Transcript Disclaimer – Please note that the following transcription has been machine generated by an AI software and therefore may include errors or omissions.

Robin Daly
Hello and welcome to the Yes to Life show on UK Health Radio. I’m Robin Daly, host for the show and founder of Yes to Life, the UK charity pushing for the adoption of integrative medicine in the treatment of cancer, an approach that broadens the focus from exclusive attention on physical signs of symptoms to include a full range of approaches to the health of mind, body and spirit.

Robin Daly
My guest today is a practitioner whose name came up during my recent interview with the lovely Julia Bradbury. Pauline Cox is a functional nutritionist who has provided invaluable support to Julia in meeting the challenges of cancer.

Robin Daly
Thanks so much for being my guest on the Yes to Life show.

Pauline Cox
Hi Robin. It’s lovely to be here with you.

Robin Daly
So you’ll be aware that I recently had the fabulous Julia Bradbury as my guest on the show and she was singing your praises for all the support that you’ve given her and so I was very keen to speak to you myself.

Robin Daly
You described yourself as a functional nutritionist I believe. I was just hearing from someone very recently who’d been thrown into the world of cancer and I was very pleased to hear she’s listening to these shows and appreciating them and she’s eager to find out all about integrated medicine and what it has to offer her but she also expressed what a vast and confusing and unfamiliar world it is full of terminology that doesn’t mean much to people who are lucky enough not to be diagnosed with cancer.

Robin Daly
So can we start out by exploring what a functional nutritionist actually does?

Pauline Cox
Yeah, that’s a great question because I personally very much sympathise with that individual you were talking to. It should feel very overwhelming and the terminology can be quite confusing. Now, a functional nutritionist, what my role is really is to find the foods that have specific actions and can particularly help with specific conditions, target certain pathways.

Pauline Cox
So I look at diet as a whole, particularly metabolic health, it’s an area I’m incredibly passionate about. And when it comes to cancer, this is a very, very important part of not just looking at how we’re reducing one’s odds of getting cancer, reducing the risk, but also how we can help support their journey through cancer and beyond.

Pauline Cox
So metabolic health, firstly, is looking at a broader picture of what someone’s eating, their diet and lifestyle. And then functional nutrition is more looking at the specific dietary requirements, those foods that can really help someone in particular parts of their health, whether that’s inflammation, for example, or whether that’s improving sleep, optimising serotonin pathways.

Pauline Cox
So it’s using food in its purest form of medicine.

Robin Daly
mm-hmm targeted food yeah great all right that’s very health okay so you’ve had a pretty unusual health care trajectory and I believe one that informs your views on well-being in a unique way can you tell us about your training and experience beginning with what got you started in the first place

Pauline Cox
Yeah, well, you’re absolutely right. I started many, many moons ago now, over 25 years ago, my first degree was in Bristol, University of Bristol, where I studied anatomical science. I’ve always found human science just fascinating.

Pauline Cox
And so my first degree gave me that real insight into us as a species, understanding our cellular physiology and really the core functions of our cells, which, and there’s a lot of comparative anatomy in there as well, so dogs and monsters as well as humans.

Pauline Cox
Okay. From there, I recognised my desire to work in healthcare and so went on to do a further degree in physiotherapy and thoroughly enjoyed that career. However, was very much recognising the fact that people were coming to me when their problems have already been long-standing, inflammation, tissue pain, musculoskeletal pain.

Pauline Cox
I believed at that time that my skills would be better used, trying to help people prevent those chronic conditions. And so started to examine nutrition in more detail and it opened a hole doorway, led me down a rabbit hole, which saw me going back to the University of Bristol to study for a Masters in Nutrition and Public Health.

Pauline Cox
And from that point, recognised that, yes, nutrition is of great importance, but actually there’s this whole field of integrative medicine, which then took me to the National Centre for Integrative Medicine to do more further training and bringing together the understanding of conventional approaches with this very holistic approach to healthcare and the importance of mind-body medicine, of nutraceuticals,

Pauline Cox
IVD, herbalising, all of these incredible tools that we have at our disposal that are not necessarily being used in mainstream at all.

Robin Daly
Very interesting. My experience, of course, I’ve talked to many, many nutritional specialists in the show and nearly all of them have gone straight into nutrition because they’ve actually had an experience themselves of how enormously it’s changed their lives.

Robin Daly
Quite likely they’ve had cancer and nutrition has been such a keen player in regaining their well-being that they felt like, I must know more about this and I must pass this on to others. You, on the other hand, have come right in with this very foundational science about the body and the anatomy and working your way through then and coming to nutrition.

Robin Daly
It’s quite a different basis really, but I imagine that is enormously helpful to you in the way you look at people’s overall well-being. It’s because you’re a very 360 degree view of not only physical health but also medicine.

Pauline Cox
Yes, definitely. And there was a very interesting lady who really inspired me to get into nutrition in a serious way, which was Dr. Terry Wall. And she was a medical doctor in America that was suffering with MS and had the best neurological, pharmaceutical options available to her and found herself deteriorating rapidly.

Pauline Cox
And it was only when she really deep dived into nutrition, and particularly cellular physiology, cellular biology, looking at the mitochondria, understanding the impact of nutrients on the various pathways in the body, that she was able to significantly improve her condition and went from being in a reclining wheelchair to cycling 18 miles a day again.

Pauline Cox
And this inspired me to look at nutrition as a science rather than just what we need to feel ourselves every day. And I myself did a lot of healing through understanding that. That was the basis of my first book, Primal Living in the Modern World.

Pauline Cox
I really managed to influence my own hormones. Having seen my mum go to a hysterectomy at 39 due to endometriosis, I accepted that as being part of a woman’s life. The way we normalize our hormonal imbalances, and then through my deep learning of the influence of what we’re eating and how we’re living, not just on our overall health, but on our hormonal health as well, radically changed my own health and hormonal health.

Pauline Cox
So it just hounded this session I had for taking a step back and looking not just at diet, but lifestyle, stress, sleep, all of these very, very important variables that have such a big impact on our immediate health, also our long-term health.

Robin Daly
That phrase he used there about normalizing our hormonal imbalances, there are so many things that actually are deep ill health that are becoming normalized in a certain way nowadays, which is very worrying.

Robin Daly
You know, you take cancer, for example, we blindly accept the one in two statistics as like, you know, it’s a disaster. It’s by far the biggest healthcare crisis that human race has ever faced because it’s not, we’re not on top of it.

Robin Daly
It’s getting worse. It’s going to be one in one soon, everybody’s going to get cancer and then they’ll be counting how many times they’ve had cancer in their life. It’s scary to feel that we’re so out of control of this epidemic of cancer and it is sort of normalized.

Pauline Cox
Yes, and yet we have, as humans, we’re incredibly adaptable, very resilient and tough as a species. It’s part of how we’ve survived for so long in various climates and going through food scarcities. We are just wonderful in our ability to adapt to our environment.

Pauline Cox
What makes us less able to adapt to the toxins and the various stresses that we’re experiencing in modern life very much comes down to the food choices and our body’s metabolic inability to cope with the various stresses we’re exposed to now.

Pauline Cox
And so what’s really nice for people to feel is we do have an element of control, yet we have rather a large element of control when it comes to safeguarding and protecting our health against those statistics that you mentioned.

Pauline Cox
And that really first of all comes down to understanding that the choices we make on a daily basis, what we eat and how we live in our sleep and stress, but particularly what we’re eating, is our body’s greatest source of defence.

Pauline Cox
It’s building our immune system and it’s really helping us at a cellular level to reinforce that resilience that we inherently have.

Robin Daly
Oh, it’s a great message and it’s rather different to the kind of victim of cancer story which we’re in danger of just falling into otherwise. So yeah, great. All right, so we had a little introductory chat recently and I quickly got the idea there’s a mass of topics we could easily get into, but I actually want to stick as much as possible to the experience of those with cancer and the particular set of challenges they face and where the biggest wins are to be had in terms of lifestyle strategies.

Robin Daly
So I’m confident you have lots up your sleeve to help with a whole range of symptoms and side effects, but for this interview, I’d like to stick to two central issues. You’ve mentioned both of them already, inflammation and hormones.

Robin Daly
I mean, either could take up the whole show, but let’s see what we could do. So I don’t think there’s anybody nowadays who wouldn’t agree that inflammation is a key driver of cancer as well as plenty of other chronic diseases and something well worth paying attention to.

Robin Daly
So do you want to just say, well, why does it matter? And what are your frontline strategies for assessing inflammation and helping to control and mineralize it?

Pauline Cox
Yeah, absolutely. And inflammation is, it’s something that happens over time. I think it’s really important to note that because inflammation is something that’s really important and it’s a, it’s a part of our defense strategy.

Pauline Cox
You cut your thumb, we need inflammation to protect ourselves from, from that thumb becoming infected and sepsis kicking in. So inflammation is not inherently bad. Chronic inflammation is what’s damaging to the body.

Pauline Cox
And so when we look at what’s driving chronic inflammation, one of the easiest wins for us as humans to look at is what we’re eating, because this has a huge impact on our inflammatory levels. So there are a number of pathways that we can explore when it comes to dietary impact of inflammation.

Pauline Cox
First of all, what we’re eating. So when we look at certain foods, they have a different fatty acid profile. So let’s break this down into omega-3 and omega-6. Omega-6 is typically pro-inflammatory. It supports the body’s reactiveness to inflammation.

Pauline Cox
Omega-3 is typically anti-inflammatory, so it helps to quieten and dampen down that inflammatory response. And so as a species, we would be ideally looking at a ratio of two omega-6 to one omega-3 intake.

Pauline Cox
So keeping that inflammatory and anti-inflammatory balance pretty stable. Our modern diet looks more like a 20 to one intake of omega-6 to omega-3. Wow, as fast as that. We already see that we’re driving that pro-inflammatory pathway just by the nature of the omega profile of the foods we’re taking.

Pauline Cox
So omega-6, we’ll see in foods like rapeseed, sunflower seed oil, foods that are cooked in these deep fat fried foods, convenient foods, ready meals. Many of the modern, convenient foods are very high in omega-6.

Pauline Cox
The omega-3s are typically found in our oily fish, in eggs to some extent. There are some omega-3s, not as much as oily fish. Chia seeds, linseed, hemp seed, all our nice healthy seeds, particularly chia seeds, are all rich sources of omega-3.

Pauline Cox
Now the types of omega-3 we are generally lacking are the intelligent brain fats that we find in oily fish. However, our seeds are now practically clean and highly polluted. They’re full of microplastics, and so people not only are concerned about eating fish from the ocean, they’re also concerned about farmed fish, which I would also agree with.

Pauline Cox
I don’t want to be eating farmed fish because they’re not the same quality as wild fish. The expense of eating oily fish. So we have this very challenging food environment that we face where the foods that are typically incredibly important and good for us are not as easy to obtain, they’re more expensive, and they’re generally more polluted and contaminated.

Pauline Cox
So we need to find alternative ways of boosting our omega-3, and particularly those important intelligent fats, the EPA and DHA that we get from our oily fish. So plant-based sources typically don’t have those higher intelligent fats, but there is a crop regeneratively grown in the UK called ahi flower.

Pauline Cox
Now this particular plant, which is related to the Borash family, is firstly regeneratively grown, it’s sustainable, but it also has a very similar impact to fish oil on our human health in that it helps to increase these intelligent fats.

Pauline Cox
So there are these emerging plant-based heroes that can start to support our human health in a way that also supports planetary health. So finding ways of upping our omega-3 in a way that feels good and is not introducing yet more oxidized or rancid oils like some of the pork walnut-y fish oils, and reducing our intake of omega-6 can really help to bring that balance back of pro-inflammatory and anti-inflammatory fats in our diet.

Pauline Cox
Does that make sense Robert?

Robin Daly
It does make complete sense. Yeah, that’s great.

Pauline Cox
So that’s a sort of primary initial looking at the Amiga influence on inflammation. Now, as soon as we consume a food, it’s going to have an impact on a very important part of our body, and that’s the gut.

Pauline Cox
Now, our gut health is a incredibly important driver or not of inflammation. So the gut microbiome, first of all, this collection of microbes, fungi, viruses, environments, trillions of microbes that we are host to have this very important symbiotic relationship with us.

Pauline Cox
They are like infant factories producing compounds that benefit us as humans from vitamins to these very important short-chain fatty acids that support the health of colon and the health of our brain.

Pauline Cox
They send their molecules all over the body by the bloodstream to impact different parts of the body. Now, if that gut microbiome shifts from being a beneficial environment to having more of the poor bacteria balance, then that itself can start to create this inflammatory environment, this pro-inflammatory environment where the toxins produced by the bacteria end up in the bloodstream and the immune system detects these endotoxins and then becomes switched on.

Pauline Cox
So we have the influence of the gut microbiome, and the gut microbiome is directly influenced by what we’re eating, what we’re feeding it. Are we killing the microbiome with highly processed foods, with alcohol, with all of these additives, with highly sprayed foods, or are we supporting the microbiome with a fiber-rich diet, with plenty of polyphenols, with the food that the gut microbiome thrives on?

Pauline Cox
So the microbiome is a very influential part of our health to look at, and Tim Spector spoke about this at the Integrative Facialised Medicine Conference. I believe it was last year where he was saying that the status of the microbiome directly impacts your outcome of chemotherapy.

Pauline Cox
It’s really important that we’re not just seeing a microbiome as this sort of static thing that we’re born with. It’s something that we have a great deal of influence on through what we’re eating, the fresh air we have, gardening, pets in the house.

Pauline Cox
These are all constantly influencing the health of our gut microbiome. And as I said, it has the ability to either be super beneficial, anti-inflammatory, producing all these beneficial compounds, or a source of chronic inflammation.

Pauline Cox
So let’s just go back a moment. The omega-3 fatty acids we’re taking in, the food we’re taking in by the connegatively impact the microbiome, positively impact the microbiome, and then the foods that we’re consuming that impact the integrity of the gut lining.

Pauline Cox
Again, this is incredibly important. And I think this is something that 10 years ago, Robin, we’d have been sat here talking about it and it would have been seen as fringe science, something a little bit woohoo, leaky gutty doesn’t exist.

Pauline Cox
What is that? That’s just some sort of, you know, layman’s term for some, it’s something that doesn’t even exist in medical literature. Leaky gut is now something that’s undeniable. It’s hyper permeability of the intestinal lining.

Pauline Cox
And what this means is the integrity of the gut lining is that it’s a semi-selective membrane, it allows certain things to pass through the gut lining into the bloodstream, it stops other things passing through.

Pauline Cox
The foods we eat and the lack of certain microbes within the gut or the presence of other microbes influences the integrity of the gut lining. So think of it as a brick wall with mortar between each brick.

Pauline Cox
As that mortar begins to erode, certain food particles and microbes can pass through into the bloodstream and again, switch on the immune system into that chronic inflammatory state. And so the integrity of your gut lining, constantly thinking about what am I eating, what am I doing?

Pauline Cox
How, what foods am I consuming that might be causing my gut lining to become less healthy than it should be, i.e. leaky, i.e. not as integral as it’s meant to be and driving systemic inflammation. And this is something I’ve seen for years over the course of my career.

Pauline Cox
When people change their diet, they change their shoulder pain, neck pain, migraines, knee pain, their ankle pain, back pain, their skin conditions tear up because this systemic inflammation has been driven by the intensity of your gut lining influences all aspects of your health.

Robin Daly
Pretty interesting. And what particular things affect the integrity of the cut lining? Is it the kind of additives and things like that? Or are they some particular foods?

Pauline Cox
That’s a great question. So it comes down to a number of factors. Firstly, the microbes, the bacteria. There are really helpful bacteria within the gut. One with a very long name called Acromasia mucinophilia.

Pauline Cox
Mucinophilia means mucus-loving. So this particular microbe, which is only present to about 5% degree in the whole of the microbiome, but that small presence is really important. And this particular microbe produces this mucus lining that helps to protect the barrier, the gut lining.

Pauline Cox
It’s also the presence of certain compounds that the bacteria are producing to help tighten up fight junctions between each of these cells. So the fuel produced by the bacteria helps the cells along the gut lining to be healthy and do their job to produce the proteins that helps strengthen the barrier.

Pauline Cox
But we also have things like alcohol and bad bacteria, as well as some quite common irritants such as butane for a lot of people. They might not have celiac, but they might note that when they eat butane, they start to feel like a headache or might get joint pain that they don’t associate with some of these foods that we commonly eat, that as hunter-gatherers, we would not have been eating.

Pauline Cox
And so sometimes it’s worth removing some of the foods and just taking it back to basics, having our fruit, vegetables, eggs, fish, meat, and seeing how removing some of these wheat-based foods can have a real impact on our gut health, but also the symptoms that someone might be noticing.

Pauline Cox
Gosh, my skin’s in the pool, my ex is tearing up, my ankle swelling has improved, my migraines, my sleep, my mood, my anxiety, all of these things, because they’re so far away from the gut, we don’t always link to our gut health.

Robin Daly
Okay, and obviously part of the whole story here when you’re dealing with somebody is assessing the level of inflammation that they’re suffering from. Do you do that simply by looking at their symptoms or do you test for it?

Pauline Cox
I personally do it by looking at their symptoms. So for me, it’s an in-depth pre-consultation form, and it’s like being a human detective. You can really start to get an idea from someone’s stool, their bowel movements, their eye dryness, their nail health, skin health, sleep, anxiety levels, menstrual cycles for women before menopause, obviously.

Pauline Cox
Urinary function, there are so many different areas of our health that are whispers, that the body is struggling in certain ways, that we become so used to, that we don’t see the acid reflux or the waking up several times during the night to urinate.

Pauline Cox
We don’t see those as little tell-tale signs. We see them as, it’s my age, or I’m stressed. That’s why I’m always tired. I’ve always had heavy periods. I inherited that from my mum. We tend to normalize these things.

Pauline Cox
And actually, when we really start to track back to the various symptoms, how the thyroid’s in pinks by our hormonal health, how a lack of magnesium, one of the very, very important minerals that has a very widespread influence over many systems of the body, to the point where it’s needed to activate vitamin D.

Pauline Cox
So someone could be supplementing vitamin D, for example, to really support their immune health. And yet, they’re not getting the impact of that vitamin D because they’re low in magnesium. So it’s really about tracking back to see, where’s the low-hanging fruit?

Pauline Cox
What could we really start to target first? How do we get the foundations in place before we start looking at the more complex symptoms? Because often, if you get the foundation right, as humans, we’re so inherently smart and adaptable, as I mentioned at the beginning, that you start to give the body what it needs, it will start to fall back into good health again.

Pauline Cox
And the anxiety, the sleep, the fatigue, the tiredness all the time, the itchy eyes, the restless legs, all of these various symptoms can start to improve when we reduce the inflammation. We balance out blood sugars.

Pauline Cox
We restore metabolic health at a cellular level. We absolutely focus on insulin resistance, which a lot of people have. And when we start to look at improving metabolic health and sleep and stress, that just hits so many skittles when it comes to how we’re moving the needle when it comes to sin and health.

Robin Daly
Interesting, you get a real sense of how an adjective overview can really contribute to somebody’s situation as opposed to that kind of day-to-day experience where you’re just putting things in boxes and carrying on.

Robin Daly
But taking the time to step back and just look at the whole picture, all the aspects of it, and apply the expertise that you have obviously has immense value in seeing what’s going on overall.

Pauline Cox
And I would say, Robin, that one of the first areas I approach when it’s, if someone comes to me, it’s, it’s almost irrelevant that the complaint they have. The first thing I would look at is their sleep, because without sleep, we’re not going to be getting the gains that we need.

Pauline Cox
And melatonin is such an important hormone. It’s a neurotransmitter that has huge implications, not just for the quality of our sleep, but it’s anti-inflammatory benefits.

Pauline Cox
we’re looking at optimizing someone’s sleep, which often comes from a nutritional deficiency, high levels of stress and someone who, particularly if they have chronic health issues, that over stimulation of the nervous system or fight or flight is very active, they are usually in a state of, they’ve trained themselves into core sleep patterns and they need to get that restorative sleep, they need to get a circadian rhythm back into flow in order to allow the body to get into a state of rest and digest for healing.

Pauline Cox
It’s fundamental for all aspects of our health so sleep is the number one pillar that we would focus on together in order to first and foremost get them on the right pathway.

Robin Daly
Great. All right, there’s lots more I could ask you about this, but I do want to speak about hormones a bit as well. So let’s dive in there. So I know it’s something you focus a lot of attention on. In fact, you’ve got a recent book, Hungry Willing, Eating for Good Health, Happiness and Hormones, which shines a spotlight on the importance.

Robin Daly
So why don’t you start off by just briefly telling us about your book and why you wrote it? And then we can go on and talk about the role of hormones in cancer.

Pauline Cox
Yeah, I wrote this book for women of all ages because I really felt when I dived into hormone health myself and the influence of diet and lifestyle on our hormone health, it just made me think, Robin, that all women need to understand this from their teenage years, because there is so much suffering that’s accepted with hormonal health from heavy periods, painful periods, PMS, endometriosis, fibroids,

Pauline Cox
polycystic ovarian syndrome, fertility issues, and the perimenopausal journey. Women feel so out of control when it comes to that hormonal health that we have to hand ourselves over to the pill or to HRT like we have no other option.

Pauline Cox
And that is a choice that we should be making, it shouldn’t be our only choice, it should be part of a range of options. Okay, I’m going to explore the impact of what I’m eating, how I’m living, I want to understand the balance, the importance of the balance between congestion and estrogen.

Pauline Cox
And so to me this book is a manual for women, a very easy to access wide tune. Here’s what assets women’s are, and here’s what influences them negatively and positively. So here’s what you can do, and here’s what happens when that becomes out of balance, and here’s what we can do to try and bring them back into balance.

Pauline Cox
So it’s my holding someone’s hand and guiding them through the teenage years, the 20s, 30s, 40s, and beyond to post-menopause to understand the neuroprotective effects of estrogen on the brain, the cardioprotic on the heart, the importance of these hormones, but also the really important messaging that must come across when it comes to women’s brain health, and how we are at risk of things like Alzheimer’s disease and neurodegenerative conditions if we don’t address that hormonal health soon enough.

Pauline Cox
And you know, it’s never too late, but it’s so much better to be focused on that in our 40s and 50s and 60s, rather than 70s and 80s when the manifestation of these neurodegenerative conditions are there, but the clinical relevance has been there for all their aids before.

Robin Daly
OK. Sounds like a great resource. OK, so it’s universally accepted that hormones play a central role in many of the most common cancers. So why is that, would you say, and what are we doing wrong? Why are so many people getting hormone-driven cancers?

Pauline Cox
Yeah, it’s such an interesting question, isn’t it? And I think it, firstly, it comes down to understanding that oestrogen is not an inherently bad hormone at all. It’s a, it’s a Goldilocks hormone. We don’t want too much, we don’t want too little, we want just the right amount.

Pauline Cox
And the body’s very wise in trying to achieve that just the right amount. So let’s just quickly look at oestrogen nonprogesterone and the importance of having the two imbalances. That’s really fundamental to this hormonal imbalance picture.

Pauline Cox
So I heard an analogy many, many years ago that oestrogen is like grass that grows thick and long. Oestrogen is a growth hormone. It drives the thickening of the endometrial lining. It’s important for the female form that’s developed at puberty.

Pauline Cox
So it helps to lay down fat tissue in the hips, but the breast. So it’s a very important driving hormone. So you get this thick, long grass growing. Progesterone is the lawnmower that keeps it in check.

Pauline Cox
It stops it going wild and overgrown. So you can imagine the relationship, the balance of these two hormones is incredibly important. When we start to see this driving this oestrogen dominance, we need to address why that’s happening.

Pauline Cox
So there are a number of reasons that can happen. Firstly, it can be because we genetically don’t detoxify oestrogen, particularly effectively. It can be that we are not detoxifying oestrogen due to our dietary choices and lifestyle.

Pauline Cox
It can also be because our progesterone levels have been depleted. So when we look at these three variables to start with, the genetic side of things, there’s not a great deal we can do to change our genetic detoxification abilities.

Pauline Cox
But what we can do is support the body’s detoxification pathways when it comes to hormonal balance. So the detox pathways are an area I address in my book, and it’s a really, really important area because there are sort of these multiple failure points.

Pauline Cox
So there are these multiple areas that we can improve on. So when we look at detox pathways, we’re looking at the liver first and foremost, because that’s where oestrogen is used. Oestrogen goes to the liver, it’s tanned, so the body fangs it to say it’s ready to be removed and flushed away down the pan.

Pauline Cox
So it’s tanned in the liver and then bile takes this tanned oestrogen via the gut, via the bowels with the faeces and out. So if our liver function is not optimal, and we’re not tagging or conjugating that oestrogen particularly effectively, then that’s one of the first areas that we need to address is our liver function.

Pauline Cox
So the liver is a very, very important organ for hormone health, for hormone balancing. And if we have a hormone imbalance that’s shown up via endometriosis, or fibroids of skin issues, then it’s really important that we look at the liver health as a whole to start with.

Pauline Cox
So that might be looking at the nutrients that the liver needs to convert and use these in phase one, phase two declassification. The liver needs lots of V vitamins, it needs zinc, it needs all of these core nutrients in order to function at its best.

Pauline Cox
So we’re low in these really important nutrients, the liver can start to become sluggish. If the liver is full of fatty deposits, because we’ve been over consuming high sugar foods, which are converted to fat and dumped into the liver, or we’re drinking too much alcohol that can be converted and dumped into the liver’s fat, if the liver’s inflamed, these are all things that impact our liver function and liver health,

Pauline Cox
then impacts the body’s ability to detoxify the used estrogen. And really when it comes down to the liver, it’s a very, very hard working organ, but a very forgiving organ at the same time. It can take a great deal of abuse and really regenerate and revert back to being a very healthy organ.

Pauline Cox
So it doesn’t take a great deal of, I’m not going to say it doesn’t take a great deal of effort because it does take change, but the liver’s responsive. I mean, like some organs that struggle to regenerate, the liver is such an immensely powerful organ that it can transform itself and we can start to see a liver function just by virtue of skin health, menstrual cycles and hormonal balance.

Pauline Cox
So the liver being that first point, secondly, it’s bile production. So the bile removes the toxins from the liver. So the bile is taking the used estrogen down into the gut. And again, the amount of bile we’re producing is reflective of the health of the liver.

Pauline Cox
And bile, whilst it’s not a particularly sexy or interesting subject, is an incredibly important substance for the health of our detoxification pathways. But bile’s also very antibacterial and antimicrobial because it’s passing through the gut, it’s helping to restore the balance of the microbes.

Pauline Cox
Now, again, as we’re taking the used and detoxified products from the liver via the gut, we encounter the gut microbiome. And if we have bad bacteria within the gut, something called the estrobolome, so these particular microbes are very important for modulating estrogen levels, then they can untag this estrogen and allow it to be reabsorbed back into the body.

Pauline Cox
So again, we want to be thinking about health, not just for the inflammatory effect or anti-inflammatory effect or beneficial effect it has on the gut brain axis and all of the other things we now understand more about the gut, but also for our hormonal balance.

Pauline Cox
So the liver plays its role, the bile, the gut microbiome, and then we come to the biles themselves. Now, bile is really important for the smooth passage of our bowel movements via the bowel and out, and magnesium is really important for relaxing the bowel, which is a muscle, and again, allowing effective bowel movements.

Pauline Cox
So we want to be having at least one weird bowel movement a day in order for the feces to what we sat in the bowel and give the opportunity for used hormones and other toxins to be reabsorbed back into the body and recirculated into the body.

Pauline Cox
So there’s this very important opening up of the detected pathways to stop this drive of estrogen dominance and kind of imbalance of estrogen to progesterone.

Robin Daly
Amazing, amazing. Well, thanks a fantastically clear description of what’s going on and just quickly maybe you can tell us how you assess somebody’s hormonal condition.

Pauline Cox
That’s a really good question because I myself don’t take blood levels. What I will do is, again, going back to that form at the beginning, is understanding, let’s say a young woman in her late twenties, close to me, and she has heavy periods, symptoms of PMS, skin issues, her diet is poor, she’s high stress, she’s not sleeping well.

Pauline Cox
She has high levels of anxiety. We can start to build a picture without necessarily measuring the progesterone and estrogen and all the different markers in her blood by just accessing low hanging fruit.

Pauline Cox
So it comes back down to creating the pillars, the foundational pillars of health, sleeping well, eating well, supporting the liver through, eating more cruciferous sulfur rich vegetables, more fiber to help with the gut and the bowel movements.

Pauline Cox
These are simple things that can have such a big impact on some of the symptoms without necessarily having to go down the over testing and medicalised route. So again, just going back to the progesterone and estrogen balance.

Pauline Cox
Progesterone is a really important woman that can start to decline early, very early stages of perimenopause. So a woman in her late thirties may present with blooding periods, very heavy, but first three days may be very heavy and then light knob.

Pauline Cox
Now progesterone helps to keep the endometrial lining in place. So when progesterone levels decline, 60 at very early perimenopause, then that blooding period is typical, but also what’s typical is high anxiety, full sleep, because progesterone is a very calming, a very calming sex hormone whilst also balancing out the effects of estrogen.

Pauline Cox
So estrogen is now building, driving this thickening of the endometrial lining. Progesterone is supposed to be helping to thin it and keep it in check, fold it there. When progesterone starts to decline, then that, that blooding can start to happen and it can be very clotty, heavy periods.

Pauline Cox
So when we look again at what depletes progesterone more rapidly, cortisol, the stress hormone robs the body of progesterone. So stress has a really influential impact, negative impact on the sex hormones and particularly the estrogen progesterone balance.

Pauline Cox
So it, yes, we’re looking at diet, what’s driving inflammation, sugar’s driving inflammation. What we’re eating is impacting our liver health, but also our lifestyle, high stress, full sleep, high sugar, lots of caffeine, living off adrenaline.

Pauline Cox
These are all still influential on our sex hormone balance and the long-term health of our female physiology. But by putting these cornerstones of health in place first, then we can start to see what’s still remaining as a symptom, maybe a month or two later.

Pauline Cox
But, Robin, most of the time, those symptoms resolve once we get the foundation of health in place and that’s sleep, that’s minimising stress, that’s optimising blood sugars, that’s opening up the detoxification pathways, it’s getting out in the morning light, going for a walk, connecting with loved ones, soothing a stressed nervous system.

Pauline Cox
So much starts to happen when we give the body these fundamental essentials that it needs to restore its own homeostasis, its own balance, nutrient dense foods, and then supporting it with supplements.

Pauline Cox
I’m a big fan of getting the foundational supplements, right? Magnesium, omega-3s to help restore that omega-3, omega-6 balance. Magnesium and omega-3s can be incredibly helpful just to get someone back on track and reduce inflammation, get them back into a good sleep pattern, reduce anxiety, balance blood sugars, help improve energy.

Pauline Cox
And from there, they can start to make better choices throughout the day, because it’s really hard to make good choices when you’re tired, you haven’t slept, rest, you don’t feel good about yourself.

Pauline Cox
Giving the body the support it needs just to get that domino, that first domino down, it can be, it can be, it can be the one domino that gets the whole stack.

Robin Daly
Amazing. What a fantastic message, very empowering and very down to a good sense and look, the times whistle the way. That’s it. Amazing tour de force of fantastic information Pauline. Thanks so much.

Robin Daly
You speak so clearly about this and it’s very accessible for everybody so I’m sure the listeners are going to really appreciate what you’ve had to say today. So thanks very much for coming on the show.

Pauline Cox
Thank you, Robin. Thank you for having me. Bye.

Robin Daly
What a wealth of accessible information. Pauline is someone well worth listening to and I strongly encourage you to seek out other resources from her. Thanks so much for listening. I’ll be delighted if you can join me again next week for another Yes To Life show here on UK Health Radio.

Robin Daly
Goodbye. Thank you.