If I'm on HRT, does what I eat still matter?

The majority of peri/menopausal women who come to see me in clinic are now taking HRT or considering it, which is a big shift from when I started practicing in 2018.  One of the most common questions I get asked in clinic, often by women who have just started HRT, or are considering it is

"If I'm on HRT, does what I eat still matter?"

Or the flip side I’m also asked:

"I don't want to take HRT and can nutrition fix my symptoms instead?"

Both are completely valid questions, and both deserve an honest answer. So here is my view not as someone with an agenda either way, but as a nutritionist who works with women navigating this transition every single day. And full disclosure, I take HRT myself; you may know that I had early menopause at 44 but initially resisted it because of the reputational issues which are detailed below. Read on…

First, let's talk about HRT

Hormone Replacement Therapy has had a complicated history and reputation. For years, many women were scared away from it following the WHI study in the early 2000s that linked it to increased health risks. The good news is that the science has moved on considerably, and for most healthy women, modern body identical HRT is now considered safe, effective and for many  genuinely life-changing.

HRT works by replacing the oestrogen (and often progesterone) that your ovaries are producing less of. It can dramatically reduce hot flushes, night sweats, mood swings, vaginal dryness, joint pain, and sleep disruption. It also has protective effects on bone density and cardiovascular health when started at the right time.

NB. If you are considering HRT or have questions about whether it is right for you, please speak with a GP, gynaecologist or menopause specialist. It’s not within my remit as a nutritional therapist to advise on medication. A great resource is the My Menopause Centre website https://www.mymenopausecentre.com/

So Where Does Nutrition Come In?

In all honesty, HRT and good nutrition are not competing choices. They work on entirely different systems, and for most women, combining both produces far better outcomes than either alone.

HRT replaces hormones but it doesn’t:

• Repair your gut microbiome which directly influences how you process and clear those hormones

• Reduce chronic inflammation which amplifies virtually every perimenopausal symptom

• Rebuild muscle mass that declines with age and dramatically affects metabolism and long-term health

• Stabilise blood sugar which, when dysregulated, worsens hot flushes, mood, energy, and sleep, even on HRT

• Support your liver which is responsible for metabolising the hormones HRT delivers

• Replenish the micronutrients that perimenopause depletes

In other words, HRT addresses the hormonal piece of the puzzle and nutrition and lifestyle changes addresses everything around it.

What I See in Clinic

I work with women across a wide spectrum  some on HRT, some not, some in the early stages of perimenopause, some well into post-menopause. And what I observe consistently is that women on HRT who also eat well tend to do significantly better than those who rely on HRT alone.

Their energy is often more stable and their mood is more resilient, and they maintain muscle and bone density more effectively. They sleep better, and often they need lower doses of HRT to feel well because their body is better equipped to work with it.

On the other side, I also see women who have chosen not to take HRT for personal, medical, or cultural reasons  and who have made remarkable improvements through nutritional intervention alone. It’s not always a complete solution, and I will always be honest when I think someone needs medical support; but nutrition can move the dial considerably, even without HRT.

 The Key Nutritional Pillars Alongside HRT

Whether you are on HRT or not, these are the areas I focus on most in clinic:

1. Blood Sugar Balance

Fluctuating blood sugar is one of the biggest drivers of perimenopausal symptoms  and it is almost entirely within our control through diet. Protein at every meal, avoiding refined carbohydrates, not skipping meals, and eating within a reasonable window all make a significant difference.

2. Gut Health

Your gut microbiome contains a community of bacteria called the oestrobolome, which helps regulate oestrogen levels in the body. A disrupted gut can lead to oestrogen being reabsorbed rather than cleared contributing to hormonal imbalance. Fermented foods, fibre diversity, and reducing ultra-processed foods all support this.

3. Liver Support

Your liver processes hormones  both the ones your body makes and those delivered by HRT. A sluggish liver means hormones are not cleared efficiently. Cruciferous vegetables (broccoli, cauliflower, Brussels sprouts), adequate hydration, and reducing alcohol all support liver function.

4. Protein and Muscle Mass

From our mid-thirties onwards, we begin to lose muscle mass; a process that accelerates during perimenopause. Muscle is metabolically active tissue; losing it slows your metabolism, weakens your bones, and affects your blood sugar regulation. Most women I see are significantly under-eating protein. Aim for a palm-sized portion at every single meal.

5. Anti-Inflammatory Eating

Oestrogen has natural anti-inflammatory properties. As it declines, many women notice they feel more achy, more reactive, and more inflamed. An anti-inflammatory diet  rich in oily fish, colourful vegetables, olive oil, nuts, and seeds helps compensate for this.

6. Targeted Nutrients

My top three are  magnesium for sleep and anxiety,  Vitamin D for mood, immunity, and bone health and Omega-3s for brain health and inflammation. B vitamins can be useful for energy and nervous system support. These by no means replace HRT  but they create the nutritional environment in which your body can function at its best.

My Honest Answer to the Question: Do you need both HRT and good nutrition?

If you are on HRT: yes, nutrition still matters enormously. Think of HRT as addressing the hormonal foundation, and nutrition as building everything on top of it because one without the other can leave significant gaps.

If you’re not on HRT: nutrition becomes even more important, because your body has fewer hormonal resources to draw on. It can’t do everything, but it can do a great deal.

And if you are undecided about HRT: please don’t  let the nutrition vs. medication framing push you one way or the other. These are not opposing camps, a good nutritionist and a good menopause doctor should work towards exactly the same goal in helping you feel well in your body during one of its biggest transitions.

Personalisation is key…

One thing I feel strongly about is that perimenopausal nutrition is not one-size-fits-all. The woman who is struggling primarily with sleep needs a different focus than the woman whose main issue is joint pain or anxiety or weight gain. We’re all biochemically individual and what works brilliantly for one person may be irrelevant for another.

If you would like to explore what a personalised nutrition approach could do for you whether you are on HRT or not, please get in touch I’d love to hear from you x

Making old bones-what's really happening to your skeleton at menopause?

I had a DEXA scan recently and it got me thinking that in menopause, the conversation often centres on hot flushes, sleep disruption, and mood changes. But one of the most significant  and frequently overlooked things happening beneath the surface is what's going on with your bones. It’s often much later in life that our carcass can start to cause issues, so my view is that it’s never to early to start taking care of the ole skeleton!

Why does bone loss accelerate at menopause?

To understand what happens at menopause, it helps to know a little about how bone works in the first place.

Your skeleton is not the static structure it might seem. Bone is living tissue, constantly being broken down by cells called osteoclasts and rebuilt by cells called osteoblasts and  in younger years, this process tends to favour building. As we age, the balance tips gradually towards loss  but at menopause, that tipping accelerates dramatically.

The reason is oestrogen; this hormone plays a crucial protective role in bone metabolism, essentially acting as a brake on bone breakdown. During perimenopause  we know that oestrogen levels begin to fluctuate and decline and once you reach menopause oestrogen drops significantly and stays low.

Without oestrogen's protective effect, osteoclast activity increases and bone is resorbed faster than it can be replaced. Research suggests that women can lose up to 10% of their bone density in the first five years after menopause. This is why postmenopausal women are disproportionately affected by osteoporosis,  a condition where bones become porous, fragile, and more vulnerable to fractures.

The perimenopause years are actually a window of opportunity, because the earlier you start supporting your bones, the better equipped you'll be.

The key nutrients your bones need – and it’s not all about calcium….and calcium isn’t just about dairy products!

Calcium is the mineral most people associate with bone health  and rightly so. Around 99% of your body's calcium is stored in your bones and teeth. But what's less well known is how calcium is regulated in the body.

When dietary calcium is too low, your body draws calcium from bone to maintain adequate levels in the bloodstream. This is why consistent, adequate intake matters a lot especially when oestrogen is no longer there to help regulate the process.

Good food sources: dairy products (milk, yoghurt, cheese), but also fortified plant milks, sardines and salmon with bones, tofu (if made with calcium sulphate), almonds, and leafy greens like kale, pak choi, and spring greens.

Vitamin D

Vitamin D is essential for calcium absorption in the gut. Without it, even a calcium-rich diet can't do its job properly. Vitamin D also plays a direct role in bone mineralisation and helps regulate the activity of osteoblasts and osteoclasts.

In the UK, sun exposure is insufficient for most of the year to produce adequate vitamin D, and food sources alone rarely meet requirements. The NHS recommends that everyone in the UK consider a daily supplement of 10 micrograms (400 IU) of vitamin D throughout autumn and winter but many nutritional therapists suggest this may not be enough for optimal bone health, particularly in older adults.

Good food sources: oily fish (salmon, mackerel, sardines), eggs, fortified foods. But supplementation is typically needed during the darker months

Vitamin K2

This is one of the unsung heroes of bone health  and often missing from the conversation. While vitamin K1 is involved in blood clotting, it's vitamin K2 that plays the key role in bone metabolism.

Vitamin K2 activates a protein called osteocalcin, which helps bind calcium into bone matrix. Without adequate K2, calcium may circulate in the blood and potentially deposit in soft tissues (like arteries) rather than where it's needed in your bones. When I recommend a Vitamin D supplement to midlife women I always suggest a Vitamin D/K2 combo for this reason.

Good food sources: natto (fermented soya beans …an acquired taste for some of us!), hard and soft cheeses, egg yolks, butter, and chicken. Fermented foods like sauerkraut contain some K2 as well.

Magnesium

Magnesium is involved in hundreds of biochemical reactions in the body, including bone formation. Roughly 60% of the body's magnesium is stored in bone. It also plays a role in activating vitamin D, so low magnesium can impair the whole cascade of bone-supporting nutrients. (You all know by now that Magnesium is my desert island supplement!).

Good food sources: dark leafy greens, pumpkin seeds, almonds, dark chocolate, legumes, wholegrains, and avocado. For supplementation I love the Viridian High Potency Mg, one capsule at bedtime.

Watch the bone burglars

Some dietary patterns and lifestyle factors can actively work against bone health:

• Excess alcohol: heavy or regular drinking is linked to reduced bone density

• Smoking : reduces oestrogen levels further and impairs calcium absorption

• High caffeine intake : very high coffee consumption has been associated with modest increases in calcium excretion; moderate intake is generally fine

• High salt :  can increase urinary calcium losses

• Very low calorie diets:  chronic undereating is detrimental to bone density

• High sugar and ultra-processed foods : promote inflammation and displace more nutrient-dense foods

Move Your Body In the Right Ways

Exercise is one of the most powerful tools for bone health. The key principle is mechanical loading: the stress placed on bones during exercise stimulates osteoblast activity and encourages bone formation.

Most effective for bone health:

• Resistance training (weights, bodyweight exercises, resistance bands)  ideally 2–3 times per week

• Impact exercise (walking, jogging, dancing, tennis, aerobics)  regular, varied impact is beneficial

• Balance and stability work (yoga, Pilates, tai chi)  helps prevent falls, which is equally important as we age

Swimming and cycling, while excellent for cardiovascular health, are low-impact and don't stimulate bone density to the same degree. They can absolutely be part of your routine, but try to incorporate load-bearing activities too.

Consider HRT

Hormone Replacement Therapy (HRT) is one of the most effective ways to protect bone density during and after menopause, as it addresses the underlying hormonal cause of accelerated bone loss. Whether HRT is appropriate for you is a personal decision made in conversation with your GP or gynaecologist, taking into account your full health picture.

Testing and bone density measurement

A DEXA scan (Dual-Energy X-ray Absorptiometry) is the gold standard for measuring bone density. It's painless, quick, and gives you a clear picture of your bone health.

You might want to discuss a referral with your GP if:

• You are postmenopausal and have one or more risk factors (family history of osteoporosis, low BMI, long-term steroid use, history of disordered eating, or having had a fragility fracture)

•    You had an early or premature menopause . I went into early menopause at 44 and initially resisted HRT until the benefits  were properly explained to me. My mum (who also had early menopause at 46) was later in life diagnosed with osteoporosis so it’s also useful to have a knowledge of your family history here.

• You have a health condition associated with bone loss (such as coeliac disease, inflammatory bowel disease, rheumatoid arthritis, or hyperthyroidism)

• You smoke or drink heavily

NB there is no routine DEXA scanning programme in the UK so this is something you will need to request from your GP. In addition to DEXA scanning, a blood test panel can give useful information including vitamin D levels, calcium, parathyroid hormone, thyroid function, and markers of bone turnover. A nutritional therapist or functional medicine practitioner can help you interpret these results and personalise your approach.

Bone health is one of those areas where the actions you take now will have a profound impact on your future wellbeing. The peri/menopause transition can sometimes feel like a lot to navigate  but it's also a genuine invitation to invest in your health in ways that will serve you for decades to come; I definitely still want to dance at 80 years old!

If you'd like personalised support around nutrition and bone health, I'd love to help. Feel free to get in touch..

Jo x

The Menopause Gold Rush: Why who you trust with your health really matters

Welcome to the Age of Menowashing

 There has never been a better time to be a wellness brand targeting women in midlife. Or depending on how you look at it, a worse time to be a woman in midlife trying to figure out what's actually going to help you feel better.

The peri/menopause space has exploded in the past 5 years; when I entered early menopause ten years ago NO-ONE was talking about it and menopause shampoos/moisturisers/£100 per month supplement subscriptions weren't even a glint in the eye of the most opportunistic marketer.   And while some of that is genuinely great as women are finally talking openly about their experiences and the taboo is lifting, a significant chunk of what's filling that space is sadly opportunistic BS.  A plethora of supplements with "menopause balance" on the label or a collagen powder "specially formulated for women over 40." A gut health programme "designed for hormonal harmony."

It sounds credible and it's packaged beautifully but it also costs a lot. And it’s absolutely banking on the fact that you're exhausted, overwhelmed, and desperately looking for answers. The menopause industry is now worth billions and it is growing fast. Brands are not investing in this space because they care deeply about your wellbeing, they're investing because there is serious money to be made from women who are struggling and have been failed, for too long, by mainstream medicine. That's not cynicism but that's just how markets work. And understanding it is the first step to protecting yourself.

The "everyone's an expert" problem

In addition to the menopause “goldrush2, it would appear that the wellness space also has a serious credibility crisis.

Because peri/menopause has become such a hot topic, it has attracted a wave of people positioning themselves as experts with little to no formal training to back it up. Personal trainers offering nutritional protocols for hormonal balance. Influencers selling supplement programmes or life coaches running menopause retreats after completing a weekend course. None of this is necessarily coming from a bad place and let's face it, everyone needs to make a living. But good intentions are not the same as clinical training; and when you are dealing with something as complex and individual as perimenopause which can affect everything from your cardiovascular health to bone density to mental health, the stakes of getting it wrong are real.

Nutrition in particular is an area where the "everyone's an expert" problem runs deep. Food is something we all engage with every day, which can make it feel like fair game for anyone to advise on. But nutritional biochemistry, and the interaction between nutrients and hormones is incredibly nuanced. Understanding how to take a thorough case history and work with a woman's individual picture is a specialised skill set that takes years to develop.

A weekend course does not get you there, nor does a large Instagram following.

What actually helps (Spoiler alert: it's not a £90 supplement)

The interventions with the strongest evidence base for supporting women through peri/menopause are, almost without exception, unglamorous. They cannot be branded and sold with a mark-up, which is precisely why they don't trend.

They include:

• Eating well: more vegetables, adequate protein, way fewer UPF's

• Thorough comprehensive blood testing and knowing your numbers and markers….full thyroid panel/blood sugar/cholesterol/iron

• Further functional testing if indicated

• Moving consistently: particularly strength training, which matters enormously for bone and metabolic health

• Prioritising sleep: not just getting to bed earlier, but understanding what's disrupting it

• Managing stress meaningfully: not just talking about it but actually addressing it

• Social connection: real IRL nourishing human contact and belly laughing

• Time outdoors: natural light, movement, fresh air

• Honest conversations with your GP including where appropriate, a HRT prescription

And critically working with a qualified practitioner who can look at your individual picture. Because perimenopause is not one-size-fits-all. What's driving your symptoms, what your nutritional gaps are, what your history looks like matters enormously and untangling it takes proper training and time.

Why Credentials Actually Matter

I trained at the College of Naturopathic Medicine in London, a three-year, in-depth course where I underwent 200 clinical supervised hours.  I've been in practice since 2018, and have invested my own £££ significantly in ongoing CPD and mentorship throughout that time because this field moves and evolves, and staying current matters.

I'm registered with both BANT (British Association for Nutrition and Lifestyle Medicine) and CNHC (Complementary and Natural Healthcare Council) the two key professional bodies that set standards for nutritional therapy in the UK. Registration with these bodies means I'm working to a recognised code of practice, I hold professional indemnity insurance, and I'm committed to evidence-based, ethical practice. That's not me blowing my own trumpet but being transparent about why it matters who you choose to work with.

A Note to My Fellow Professionals

If you're a health or fitness professional reading this: please know this isn't an attack on you. Personal trainers, yoga teachers, health coaches, acupuncturists- you all do valuable work. But there are boundaries to a scope of practice that exist for good reason. I wouldn't dream of telling a client what weights to lift, or stick needles in someone, or advise on a HRT dose.  Staying in my lane is essential to my professional credibility and ethics and is a code very much shared by my community of nutritional therapists. I frequently refer potential clients on to other practitioners if I feel that I'm not the right fit or that their issues are beyond my remit (e.g. a history of cancer and eating disorders  require extra training).

The bottom line

The menopausal transition is significant but it is one you can navigate well, with the right support.

Be sceptical of anything that promises dramatic results through a single product. Before you part with your money ask about qualifications and look for BANT or CNHC registration when seeking nutritional support. Choose practitioners who are transparent about what they know, and honest about what they don't.

And if something (and yes i’m looking at you NADH+ injections/huge creatine doses/anything that is “maxxed”) seems too good to be true it nearly always is! This old adage has never resonated more....and the noise in this space is only going to get louder. I'll keep cutting through it as best I can.

The Cortisol Connection: Why stress hits harder in perimenopause

Rare is the occasion that a client comes to see me who isn’t under some kind of significant stress. I work with a lot of women in midlife who are not only dealing with the physical weight of the peri/menopausal transition but often caring for ageing parents, and navigating relationship issues on top of either hitting peak career or dealing with redundancy in increasingly ageist workplaces.

April is Stress Awareness Month, and if you have ever reached for a biscuit after a difficult meeting, or noticed your digestion going haywire during a particularly busy week, you already know that stress and food are deeply connected. But the relationship goes both ways, and that is something not enough people talk about.

For women in perimenopause or menopause, this connection runs even deeper. Fluctuating oestrogen and progesterone directly affect the stress response, mood regulation, and gut health which means that what might feel like "just stress" is often a more complex hormonal picture.

What Stress Does to Your Body, and Why Hormones Make It Harder

When you are stressed, your body releases cortisol,  your primary stress hormone. In the short term, cortisol isn’t the devil and is useful as it sharpens focus and mobilises energy. The problem is that modern life keeps cortisol chronically elevated, and during perimenopause and menopause, this is compounded by declining progesterone (our calming hormone) and fluctuating oestrogen, which plays a key role in regulating cortisol.

This results in many perimenopausal women finding that  their stress tolerance drops, their sleep deteriorates, and their eating habits shift; not because of a lack of willpower, but because of genuine hormonal changes.

Elevated cortisol can:

• Increase cravings for high-sugar, high-fat foods because your brain is seeking quick energy

• Slow digestion and worsen bloating, constipation, or IBS symptoms (already common during menopause)

•Disrupt blood sugar balance, contributing to the energy crashes and mood swings many women experience

•Worsen sleep which raises ghrelin (the hunger hormone) the next day; leading us to snack on sugary foods to boost energy

•Encourage fat storage around the belly, which many women notice during the menopause transition

In other words, if you feel like stress hits you differently than it used to, you’re not imagining it!

The Gut-Brain-Hormone Axis: A Three-Way Conversation

Your gut and brain are in constant dialogue via the gut-brain axis; a communication network that influences mood, anxiety, and the stress response. Around 90% of your body's serotonin is produced in the gut, so when gut health suffers, mental resilience often does too.

For perimenopausal and menopausal women, there is an added layer: oestrogen receptors are found throughout the gut. As oestrogen declines, gut motility can change, microbiome diversity may reduce, and inflammation can increase; all of which affect both digestion and mood. This is one reason why anxiety, low mood and digestive complaints so often appear together during this life stage.

Supporting your gut is therefore not just about digestion; in menopause it’s one of the most powerful things you can do for your hormonal and emotional wellbeing.

Foods That Help, and Those That Quietly Make Things Worse

What to focus on:

•Magnesium-rich foods such as dark leafy greens, pumpkin seeds, dark chocolate, and legumes. Magnesium supports sleep, reduces anxiety, and helps regulate cortisol. Needs increase during perimenopause.

•Phytoestrogens – we’re  talking  flaxseed, edamame, chickpeas, and organic soy. These plant compounds gently mimic oestrogen and may help ease hormonal fluctuations that amplify stress sensitivity.

•Omega-3 fatty acids ie. oily fish, walnuts, and flaxseed. Anti-inflammatory and supportive of both brain health and hormonal balance.

• Fermented foods so live yoghurt, kefir, kimchi, and sauerkraut. These feed beneficial gut bacteria, supporting the gut-brain axis and mood regulation.

•Complex carbohydrates like oats, wholegrains, and root vegetables help stabilise blood sugar and support serotonin production. Particularly important for managing mood and energy dips.

•B vitamins- eggs, meat, legumes, and leafy greens. Essential for nervous system function and rapidly depleted under stress. B6 in particular is important for hormone metabolism.

What to be mindful of:

•Caffeine which stimulates cortisol and can worsen hot flushes, anxiety, and sleep disruption. We all react differently to caffeine and I often recommend to cease consumption after 11.00am

•Alcohol is a  disruptor of sleep architecture, depletes B vitamins and magnesium, and can worsen hot flushes and mood instability.

•Ultra-processed foods and refined sugar: these drive blood sugar instability and inflammation, both of which are already heightened during the menopause transition.

Small Changes That Make a Real Difference

•Eat regularly:  skipping meals destabilises blood sugar and heightens cortisol. Even a small, balanced snack matters, I often suggest an apple with a piece of cheese, or a palmful of nuts with a square of quality dark chocolate.

•Prioritise protein at every meal… it supports blood sugar stability, helps maintain muscle mass (super important post-menopause), and reduces cravings. And ensure you eat enough; a piece of toast or small pot of yogurt and fruit does not make a proper breakfast!!

•Add one fermented food per day; just a small pot of live yoghurt/kefir or a spoonful of sauerkraut is enough to begin supporting your microbiome.

•Include flaxseed daily: one to two tablespoons on porridge or in a smoothie provides phytoestrogens, omega-3s, and fibre in one easy step. Linwoods is a nice brand that I frequently recommend to clients.

• Eat mindfully when you can as even five minutes away from screens at mealtimes activates the parasympathetic nervous system, improving digestion and reducing stress.

The Bottom Line

Stress is unavoidable and sometimes can feel like it’s taking over your life but being nutritionally depleted, hormonally unsupported, and running on empty does not have to be. For women navigating perimenopause or menopause, the stakes are higher and the connection between food, hormones, and stress is more intricate. But so is the opportunity for real, noticeable change.

With the right nutritional support, your body is remarkably capable of finding its balance again.

Want to explore how your diet could better support your hormones and stress levels? Get in touch to book a no strings discovery call

JO x

Endometriosis and nutrition - what can we actually do?

March is Endometriosis Awareness Month; and a time to raise awareness of a condition that affects approximately 1 in 10 women worldwide.

This very much resonates with me as I was finally diagnosed with severe endometriosis at 38 after suffering with terrible period pain since I was 12 years old. Mine was diagnosed via a keyhole surgery called a laparoscopy; which is the gold standard in endo diagnosis, and explains why so many women suffer without being properly diagnosed.

Endometriosis is often misunderstood as “just bad periods.” In reality, it is a chronic inflammatory condition that can affect the ovaries, fallopian tubes, bowel, bladder, and pelvic lining, causing significant pain, fatigue, digestive issues, and fertility challenges.

Nutrition is not a cure, as endo is complex and requires medical care, but food can meaningfully influence inflammation, hormone metabolism, gut health, and pain pathways; all of which are relevant in endometriosis.

What Is Endometriosis?

Endometriosis occurs when tissue similar to the lining of the uterus grows outside the uterus. Unlike the uterine lining, this tissue has no way to exit the body during menstruation, contributing to inflammation and pain.

It is associated with:

• Chronic pelvic pain

• Severe menstrual cramps

• Pain with ovulation or intercourse

• Heavy bleeding

• Bloating and IBS-like symptoms

• Fatigue

Research suggests endometriosis involves:

• Chronic inflammation

• Oestrogen sensitivity

• Immune system dysregulation

• Oxidative stress

• Alterations in the gut microbiome

How can Nutrition be helpful?

The good news is that nutrition can influence several of these pathways.

Reducing Inflammation Through Food

Endometriosis lesions produce inflammatory compounds such as prostaglandins and cytokines. While we cannot eliminate inflammation entirely, we can influence its intensity.

Focus on Anti-Inflammatory Foundations

• Omega-3 fatty acids (salmon, sardines, mackerel, chia seeds, flaxseed)

• Extra virgin olive oil

• Colourful vegetables and berries (rich in polyphenols)

• Turmeric and ginger

• Nuts and seeds

Omega-3 fats are particularly important because they help shift the balance toward less inflammatory prostaglandins.

Consider Reducing:

• Ultra-processed foods

• Trans fats

• Excess refined sugars

• Frequent deep-fried foods

This isn’t about perfection,  it’s about patterns.

Supporting Oestrogen Metabolism

Endometriosis is an oestrogen-sensitive condition, and while the female sex hormone oestrogen itself isn’t “bad,” how the body metabolises and clears it matters.

Oestrogen is processed in the liver and eliminated through the gut, and if gut health is compromised or constipation is present, oestrogen can be reabsorbed into circulation.

Nutritional Strategies:

• Cruciferous vegetables (broccoli, kale, cauliflower, Brussels sprouts)

• Adequate fibre intake (aiming for 25–35g daily)

• Ground flaxseed (supports healthy oestrogen metabolism)

• Adequate protein (for liver detoxification pathways)

• Hydration and regular bowel movements

Blood Sugar Balance & Hormonal Signalling

Blood sugar fluctuations can increase insulin levels, which may influence ovarian hormone production and inflammation.

Balanced meals can help stabilise this, and some tips are:

• Protein at every meal

• Fibre-rich carbohydrates

• Healthy fats

• Avoiding long gaps between meals

• Minimising high-sugar snacks on their own

Protein + Fibre + Healthy Fat at each meal is key here.

This approach also supports low energy, which something many with endometriosis struggle with.

Gut Health & Endometriosis

Endo can also really influence digestive health and the below symptoms can be experienced; this is because the gut and immune system are deeply connected.

• Bloating

• Alternating constipation and diarrhoea

• Food sensitivities

• IBS-like symptoms

Supportive Strategies include:

• Fermented foods such as sauerkraut and kefir (if tolerated)

• Probiotic-rich foods

• Identifying triggers without extreme restriction

However, over-restricting can worsen stress and nutrient deficiencies and the goal here is gentle investigation, not fear-based elimination.

Key nutrients to consider:

There are several nutrients here that may be relevant for the endo sufferer:

Vitamin D - Low levels are common in endometriosis and may influence immune regulation. Ensure you take 1000IU daily October-March and consider testing your level.

Magnesium - Supports muscle relaxation and may reduce cramping.

Zinc - Important for immune balance and tissue repair.

Iron - Heavy bleeding increases risk of deficiency so testing is important.

Curcumin - Found in turmeric; has anti-inflammatory properties.

As always, (and I’ve blogged about this before!) supplementation should be personalised and it’s always a good idea to test levels first and work with a nutritionist.

Food should be regarded as a tool; one part of a larger care plan that may include medication, surgery, pelvic physiotherapy, and stress support.

A Final Word

Sadly all too often diagnosis of endometriosis is very often delayed by years. Many individuals are dismissed, the pain becomes normalised and women don’t push for investigation. I speak from experience and this is very much what happened to me; it was only when my bleeding got out of control and fibroids were suspected (yes I had those too!) that the correct diagnostic procedure was performed.

If you suspect endometriosis, please advocate for yourself and seek medical support (and second opinions)  because your pain deserves to be taken seriously.

Nutrition won’t ‘cure’ endometriosis, BUT it can support resilience, reduce inflammatory burden and help you feel more empowered in your body.

And that matters….Please don’t hesitate to book a discovery call with me if this resonates and you’re seeking support.

Women’s health isn’t a “Women’s Issue” - It’s a workplace issue

A personal one for me…

For too long, women’s health has been treated as a personal matter, something to manage quietly and individually. In reality, it shows up at work every day, influencing energy, concentration, resilience, and attendance across the working life of a woman. I speak from experience as someone who from puberty suffered from heavy and painful periods and was much later diagnosed with endometriosis and fibroids, only to be followed by early menopause and all of the joyous symptoms that came with that at 44 years old. It definitely impacted my career trajectory; the silver lining being that it inspired me to learn more about my body and eventually retrain in nutrition. Below is some of what I’ve learned along the way…

Women’s health impacts performance - not just wellbeing

Hormonal health affects far more than reproductive health. Across the menstrual cycle, during fertility journeys, pregnancy, perimenopause and menopause, hormonal changes can influence:

• Energy levels and fatigue

• Cognitive function and focus

• Stress tolerance and emotional regulation

• Sleep quality

• Attendance and engagement

These changes don’t happen in isolation; they happen during meetings, deadlines, commutes, and long working days.

In the UK, menopause alone is increasingly recognised as a workplace issue, with many women reporting that symptoms negatively affect their professional lives. But menopause is not the beginning of workplace health challenges . Earlier transitions, including menstrual health and perimenopause, also have a measurable impact on performance and retention, particularly for women in their 30s and 40s.

The cost of overlooking women’s health

Ignoring women’s health in corporate wellbeing strategies often results in:

• Increased sickness absence

• Reduced engagement and confidence

• Higher turnover of experienced female employees

• Women stepping back from progression or leadership opportunities

Supporting women’s health is not about special treatment; it’s about creating environments where people can function at their best.

Nutrition: practical, every day support

One of the most overlooked levers for workplace women’s health is nutrition.

Nutrition underpins:

• Hormone production and regulation

• Blood sugar balance and energy stability

• Stress hormone (aka cortisol) response

• Cognitive performan ce and mood

Importantly, nutrition support is not medical treatment. It complements clinical care and policy approaches, providing workplaces a practical and inclusive way to support wellbeing. Simple strategies, such as supporting regular meals, adequate protein, hydration, and balanced snacks can make a tangible difference to energy, focus, and resilience during the working day.

Supporting women at work and what organisations gain

When workplaces proactively support women’s health, the benefits are clear:

• More stable energy and focus

• Improved resilience during hormonal transitions

• Reduced absenteeism and presenteeism

• Stronger retention of experienced women

• An open culture that genuinely supports equity and inclusion

These gains are tangible, measurable, and directly linked to business performance. Small, consistent supports often have a disproportionate positive impact.

Looking ahead

Later this year, as International Women’s Day approaches, conversations about workplace support for women’s health will come into sharper focus. Organisations that understand the value of investing in women’s health; including practical nutrition and everyday support will be better placed to give women what they need and gain the benefits in return.

For now, the key takeaway is clear: women’s health is a workplace issue, and supporting it benefits everyone.

How to know if you have Candida (and what to do about it)

I've had a few clients of late who have come to me with suspected candida, and testing has lo and behold proven positive. This, alongside my own history of candida has inspired me to do a deeper dive into this pesky yeast overgrowth and explore what we can do about it. Firstly we’ll look at identifying it through testing and then eliminating it via nutritional and lifestyle strategies; as well as discussing ongoing support to prevent recurrence.

So what is Candida?

Candida is a type of yeast that naturally lives in the human body; mostly in the gut, mouth, skin and vaginal tract. In a balanced microbiome it causes no issues, but certain lifestyle or health factors can allow it to grow beyond its ideal range. When this internal balance is disrupted, people may experience discomfort or recurring symptoms.

Why does it happen?

Several factors can shift the microbiome and create conditions that favour yeast growth such as:

1. Antibiotic Use

Antibiotics can reduce beneficial bacteria in the gut, which normally help keep candida in check.

2. High Sugar or Refined Carbohydrate Diet

Candida can thrive when simple sugars (from processed foods) are readily available.

3. Stress

Chronic stress can affect digestion, immunity and the microbiome — all of which influence yeast balance.

4. Low Stomach Acid or Digestive Issues

5. Hormonal Fluctuations

Certain hormonal changes can influence the vaginal or gut microbiome, especially the menopausal transition. Long term use of the contraceptive pill can also be a factor here.

6. Weakened Immunity

The immune system naturally regulates yeast levels. When immunity is compromised, yeast can grow more easily.

7. Alcohol Intake

Alcohol can disrupt gut bacteria and irritate the gut lining.

How does it show up in the body?

Signs and symptoms can vary widely and overlap with many other conditions, which is why proper assessment is important. Some signs associated with candida imbalance include digestive symptoms such as bloating and gas alongside constipation and loose stools, and intense cravings for sugar and junk food. Itchy skin can be another sign, as can recurrent fungal skin infections. Most common can be vaginal itching, discharge and soreness as well as brain fog, fatigue and low mood.

Test don't guess

This is very often my mantra and none more so when it comes to candida. This insidious yeast can hide in even the most comprehensive of stool tests, and I've had success in identifying it via the KBMO Fit 176 blood spot test, where candida is one of the key gut barrier markers. The other super useful part of this test is that it explores food sensitivity against 176 foods, so if any of these show up as 'red' triggers they can be removed (and hopefully re-introduced) as the nutritional therapy programme gets underway.

My own candida experience

I discovered that I had candida back in 2012; I was on a health retreat and the candida spores were seen during a colonic hydrotherapy treatment (that I wouldn't necessarily recommend nowadays, but that's another blog post!). I was sent on my merry way with a diet and supplement protocol to be taken for several weeks... it did actually work and the experience was one of many that inspired my interest in natural health.

The diet however was draconian, I remember existing on eggs and wild salmon with green leafy veg, there was no sugars allowed WHATSOEVER, including the slightly starchier veg...so therefore no carbs or grains except for buckwheat and millet. To say it was miserable and anti-social is an understatement!

From then to now the science has evolved somewhat, and candida diets, while still fairly restrictive now allow some natural sugars from whole foods because they support beneficial bacteria, don't feed candida aggressively and provide antioxidants and gut supportive compounds.

But what CAN I eat?!

Dietary no-no's definitely include refined sugar, sweets, soft drinks, pastries, white carbs and alcohol; cutting these out helps to promote a less yeast friendly environment.

Depending on what has been demonstrated in food sensitivity testing I will normally recommend eating vegetables of all colours as well as lentils beans, chickpeas, quinoa, brown rice, nuts, seeds, and flaxseed. Small amounts of starchier veg and low sugar fruits such as berries, apples and pears; the focus here is on fibre rich foods to help beneficial bacteria thrive.

Antifungal foods are also super important so coconut oil, turmeric, garlic, oregano, ginger cloves and cinnamon are the order of the day.

Are Supplements necessary?

In short yes they are, and I’ll develop a plan based on severity of symptoms and this is typically done in stages; firstly to cleanse the digestive system and the liver before going in to eradicate the candida and deal with the die-off reactions (if any).  If the candida has been systemic for a long while it can form a resistant shell known as a biofilm, and oftentimes extra support is needed to break this down. We then work on supporting the gut and immune system with specific supplements and probiotics; so I’ll often recommend working with me on my 12 week programme. This is to ensure that self care measures are in place to prevent overgrowth recurrence.

And finally…

It's important to remember that candida is a normal part of the microbiome , not an enemy to eliminate, but an organism to keep in balance. When imbalance occurs, supporting the gut, immune system and diet can make a measurable difference.

If the above resonates and think that you need some tailored support please do get in touch; I offer a 15 minute no-strings free discovery chat to all new potential clients.

Supplements Aren’t Magic — But They Can Help (And Here’s How)

The world of supplements is a prominent one in nutritional therapy , and often when I see a client for the first time they'll be already taking an array of remedies with no clear reason as to why.  Sometimes on the recommendations of friends but also influencers and advertising telling them that this or that vitamin or herb will solve their health issue, or make them feel 10 years younger.   But do we all need them? The truth is, while a balanced diet is always the foundation of good health, there are times when supplements can play an important role. We’re also going into cold and flu season and we’re all feeling that we need all the help we can get to minimise the effects of the inevitable viruses.

In this post, I’ll explain when supplements may be beneficial, when they might not be necessary, and how to make informed choices. 

Food first, always

It’s important to start with the basics: no supplement can replace the power of whole foods. Fruits, vegetables, wholegrains, legumes, nuts, seeds and lean proteins provide a vast array of vitamins, minerals, fibre and plant compounds that work together to support health.

For most healthy adults, eating a varied diet can provide the majority of essential nutrients. However lifestyle, environment, individual needs and life stages mean there are situations where supplements are helpful and in some cases essential.

When Supplements Are Necessary

Here are the most common situations where supplements are either recommended or strongly advised in the UK:

Vitamin D

The NHS recommends that everyone in the UK take a daily 10 microgram (µg) vitamin D supplement during the autumn and winter months. Our bodies make vitamin D from sunlight, but between October and March the sun isn’t strong enough. Vitamin D is found in certain foods but it's hard to derive adequate amounts so supplementing is essential for bone health, immunity and muscle function. You can take either a pill, or an oral spray/drops if you prefer, and start taking that Vitamin D now to maintain your level during the winter months and cold and flu season.

B Vitamins

Folate (B9) for pre-conception and pregnancy is essential in the first 12 weeks. Vitamin B12 is essential for nerve function and the production of red blood cells. It’s mainly found in animal products, so vegans (and some vegetarians) are advised to take a B12 supplement.

Iron 

Some groups, including women with heavy periods, pregnant women, or those with a diagnosed deficiency may need supplementation. However, iron should only be taken if recommended, as too much can be detrimental as too little. There isn't normally a need for iron post-menopause, as women are no longer bleeding regularly. However so often I'll see women in this life stage who were once upon a time anaemic and still taking a multivitamin including iron - so test don't guess is my advice here.

When Supplements May Not Be Helpful 

High doses can be dangerous; e.g. too much vitamin A can damage the liver, and excess iron can be toxic. Herbal supplements aren’t harmless and risk-free either and can interfere with prescription medications including antidepressants and the contraceptive pill. Supplements should be targeted to your needs, not taken as a blanket safety net.

How to Supplement Safely

If you’re considering supplements, here are some tips for doing so wisely:

• Check quality. Look for brands that are tested for safety and purity, as well as those who don't contain too many fillers or binders, cheap isn't always cheerful and some brands are far superior to others.  In the UK, supplements are regulated as foods not medicines, so quality can vary.

• Avoid mega doses. More isn’t better. Stick to recommended daily amounts unless advised by a professional,

• Check interactions. If you’re on medication and unsure, check with your GP, pharmacist or nutritional therapist before starting anything new.

It’s worth remembering that supplements should support a healthy lifestyle, not replace it. Sleep, stress management, exercise, hydration, and a balanced diet all have a profound impact on your wellbeing. A vitamin tablet can’t undo the effects of poor sleep or a heavily processed diet.

Conclusion

Supplements can absolutely play a role in supporting your health, but they’re not a magic fix. Think of them as filling the gaps, not building the foundation.

If you’d like tailored advice on whether supplements could benefit you, I offer one-to-one consultations where we can look at your diet, lifestyle and individual requirements in detail. I also offer functional blood testing where we can take an in depth look at your blood chemistry to see what your body really needs.

Do feel free to contact me for a discovery call and we can chat x

Weight loss drugs - and how Nutritional Therapy can help

It's now August, and if there's one nutrition topic in 2025 that has divided opinion and been given the most airtime it has to be that of "weight-loss jabs" aka Ozempic, Wegovy and Mounjaro.

GLP-1 receptor agonists (to give them their correct name) were originally developed to treat type 2 diabetes, and have gained popularity as powerful weight loss aids. These medications are now frequently prescribed for individuals with obesity or weight-related conditions. But what exactly do these medications do, and how can Nutritional Therapy help?

What Are They?

GLP-1 (glucagon-like peptide-1) is a hormone that helps regulate blood sugar, slows gastric emptying, and reduces appetite. These drugs mimic that hormone, leading to:

• Reduced hunger

• Slower digestion

• Improved insulin sensitivity.

This in turn can then lead to improvements in metabolic health, such as blood glucose levels, insulin sensitivity, cholesterol and blood pressure. The "food noise" is also reduced and fewer cravings can (in theory) help establish healthier eating habits.

The downside however is side effects and common issues include

• Vomiting

• Constipation or diarrhoea

• Fatigue

More serious (though rarer) concerns:

• Pancreatitis

• Gallbladder issues

• Potential thyroid tumors (based on animal studies)

Another issue is cost; in the UK, the NHS prescription criteria is very strict and the vast majority of people are buying the drugs online (with no medical supervision) spending up to £250 per month.

How Nutritional Therapy can help

I know from clients I see in my clinic that obesity is often truly devastating, and the reasons for it can often be multi-factorial, and not just down to poor diet, excess alcohol and a sedentary lifestyle (although this of course can be the case). Weight gain can be caused by chronic health conditions, reliance on certain medications and inactivity due to both of these factors. Add the hormonal fluctuations of perimenopause and menopause into the mix and the result is a perfect storm of frustration and unhappiness.

My clinic is free of judgement and although I'm a "holistic" practitioner I can see the positive benefit that these drugs are having on many people; many of my clients are already taking other pharmaceutical drugs and I see GLP-1 as another of these that needs to be worked with.

A common side effect however is malnutrition, muscle loss and micronutrient deficiencies such as B12 and iron. As appetite is suppressed; patients tend to eat much less, and unfortunately aren't often advised about nutrient dense foods and supplements they need to implement while undergoing the weight loss transition. In an ideal world I'd love to see people use the opportunity to embrace behavioural change around diet, food choices and exercise, so that when they stop the medications sudden weight gain is mitigated leading to improved health outcomes.

So if you are taking the drugs or considering doing so I'm happy to support you without judgement. They can be life-changing for the right individual, but they work best when paired with behavioral change, optimum nutrition, and accountability.

Do feel free to book in for a chat x