Summary
Dr. Stephen Cabral answers listener questions on managing perimenopause while on birth control, testing for menopause proximity using anti-Mullerian hormone, choosing organic produce to minimize pesticide exposure, and addressing thyroid symptoms that worsen in winter. He also covers supplements for male fertility and the role of alkaline phosphatase as a health marker.
Key Points
- Anti-Mullerian hormone (AMH) testing gives a better estimate of ovarian reserve and menopause proximity than FSH alone.
- Birth control masks perimenopausal symptoms but doesn't stop the underlying hormonal transition from happening.
- Follow the EWG Dirty Dozen list to prioritize which produce to buy organic for maximum pesticide reduction.
- Thyroid symptoms worsen in winter because less sunlight reduces vitamin D, which supports thyroid hormone conversion.
- Male fertility supplements with the strongest evidence include zinc, folate, CoQ10, and selenium.
- Low alkaline phosphatase can indicate zinc deficiency, malnutrition, or hypothyroidism and should prompt further investigation.
Key Moments
Testing for menopause proximity with anti-Mullerian hormone
Dr. Cabral explains that anti-Mullerian hormone (AMH) is a more reliable marker than FSH alone for determining how close a woman is to menopause, and that it can be tested even while on birth control.
"FSH is great to test. No doubt about it. We test that, right? We're looking at that 25 or but my my other big one is anti-mullerian hormone, sometimes just written as image, like FSH is written, right? So that is called the menopause infertility test."
Why organic produce matters beyond just pesticide avoidance
Dr. Cabral explains that organic produce is not just about avoiding synthetic herbicides and pesticides but also about healthier soil that produces more nutrient-dense food, and recommends the dirty dozen and clean fifteen lists for prioritizing organic purchases.
"When you use organic, you are not allowed to use synthetic herbicides, pesticides, etc. You're not. Can you use organic base matter such as a copper base spray or others? Yes, you can. So my goal is for people to wash all produce, but it's so much less when you use organic."
Using sauna to support thyroid function during winter months
For listeners experiencing worsened thyroid symptoms in winter, Dr. Cabral recommends regular sauna sessions of 20-30 minutes at least five times per week to warm the body and counteract cold-induced stress.
"sauna could be a really great one for you as well, heating up the body, especially if you're feeling cold. So in Ayurveda, what are we looking to do? We're looking to essentially pacify the cold, which would be like the vata, right? Cold dry is very vata-based."
