about I think the most important aspect of an anti-inflammatory diet is first of all removing the inflammatory foods, and then think about adding in anti-inflammatory foods. But as you’ve said, in my experience – and it’s interesting how much things change and how much things stay the same, because 20 years ago in my training, we were told – without as much understanding of why we were doing it, but we were told “take people off wheat, cow’s milk, sugar.”

Those are the most inflammatory foods in my experience. I guess the next one after that would be the omega-6 vegetable oils, which we understand more about now. But the gluten is an inflammatory protein, and the A-1 casein that’s one of the proteins in normal milk is quite inflammatory in certain people, and excess fructose, in the form of sucrose, creates inflammation and suppresses immune function in everybody.

So that’s the bulk of what I’m trying to get people to do. Many of the patients that come to see me – I’m happy when sometimes I get a patient who’s come to me who is doing that already and is a long way down that path, but most of the time I’m just trying to get people off of those big worst foods.

Anti-inflammatory foods are vegetables, basically. Variety of vegetables and their phytonutrients, which are anti-inflammatory by speaking directly to our physiology and in many cases to our genes, to switch off inflammatory pathways.

KUNAL: Can we add in grass-fed butter and meats?

LARA: Yes. And you could add in the medium chain fatty acids that you get from butter and grass-fed meat and coconut milk and coconut oil. Also, obviously, the omega-3 fish oils as well are inflammatory.

LEON: So your favorite anti-inflammatory food would basically be all of those things chucked in a blender?

LARA: (laughs) I tend to have – I eat a lot of butter. I tell myself I like that it’s anti-inflammatory. (laughs) You could do it in a blender as well.

KUNAL: Yeah, we make sure we buy New Zealand butter, because that tends to be from pasteurized cows, whereas in Australia, what tends to happen is if there’s a shortage of pasture, then they do tend to be given feedstock.

LARA: Grain-fed. Right. So even the organic butter would be – I saw that on your website, I think, that sometimes even the organic butter would be grain-fed. Is that what you’re saying? Okay.

LEON: But you know what, I got an email from a customer the other day who said that at the moment in New Zealand they’re having a bit of a drought, so maybe we’re not always so safe with New Zealand butter after all.

LARA: One of my patients owns her own Jersey cow and makes her own butter. That’s another way you could go.

KUNAL: There we go.

LEON: So she pays you in butter, does she? (laughs)

KUNAL: We’re going to have to get her details and pay her a visit.

LARA: (laughs) Good.

KUNAL: You still haven’t told us your favorite food.

LARA: My favorite anti-inflammatory food… I think in the phytonutrient category, vegetables that have beneficial phytonutrients, certainly turmeric. That’s a favorite.

KUNAL: I guess what I’m asking is what are you having for dinner tonight?

LARA: We’re having potatoes with butter and organic broccoli and organic lamb sausages. I’m hoping they’re grass-fed, but I don’t know for sure. (laughs)

LEON: Something that we’re really interested in at OptimOZ is this idea called bio-hacking, which is all about using supplements and using gadgets and optimizing your wellness so that you can perform at your peak all the time. Some approaches to that might be making sure you don’t have any vitamin deficiencies, but a big part of your performance must have something to do with your hormone levels and the health of your endocrine system. In your experience, is there anything that you’ve done from that respect, to improve your performance or to get more well? Is there something actionable that people out there could do?

LARA: Sleep, I would say. (laughs) No, I’m just trying to – by performance, you don’t necessarily mean athletic performance or performance in the gym?

LEON: No, just not getting that kind of sluggish brain fog after lunch. Doing a good job, not being a grumpy partner or parent. Just something to make you [inaudible 00:33:14] in general. It has relevance to any aspect of life.

LARA: Kind of looking for a soundbite about that. I did something with a TV interview last week. She was saying, “I just need a catchy soundbite, just like one sentence.” (laughs)

LEON: Sleep’s a good one.

LARA: Sleep – if I’m talking to a Sydney population – I know your audience is broader than that, but they are sleep-deprived. I don’t think they realize how much of their brain fog and irritability is due to that. The truth is, Leon, it’s everything we’ve talked about. For example, sources of brain fog as a symptom would be, after sleep deprivation, I’d say the next big one is the wheat toxicity. The negative effect on the nervous system by the wheat, by gluten, the opiate-type chemical that gluten forms in the body. Disrupted intestinal bacteria cause brain fog. We talked about how they actively secrete neurotransmitters that affect our brain.

If I was going to say the top things to increase someone’s day-to-day wellness and performance would be getting enough sleep, reducing wheat and sugar in the diet, and probably the next thing, in terms of supplements, would be magnesium. Because it’s the nutrient that I get the biggest clinical results with. Most of us are deficient in magnesium, and there’s different reasons for that. It’s highly influential in the HPA axis that we talked about before, the communication between the brain and the adrenal gland system. It calms that. It calms stress. Improves the production of all hormones, including testosterone, progesterone, all the hormones we need for our vitality.

LEON: What kind of magnesium do you usually use?

LARA: I get the best results with magnesium chelate, which is magnesium joined to the amino acid glycine. I think it’s partly to do with the availability of magnesium, and partly I think it must also be that glycine has some of its own benefits in terms of calming the nervous system and also it supports one of the phases of liver detoxification, phase 2 liver detoxification. So it helps to clear from the body toxins, including some of the xenoestrogens that we’re exposed to, some of the estrogenic plastics and pesticides and things like that that we’re exposed to. That’s one of the many ways it helps us. Hardly a patient escapes my office without a magnesium glycenate supplement. (laughs)

KUNAL: Do you ever prescribe transdermal?

LARA: I don’t. I know of it, and I can’t speak to its effectiveness. I love the magnesium chelate so much that I’ve been reluctant to stray from that. I tend to think I don’t know how you could get the dose from it that people need, because I think they do need at least 200 or 300 milligrams of elemental magnesium per day.

KUNAL: What if someone has leaky guts, for example, and isn’t going to get the absorption or bio availability from taking any supplements orally?

LARA: I don’t think it’s fair to say that leaky gut impairs all nutrient absorption. It certainly does create issues –

LEON: It impairs what you can’t absorb, right? Like it breaks down the filter between your gut and your bloodstream?

LARA: Primarily, it’s not what it’s keeping out, but what it’s letting in. The problem with intestinal permeability is that it’s letting in some of the toxins from the intestinal flora, which are a huge burden for the immune system to deal with. It’s a massive source of inflammation. But in terms of absorption, my experience is that the magnesium chelate, the magnesium glycenate, appears to be – I would say it’s being absorbed, even by people with impaired digestion, because they’re getting clinical benefits from it.

The minerals that are hard to absorb – the real absorption problems is some of the magnesium oxide and some types of iron and supplements, which, if you don’t have the stomach acid to break that down, that stomach acid to assist with digestion, then it can be quite difficult to absorb them. Low stomach acid is probably another source of intestinal malabsorption problems.

LEON: In terms of providing a protocol for your patients to take magnesium, what time of day do you advise?

LARA: I’m trying to get it into them, so I often give it twice a day. But if you were just to pick one time of day, I would say nighttime, because it’s sedating and it will help with sleep for anyone that’s having difficulty sleeping. Reduces cortisol. I mean, it actively reduces cortisol, through a few mechanisms. So that’s one simple thing people can do.

LEON: So take magnesium chelate, take it at night, and how much is the typical dose again?

LARA: Probably 200 milligrams of elemental magnesium. Lots of different brands. It’s a popular supplement.

KUNAL: Would you recommend GABA or l-theanine for sleep as well?

LARA: Yes. Yes I do.

KUNAL: In combination with magnesium?

LARA: Yeah, you could. You could combine it.

LEON: With GABA and l-theanine is there a risk to taking it long-term? Is it something that you can take every day?

LARA: My understanding is it’s not addictive, so my understanding is you could withdraw it at any time and your nervous system would hopefully even maintain the benefits of reduced activity that it had from the GABA. Yeah, I do prescribe GABA. I don’t know if you can actually get that in Australia right now, but some of my patients do import it. Here’s the thing, the intestinal bacteria make GABA. So that’s another good reason to have healthy intestinal bacteria.

One last thing, if you can include this, is another major source of disruption to the intestinal bacteria is the pill. It kills them, basically. Those synthetic – because the bacteria are trying to handle estrogens, and imagine when you swallow a tablet of heavy dose synthetic estrogen. The first frontline to take the damage from that is intestinal bacteria.

KUNAL: That’s really scary stuff about the pill.

LARA: It’s really sad, actually. It’s scary and it’s very sad. What makes me sad is to see women trying so hard to do everything else right with their diet, and then just feeling terrible and feeling depressed and having sugar cravings and non-functioning intestinal bacteria and bladder infections. The whole works.

LEON: You know what, they’ve probably got really good intentions, too, but they’re just out there with the wrong information, eating whole grains and all that kind of stuff too.

LARA: Absolutely. No, I don’t blame the women. I just hopefully try to help them to understand that they’re better off without it.

LEON: Can you just give a little blurb about what you do and how people can get in touch with you?

LARA: Yes, okay. They can reach me at a couple locations. My blog is larabriden.com, and in my blog I’m trying to put to the test certain beliefs about health and hormonal health and find the truth of that, based on evidence and based on my own clinical experience. Then my clinic is Sensible Alternative Clinic in Sydney, and I see patients three days a week. People can email me or call my assistant and reach me that way.

LEON: Great. We’ll have links to both of those in our blog post.

LARA: Yeah, great.

KUNAL: That’s awesome. Thanks, Lara. It’s been a real pleasure talking with you. We appreciate your time. And thank you to everyone for tuning in today.

LARA: Okay. Thank you.

LEON: Thank you so much.

LARA: Yep. Bye.