Fixing Midlife Hormonal Symptoms Using Food with Dr. Alan Christianson

Content By: Ari Whitten & Dr. Alan Christianson

In this episode, I am speaking with Dr. Alan Christianson, who is a board-certified naturopathic endocrinologist and the founding president of the Endocrine Association of Naturopathic Physicians and the American College of Thyroidology. We’ll discuss his new book, the Hormone Healing Cookbook, and specific foods for resolving pesky symptoms driven by hormonal changes in midlife.

Table of Contents

In this podcast, Dr. Christianson and I discuss:

  • The natural decline of hormones with age and the evolutionary significance hereof
  • Key symptoms of age-related hormonal changes
  • The benefits of nitric oxide (and the foods that promote its production)
  • Potential risks associated with long-term low-carb diets on hormone production
  • Essential foods and supplements for enhancing brain function and cognitive performance
  • Foods that promote better sleep

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Listen outside iTunes


Ari: Hey, this is Ari. Welcome back to the Energy Blueprint podcast. With me today is my close personal friend, Dr. Alan Christianson, who is a board-certified naturopathic endocrinologist and the founding president of the Endocrine Association of Naturopathic Physicians and the American College of Thyroidology. He has written a number of books, but his most recent one is The Hormone Healing Cookbook.

Basically, this takes you through a number of specific recipes and specific foods that are useful for dealing with some of the symptoms that emerge typically in midlife that are associated with hormonal changes, both in men and women, but I would say probably with a focus on the hormonal changes in women. There’s a lot of interesting insights in this book and we talk about a lot of those insights here in this podcast. With no further ado, enjoy this podcast with Dr. Alan Christianson.

Dr. Christianson, it’s a pleasure to have you back. I think this has got to be number four at least, maybe number five. I don’t know. We’ve had so many conversations on podcasts. It’s hard to keep track.

Dr. Alan Christianson: Woohoo, I’ll take it.

How hormonal changes affect us

Ari: Yes, absolutely. You have a new book coming out, and it is the Hormone Healing Cookbook. It’s very cool stuff. There’s a lot of novel stuff in here that’s not common for people to talk about. I learned a few new things, which I’m always grateful for. I’m excited to dig into this with you. We’re going to be talking all about healing hormones and how to do so with food.

Maybe as broad context to get us into this discussion, talk to me about why hormone levels change in the first place as we age, so why do women go through menopause and why do men go through menopause? That’s a commonly joked-about term now. What’s going on here with these hormone changes?

Dr. Christianson: It’s a fascinating question. One older model was that we were out and our bodies are just tired, and therefore, there’s less of them because we can’t make them. That’s not really taken seriously anymore. The body has the capacity to make hormone. There’s not a lot of metabolic cost to making hormone, but there’s a lot of ways in which we intentionally down-regulate our energy output and our repair because we can’t sustain it as well.

Yes, hormones are controlling all of that stuff. As our bodies enter into some planned obsolescence, so to speak, our genetic code starts to slow us down, so hormones are often mediators for that. They’re changing. What happens is that it correlates with so many of the symptoms of age, body mass, the changes in cognitive function, decreased rates of tissue repair, less energy output. These things are all pretty well track with these hormonal changes.

Ari: Explain to me planned obsolescence a little bit more in detail. Obviously, in the context of technology, there’s a very clear and explicitly financial incentive for makers of technology to incorporate some degree of planned obsolescence into the technology, but-

Dr. Christianson: Your razor blades wear out after a few weeks and you buy new razor blades. [laughs]

Ari: Yes, or iPhones. We want people to feel a year or two from now their iPhone or their Android phone or whatever is a little bit ancient and a little bit primitive compared to the latest technology and maybe it’s already starting to dysfunction a little bit. How do you see that working as far as humans? Obviously, there’s no financial incentive for our maker to create that planned obsolescence, whether our maker being God or evolution or nature or however you want to see it, but is it a resource thing? What would be the reason for humans to become obsolete as we age?

Dr. Christianson: Well, for starters, to say that there is a tidy answer to aging or that we know tidy answers to aging, we got to put a lot of asterisks and caveats on that stuff. I’ll throw that out there. In terms of incentives– and I guess another thought, there’s two facets to this. There’s, do we think this happens? There’s a reason why it would happen. There’s strong arguments from geneticists that a lot of aging is not just wear and tear or oxidative damage, that it’s deliberate.

A lot of ways, our bodies are hardwired to quit after a little while. We see limits on cell replication. Cells quit dividing at some point. A lot of aging is that new cells cannot replace the old dead cells very readily. It’s not so much that they couldn’t, it’s that there’s been an expiration date, so to speak, there’s been this Hayflick limit, there’s been this number of times in which now we’re not allowed to copy any further.

It seems that it’s not a matter that we couldn’t go longer, it’s a matter that there’s some deliberate ways by which our genetic codes inhibit us from doing so. Then the question as to why would that happen? I picked this book up again, not written too long ago, Rudyard Kipling wrote the Just So Stories, and there’s all these fun stories about how the elephant got his trunk. There’s a story about how the elephant. His line was a mere smear boot of a trunk. One day he went to ask the crocodile what the crocodile had for breakfast, and so the crocodile grabbed his stumpy trunk and pulled on it, so now the elephants have long trunks. There’s just so stories.

You can always make just so stories as to why things happen, but one argument as far as just so story of why this happens is that at some point, we could become utilizing resources. The more there are old apes around, there’s too many old apes to compete with young apes for the bananas. Another just so story is that we would have a slower timeframe for iteration. If we had one genetic model out for a long period of time, it may not adapt as readily. If the generation timeframe was longer, there’d be fewer generations within a certain time window to allow for less adaptation. Yes, there are some reasons we can think of why…

The hormone’s role in aging

Ari: With that model in mind it’s interesting for people to note that different species of animals have very different genetically predetermined maximal lifespans. I think that fits into that last factor that you gave there, which is multiple iterations over a given length of time maybe as opposed to fewer gives a survival advantage in a more rapidly changing environment.

Dr. Christianson: I just wrote a paper, a story actually of National Geographic, one of the current ones about the longevity of certain animal species and those that have the most marked longevity. There are some versions of Icelandic sharks that live like 500 years. It surprised me, but these are environments that don’t really offer a lot of radical change. Certain tortoises, certain large whales, they’re rather stable environments. You’re saying something that aligns with that. We think that the more need there is for adaptation, ideally, in terms of the species advantage, not the individual’s advantage, but the species advantage, you could iterate a little more quickly.

Ari: Hormones tie into the story again in the sense that this is essentially a function of aging that seems to be largely biologically predetermined. We are, in a sense, supposed to have declining levels of hormones beyond certain ages. Is that accurate to say? How would you phrase it differently?

Dr. Christianson: It is, and there’s two big facets to that. There’s just the crude level of hormones and then there’s this big, rich world of hormone metabolism, about how we circulate, how we convert, how we up-regulate, how we block. The quality of life– there’s that certain amount of just hormone [unintelligible 00:08:00] levels, there’s not a lot to do with that. There’s certainly cases where you can discuss the idea of replacing what’s lacking, but past that point, there’s a huge difference in how we can utilize what is there, and that’s things that we can do a lot with through lifestyle.

How lifestyle affect hormones as we age

Ari: With that in mind, let’s say women are going through pre-menopause or menopause symptoms at, let’s say, their late 30s, maybe mid 30s, late 30s, and other women are going through it in their late 40s and early 50s. Some women have very severe symptoms as they’re going through that, debilitating symptoms or certainly of greatly affecting their functionality in life, and other women experience relatively mild symptoms. Do you think those dimensions of that experience, what age you experience it, how severe of symptoms, do you think that those are largely influenced by lifestyle factors or are genetically predetermined? How do you see that?

Dr. Christianson: There’s certainly always some combination of lifestyle and genetics. There’s not much else besides that, and the question comes up as to, is there an opportunity? We’ve got good data saying that even if you look at the same hormone levels, there’s still going to be a big spectrum of experience, what you described as far as when this happens, how severe it’s experienced, that’s not consistent even at the same amount of hormones in the system. There’s a big range in how they’re utilized, how the body breaks them down, how they’re absorbed, how they’re excreted. Those are things that lifestyle, and specifically diet and specifically choices of plant categories can have a lot to do to modulate.

Ari: Before we get into the specific foods, let’s talk about some of the symptoms, and you could differentiate it by sex if that’s warranted. What are some of the key symptoms that would indicate hormonally-driven issues in middle-aged humans?

Dr. Christianson: Yes. A good point is to have someone think about that they’ve come on over a certain time frame. A lot of us have our weak links, things have always been there. Those things can worsen or be affected. It’s more so things that are emergent around those time frames. You really nailed them, especially sometimes starting in the later 30s, but more commonly mid-40s, later 40s. The top five independent of sex would really be weight struggles, energy issues, cognitive function, hot flushes, bigger thing for both genders than I was even aware of until I read some of the studies.

Ari: For men too, hot flushes?

Dr. Christianson: Yes, big subset-

Ari: Oh, I didn’t know that.

Dr. Christianson: Sometimes a third or a third to 50% of the populations have significant ones.

Ari: Interesting. I’ve been sweating my ass off here in Costa Rica. Maybe that has something to do with it or it could just be that I’m in a tropical environment. I feel hotter than normal lately, though.

Dr. Christianson: Come on up here to the frozen thundra. That’ll change.

Benefits of nitric oxide

Ari: I’m sure that’ll change pretty fast. I have no doubt that if I was next to you in frozen Minnesota right now, I would have a very different amount of sweat pouring out of my body each day. Let’s tie this into nutrition. You’ve written a wonderful cookbook. There’s lots of great tips in here. It’s not just recipes, it’s actually educating on the science of how some of these foods actually work to affect some of these five symptoms that you just mentioned. Actually, maybe I’ll save the phytochemical thing for later because I think we might get a little bogged down. I know we maybe have some differences of opinion on that one.

Let’s go into some other mechanisms around this. One cool mechanism I think for people to know is nitric oxide. You wrote quite a bit about that and how nitric oxide is utilized in the body. You know what’s interesting? You probably know this, of all people, you’re one of my friends who seems to know the most fun, trivial facts and histories of things. Back in the 1980s, nitric oxide was really seen just as a toxic waste gas, like it was associated with air pollution.

Then it eventually was the case that researchers discovered it has all these important roles in human physiology. Those researchers went on to win a Nobel prize for their discovery around the importance of nitric oxide in human physiology. I think even circa 2023, we’re still learning a lot about this story. Many new layers of this story are unfolding. For example, the role of the oral microbiome in producing nitric oxide that goes systemic and all these how it ties into stem cells and all kinds of cool stuff. You wrote quite a bit about this in your book and certain foods that affect it and what pathways and symptoms it affects. Tell us about the nitric oxide story.

Dr. Christianson: That’s a cool one. It’s an odd thing. I won’t go too far into this, but you mentioned that there’s also the whole nitrate and sodium nitrate. Is this a carcinogen? Is it an ergogenic? There are some complicated stuff there. It’s that same story where foods and food matrices work different than the constituents might predict. Yes. The answer of that-

Ari: Tell us about that, because that was a really interesting part of your book, differentiating the nitrates in, for example, leafy greens and beets versus the nitrates in processed meats. You talked about in your book different health outcomes that we have in the research that are associated with those two different sources of nitrates.

Dr. Christianson: Yes, and it’s curious. There’s some things that engender a stress response and engender free radical damage in ways that in the case of smoked and processed meats, it seems that their correlations with stomach and esophageal cancer correlates with their nitrate content. Yet we can also see nitrates engendering a different response in the context of whole foods, in the context of polyphenols and whole foods.

The same things, given their context, given their food matrix, a common phrase now, they work completely differently. One is a clear thing for cancer risk and one is a clear thing benefiting aerobic performance.

Ari: Yes, super interesting. How does nitric oxide and that story, nitrates and nitric oxide tie into the five hormonally driven symptoms that you mentioned?

Dr. Christianson: We’ve got massive data sets on endurance of the athletes and the effects that nitrate-enhancing compounds have on them. There’s also some good data sets on those who are struggling with fatigue. I argue there that these populations, their goals are often different, but the mechanisms are the same. Someone who wants to just be able to get off the couch and function and get past a built in fatigue, they want to generate energy more effectively. That’s really the same thing as someone who’s trying to run a long event or do whatever else. It’s the same process, they’re different expressions. We’ve seen, for example, that aerobic capacity can be modulated, improved by 24% over the course of short timeframes with high beet intake. That’s on par with blood doping. It’s a really big deal. [laughs]

Ari: Yes, I’ve actually personally been experimenting a lot lately with nitric-oxide-boosting strategies in a number of different ways, beets being one of them, other nitrate rich foods, arginine and citrulline and some other stuff. have to say, I have a very noticeable improvement in my endurance and stamina while surfing and playing tennis. It’s not subtle, it’s one of the most noticeable things that I’ve ever done as far as really seeing a clear performance enhancement from it. I’m a believer.

I recently found out based on my gene analysis– I had the owner of The DNA Company, Kashif Khan, on my podcast and he did a very personalized deep dive into my personal genetics. One of the things he said is that my gene variants related to nitric oxide production are among the worst possible. That matches up because, genetically, if I’m performing nitric oxide production very poorly, then that might be somewhat of a limiting factor for me. When I do endurance exercise, and then it might become more noticeable for someone like me especially, who maybe has a deficit in that to use some of these nitric-oxide-supporting supplements and foods.

Benefits of nuts in your diet

Dr. Christianson: Yes, that all fits. You mentioned that oral microbiome, there’s some evidence arguing that we’ve got to actually chew this stuff or taste it to have it be particularly effective. It’s got to mix with saliva, perhaps.

Ari: Yes. Actually, that’s an area that I’ve spent the last few months doing a deep dive in. I actually think there’s a lot more to the saliva story than people commonly realize and commonly talk about. Even among dentists, I think that most are not totally aware of this. I think there’s a lot of stuff that is very intentionally getting transported from our blood into our saliva, and nitrates being one of those things, and nitrites being one of those things.

There’s a lot to the story of the oral microbiome and nitric oxide production. There’s research that you probably saw, where they’ve shown that a lot of the sterilizing compounds that are used in dental mouthwashes that are antimicrobial affect systemic blood pressure, because when you kill microbes in the mouth that are nitric-oxide-producing microbes, all of a sudden blood pressure goes up throughout your whole body.

We’re discovering all these interesting links between the foods you eat, blood transporting and pumping into the saliva, and then those nutrients, when they’re in the saliva, being transformed by microbes that then do other things that produce molecules that have systemic effects on our whole body. Then something as simple as using the commonly prescribed, by your dentist, oral hygiene products are now all of a sudden affecting your oral microbiome and maybe even something like erectile dysfunction, for example, which is also heavily nitric-oxide-dependent. There’s all these interesting links there.

One of the other things that you talked about in your book that was very interesting was you talked about some interesting things around nuts and almonds and walnuts in particular. Can you talk about that?

Dr. Christianson: Pretty cool stuff. Walnuts have some unique compounds called walnuts oligopeptides, and it seems that they have some roles to play in helping us clear waste in the body. You’re aware of this, most are not, but we don’t really know why we get tired. There’s not a clear consensus on what makes us slow down or not function as well. We know there’s some correlation with a buildup of various types of ways. There’s some element of a factor. They’re not directly linear, but we know that these walnut oligopeptides help us clear most waste that have been tracked. Lactate dehydrogenase, blood urea nitrogen, lactic acid, these are all things that these compounds help us eliminate more effectively.

You mentioned almonds, there’s ways in which we know that foods will work that make them more than just the sum of their parts. I talk about the phytonutrients, but we think of like the macro and the micro nutrients. In many cases, it’s tempting to think about food as being just sources of these macro or micronutrients.

One of the studies that I mentioned about energy output showed that you could take cyclists and give them these cookies which were the same macronutrients and the same caloric load or you could give things that contain almonds [unintelligible 00:20:18] same blend. There was this marked change in output of capacity to exhaustion with the same caloric load and the same macronutrient load. We know that these accessory nutrients are more than sum of their parts.

Low-carb fatigue

Ari: There was an interesting sub-section in your book on low-carb fatigue. Talk to me about that.

Dr. Christianson: Simple things, just the energy source. The body’s got [inaudible 00:20:45] energy, and the more they’re available, the better we can function and perform. A lot of our energy output, of course, is [unintelligible 00:20:52] substrates, carbs, and fats to be preferential, but the main way we burn fat is beta-oxidation. That works most effectively when there’s some supply of glycogen there available. You have the stored carbohydrate as glycogen is directly a fuel source, but it’s also a catalyst for the beta-oxidation process.

We have multiple papers showing that those who are very low on [unintelligible 00:21:14] main macronutrients in the case of carbs are more rundown for a lot of reasons. Mechanistically, it’s curious, but there are some ways in which the body correlates overall fuel status with carbohydrate status. It’s not the only fuel, but in the case of insulin, for example, if insulin levels are too low, the body can respond as if there’s a marked caloric deficit and centrally inhibit thyroid hormone excretion and also lower thyroid hormone activation. Even if there’s not really a fuel deficit, you can get plenty of fuel from other sources, but in some ways, just one of those macros being markedly absent causes the body to go into a [unintelligible 00:21:51] mode.

Ari: Do you see any role for low-carb or keto diets, even done temporarily or cyclically, to have benefits or do you see them mostly as a potential problem?

Dr. Christianson: Certainly, if you show me good data, I’ll believe anything at all. I’ve seen quite a bit of data about the ketogenic diets being useful in medication-refractive epilepsy as far as clinical outcomes and there’s countless ways that one can speculate about big outcomes or big benefits about ketone bodies. If we have good clinical outcomes, I’m happy to align with that, but people need to know that there are drawbacks.

We’ve got most of our data sets about larger outcomes from some of these epileptic populations, so we know that kids don’t really get thyroid disease. The rates of that amongst adolescents kids it’s 1 out of every 1,200, but on ketogenic diets, the rate of marked hypothyroidism that requires medication is about 27%. It’s quite common.

There’s actually a recent now study done on adults on Atkins diet showing the same process that many [unintelligible 00:23:04] dysfunction, and the largest data sets actually come from looking at Ramadan. There’s 44 studies to date now looking at the effect of Ramadan on those with existing thyroid disease, and also those with normal thyroid function. This is not fasting, not marked ketogenesis, but intermittent fasting of sorts. Same thing, we see that when food intake is decreased a lot or if the timing is changed radically, the body can respond in ways to try to lower its metabolism, try to protect itself against that.

Ari: The distinction there would be that this is some sort of transient functional decrease in thyroid hormone output as opposed to overt Hashimoto’s hypothyroidism, like an autoimmune-driven hypothyroidism, or is there not a distinction like I’m implying there?

Dr. Christianson: Most data is showing more so the former, but there is some data showing onset of a latter. It’s commonly thought that if someone has some proclivity towards autoimmune disease, the more their thyroid has to be yelled at to work, the more likely that is to come on. The thyroid generates massive amounts of free radicals, so the more stimulation requires [unintelligible 00:24:19] the more the [unintelligible 00:24:21] and the more chance there is for disfunction to set in place, and in some version that could be lasting.

Energy promoting benefits of oats

Ari: Got it. Actually, before we go on within the subject of energy, since this is the Energy Blueprint, it might be worth emphasizing this one above all else, are there any other foods and supplements you think are worth mentioning in this category for improving energy levels?

Dr. Christianson: One fun one to mention, and it had some good data too, is oats. We know that beta-glucan may be part of the story, but there are ways in which they specifically can benefit Krebs cycle metabolism. This also seems to be rather independent of just their content of calories or macronutrients.

One trial that I mentioned in the book took some that had impaired quality of life scores due to chronic fatigue. The intervention was just a couple ounces of dietary oat per day. They did track the beta-glucan content, but the beta-glucan content was not different from any commercial oat products and the amount of oats consumed was rather common. They saw about a 40% improvement in quality-of-life scores over the course of a few months. Oats are really fun food, very underutilized, I think.

Ari: Yes. Agreed. Not only underutilized, but also heavily demonized in some circles now, just as being part of the grain family.

Dr. Christianson: One of my favorite recipe is with the savory steel-cut oat

The best nutrients for cognitive health

Ari: Let’s talk about brain fog. What are some of the key mechanisms or key foods and supplements that are especially beneficial for improving cognitive function?

Dr. Christianson: Lots of good data around many. The couple that I really highlighted here would be basal, rosemary, I mentioned trout, [unintelligible 00:26:14], I’ll come back to that. We think about how quickly symptoms can change, and symptoms differ in whether they’re more symptoms of how something is working or of how something is structured. An extreme example could be bone density. It takes time to repair bones, even if you do the right stuff today, you won’t have better bones tomorrow. It takes time for that to play out.

Some things can work quite quickly in the body, and there’s many ways in which symptoms can change almost instantaneously. In the case of Rosemary as a neutropic, there have been several papers showing that at the quickest amount of ingestion, whether it’s smelling it or tasting it, there can be clear improvements in cognitive function.

Iodine – friend or foe?

Ari: Okay. Talk to me about trout as well. What’s going on there, and why trout as opposed to salmon?

Dr. Christianson: Sure. There are so many great seafood options. Tricky thing that I try to balance with that is think a lot about sustainability, think a lot about contaminants. Then in my world, I think a lot about iodine as well. There’s many that are struggling with thyroid disease, and there’s some window of being on the lower amount of iodine intake that not only can stabilize things, but can reverse things for the majority of adults. We’ve got many papers showing that now.

The trick is, how do you achieve that without cutting out some really important food categories? Seafood’s a tricky one, but trout is an awesome food because it’s rather readily available, cost-effective, and rich in all the relevant micronutrients and also essential fats that we see in seafood. Also, it’s checking all those boxes; not high in iodine, no big sustainability issues. Also, not a big problem with other common contaminants like PCBs. Real winner.

Ari: You said something there in passing that might– I know it’s a matter of routine for you. I’ve had many discussions with you about this, so I know the broader story around this, but I want to make sure listeners are aware of what you said because there’s still so much information out there that exists that is really saying the exact opposite of what you just said, in the sense of people advising to improve their thyroid health by consuming more iodine, saying, “Hey, iodine, this really important nutrient for your thyroid gland to produce thyroid hormones. You got to make sure to take in iodine via supplementing with iodine, via consuming more seaweed,” those kinds of things.

It’s also the case that most thyroid-supporting supplements on the market are making a point of including iodine. I just want to draw this distinction there between that and what you’re saying, which is, “Hey, avoid excessive iodine intake. Not only don’t supplement with iodine, but actually try to minimize your iodine intake.” Just explain the broader story there for people so they can understand how to make sense of your view versus the broad, maybe more common view out there.

Dr. Christianson: Sure. Quick version of this, iodine’s not a bad guy, we do need it, but we need it in a certain window. Your listeners are used to things in more nuance and more depth and more thoughtfulness. Nutrients are never good or bad, and it’s not that there’s a linear relationship between a nutrient intake and the function of a body. My favorite analogy is like keys for the car. If your keys are missing, your cars won’t move. When you get that key back again, magically, your car works. Nutrients are like that. If your car’s running, a thousand keys won’t make your car go faster. That’s how it works in this case.

Ari: Alan, everybody knows more is always better.

Dr. Christianson: [laughs] Well, in the case of nutrients, we always know that there’s a point where you’re deficient and a point where you’re toxic. That’s always the case. In most cases, that’s a really broad spectrum. It’s rather wide, but there’s also a level of intolerance. There’s ways in which exposure may not be overtly toxic, but it may be harmful for a subset of the population.

We talked early on about how hormones– I get this visual in my mind about playing pinball, where you got the ball moving around and you’re working hard to keep it in play. You’re moving it, it’s falling through this hole, you’re moving it there. That’s how things circulate in the body. Nutrients, hormones, there’s a lot of ways they’re peripherally managed and metabolized. In the case of iodine, that’s a set of enzymes called deiodinase. A lot of people have variations in those enzymes.

Our understanding is that early humans were really in two main types of environments as far as iodine was concerned. A lot of people were in coastal areas, and they ate a lot of shellfish, probably a lot of dietary seaweed, tons of seafood. They have a set of enzymes that allows them to get rid of too much iodine very effectively. That’s cool. Another big group of people was more inland. The trade-off they had to make mechanistically was they had to be better at preserving iodine. In doing so, they gave up the capacity of getting rid of massive amounts. Either you can skimp on it and you can do well when there’s not much or you can clear a lot, but you can’t have both.

What we see is that about 20% to 30% of the US population at present is exposed to amounts that we know are excessive for some people, and anyone can get overtly harmed by levels of greater than about 1100 micrograms per day. That’s not hard to get. That’s based upon WHO data. We’ve seen pretty clear manifestations in areas that are fortified with iodine, how it affects the rate of thyroid disease. Some people, if they’re above 200 micrograms, they’re prone to have thyroid disease come on. We see this pretty repeatedly.

In the case of the US, we fortified with iodine starting in 1924. It was voluntary, it was just done in Michigan. Before then the rate of autoimmune thyroid disease was a few per 100,000, but in the following decade, the rates of it amongst women in their 30s and 40s went up 52-fold, not percent, but fold. It went from a rarity to a commonplace issue. This was written about in the Mayo Clinic Journals. Doctors were saying, “Hey, look, I’m seeing all this thyroid disease now. Why are we doing this?”

Denmark just fortified in the year 2000, they’ve tracked the last 15 years, they’ve seen thyroid disease go up. There’s three pretty pivotal studies looking at, great, we now know that there’s this window where it can be a problem, but is there an opportunity? Studies have now shown that if people get to a low enough range, not only will it stabilize their thyroid function, but it will reverse the disease for a large percent of people.

Thankfully, iodine is in so many common foods that it’s not an easy thing to get deficient in. We’ve actually had six documented cases of iodine deficiency in the US since 1980. It’s not impossible, but it’s extremely rare. Most who are prone to those issues easily get too much more so than too little.

Ari: Yes. This is a quick digression, but I can’t resist. My wife’s sister is married to an Italian guy and his name is Raffaele. He’s a wonderful guy and we spend a lot of time with him. What’s interesting is that my wife’s sister, who I’m good friends with, is very attuned to studying health and studying my work and your work and many of our friends and colleagues, and so she’s onto the latest stuff when it comes to nutrition and other aspects of health.

Her husband’s family in Italy, her husband’s parents are very entrenched in the mentality of following whatever the mainstream authorities are saying. There are certain things like they’re deathly afraid of consuming eggs because of the dietary cholesterol. They think consuming salt is really a big problem. They’ll consume a breakfast of nothing but pastries and sugar, but as long as they feel they’re avoiding the evil of dietary cholesterol that’s in eggs, they feel like they’re doing an amazing job of keeping themselves healthy.

Anyway, there’s many more examples to this, but one of the most interesting things is my wife’s sister was telling me recently she was having a discussion with her husband’s parents in Italy about salt. They’re of the opinion that like, “Yes, we have to consume iodized salt. We have get this because the authorities are telling us that iodized salt is better, we need the extra iodine, and that’s what the medical authorities are saying. Therefore, of course, we’re going to follow the medical authorities.” She’s over there saying like, “Hey, no, you should consume just regular sea salt instead of the iodized stuff,” and they’re like, “Well, why should I trust you instead of the medical authorities?”

Anyway, that’s interesting and I thought it was particularly interesting to bring up here in this discussion to get your sense of what’s going on there. There’s a psychological component to that, like the cognitive bias of defaulting to trusting medical authorities versus the contrarian position of defaulting to distrusting medical authorities. There’s also an element here where I think, generally, you would side towards maybe the mainstream, and then this case, this is something that’s like an example of more of a contrarian view where your views would differ from the mainstream.

Dr. Christianson: I would argue that everything I’ve said is reflected by comments from the American Third Association, the American Academy of Clinical Endocrinology. No one’s pushing for it iodized salt right now, no one’s pushing for iodine supplementation during pregnancy.

Ari: Meaning they’ve changed relatively recently?

Dr. Christianson: Yes. There’s not guidelines pushing for that in the modern populations. Many are arguing that it’s equivocal, and if anything, possibly even harmful. There’s often a perception of what is thought and then there’s the reality of current data, current policies. Then further you get down into a lot of medical specialties, the more they are aligned with evidence, but in many cases, existing habits and ideas do not stay current with that.

Ari: I think many other countries, like I’m down here in Costa Rica and I would say as far as common practices among doctors here, they’re common it’s at least 20 years behind what’s going on in the United States. It’s almost like traveling back in time. For example, you travel to certain places where they think margarine is still super healthy. It’s really like going back in time 20 or 30 years ago in the States, where all the medical authorities saying, “Get rid of butter, margarine is great for you and it’s going to prevent heart disease.” It’s a similar thing like that. All you got to do is just go to a different country and you can experience something like that. Talk to me about menopause and what are some of the foods that act on some of those pathways in beneficial ways?

How long menopause actually lasts

Dr. Christianson: One funny thing, you might appreciate this, do you know how long menopause actually lasts?

Ari: I don’t, no.

Dr. Christianson: [laughs] 24 hours.

Ari: Really? Okay, explain that.

Dr. Christianson: The way it’s defined, it’s stupid, but menopause is defined as the cessation of natural menstrual cycles for one calendar year, and then post-menopause is defined as a day after menopause. [laughs] When you really get down to the details, menopause is a day, which is dumb because that doesn’t fit how we think about things, but that’s just a quirk of categorization.

There’s this big transition, and the concept is that there’s a decline in ovarian output of estradiol and an increase of adrenal output of estrone. It’s pretty often a jagged process for maybe half a dozen years or so, often like mid-40s to early 50s. Then afterward, menstrual cycle stop and then we’ll enter this postmenopausal phase, which most think about that as being several years after menopause. It’s often a process of about five years of symptoms where the periods stop and then usually about half a dozen years of marked symptoms after they have stopped. Often about a decade of really experiencing something. In terms of– Oh, go ahead.

Ari: No, you go ahead. I was just going to say-

Dr. Christianson: You’re asking about foods?

Ari: -[crosstalk] of foods. Yes.

Dr. Christianson: Really cool thing. We have this effect by which foods modulate the hormones, and as a generalization, there’s different types of estrogen receptors. There’s the alpha and beta receptors, and we can think about one as being ones that are generally helpful to have activated, or good ones, so to speak, and others that can often be overactivated. When we think about how there can be these xenobiotics or these plastic compounds or synthetic estrogens and the harmful effects of them. Well, what can happen is they can overly stimulate the receptors in breast cells or in the endometrial lining and cause dysplasia or cancerous growth or whatnot.

Then we also got these receptors that are found in connective tissues, like the bones, or collagen in the skin, or even in brain cells. These are predominantly the alpha receptors. As these lose their stimulation, we start seeing more of the classic symptoms; the hot flashes, the night sweats, the thinning skin and hair, the thinning bones. The paradox, though, is that as there’s less activation of those wanted alpha receptors, there’s often continual or even more activation of those unwanted beta receptors. We see a lot of the problems of estrogen emerging when there’s less total estrogen in the body. That’s always been a bit of a paradox to have understood these receptors.

The cool thing is that plants, they contain estrogens, they’re called phytoestrogens. They’re not the same as human estrogens. What we now know is they act more so on these receptors, and they’re called selective estrogen response modifiers. If we think about these receptors as like the lock and the estrogen as the key, imagine there’s one key you don’t want open. It’s like, that’s the Pandora’s box, that’s the bad stuff that creates the cancerous growth.

Well, what these response modifiers do, they’re basically like wax that goes inside that keyhole and plugs it up. Not only do they not open it, but they prevent the regular key from opening it. On the other hand, one of the things you want to have activated, they’ll go in and tidy that up, open that key, and lubricate the lock, so now it works even better afterward. The same phytoestrogens can help some receptors and inhibit others.

Plants healthful or harmful

Ari: I have a super deep and profound philosophical question for you. It’s going to be simple on the surface, but there’s deeper layers to that. Regarding what you just said, what is your paradigm with regards to understanding the relationship of those chemicals in those plants and those actions that you just described? This being just one of, let’s say, at least 100, maybe 500, 1,000 different similar sorts of examples of interactions between phytochemicals and human physiology.

To be clear, this is not a right or wrong thing, this is just– I’m curious about what your worldview is and philosophy is in this regard. Is your understanding or your belief that this is a randomness and coincidence that these things act in a certain way or do you consider it– maybe a religious person would consider it like God’s intention to design things in this way? Obviously, I know your religious beliefs would not indicate that you believe that’s true, or do you see it as a product of millions of years of co-evolution? I guess, it’s either going to be random coincidence or in product of millions of years of co-evolution, but I’m just curious what your take on that is.

Dr. Christianson: If it was one particular chemical pathway we were talking about, I think you could make a case for random coincidence, but there’s just so many of them. I think it’s hard to argue against the idea that we’ve co-evolved and that our normal physiologic functions are not– All these things we’re talking about and all these recipes and these ideas, these aren’t ways to hack the body and make the body work better, this is what the body is used to. This is how the body works normally, and our bodies are thinking that they could do these various things, but somewhere along the way, they’re going to get some plant signal to help them do that better, and they depend upon that.

There’s probably ways you could make arguments by which the plants are expecting us to help them with their propagation and managing some of their competitors or whatnot. I think it’d be hard to argue against the idea of there being co-evolutionary adaptation.

Ari: Yes, I agree completely. Actually, there was a really funny thing from Michael Pollan, where he was talking about reconceptualizing our relationship with grass and saying that grass is using humans [chuckles] to spread all around the world. That grass has manipulated the human species in a way for its own benefit to have us– That grass as the puppeteer of humans to forcing us and manipulating us to spread it all over the world. He’s been quite successful in that regard.

Let’s talk about insomnia. Actually, you know what? Before we get there, should we go deeper into phytochemicals and insecticides? Actually, here’s one layer that would be interesting. The carnivore trend. This segues very naturally with what you’re just talking about. There’s many people out there now promoting an idea of, hey, animals can run away from us. If we’re out there trying to hunt animals, these animals have legs and they can physically run away, and that’s their mechanism of evasion.

Plants, they don’t have this capacity to run away from us, so what they evolved instead is these defense chemicals, these toxins, which are designed to poison potential predators, potentially animals that would consume them, to poison them or to make them feel ill or something like that. Basically, that these are plant defense chemicals, these are toxins designed for the plant to poison would-be consumers of that plant.

Therefore, by extension of this train of logic, that these compounds in plants are therefore toxic. They’re trying to kill us, as some people are saying, and that, therefore, they’re bad for our health. Therefore, we should avoid consuming plant foods because they’re full of toxins that are trying to kill us.

Dr. Christianson: Sure.

Ari: You and I are very much on the same page with how we understand those claims, but I would like to have people hear what your take is on people making those claims.

Dr. Christianson: I think the first thing I’d like to lead with is not even to directly address it, but to talk about the thought process. In the complex world of biochemistry and human nutrition, you can make a story for anything, and you can make it sound very plausible. What you have to ask yourself is, is this a theory? Is this an idea, or is this really an observation from living things?

We are complex systems. We self-regulate. The only way to know what will happen to us is to observe what happens to us. If it were true that the net benefit of a higher plant food intake was harmful effects, we would have abundant evidence of that. We would have many studies looking at people that have higher intakes of plant foods having more severe health outcomes.

We have the exact opposite of that in spades, so yes, we have very clear evidence that humans who consume more plants and a broader range of plants are healthier people. The mechanism they propose that’s a plausible mechanism, but it seems that these toxins in the amounts in which we ingest them in plants, and in the context of the food matrices of plants, have net benefit. That in some way, our bodies observe this possible threat and they then respond to that.

For example, we can see glucosinolates in broccoli. These things are liver toxic, but in the amounts in broccoli and in the context of the plant, in the context of a meal, if anything, they help our liver function improve. Our body realizes, “Hey, I’ve got to have this pathway work well because there might be more of this coming down the road.” In doing so, we become more effective at regulating hormones, clearing out other foreign things. There’s net benefit to that for us.

Ari: Yes, very well said. I see the type of logic, that type of thinking as also being analogous. In the spirit of what you just said about a story can be made up for anything based on mechanisms, one could say, “Hey, free radicals are really bad for you, and they cause all this damage, and look, here’s these thousand studies showing that free radicals drive this disease and that disease. Guess what? Exercise creates a huge spike in free radicals. Therefore, exercise is really terrible for you. It’s toxic. You should avoid exercise at all costs because it’s trying to poison you and kill you.”

You can actually make up a very scientific-sounding and logical-sounding story that is at complete odds with everything we actually know about the effects of exercise on human health and longevity.

Dr. Christianson: Well, the thing is, there’s no debate that we are biologically omnivores. We’ve got the [unintelligible 00:48:30] of omnivores. As such, we can subsist on a huge range of foods. We could eat only meat and not fall over dead tomorrow. That’s totally true. We can eat only plants and not fall over dead tomorrow. We’ve got a large range of things, but we’ve got good evidence that people that are the healthiest have a lot of diversity in their diets, a lot of food categories.

The other point that’s hard to square with that idea is just this point about the microbiome. I think that it’s pretty hard to deny the fact that it’s important to have good bugs in our intestinal tracts. These good bugs feed solely off of plant residues. To avoid those, it’s just like a daily ingestion of broad-spectrum antibiotics.

Improve your sleep

Ari: Yes, well said. I think we should wrap up maybe just with a quick bit on sleep, one of the other main categories that you mentioned. There are some interesting tips in here on specific foods that are useful for this. Also, tart cherry is an interesting one. There’s been some interesting exploration of the mechanisms around tart cherry over the years, some people noticing that it has small amounts of melatonin in there and saying, “Well, maybe it’s the melatonin responsible for these sleep-enhancing effects.” What’s the deal with tart cherry and maybe any other foods that you want to mention in this category?

Dr. Christianson: Yes, there’s the mechanism of the outcome. I just briefly want to mention this more because you’ve talked about this contrast too. If the mechanisms suggest something is not even possible, you’ve got to really question the outcome. [laughs] A mechanism alone is not evidence. An outcome will be more important than a mechanism. The mechanisms have to at least make it possible. If it would defy the law of physics, then you’ve got to really question the outcome.

There are some mechanisms by which plants contain melatonin, and actually in rather robust amounts. The curious thing is we’ve got clear outcome data showing that their benefits can be disproportionate to their melatonin content. Cherries, for example, there’s been shown to be some great timed sleep effects, meaning ingestion later in the day having positive effects upon sleep onset and sleep quality.

A really cool thing is that amongst elderly people, we also have data saying that it can decrease dizziness and decrease fall risk most likely. That’s important because those who are struggling with sleep, they are other consideration is sleep aids and they’re notorious for raising fall risks and impairing cognitive function.

Super brief stat, zolpidem/Ambien, one of the biggest sleep aids for quite some time, there’s data showing that irregular use of it can increase total non-apnea-rated mortality risk by nine-fold amongst people. Irregular use in this study was defined as 18 uses per year. Sleep aids are horribly dangerous, but there are safe ways that can help a lot. Cherries are one. Two others that I’ve mentioned, black rice, a rich source of more so polyphenols, but still seems to be useful in those ways. Also, more of a short-acting effect.

Then another fun one is pistachios. They’re probably the densest plant concentration for melatonin, but in the case of them and in cherries, the change in the participants’ output of melatonin greatly exceeds their ingestion. When you consume these plants that contain that, not only does it not inhibit what you make, but it augments what you make. You make it better on your own.

Ari: There are some super interesting layers to that. One interesting thing is on pistachios. I actually saw some research that emerged many years ago, I think maybe the first paper, where researchers came out and said pistachios are really high in melatonin. Then there was some other research that came out, I want to say two or three years later, that basically put the whole findings of the first paper in question, and said, “Actually, we didn’t find very much melatonin at all in these pistachios.”

It turns out the first study was funded in– I’m pretty sure I’m getting this right, it was funded in Iran, which is one of the biggest pistachio producers in the world, and maybe it was funded by the pistachio industry as a marketing ploy to get all this attention. Then the last I heard there was some discussion over maybe which subspecies of pistachios maybe do or do not have high melatonin content. The last I heard, it was all in question.

I actually retracted what I previously had taught about pistachios and melatonin content because I basically concluded, okay, I need more data to figure out what the real story is here as far as their true melatonin content and what subspecies you need to find and all that. I’m curious if you read anything about that or maybe you know the latest findings better than I do.

Dr. Christianson: For sure. Things can change quickly, but my take on it overall was that there’s definitely some uncertainty as to exactly how much you will consume and exactly how certain things will rank, but there’s clear data saying that the amount is relevant and that those who do ingest them have improved outputs and improved sleep quality. Yes, certainly, inconsistencies as far as amounts, varietal subspecies, but the high-level [unintelligible 00:53:47] about this being a useful food is still solid.

The Hormone Healing Cookbook

Ari: Beautiful. I agree completely. For everybody listening, this is a book, The Hormone Healing Cookbook, which I highly, highly recommend that you go grab. It’s full of very useful information. Lots of great science that you won’t find elsewhere, and useful tips like what you heard Dr. Christianson give here today. Dr. Christianson, is there any final words you want to leave people with or any place you want to direct people to?

Dr. Christianson: No, just wherever you get books normally, give your local bookstore some love if you can. There’s always Barnes and Noble and Amazon, of course, but stay tuned to what Ari is sharing with you, follow the things you’re learning, and know that you’ve got incredible power over your health and that affects everything. Yes, onward and upward.

Ari: Awesome. When is this book coming out, by the way?

Dr. Christianson: June 18th.

Ari: June 18th. I will release this episode right around there, maybe within a few days of that on either side of that. Just so that it’s timely and I’m not releasing this well in advance of when people can actually get it because I know people want that immediate gratification of having this in their hands and learning the information.

Again, everybody listening, highly recommend going out and grabbing this book. I have no financial incentive here to direct you to this. This is just a wonderful book from a great friend of mine, who’s one of the smartest people that I know when it comes to natural health. There’s truly a lot of information here that you will get value from, and as I said at the beginning of this, even I learned three or four or five new things that I had never seen before. Go grab it. Hormone Healing Cookbook.

Dr. Christianson, thank you so much for coming back on the show for the millionth time. I look forward to podcast number million and one with you. It’s always a pleasure chatting with you, my friend.

Dr. Christianson: Likewise. Great to see you, Ari.

Show Notes

00:00 – Intro
00:52 – Guest Intro – Dr. Alan Christianson
02:12 – How hormonal changes affect us
07:12 – The hormones role in aging
09:11 – How lifestyle affect hormones as we age
12:10 – Benefits of nitric oxide
17:55 – Benefits of nuts in your diet
21:21 – Low-carb fatigue
25:25 – Energy promoting benefits of oats
26:50 – The best nutrients for cognitive health
27:58 – Iodine – friend or foe?
38:00 – How long menopause actually lasts
42:12 – Plants healthful or harmful
50:05 – Improve your sleep
 54:48 – Hormone Healing Cookbook


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