For years, women died from heart attacks because doctors treated them the same as men. In the 21st century, there still is much to learn about the difference between men and women and their health issues.
Writer: Leigh Neely
Aside from the obvious differences that are celebrated, men and women experience health issues very differently. The GI tract muscles function differently, as do the large intestine and gallbladder. Enzymes in the liver and small intestines mean men and women process medications differently. Women also deal with hormonal issues more often and many of their illnesses are related to hormonal imbalance.
The list could continue, but the point is women’s health issues aren’t like men’s.
More women are finding, however, that what you eat makes a difference in how you feel. According to a recent study by Nielsen, there are four factors creating the stronger focus on clean eating: people are getting older, the number of chronic illnesses has increased, people find proper nutrition decreases health problems, and technology provides more health information.
According to Lori Esarey, MS, ARNP-C, FAARFM, ABAAH, whose practice is Total Nutrition and Therapeutics (TNT) in Lady Lake, most women come to her with these symptoms: fatigue and hormonal issues such as hot flashes, poor sleep, and irritability.
“Those who are completely frustrated with their weight feel like they’ve tried everything and still can’t control it,” Lori says. “Weight loss, constipation, and diarrhea are always interrupting their quality of life.”
Joanne M. Keller, ARNP, sees the same health issues in her practice, Women’s Health & Wellness in Mount Dora. “The complaint I hear most often is fatigue.”
Lori says she feels women are conditioned to just “suck it up,” pretend everything is fine, and put on a happy face.
“They do this until it’s so bad they have no choice but to get help, and at that point, they seek me out,” Lori says. “However, typically they’ve already spent a lot of money and time and feel even more frustrated.”
Most women find there are no easy answers for the health problems they’re facing, and it takes more than just “popping a pill” to find the good health they seek.
“We begin our consultation with a comprehensive lab functional panel,” Joanne says. “I ask them everything about themselves—what they’re eating, their stress level, where they work, and then a I do blood work. The comprehensive lab work we do is considered a functional panel, which is very different from the conventional approach. It includes genetics, inflammatory markers, hormone levels, vitamin levels, and mineral levels.”
Joanne says doctors normally do not share what the optimal levels are with lab results. “If the range is from 30 to 90, and your level is 35, you’re considered within the normal range. However, the optimal range may be 70 to 90.”
“Nutrition is vital,” Joanne says. “The condition of the gut (not food) is responsible for nutrient absorption, those vitamins and minerals that keep your body going. We do a stool test to see what you’re not absorbing. Malabsorption can be a big issue.”
She also points to the value and benefit of exercise, however, she readily states, “You can’t out-exercise a poor diet.”
Joanne goes on to say when most patients have fatigue, it’s usually because of the thyroid. “Most doctors only test the TSH, which tells you what the pituitary is doing. It doesn’t tell us what the actual thyroid is, which is the free T3,” she says.
TSH is thyroid-stimulating hormone, and free T3 is triiodothronine, the free, unbound levels of hormone thyroxine, the storage hormone.
Nan Cobb came to Joanne after seeing a number of doctors who could not diagnose what was causing her hands to crack and bleed, meaning she was unable to do simple things such as washing dishes.
“The doctor was referring me to the Mayo Clinic, but I refused,” Nan says. “I saw Joanne at Business after Hours, and she took one look at my hands and said, ‘Candida.’”
Said to be the largely unknown health epidemic, candida is a systemic fungal infection, an autoimmune disease.
“I had to be treated systemically, and I also had a leaky gut and my cortisol level was shot,” Nan says. “A lot of detoxes later—and it was a rough time—I’m eating only whole foods, and I’ve lost 100 pounds. The weight loss was a side effect. I did what I did to heal myself.”
Lori says many women put up with a variety of little things for quite a long time.
“When they finally see a health-care provider and have lab work done, they receive the answer, ‘Your labs were fine,’ and they’re categorized as depressed, which seems like a ‘catch-all’ diagnosis,” she says.
Treatment at TNT begins with a metabolic evaluation. Prior to the visit, a body composition analysis is completed to evaluate weight, pounds of fat, pounds of lean muscle, amount of brown or visceral fat, and phase angle or health of the cell. That analysis is followed by a meeting with the patient to discuss symptoms, medical history, what the patient tried that didn’t work, and to ensure TNT has the resources to help.
Andrea Soukup is a patient of Lori’s, and she says she went to TNT to learn how to eat.
“Most of my adult life, I’d been a food addict,” Andrea says. “I always ate what I wanted and as much as I wanted.”
Using food as a coping mechanism is a common problem for women, and Andrea realized that was her problem.
“I went to Overeaters Anonymous for 30 years before I finally woke up to the fact that I needed help,” she says.
She first sought help from a therapist, realizing there were psychological issues she needed to address. After many years of yo-yo dieting, losing and gaining weight, she was taking medication for high blood pressure. After getting the comprehensive lab work done, she found she had metabolic syndrome and was on the verge of diabetes.
“I also had no idea how unhappy I was. When I first went to see Lori, I had no appetite. I only ate because I knew I had to,” Andrea says. “I had constipation, and I’m sure I had a ‘leaky gut,’ but my timing in connecting with Lori will keep me from being diabetic.”
Joanne approaches each new patient as she would a jigsaw puzzle. She has to find all the pieces to put it together correctly so the patient achieves optimal results.
“Each patient completes a detoxification questionnaire. We do a health assessment to determine if the problem is mild, moderate, or severe,” she says. “We also use a machine that gives us a body composition analysis.”
This provides information about body fat percentage, where the body is strongest, bone density, and other elements that are used in preparing a treatment plan.
“After treatment begins, patients understand the results of the changes they’ve made better when we put them on the Body Composition Analyzer, because it measures so much more than the scale does,” Joanne says.
Lori says it’s important to help patients understand that true change is transformation because the change is permanent.
“When we say it requires knowing the real ‘why,’ that means finding a number of things: why I feel this way, why my body is behaving this way, why I respond the way I do, why I made certain decisions that contributed to my problem, why my family history/genetics is making a difference,” Lori says. “Quite frankly, the why means ‘root cause analysis,’ which includes all the contributing factors.”
That’s what Andrea discovered when she turned to Lori for answers, and it changed her life.
“The thing I like most about coming here is I feel like I’m their only client,” she says. “There’s such passion and commitment. They totally believe in what they do.”
The education received from TNT made a difference, too. “When I look at a piece of cake now, I know what it will do to my body, and I can pass it up.”
Many of the symptoms women deal with related to their monthly menstrual cycle are a byproduct of metabolic disorders according to Lori.
“I have a master’s in nutritional and metabolic medicine and, typically, every woman I see has some sort of hormonal imbalance, which is a primary disruptor of their metabolism and creates a variety of symptoms,” she says. “Some of them they recognize, some of them they’re unaware of until we discuss them. Once the disruptor is identified, actions are taken and symptoms begin to reduce and may be resolved.”
Finding the right hormonal balance is an area Joanne focuses on, too. “Fixing the underlying problem can significantly reduce the need for pharmaceuticals.”
She offers bio-identical hormone replacement therapy (HRT), which can improve quality of life for men and women.
Hormones work in the body like a symphony. None are more important than the other. “The one hormone that most women are unaware of that they desperately need is testosterone,” Joanne says. “This is where the hormone pellet therapy becomes a convenient delivery system to help both men and women achieve optimal Testosterone levels. When hormones are optimized, we are then able to alleviate symptoms and improve the quality of life of our patients.”
HRT can help, she says.
“I believe this therapy is needed so much I have made hormone pellet therapy a significant part of my practice,” Joanne says. “I have individual care plans for each patient, but I’m amazed at how many have found hope and better health with this process, both women and men.”
The pellet is inserted with a small incision that is easily closed.
“There are side effects, of course. For women who take the testosterone, there can be increased darker facial hair and maybe acne,” Joanne says. “For men, it’s usually water weight gain, but most of the time, these symptoms are temporary.”
Young women also have issues that Lori deals with in her practice. She says the biggest may be stress—the need to look good, be slimmer, perform better, be Wonder Woman.
“In young women, stress manifests in a multitude of physical illnesses, such as anxiety, bowel disorders, food allergies, ulcers, weight gain, thyroid disturbances, which can lead to body issues and maybe even depression,” Lori says.
Many people find bowel issues embarrassing and often won’t discuss them until the situation is unbearable. Common problems for women are constipation, irritable bowel syndrome, diarrhea, inflammatory bowel disease, ulcerative colitis, Crohn’s disease, diverticular disease, Celiac disease, colon polyps, and possibly colon cancer.
All of these are issues your doctor or practices like TNT and Women’s Health & Wellness can address, and don’t hesitate to talk about any problem in the digestive or bowel system. The human digestive system runs from the mouth to the anus, so there are many areas for problems to occur.
“Many of my patients turn things around with nutrition, and I stress that everyone needs antioxidants and probiotics to do it,” Joanne says. “Food addiction comes from sugar.”
Both Lori and Joanne know nutrition is the key to beginning a permanent transformation. Educating yourself about the body and how food affects it, knowing what foods are detrimental to your health, and creating a food plan that fulfills your hunger needs and makes you healthier are vital.
“I’ll go see Lori until I know that I don’t need to go,” Andrea says. “Healing insulin resistance and metabolic syndrome is a slow process. After I began feeling better, it was a revelation to me to see how unhappy I was. Now I feel empowered and I’m happy. It’s about me making choices, and I feel amazingly supported in this process by Lori and her staff.”
Patients must develop this “wellness mindset,” Lori says, which means finding what wellness means to you.
“Once you have clarity in this, you live intentionally, minute to minute, and decision to decision, knowing you need to ask, ‘Is my current action moving me toward optimal health or not?’ My wellness mindset is I want to live life well,” Lori says. “Unfortunately, many of my clients have not felt good in a long time and do not have the clarity yet to know what wellness feels like.”
Most often, Joanne recommends the Paleo diet, which stresses fish/seafood, wild meats, fresh fruits and vegetables, eggs, nuts and seeds, and healthy oils. Avoid carbs, legumes, sugar, dairy, processed foods, refined oils, and salt.
Lori and Joanne both say the infancy stage of developing a wellness mindset requires many conscious decisions that begin with trusting the professional who is guiding you and knowing things will get better.
“A lot of people thought I had cancer,” Nan says. “But I just needed to heal myself from the inside out. It has been a roller-coaster ride, but worth it. My hands look good now.”
It’s important to eat the right foods, but it’s more important to find the root of problems, so you know what foods will effectively help your body heal and reach its maximum health potential.
Dealing with No. 2
Constipation affects around 42 million people in the United States, according to the National Institute of Diabetes and Digestive and Kidney Diseases. It is defined as fewer than three bowel movements a week, or movements that are hard, dry, and small, making them difficult to pass.
Several factors can lead to constipation, including medications, being inactive, traveling, pregnancy, diet, and health conditions that slow digestion. In addition, suffering from constipation for long periods leads to other complications (hemorrhoids, anal fissures, rectal prolapse, and fecal impaction).
Often, this happens because more fiber is needed in the diet. There are two types of fiber. Soluble dissolves in water and is found in beans, fruit, and oats. Insoluble does not dissolve and is in whole grains and vegetables. Both fibers help prevent constipation.
You should eat 22-34 grams of fiber every day, but if you’re changing your diet to do that, increase the rate gradually. Otherwise, you’ll have to deal with gas, bloating, and cramps. Give your body time to adjust. Also, drink plenty of fluids (water, fruit and vegetable juice, clear soups) to help the fiber work effectively.
Avoid foods that might make the constipation worse: cheese, chips, fast food, ice cream, meat, and processed foods.
If the problem continues, don’t keep trying to fix it yourself. Go see your doctor or health-care professional and get your body back on the right track.