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Doctors+ | Show Notes | Interview With Dr. Kyrin Dunston, Md

In this Alternative Food Network interview with Dr. Kyrin Dunston, MD, a board certified OBGYN and Functional Medicine practitioner, listeners will learn about the various hormones in our body and why diet can play an important role in hormonal balance. Dr. Dunston shares her own personal and professional journey to achieving better health outcomes and offers diet tips to balance hormones. 

Why Dr. Dunston switched from practising as an OBGYN to becoming a functional medicine practitioner
Dr. Dunston went into gynecology because she fell in love with the specialty when she was a medical student. She loved participating in women’s lives and being a part of their families in one of the most important events of their life. However, with a challenging schedule and a family of her own, her own health started suffering. She was overweight, suffered with chronic fatigue, fibromyalgia, anxiety and depression. “I wasn’t able to participate in life. I wasn’t able to be a mom and a wife, and I really became a stranger in my own life”, says Dr. Dunston. She checked her thyroid at least 10 times, and it was “normal”. Other tests came back “normal”. She felt like she was living in a shell of a body that used to be vital and healthy and alive, and her vitality had just gone away. Upon her discovery of functional medicine, everything changed.

What is functional medicine?
According to Dr. Dunston, traditional Western medicine is all about symptom management. If your blood pressure is high, you’re given a medication to bring your blood pressure down. Nobody digs into why do you have high blood pressure.

Functional medicine is concerned with the ‘why’.
Dr. Dunston breaks down the ‘why’ into four categories:

  • Hormone imbalance
  • Toxicity
  • Nutritional deficiencies
  • Energetic imbalance

Dr. Dunston claims that mainstream doctors are not educated in this. “I don’t blame them. They’re doing the best that they can with the information they’re given, and that’s what I did for years. But like Oprah says, “when you know better you do better”.

When asked if most functional medicine practitioners are MD’s, Dr. Dunston says no. There are two main organizations that train and certify functional medicine practitioners and they allow different levels of medical providers to become certified.

Dr. Dunston wants listeners to know that if they have symptoms and their health is not vital and alive with bountiful energy, a normal weight and no prescription medications, then there’s a reason why they are not feeling well. “If you’re not getting the answers that you need at your regular doctor’s office, seek out other answers, and functional medicine just might be a part of the answer for you”.

What are symptoms of hormonal imbalance?
In a 20-year-old woman, she could have polycystic ovarian syndrome, which symptoms might be heavy, painful and very irregular periods, acne, bloating, and infertility. A perimenopausal woman at 45 could have heavy, irregular periods with moodiness and/or low sex drive. A menopausal woman who’s 60 could have lack of sex drive, poor memory and fatigue.

Every woman has estrogen, and there could be varying degrees of dysfunctional levels. Every woman has progesterone and there could be varying degrees of dysfunction. Every woman has the stress hormone cortisol and there can be varying degrees of dysfunction with that. There’s always root causes.

Types of hormone replacement therapy
Dr. Dunston says the average age at which menopause occurs is 51 in the United States, and perimenopause can start 5 to 10 years before that.

Hormone replacement therapy is designed to replace hormones that the body naturally makes when in an optimal state. There are different types of hormone replacement therapy explains Dr. Dunston. There’s the traditional mainstream hormone replacement therapy that includes what started over 50 years ago as horse estrogen which was taken from pregnant horses. The estrogen was extracted and they started giving it to women. But when it was realized there was an increased risk for uterine cancer, something was needed to counteract the effect of estrogen. So they went into the lab and took the body’s natural progesterone and chemically modified it. It is commercially sold as Provera with the goal of counteracting the effects of the estrogen on the uterus so women wouldn’t get uterine cancer. This has been shown in large scale studies to have serious side effects and increase the risk of many diseases, including cardiovascular diseases and strokes, and not to be beneficial to women according to Dr. Dunston. There was a big move many years ago with a Women’s Health Initiative study to get women off of this traditional hormone replacement therapy.

Another type of hormone therapy is bioidentical hormone replacement which means that hormones are replaced with something identical to what a woman’s body naturally makes. Dr. Dunston says there is enough data now to show that health outcomes for women and quality of life are markedly improved with biologically identical hormone replacement.

Dr. Dunston thinks women have been left out to dry and perimenopausal and menopausal women are totally underserved because there is no standard of care for checking hormone levels. A woman should have her hormone levels checked by someone who knows what they’re doing and then evaluated. Dr. Dunston indicates that she is by no means someone who says that every woman needs hormone replacement. There are some women who go through menopause and they’re fine. Dr. Dunston acknowledges that hormone replacement therapy is a very big and controversial topic.

At what age should a woman test her sex hormone levels?

It is Dr. Dunston’s position that women’s hormone levels should be checked throughout the life cycle. “We want to know where women are when they’re in their younger years and teens, and then we have something to compare it to. We want to know where they are in their twenties thirties, forties and fifties. It should be checked as standard of care.”

What are the various types of hormones?
There are many hormones, not just the sex hormones estrogen, progesterone and testosterone. The other four major hormones that Dr. Dunston evaluates when assessing someone for hormone imbalance are: 1) thyroid 2) insulin 3) cortisol and 4) DHEA.

Hormonal imbalance and diet
When it comes to eating, insulin is the hormone that is primarily affected. A strategy for eating to help balance hormones involves helping insulin and cortisol to function better. One might think that sex hormones don’t have anything to do with these other hormones. They do. They’re all interrelated according to Dr. Dunston. So if you take care of your insulin and your cortisol, it helps your sex hormones and your thyroid.

Insulin is the hormone that is given the task of keeping blood sugar from going too high. Blood sugar is a main fuel source that cells use to make energy to do anything. A secondary fuel source is fat. Sugar comes from the food that we eat in varying degrees. Every time you eat, you get some degree of sugar. If you eat high glycemic index or high sugar content foods, you get more sugar, like white rice, potatoes, cakes, candies, cookies, bread and pasta. If you eat low sugar containing foods with a low glycemic index like broccoli and green beans, you get a bit of sugar.

Blood sugar roller coaster
Whatever you eat in a meal is going to give you your dose of sugar or glucose, and then your insulin is going to come in to tell you what to do with that glucose. It keeps your blood sugar from going too high because too high blood sugar is a problem. One of the biggest issues worldwide is diabetes. For the majority of people who have diabetes type two, they consume too much sugar, and the insulin cannot keep up with the level of sugar that they’re consuming. So insulin starts going up to try handle the high level of sugar, and eventually it can’t do its job and the cells in the pancreas that make insulin start dying because it’s like they’re being blown out.

The problem is that as insulin goes up, what goes up must come down. Blood sugar goes up and the higher it goes and the faster it goes up, the faster it goes down and the lower it goes. And when it comes down, there are a couple of hormones that are tasked with bringing it back up. One is glucagon and the other is cortisol.

Cortisol is the stress hormone. It regulates the sleep-wake cycle. It helps to regulate blood sugar, energy level, weight and how the immune system functions or does not function. Blood sugar has to be maintained in a very narrow range. You could die if your blood sugar goes too low. Your body considers that an emergency. Cortisol is the emergency hormone. You eat too many high glycemic index foods, blood sugar goes up, and then it crashes down and then cortisol is stressed out and you go up and down. This is the blood sugar roller coaster.

How does one know if they’re on the blood sugar roller coaster? You get hangry; you get angry, irritable and feel all out of sorts.

How should we be eating?

Dr. Dunston loves what she calls a modified paleo diet – primarily plant based.
In her opinion, vegan diets can have health benefits if you do them for 3, 6 or in certain circumstances, 9 or 12 months. But in her opinion, it’s not something that is a viable option as a lifestyle. She says there are certain nutrients that one can only get from animal protein. Supplements can be taken but Dr. Dunston thinks most people who are vegans do not supplement properly. (For another opinion, listen to vegan dietician Ashley in Alternative Food Network’s podcast, Plant Based Diet, episode 1.)

Dr. Dunston continues to explain that eating vegan is a tool to use, but as a lifestyle, to just do that and not do it under medical supervision without proper assessments and support, it’s probably in the long run going to cause problems.

It’s a volatile issue because people are very attached to their philosophical and political views and rightly so says Dr. Dunston. But as a physician, if you take dogma out of it, Dr. Dunston thinks the body really does need animal protein. However, she will sometimes suggest a vegan diet as a medicinal tool for a finite period of time as there can be a lot of benefit to it.  

The problem with today’s standard diet
Several hundred years ago, all we had was food from the earth. It was primarily plant food that was seasonal and local. We didn’t have meat in the degree that we now have. We way overeat meat. The standard American diet, which has been adopted by many countries around the world, is really pretty nutrient deficient and it’s just out of balance.
Dr. Dunston uses orange juice as an example. We love orange juice because we’re biologically predisposed to love sugar, and then we make that a part of our everyday, and what we’re not paying attention to is what this is doing to our body. It’s spiking our insulin and it’s dinging our cortisol and if we stay on that path to diabetes long enough, first we become insulin resistant, and then we become diabetic.

Dr. Dunston’s top food picks

  • Vegetables, vegetables and more vegetables – spinach, kale, collard greens, mustard greens, turnip greens. Dunson tells people to get nine servings of vegetables per day.
  • Garlic
  • Ginger
  • Spices -turmeric, curcumin, oregano
  • Berries
  • Healthy proteins

Additional Resources
The Diet Deceptive Dozen: 12 Foods Flying Under Your Radar by Kyrin Dunston