The Connection Between Your Hot Flushes and Folic Acid in Menopause.
You needed to hear the delight in my voice. A month away from my home in the North Island of New Zealand and the spinach, parsley and kale had flourished in the winter rain and cold. I planted it during lockdown back in May, but how I wish that I had planted it a few years ago when I was in peri-menopause and taking so many supplements to try and alleviate my hot flushes and night sweats. I didn’t know what I know now. So, I want you to know instead … and that is, if you don’t want to spend endless money that you may not have on menopause-related supplements, then do as your mother told you and eat your greens instead.
Spinach, Kale and Parsley are high in a nutrient called Folate or Folic Acid. I knew about the importance of this for pregnancy, but when I arrived in menopause, I had no idea that I needed it to help alleviate my hot flushes and night sweats. I’ve just finished wilting some of this beautiful spinach and kale in olive oil for my breakfast. It’s delicious.
“Folic acid was effective in reducing the severity, duration, and frequency of hot flashes during menopause. Therefore, it can be recommended as an affordable and accessible method for treating menopausal hot flashes for women.” [Bani, Hasanpour et al, 2013].
Folic acid is one of the B vitamins that when absorbed into its active form is converted to tetrahydrofolate. Known simply as Folate, this is an essential cofactor (helper) for the production of both nor-adrenaline/nor-epinephrine (a nerve transmitter that is related to your stress hormones) and serotonin. As many of you on menopause-related anti-depressants already know, serotonin production in our brain is reduced as our oestrogen production declines during menopause. But did you know that studies have shown that taking folic acid has effects similar to that of antidepressants? [This is the type of information I have for you in the module in my programmes for those of you on anti-depressants – and no, I don’t interfere with any medical interventions as that is between you and your Doctor. However, you also need the evidenced lifestyle solutions for helping to manage depression in mennopause and I’ve researched these for you].
It took me around 6-7 months before I threw my menopause supplements in the bin.
Spending over NZ$100 a month on menopause-related supplements was frustrating as in reality they weren’t making a difference to my sleep, hot flushes and night sweats – nor my aching sore joints or weight. I didn’t realise that what my body needed instead, was to change my nutrition in ways that suited me and not my teenage children nor my husband. Looking back, I realise that sorting out my changing liver and gut health was important too as how our gut and liver are behaving affects the absorption of nutrients that help to alleviate our symptoms.
For example, the total body content of folate is estimated to be 10 to 30 mg; about half of this amount is stored in the liver and the remainder in blood and body tissues. If your liver isn’t healthy, or your alcohol intake is high, please take note – alcohol interferes with folate absorption and metabolism and accelerates its breakdown, rather than it’s absorption. [National Institutes of Health Factsheet] It’s why one of the main modules I have for you in my programmes, is called ‘Liver Lover’ … with the information in this module, you will understand the evidence behind helping your liver absorb not only folate, but other B-vitamins too.
There is so much pressure on us to buy supplements for our menopause symptoms, especially in many Western countries whereby, the supplement industry is booming. The phenomenal growth in menopause supplements has happened over our lifetime. However, if you look at the ingredients in many that are promoted for menopause, they often promote B-vitamins, including Folate. Don’t get me wrong – many are extremely useful, but so too is understanding the nutrients that our body needs at this age and stage of life.
When I undertook my PhD studies, I interviewed women from around New Zealand. One of the questions I asked was about their nutrition as they moved through menopause and where they were sourcing nutritional information from. Most said that they relied on their exercise specialists and/or Personal Trainers to have this knowledge. But when I enquired as to how they might know that their Trainer knew about nutrition for healthy ageing and menopause, most said, “I just expect them to know, but I don’t know where they get the information from.” At the time, I looked at every course available to Personal Trainers here in New Zealand, and not one of these courses had information about nutrition and menopause. No surprises there as we are the first cohort to come into menopause in the context of the changing landscape of sports and fitness activities. As such, educational courses haven’t arrived in this space yet.
But here’s the thing – I was confused as well. I was so busy relying on supplements that are heavily promoted to us and not focusing on my nutrition, nor was I focusing on managing my Gut Health. (Please note that I have a stand-alone module for you if you don’t want to come on the 12 week programmes and you can read about this HERE).
How much are you spending on various supplements that are promoted to you in menopause? Do they work? How do you know?
One of the things I needed to do was increase my greens (2 cups a day in fact) – because when we do (and if our gut and liver health is optimal for improved absorptionof folate), then we allow the folate that we do absorb, to help to keep our homocysteine levels in check. And doing this is good for your ageing heart and your hot flushes. Homocysteine is an amino acid (protein) and is a natural compound that needs to be kept in check. If it becomes too high, then we can develop allergies and/or develop heart disease and/or our hot flushes and night sweats may increase too.
What’s the connection with greens? The body uses folate and other B-vitamins to keep homocycsteine in check. If you’re a smoker, then this is even more important to understand, as smoking is known to reduce the absorption of folate. [Ganguly & Alam, 2015].
Spinach, steamed or slightly boiled or wilted to break down the fibres, is probably your best bet for managing homocysteine and helping to reduce your hot flushes. Around 1/2 a cup of spinach delivers 130 micrograms of folate and with the recommended daily intake being around 400 micrograms per day, greens such as spinach pack a powerful punch. Don’t forget too, that Folate intake is strongly influenced by various methods of cooking that can degrade the natural forms of the vitamin in foods. This fabulous nutrition study out of the United Kingdom suggests that steaming (less than 4 minutes) is best so you don’t lose the folate benefits of the spinach.
Folate is found naturally in a wide variety of foods, including vegetables (especially dark green leafy vegetables), fruits, nuts, beans, peas, dairy products, poultry and meat, eggs, seafood, and grains. Spinach, liver, yeast, asparagus, and Brussels sprouts are among the foods with the highest levels of folate and these are all included in the MyMT™ Food Guide which is part of the 12 week programmes I’ve designed for women at this important life-stage. Whilst folate is added to many processed products, I teach women how to reduce the emphasis on these and get their folate and other nutrients from natural plant-based foods instead. I know it’s often difficult to change our nutrition when we are cooking for others, so that’s why I have a lot of evidenced behaviour-change strategies in the programmes for you.
In addition to folate, certain greens, particularly beet greens, chicory (a type of dandelion), spinach and kale, also provide the heart healthy minerals magnesium, potassium and calcium.
I spoke about the importance of calcium for those of you who are regular exercisers in last week’s briefing, so I hope that you managed to read this. All of these minerals (magnesium, calcium and potassium), along with sodium, help to regulate the amount of fluid that your body retains. All too often, women in menopause are holding on to fluid and feeling ‘puffy and bloated’, so there is a tendency to have too much sodium (especially if bread and processed foods intake is higher than it should be) and too little of the other three nutrients, which can lead to high blood pressure. When blood pressure is high, then your hot flushes can also become worse, or your hot flushes stay with you into your post-menopause years.
When our symptoms over-whelm us in menopause, it’s difficult to ascertain why. But as I always say to women who join me on the online 12 week MyMT™ programmes, “it’s important to understand that our body is changing and declining oestrogen and progesterone are a normal part of menopause. What we need to know, is how to look after ourselves in a changing hormonal environment, that is the gateway to our biological ageing.”
So, if you are confused about what’s going on now that you are at the stage of life (aroung 45-60 years on average) whereby your body wants to naturally go into it’s biological ageing, then please watch my 2 hour MASTERCLASS ON MENOPAUSE. Last week I re-recorded it for you and because it’s all pre-recorded you can watch it when you like and pause it whenever you like as well – I have put it into 2 parts for ease of time as I know how busy you are. Now that I can’t travel, I hope you can watch it at your leisure. There is a small cost to it, but it has a ton of information and solutions that you can put into place. My short video below describes the Masterclass for you.
NZ$15/ AUS$14/ UK£10/ CAN$12/ US$10
I know that those of you in Victoria, Australia, are back in extended lockdown and many of you are facing challenges with the continued pandemic affecting your lives. So, I hope that you can immerse yourself in some ‘you’ time over the upcoming weekend and have some time out to relax, or perhaps you can find time to plant some spinach and parsley in your garden as Dianne from Brisbane did as well.
Bani, S., Hasanpour, S., Farzad Rik, L., Hasankhani, H., & Sharami, S. H. (2013). The effect of folic Acid on menopausal hot flashes: a randomized clinical trial. Journal of Caring Sciences, 2(2), 131–140. https://doi.org/10.5681/jcs.2013.016
Folate Fact Sheet for Health Professionals. https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/
Ganguly, P., & Alam, S. F. (2015). Role of homocysteine in the development of cardiovascular disease. Nutrition journal, 14, 6. https://doi.org/10.1186/1475-2891-14-6
Milart, P., Woźniakowska, E., & Wrona, W. (2018). Selected vitamins and quality of life in menopausal women. Menopause review, 17(4), 175–179. https://doi.org/10.5114/pm.2018.81742
Young S. N. (2007). Folate and depression–a neglected problem. Journal of psychiatry & neuroscience : JPN, 32(2), 80–82.