# llms-full.txt Generated: 2026-10-06T10:12:04.387Z Source index: https://www.drsmithnd.com/llms.txt Documents included: 75 --- title: "Home" entity: "page" canonical_url: "https://www.drsmithnd.com" markdown_url: "https://www.drsmithnd.com/llms/page/home" lastmod: "2026-10-05T01:14:45.165Z" --- # Dr. Kirsten NATUROPATHIC DOCTOR SMITH, ND, MSCP Work with me ### Struggling with your hormones? You’re in the right place. ## Hi, I’m Dr. Kirsten. Women’s health warrior and advocate with 15+ years of experience in hormonal health. I work in the pioneering space where naturopathic and functional medicine meet conventional medicine, bringing an evidence-based, integrative approach to helping women reach their health goals. I close the gap between these paradigms merging the best of both worlds to deliver integrative cutting edge medical care to my patients. If you desire personalized precision medicine that handles both acute situations and is the very best approach to preventative care, then you have arrived at the right place. I provide solutions that are strategic and based on specific end points. As a Menopause Society Certified Practitioner and Naturopathic Doctor, my goal is to support women at all stages of their hormonal journey, through pre-perimenopause, perimenopause and post-menopause with bespoke, cutting edge integrative care. Work with me ## "To see my patients decide that they are worth it, decide to rally, and decide to make empowering choices – there is nothing more inspirational than that." - Dr. Kirsten Smith I N T E G R A T I V E W O M E N ’ S H E A L T H C A R E ## [Areas of Focus](https://drsmithnd.hiveality.com/areas-of-focus) ### HORMONAL HEALTH ### UNDER 35 Vaginal Health Endometriosis PMS PMDD PCOS Painful, Heavy or Irregular Periods Fatigue Perinatal Health ### PERIMENOPAUSE *Starts ~10 years before menopause* Vaginal health Menopause Hormone Therapy (HRT) Mood Brain fog Weight gain Sleeplessness Fatigue Libido Hot flashes ### POST-MENOPAUSE *The rest of your life after 12 consecutive months without a period* Menopause Hormone Therapy (HRT) Vaginal dryness/health Urinary Tract Infections, Incontinence, Bladder Health Cardiovascular disease prevention Osteoporosis prevention Dementia prevention Weight Loss & Healthy Body Composition Mental Health ### Hi, I’m Dr. Kirsten. Women’s health warrior and advocate with 15+ years of experience in hormonal health. My work closes the gap between current medical diagnostics, therapies, research and naturopathic medicine; merging the best of paradigms and delivering optimal integrative medical care to my patients. My goal is to support women at all stages of their hormonal journey, through pre-perimenopause, perimenopause and post-menopause. ## Proudly Certified by The Menopause Society As a Menopause Society Certified Practitioner, Dr. Kirsten has advanced training to support women through perimenopause, menopause, and beyond. This certification reflects her commitment to evidence-based, compassionate care — so you can feel confident you’re getting expert guidance tailored to your unique journey. ## How to Work With Me ##### Let's explore together how my naturopathic and evidence-based approach can support you. ## 01 #### BOOK A CONSULTATION If you're on the fence [about](https://drsmithnd.hiveality.com/about) jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. Book Now ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. Book Now ## Patient Testimonials I suffered for 2 years with hormonal imbalance due to perimenopause. The doctors I saw did very little to help and just wanted to give me medication to suppress the symptoms. Dr. Smith not only took the time to listen to me but she truly empathized and cared. It's only been 2 months and I am already on my way to feeling like a "normal" human being again, who is able to function and cope with life's stresses normally! Thank you Dr. Smith for caring, empathizing and being compassionate about helping women like me! Karen D Dr. Smith helped me with my menopause symptoms such as frozen shoulder, hot flashes, anxiety, sudden outbursts, mood swings, and other unexplained feelings that I had because of menopause. She taught me to eat better and more nutritious. Now I feel so much better physically and mentally. I am able to sleep and have more patience and less anxious. Thanks so much Dr. Smith for helping me become a happier and healthier person! Chi S Dr Smith is the best thing that has ever happened to me as it relates to my health. She completely transformed my health and has helped me navigate peri-menopause every step of the way. She's emphatic, an incredible listener and has an extraordinary ability to diagnose the core issue, as my issues have changed over the year. I feel incredibly lucky to her as part of my health journey. Allison B --- title: "About" entity: "page" canonical_url: "https://www.drsmithnd.com/about" markdown_url: "https://www.drsmithnd.com/llms/page/about" lastmod: "2026-08-29T08:50:06.147Z" --- # About Dr. Kirsten Smith ## Where your journey to strong health is personalized, strategic and efficient. Dr. Smith brings a wealth of knowledge, compassion, and dedication to her practice, specializing in the intricacies of women's health, hormonal conditions and phases of life. #### Learn More ## About Dr. Smith Dr. Kirsten Smith, ND, MSCP has 15+ years of experience delivering solutions to women struggling with hormonal issues or life transitions like perimenopause and menopause. Dr. Smith's unique methodology and training closes the gap between current medical diagnostics, therapies, research and naturopathic and functional medicine, merging the best of both paradigms delivering patient-centred integrative medical care to her patients. ### Areas of Focus ## Education & Expertise Dr. Smith began her focus on women’s health when she graduated in 2008. For over a decade, Dr. Smith partnered with an MD who specializes in women’s health and more specifically hormonal and thyroid health. Together they offered full spectrum care, merging the naturopathic and conventional medical approaches delivering pioneering care. This provided a medical residency experience that significantly contributed to Dr Smith’s breadth and depth of knowledge making her a leader in her area of expertise (women’s health) in the naturopathic medical community. She is a revered and skilled diagnostician and clinician. Dr. Smith is committed to a high standard of care with an evidence-based approach and works collaboratively with MDs, specialists, and various practitioners. Dr. Smith received an honours degree in communications at Queen’s University and later, took pre-medical science courses and completed the 4-year full-time program at the Canadian College of Naturopathic Medicine, one of six accredited naturopathic medical schools in North America. Subsequently, she has completed advanced medical studies in various areas but focuses on PCOS, endometriosis, PMDD, thyroid disease management, diabetes, menopause, gastrointestinal disorders, anti-aging and environmental and functional medicine. Dr. Smith continues to strive for excellence by taking ongoing medical education courses and attaining advanced clinical training in Canada, the United States, Germany, India and Costa Rica. In June of 2025 Dr Smith wrote the board exam for The Menopause Society (formerly NAMS, the North American Menopause Society), to become a Menopause Society Certified Practitioner (MSCP) to round out her clinical experience and remain on the frontier of evidence-based hormone health for mid-life women and beyond. ## Background Dr. Smith has a wealth of life experiences because prior to becoming an ND, she worked for many years as a producer in television, radio and documentary film in current affairs and related programming. She worked, volunteered and lived all over the world from Bangladesh to the Amazon to Antarctica, and learned about the formidable power of various ancient medicines which inspired her to investigate naturopathic medicine and completely change her life. Between balancing being a parent and managing a business and while walking the talk and putting the time and work into staying healthy and having crossed through peri/menopause herself, Dr. Smith has a deep understanding of how to help move you forward – this being the art of practicing medicine. Kirsten is often a guest speaker on podcasts, at conferences, in programs and at events teaching about women’s health, hormones, perimenopause and menopause medicine, committed to bringing it all into the modern era. Women deserve a lot more research and care than they are currently getting, and it is her commitment to be a part of the change. Kirsten is a mother to a beautiful boy and they dedicate a lot of time to adventuring, travelling, surfing, skiing and playing outside with their pup Birdy. ### Licenses & Certifications Dr. Smith is an active member of The Menopause Society, the Canadian Association of Naturopathic Doctors, and the Ontario Association of Naturopathic Doctors. ## How to Work With Me ##### Discover the difference of care rooted in compassion, customized to your unique needs, and committed to your lifelong wellness. ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. ## Patient Testimonials Dr Smith has been a saviour for me. She worked diligently to find the root cause of my issues that were overlooked or minimized by other med professionals. After years and years of struggling with gut issues and mental health issues, she figured out I was celiac and going through menopause. I don't know where I would be today without Dr Smith's determination to help me bring me back into the light. Highly recommend her! Wendy K Dr Smith has been helping for many years with my health issues. She does exemplary work and gets to the root of the problem. She has a very kind, genuine and caring disposition towards her patients. She really turned around my health which is a testament to her skills, abilities and extensive knowledge. I feel so grateful to have been treated by her. John F For the past few years, Dr Kirsten Smith has been my Naturopath. I find her to be a professional not full of hubris, but rather someone with empathy, who makes me feel listened to with respect to a collaborative approach and the best treatment suggestions. I am enjoying good health in my seventies; my trust in Dr Smith is based on my ability to speak freely, honestly, and I feel privileged to have found Dr Smith. Linelle M --- title: "Adrenal Fatigue Treatment" entity: "page" canonical_url: "https://www.drsmithnd.com/adrenal-fatigue-treatment" markdown_url: "https://www.drsmithnd.com/llms/page/adrenal-fatigue-treatment" lastmod: "2026-08-29T08:50:06.643Z" --- # Adrenal Fatigue Treatment As the name suggests, fatigue is the dominant symptom. Adrenal fatigue is not recognized by western medicine but is in fact both real and very treatable especially working within the realm of naturopathic medicine. UNDERSTANDING ADRENAL HEALTH ## What is Adrenal Fatigue? Adrenal fatigue is a state in which the adrenal glands fail to generate sufficient hormones because of prolonged periods of extreme stress without proper rest. This can lead to symptoms like feeling sick, fatigued, and unable to manage even minor stressors. The adrenal glands are vital in aiding the bodys response to stress and keeping equilibrium in bodily reactions. Hormones produced by the adrenals assist in controlling various metabolic functions and guarding against inflammation and swelling in reaction to diverse circumstances. After mid-life (menopause in women, andropause in men), the adrenal glands gradually become the major source of the sex hormones circulating throughout the body in both men and women. These hormones themselves have a whole host of physical, emotional and psychological effects, from the level of your sex drive to the tendency to gain weight. Adrenal fatigue can wreak havoc with your life. In more serious cases, the activity of the adrenal glands is so diminished that you may have difficulty getting out of bed for more than a few hours per day. With each increment of reduction in adrenal function, every organ and system in your body is more profoundly affected. Changes occur in your carbohydrate, protein and fat metabolism, fluid and electrolyte balance, heart and cardiovascular system, and even sex drive. Many other alterations take place at the biochemical and cellular levels in response to, and to compensate for, the decrease in adrenal hormones that occurs with adrenal fatigue. Aside from gathering a thorough medical history, evaluating for adrenal imbalances may require blood tests or a 4-point salivary cortisol test for a more comprehensive assessment. Treatment is often very effective and includes the use of adaptogenic herbs, supplementation with specific vitamins and minerals, optimizing sleep habits in alignment with our natural body clock, limiting screen time, improving overall nutrition with whole foods, and occasionally recommending intravenous vitamin infusions. Each treatment plan is tailored to the individual, but these are fundamental principles to consider. ## Symptoms of Adrenal Fatigue Adrenal Fatigue leads to lower levels of a number of hormones, and those hormones can affect every part of your body. So every case of adrenal fatigue tends to present itself slightly differently, although there are almost always common symptoms and experiences. ##### Common: ##### Other: - Asthma, allergies or respiratory complaints - Dark circles under the eyes - Dizziness - Dry skin - Extreme tiredness an hour after exercise - Frequent urination - Joint pain - Lines in your fingertips - Loss of muscle tone - Low blood pressure - Low blood sugar - Low sex drive - Lower back pain - Numbness in your fingers / Poor circulation - Weight gain T H E I M P A C T O F S T R E S S O N B L O O D S U G A R ## Blood Sugar Balance and Sugar Metabolism Adrenal fatigue can affect blood sugar and sugar metabolism as stress normally causes the adrenal glands to produce more cortisol, which helps raise blood sugar levels so the cells can more glucose to generate energy for your response to the stressor. The elevated blood sugar, in turn, requires higher levels of insulin to get the glucose from the blood into the cells. When this cycle is repeated frequently, the cells may become insulin resistant to protect themselves from too much glucose, especially when no energy-consuming physical action is taken in response to the stress. The greater the insulin resistance, the more insulin it takes to get glucose into the cells. In this way, chronic or repeated stress can contribute to persistent insulin resistance, and the resulting high levels of glucose (hyperglycemia) and insulin circulating in the blood that are likely precursors to metabolic syndrome and type 2 diabetes. ## Testing for Adrenal Fatigue Dr. Smith will likely order blood work, but in some cases salivary cortisol levels taken at four different times over the course of the day (a kit you take home) is a better option for a more detailed survey of adrenal function. Usually Dr. Smith will also assess some other adrenal hormones in her lab work such as DHEA. Both blood and salivary tests are equally sensitive when testing cortisol levels. H O L I S T I C A P P R O A C H E S T O H E A L I N G A D R E N A L F A T I G U E ## Treatments for Adrenal Fatigue Treatments for adrenal fatigue vary from using certain botanical medicines – which certainly will always play a major role, to using intravenous vitamin therapy. Usually this combination very quickly delivers results that both address the symptoms and nourish your adrenals back to optimal function. Additionally, patients usually need some blood sugar support and dietary changes to support stabilizing and decreasing insulin resistance while healing the adrenal glands. Bioidentical hormone therapy works importantly and symbiotically with other adrenal fatigue treatment interventions to also support and balance normal sex hormone levels. Often with hormones we must come at a few of them simultaneously to achieve lasting results and regain optimal function, however it does require expertise. Additionally, many botanical medicines are not safe in conjunction with conventional drugs, so it is crucial to see a licensed naturopathic doctor when using herbs as medicine. THE PROCESS ## How to get started ##### Your journey towards a balanced, vibrant life begins with a choice—a choice to prioritize your health and well-being. Let's explore together how natural hormone treatment can unlock your fullest potential. ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. --- title: "Areas of Focus" entity: "page" canonical_url: "https://www.drsmithnd.com/areas-of-focus" markdown_url: "https://www.drsmithnd.com/llms/page/areas-of-focus" lastmod: "2026-09-22T00:02:51.826Z" --- # Areas of Focus ## Dr. Smith has 15+ years of experience working with women at all stages of their hormonal journey. Dr. Smith is focused on educating and empowering women to achieve their optimal health goals through evidence-based research and clinical findings. She provides strategic, multi-modality treatment approaches for all manner of endocrine condition from endometriosis to polycystic ovarian syndrome , to thyroid disease to hormonal transitions like perimenopause . And yes, of course she also helps women in menopause - a many decades long phase of life - achieve optimal, strong health reducing disease risks and frailty. #### She works with a full range of conditions requiring various treatments and interventions: Perimenopause/Menopause Environmental Medicine Adrenal Fatigue IBS Thyroid Treatment Candida Treatment Hair Loss Treatment Depression Treatment Nutrition as the Foundation of Naturopathic Medicine ## A Holistic Approach to Healing There are very rarely cases where she only uses one modality, in particular because clinical nutrition is the foundation of naturopathic medicine and healthy, balanced living. Accordingly, nutrition tends to be the starting point and then decisions about appropriate treatments stem from there – the exception of course being with acute illness. ## Services Offered By Dr. Smith Functional Medicine Lab Testing and Analysis Botanical Medicine HRT Prescription ### Hi, I’m Dr. Kirsten Women’s health warrior and advocate with 15+ years of experience in hormonal health. My practice closes the gap between current medical diagnostics, therapies, research and naturopathic medicine; merging the best of paradigms and delivering optimal integrative medical care to my patients. My goal is to support women at all stages of their hormone journey, through reproductive years, perimenopause and of course in menopause which is the rest of our lives. ## How to Work With Me ##### Let's explore how I can help you unlock your fullest potential by providing personalized, cutting edge, multi modality strategies for you to have and maintain your strongest health. ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. Book Now ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. Book Now ## Contact Email: info@drsmithnd.com Phone: +1(343)-668-9767 Clinic Hours: Weekdays: 10AM - 4PM ## Patient Testimonials Dr Smith has been unequivocally one of the most instrumental healthcare practitioners in my healing through intensely challenging hormonal imbalances over the years. She's consistently demonstrated expertise, knowledge of the most updated relevant research, and most of all, incredible empathy, openness, heartfelt compassion, consciousness and humility. I wouldn't want any other ND to help me through my hormonal issues. I can't recommend her services enough. J C Dr Kirsten Smith is a great naturopath. She is genuinely caring, clear with her candour, and respectful, by which I mean, understands that your needs/emotions/mental state are an important part of the treatment process. If you feel you need different medical attention, she'll be supportive. That said, at a time when nothing else would ease my back pain, she knew precisely what I needed to finally feel relief and return to full health. I trust her, and know she'll do her utmost, well above and beyond the norm, to help her patients. Simal S I have been a patient of Kirsten's for many years and have also referred others to her with great confidence. She is very knowledgeable, kind, compassionate and truly listens; always wanting to really resolve any health issues. She is always upgrading her knowledge so that she can offer the best solutions but also understands that sometimes costs are a factor in what can/cannot be done right away. I am grateful that Kirsten is part of my like and wellness journey. Barbara C --- title: "Candida Treatment" entity: "page" canonical_url: "https://www.drsmithnd.com/candida-treatment" markdown_url: "https://www.drsmithnd.com/llms/page/candida-treatment" lastmod: "2026-08-29T08:50:05.591Z" --- # Naturopathic Candida Treatment Approach to Treating Candida with Naturopathy ## What is Candida? Candida is a term often applied to when a patient has an overgrowth of detrimental yeast species that can proliferate throughout your digestive system. This can result in a weakened immune system, digestion, chronic vaginal yeast infections, liver and bowel function issues and can lead to skin rashes. There are approximately 150 species of yeast in and on the human body. The most prevalent type is Candida albicans however people can get many types of yeast. This fungus usually inhabits the mouth, intestines and vagina and sometimes skin. Candida / yeast is kept at a low level by having a good amount of good bacteria that also make their home in the intestines, bowel and vagina. Lactobacillus acidophilus and Bifidobacteria bifidus are the well studied predominant friendly flora that inhabit our bodies but there are many, many more. Similar to the bacteria in yogurt these bugs make acetic acid, lactic acid and bacteriocins to help regulate the intestinal pH, enhance immune system controls and help maintain gastrointestinal health. They are also known to inhibit overgrowth of candida, help reduce food intolerance, provide important nutrients such as vitamins and lower cholesterol by preventing its absorption. Unfortunately many things will reduce the volume of good bacteria we have: alcohol, processed food (low fiber diets), antibiotic use (although sometimes necessary), high stress, high sugar / refined carbohydrate diets, the list goes on. ## Signs of Candida/Yeast Overgrowth U N D E R S T A N D I N G T H E R O O T O F C A N D I D A O V E R G R O W T H ## What Causes Candida? Candida is caused by an opportunistic microflora which over proliferates in the body when the conditions are right, such as an acidic, damp and sugary environment. U N D E R S T A N D I N G T H E I M P A C T O F C A N D I D A ## Effects of Candida Overgrowth Over time a persistent intestinal overgrowth can result in Candida invading the mucous membranes lining the gastrointestinal tract, particularly in the lower intestines and colon. This process severely interferes with normal mucosal health and produces microscopic holes in the membranes allowing yeast, bacteria, undigested food particles, pollen, environmental pollutants and other material to enter the bloodstream. This condition is known as “leaky gut syndrome”. If this complaint is not addressed it may contribute to further complications such as: ## How do you Diagnose Candida? Dr. Smith uses a stool test that diagnoses whether there is an overgrowth, but also identifies exactly what strain(s) is present so that the correct antifungal medicine can be prescribed. She doesn’t treat based on symptoms alone as there are many conditions which can cause this long list of symptoms and the treatment takes time, major (temporary) diet changes and appropriate medications (either botanical or conventional or both). ## What is the Natural or Functional Medicine treatment approach for Candida? To address Candida successfully, you need to adhere to a number of steps simultaneously in order to make sure the candida has no way of surviving. Again, first and foremost we must isolate what species has overgrowth with diagnostic testing so that we succeed in killing it with the right medicines. However, diet also plays an extremely vital role: ## Lifestyle factors for Candida E X P L O R I N G S O L U T I O N S ## Natural remedies for Candida ## Diet Tips THE PROCESS ## How to get started ##### Your journey towards a balanced, vibrant life begins with a choice—a choice to prioritize your health and well-being. Let's explore together how natural hormone treatment can unlock your fullest potential. ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. --- title: "Depression Treatment" entity: "page" canonical_url: "https://www.drsmithnd.com/depression-treatment" markdown_url: "https://www.drsmithnd.com/llms/page/depression-treatment" lastmod: "2026-08-29T08:50:06.284Z" --- # Naturopathic Approach to Depression Treatment ## The Impact of Untreated Depression #### Using naturopathic methods for treatment can effectively help alleviate and manage symptoms, either on their own or in conjunction with pharmaceutical drugs. Sometimes it is absolutely necessary to use pharmaceutical medication, but certainly not always. In moderate and mild depression, most cases are treatable naturopathically. Those suffering from depression often find it hard to pinpoint at first as depression can come on gradually. Things start feeling off and eventually it can be hard to find hope or positivity in your life. This can be a very scary experience and unfortunately, while things are improving, there is still some stigma around mental illness, even though ¼ Canadians will experience a serious episode at some point in their lifetime. And it is strongly suspected that this number will soon prove to be closer to 50% of all Canadians – and that includes children, sadly. Depression is can be situational, a side effect of a medication, genetic or even a result of another medical condition (such as hypothyroidism), however regardless of the cause it can be supported with naturopathic medicine. Effective treatment of depression allows people to get back to their lives with being able to access feelings of happiness, hopefulness and have the energy to do the things you enjoy. Often times depression can be made worse by anxiety, which becomes another obstacle to getting well again. Thankfully there are some excellent interventions and treatments in naturopathic medicine to treat anxiety. ## What are some of the signs of depression? E X P L O R I N G T H E I M P A C T O F D E P R E S S I O N ## How Depression Can Affect Your Life Because depression affects your energy levels and how you feel about yourself, the impact is seen throughout a person’s life – in relationships, physical health (oh yes, the mind and body are indeed very connected), at work, in parenting, etc. A S T E P - B Y - S T E P J O U R N E Y T O B A L A N C E D H E A L T H ## What Factors Influence Depression? Thyroid conditions, adrenal fatigue, hormone related issues and other illnesses. Low levels of iron, vitamin D, Omega 3s, magnesium and other vitamins and mineral that impact mood Dietary allergies and sensitivities that cause the body to be inflamed and stressed. Low serotonin levels Insomnia / trouble sleeping Lack of exercise Medications and antibiotics ## What are the options for treating Depression Naturopathically? THE PROCESS ## How to get started ##### Your journey towards a balanced, vibrant life begins with a choice—a choice to prioritize your health and well-being. Let's explore together how natural hormone treatment can unlock your fullest potential. ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. --- title: "Diabetes Treatment" entity: "page" canonical_url: "https://www.drsmithnd.com/diabetes-treatment" markdown_url: "https://www.drsmithnd.com/llms/page/diabetes-treatment" lastmod: "2026-08-29T08:50:05.658Z" --- # Diabetes Treatment N A T U R A L A P P R O A C H T O D I A B E T E S C A R E ## Naturopathic treatment of diabetes aims to lower blood glucose levels and promote overall well-being using natural therapies like diet, exercise, supplements, and herbs. In diabetes, the quality or the quantity of insulin produced is less and this is what leads to the increase in glucose (blood sugar) levels in the blood. Fortunately, it is very possible with Naturopathic treatment for patients to live a normal and healthy life, as our treatments are highly effective. Oftentimes, patients can get their diabetes under control and never need conventional medication (this is common with type 2 diabetes). Naturopathic treatments for diabetes are safe and responsible and very doable. Patients can lose weight, gain significant energy, and reduce their glucose numbers, cholesterol values, and even reduce blood pressure levels. Some patients will see their damaged nerves and kidneys recover full functioning, and those without such damage will have the tools to prevent it from developing. ## What is Diabetes? There are various types of diabetes, but the most common are type 1, type 2 and gestational (during pregnancy). While it is not possible to reverse type 1 diabetes, numerous studies have shown that type 2 diabetes can be prevented and delayed by the use of diet and lifestyle measures alone. Regular physical activity is one of the most powerful preventative therapies and in fact out performs almost any other intervention including various medicines. Weight loss is also extremely important in helping preventing or reversing type 2 diabetes. ## What Are the Symptoms of Diabetes? ##### The classic symptoms of diabetes are: ##### Other common symptoms include: ## Naturopathic Treatments Naturopathic doctors are well-trained and are able to provide patients with excellent treatment options for diabetes. Dr Smith, ND may utilize modalities such as nutrition, lifestyle counselling, botanical medicine, traditional Chinese medicine, or Intravenous Therapy. Many scientific studies have validated the use of naturopathic treatments for helping achieve optimal health for diabetics. Management of controllable factors include: poor diet, over-eating, nutritional deficiencies, high refined grains and sugar consumption, lack of exercise, and being overweight/obese. Environmental toxins and hormonal imbalances are also noted for initiating or contributing to insulin resistance, and subsequently Dr. Smith, ND will assess for these issues also. Dr Smith individualizes each treatment plan as every person experiences diabetes differently and may use various therapies differently to manage the core issues and complications of diabetes. A comprehensive treatment plan that includes diet modification, exercise and other medications truly is the best way to regulate blood sugar and manage diabetes. THE PROCESS ## How to get started ##### Your journey towards a balanced, vibrant life begins with a choice—a choice to prioritize your health and well-being. Let's explore together how natural hormone treatment can unlock your fullest potential. ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. --- title: "Disclaimer" entity: "page" canonical_url: "https://www.drsmithnd.com/disclaimer" markdown_url: "https://www.drsmithnd.com/llms/page/disclaimer" lastmod: "2026-08-29T08:50:05.755Z" --- # Health Disclaimer Health Content Disclaimer The health information provided on drsmithnd.com (the "Site") is for educational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the Site. K.A. Smith Naturopathic Professional Corporation does not endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Site. Reliance on any information provided by Dr. Kirsten Smith, ND, its employees, others appearing on the Site at the invitation of Dr. Kirsten Smith, ND, or other visitors to the Site is solely at your own risk. If you think you may have a medical emergency, call your doctor or 911 immediately. Dr. Kirsten Smith, ND does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Site. Contact Information If you have any questions about the Health Content Disclaimer, please contact us at: K.A. Smith Naturopathic Professional Corporation (434)-668-9767 info@drsmithnd.com Effective Date: Mar 24 2025. --- title: "Environmental Medicine" entity: "page" canonical_url: "https://www.drsmithnd.com/environmental-medicine" markdown_url: "https://www.drsmithnd.com/llms/page/environmental-medicine" lastmod: "2026-08-29T08:50:06.456Z" --- # Environmental Medicine ## Environmental medicine is an evolving field of medicine in which MDs and NDs diagnose and treat illness that is a result of a toxic exposure. “Transcending all boundaries of race, faith, income, and geography, this is the pollution that is in all of us and in our families; it speaks powerfully to our need to understand the risks of exposure to these chemicals and to protect those most vulnerable among us, including children who are exposed even before the moment of birth.” – Lyn Patrick, ND Dr. Patrick specializes in environmental illness, lectures internationally and is published in peer-reviewed medical journals. From the moment of conception onward, our bodies host myriad industrial chemicals that enter our bloodstream through our skin, gastrointestinal system or lungs. They are ingredients in consumer products (e.g. cosmetics, deoderant), or pollutants in air, water and food. They are the fire retardants, grease-proof coatings, plasticizers, and solvents that are found throughout our homes and work environments. They are our personal body burden of pollution. ## Research In 2000, a group of scientists in Washington DC at the Environmental Working Group, spearheaded a series of groundbreaking investigations on the pollution in people, from newborns and grandparents to mothers and teens. They’ve found pollutants in everyone. And they’ve found hundreds altogether, in combinations that have never been tested for safety. The toxins many people have in their bodies revealed by these studies exposes alarming gaps in the scientific understanding of our exposures and in our system of public health protection. In one study conducted they discovered that 457 of 538 chemicals tested were found in the blood, urine, umbilical cord blood of infants, and breast milk from a sample of 94 people. P O L L U T I O N A N D D I S E A S E C O N N E C T I O N ## Are these chemicals and toxic metals related to disease? The Collaborative on Health and the Environment is a diverse network of over 2600 healthcare providers and academic researchers in over 40 countries, working collectively to advance knowledge and effective action to address growing concerns about the links between human health and environmental factors. They have developed a database that helps us understand the links between our exposures and the ensuing health problems. P O L L U T I O N A N D D I S E A S E C O N N E C T I O N ## Are these chemicals and toxic metals related to disease? The Collaborative on Health and the Environment is a diverse network of over 2600 healthcare providers and academic researchers in over 40 countries, working collectively to advance knowledge and effective action to address growing concerns about the links between human health and environmental factors. They have developed a database that helps us understand the links between our exposures and the ensuing health problems. ## How are environmental exposures diagnosed? ### How are environmental exposures diagnosed? If there are aspects of your case that may indicate some kind of toxic exposure, Dr. Smith takes a thorough environmental exposure history regarding residential, occupational, medical and dental exposures. She then uses urine and blood tests to identify the presence of heavy metals, solvents, pesticides, herbicides and other chemicals that are stored in the body to show evidence of toxic exposures. ## What kind of training does Dr. Smith have? Dr. Kirsten Smith runs this program virtually at EnviroMed. She has completed the 30+ hours of training and is a certified Metabolic Balance™ coach. Typically, the program is conducted over 12 weeks, with a few coaching consultations peppered throughout. However, it really depends on your needs. We know from extensive research that frequent support and accountability drives better results—we customize Metabolic Balance™ to work for you! THE PROCESS ## How to get started ##### Your journey towards a balanced, vibrant life begins with a choice—a choice to prioritize your health and well-being. Let's explore together how natural hormone treatment can unlock your fullest potential. ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. --- title: "Free Guides" entity: "page" canonical_url: "https://www.drsmithnd.com/free-guides" markdown_url: "https://www.drsmithnd.com/llms/page/free-guides" lastmod: "2026-08-29T08:50:06.772Z" --- # FREE, EVIDENCE-BASED RESOURCES Educational guides designed to help you make sense of health changes and move forward with confidence—without overwhelm, noise, or misinformation ### CLEAR EXPLANATIONS Straightforward, plain-language guides that break down complex health topics without jargon, fear, or oversimplification. ### INFORMED DECISIONS Designed to help you understand what’s changing, know your options, and feel more confident advocating for your health and care. ### EVIDENCE FIRST, ALWAYS Each resource is grounded in current research and clinical experience—created to support thoughtful, evidence-based decision-making. START HERE ## A Clear Guide to Menopause Hormone Therapy This free guide breaks down what hormone therapy is, who it may be helpful for, and how to think about risks and benefits—so you can make informed decisions without confusion or fear. GET THE GUIDE RESOURCES ## EXPLORE THE FREE GUIDES ### Menopause Hormone ### Therapy Guide A clear, evidence-based overview of menopause hormone therapy—who it’s for, potential risks and benefits, and how to talk with your provider about your options. VIEW GUIDE ### Low Libido Guide An educational guide exploring the many factors that influence libido, with context and clarity to help you understand what may be contributing to changes in desire. VIEW GUIDE --- title: "FAQ" entity: "page" canonical_url: "https://www.drsmithnd.com/frequently-asked-questions" markdown_url: "https://www.drsmithnd.com/llms/page/frequently-asked-questions" lastmod: "2026-08-29T08:50:06.312Z" --- ## Frequently Asked Questions (FAQ) What is a naturopathic doctor (ND)? What is a Naturopathic Doctor (ND)?   In Ontario, Canada (and many other provinces and in various states in the U.S.), a naturopathic doctor is a regulated healthcare provider who focuses on natural and preventative medicine. NDs are trained to assess, diagnose, and treat health concerns using a variety of modalities, including clinical nutrition, botanical medicine, lifestyle counseling, and more. Do I need to be an Ontario resident to book an appointment? Do I need to be an Ontario resident to book an appointment ?   At this time, Dr. Smith's naturopathic services are only available to residents of Ontario, Canada due to licensing regulations. Are appointments conducted in person or virtually? Are appointments conducted in person or virtually?   All appointments are conducted virtually via a secure video platform (Jane App). This allows you to access naturopathic care from the comfort of your home. What can I expect during my first visit? What can I expect during my first visit?   Your first visit typically lasts 60 minutes and includes a detailed discussion of your health history, lifestyle, diet, and any current concerns. We’ll order labs and tests if necessary and work together to create a personalized treatment plan tailored to your needs. Are virtual visits as effective as in-person care? Are virtual visits as effective as in-person care?   Yes! Virtual naturopathic visits are effective for most health concerns. If physical assessments or lab work are needed, Dr. Smith will guide you through local resources or work with your primary care provider. Do I need a referral to see a naturopathic doctor? Do I need a referral to see a naturopathic doctor?   Nope! You can book an appointment directly. Are naturopathic services covered by OHIP? Are naturopathic services covered by OHIP?   Naturopathic services are not covered by OHIP, but many private health insurance plans do offer coverage. Please check with your provider to confirm your benefits. What types of health concerns can naturopathic medicine help with? What types of health concerns can naturopathic medicine help with?   Naturopathic medicine can help with a wide range of conditions, including: - Digestive issues (IBS, bloating, food sensitivities) - Hormonal symptoms (PMS, perimenopause, menopause, thyroid concerns) - Mental health (stress, anxiety, low mood) - Fatigue and low energy - Immune support - Skin conditions (eczema, acne) And more! Can Dr. Smith order lab tests, prescribe supplements or hormonal treatments? Can Dr. Smith order lab tests, prescribe supplements or hormonal treatments? YES. As a regulated ND in Ontario, Dr. Smith can recommend and interpret functional and standard lab tests,  provide personalized supplement plans AND prescribe Hormone Replacement Therapy (HRT : progesterone and estrogen) How do I book an appointment? How do I book an appointment?   Appointments can be booked easily through our online booking system below, or by contacting us directly at info@drsmithnd.com . What technology do I need for a virtual visit? What technology do I need for a virtual visit?   You’ll need a stable internet connection and a device with a camera and microphone (computer, tablet, or smartphone). The video calls are hosted on a secure, privacy-compliant platform called Jane App. REMINDER : join your appointment from a quiet, private place for optimal comfort and confidentiality.   What is the cancellation policy? What is the cancellation policy?   Dr. Smith require 48 hours’ notice for cancellations or rescheduling. Missed appointments or late cancellations will be charged in full.  --- title: "Functional Medicine" entity: "page" canonical_url: "https://www.drsmithnd.com/functional-medicine" markdown_url: "https://www.drsmithnd.com/llms/page/functional-medicine" lastmod: "2026-08-29T08:50:06.582Z" --- # Functional Medicine ## Functional Medicine; the future of conventional medicine, and it is available NOW Functional medicine is essentially a combination of naturopathic and conventional medicine. Practitioners of functional medicine aim to identify and treat the underlying causes of disease, viewing the body as a unified system rather than separate organs. This approach focuses on treating the entire system, not just symptoms, which is a key aspect of naturopathic medicine. Both functional and naturopathic medicine take a holistic approach to addressing the root causes of disease through collaboration between patients and practitioners. This patient-centered approach represents a shift from traditional disease-focused care to a more comprehensive focus on the individuals overall health and well-being. By considering genetic, environmental, and lifestyle factors that impact long-term health, practitioners of functional and naturopathic medicine strive to optimize each persons unique expression of health and vitality. ## The 6 Core Elements of Functional Medicine #### Functional medicine is guided by six core principles: ## Why do we need Functional Medicine and how is it Different? THE PROCESS ## How to get started ##### Your journey towards a balanced, vibrant life begins with a choice—a choice to prioritize your health and well-being. Let's explore together how natural hormone treatment can unlock your fullest potential. ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. --- title: "Contact Us" entity: "page" canonical_url: "https://www.drsmithnd.com/getintouch" markdown_url: "https://www.drsmithnd.com/llms/page/getintouch" lastmod: "2026-08-29T08:50:06.614Z" --- # Booking & Contact Info Book Now ## Contact Details We will respond to your email within 1–2 days. E-mail is preferred, but you may phone us too. Email info@drsmithnd.com Phone 343-668-9767 Address Virtual practice, Ontario, Canada #### Fill in the form below to connect with us. --- title: "Hair Loss Treatment" entity: "page" canonical_url: "https://www.drsmithnd.com/hair-loss-treatment" markdown_url: "https://www.drsmithnd.com/llms/page/hair-loss-treatment" lastmod: "2026-09-22T00:02:51.336Z" --- # Hair Loss Treatment U N D E R S T A N D I N G T H E C A U S E S O F H A I R L O S S ## Both men and women can be affected by hair loss which can be caused by many different things. It is vital, through lab testing, to assess and determine the root cause of your hair loss, because from there Dr Smith may be able to effectively treat and in some cases reverse your hair loss. Although a certain amount of hair loss occurs naturally with aging, it’s a concern that should be taken seriously, particularly in women, due to the major impact it has on self-esteem. Book A Consultation ## What Causes Hair Loss #### Some of the causes may include but are not limited to: Celiac Disease or Gluten Intolerance An immune reaction to eating gluten, a protein found in wheat, barley and rye. If you have celiac disease, eating gluten triggers an immune response in your small intestine. Over time, this reaction damages your small intestine’s lining and prevents absorption of some nutrients (malabsorption). The intestinal damage often causes diarrhea, fatigue, weight loss, bloating and anemia, and can lead to serious complications. Hypothyroidism Hair loss can be one of the early symptoms of Hypothyroidism, a condition that occurs when the thyroid gland does not produce enough thyroid hormones to meet the needs of the body. Nutritional Deficiencies Deficiencies of any essential nutrient can cause hair loss. Dr Smith can assess nutrient levels and determine adjustments to diet and diet supplementation. Additionally, protein malnutrition will cause hair loss. Common deficiencies include: Vitamin A Vitamin D Zinc Iron EFAs – Essential Fatty Acids Drug-Induced Hair Loss Pharmaceutical drugs have been known to cause hair loss. Some of the most common are: Antibiotics Anticoagulants (Coumadin, heparin) Antidepressants (Prozac, lithium) Antiepileptics (Valproic acid, Dilantin) Cardiovascular drugs (ACE inhibitors, beta-blockers) Chemotherapy drugs Endocrine drugs (Clomid, danazol) Gout medications (Colchicine, allopurinol) Cholesterol-lowering drugs Non-steroidal anti-inflammatory drugs (Ibuprofen, naproxen) Ulcer medications (Zantac, tagamet) Androgens – Hormone-related The primary and most well-known androgen is testosterone. Dihydrotestosterone (DHT) and androstenedione are less known generally, but are of equal importance in male development. Later in life DHT can contribute to male balding. Although androgens are described as male sex hormones, both males and females have them to varying degrees, as is also true of estrogens. Female hair loss can be androgen-related and is referred to a “female pattern hair loss”. There are a number of reasons why a woman may be affected by androgen-related hair loss. Genetics, excess androgen production due to aging, insulin resistance, diabetes, polycystic ovarian syndrome, and low antioxidant status are all associated with female pattern hair loss. There are excellent botanical treatments to address this once this has been established with blood work as a problem. Autoimmune disorders: Alopecia – (Medical Term for Baldness) Alopecia areata is a condition that causes a person’s hair to fall out. It is an autoimmune disease which means that the person’s immune system is attacking their own body. In this case, their actual hair follicles. When this happens, the person’s hair begins to fall out, often in clumps the size and shape of a quarter. The extent of the hair loss varies; in some cases, it is only in a few spots. In others, the hair loss can be more pronounced. Genetics can play a role in autoimmune conditions including alopecia areata, along with other unknown triggers. Alopecia areata is an unpredictable disease. In some people, hair grows back but falls out again later. In others, hair grows back and remains. Each case is unique and is hard to predict. Naturopathic doctors have a lot of herbs which play a vital role in stabilizing autoimmune disease – so this is the direction Dr. Smith would be going in this type of hair loss. There are various autoimmune diseases that will cause hair loss. ## Can Stress Really Cause Hair loss? YES. Stress can deplete us of vital vitamins and minerals, many of which correlate to hair loss. Stress can also deplete the adrenal glands that manage our stress physiology, so our capacity to handle stress goes down, which makes the stress response worse. High stress can also throw us into an autoimmune state. Three types of hair loss that can be associated with high stress levels are: Telogen effluvium In telogen effluvium (TEL-o-jun uh-FLOO-vee-um), significant stress pushes large numbers of hair follicles into a resting phase. Within a few months, affected hairs might fall out suddenly when simply combing or washing your hair. Trichotillomania Trichotillomania (trik-o-til-o-MAY-nee-uh) is an irresistible urge to pull out hair from your scalp, eyebrows or other areas of your body. Hair pulling can be a way of dealing with negative or uncomfortable feelings, such as stress, tension, loneliness, boredom or frustration. Alopecia areata A variety of factors are thought to cause alopecia areata (al-o-PEE-she-uh ar-e-A-tuh), possibly including severe stress. With alopecia areata, the body’s immune system attacks the hair follicles — causing hair loss. Stress and hair loss don’t have to be permanent. If you get your stress under control, your hair might grow back – but there is no guarantee that it will, unfortunately. If you notice sudden hair loss or more than usual hair loss when combing or washing your hair, talk to your doctor or naturopathic doctor. Sudden hair loss can signal an underlying medical condition that requires treatment. ## Treatment of Hair Loss Treatment depends entirely on what is causing the hair loss. Dr Smith takes an individualized approach to treatments and will perform tests to determine the cause. Once the root issue (no pun intended) is determined, hair loss can be addressed using naturopathic medicine by: Improving nutrient (iron or any others which are low) intake AND absorption Enhancing production and function of thyroid hormones, estrogen or progesterone Lowering excess testosterone, DHEAs and/or DHT Stress reduction techniques and adrenal gland support to allow healthy adaptation to stress Address food sensitivities in the case of autoimmune hair loss and use appropriate herbs THE PROCESS ## How to get started ##### Your journey towards a balanced, vibrant life begins with a choice—a choice to prioritize your health and well-being. Let's explore together how natural hormone treatment can unlock your fullest potential. ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. Book Now ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. Book Now --- title: "Hormone Health" entity: "page" canonical_url: "https://www.drsmithnd.com/hormone-health" markdown_url: "https://www.drsmithnd.com/llms/page/hormone-health" lastmod: "2026-08-29T08:50:05.842Z" --- # Hormone Health ### Dr. Smith has 15+ years of experience working with a variety of hormone health-related issues such as: ## Work with Dr. Smith ##### Your journey towards a balanced, vibrant life begins with a choice—a choice to prioritize your health and well-being. Let's explore together how natural hormone treatment can unlock your fullest potential. ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. ## Proudly Certified by The Menopause Society As a Menopause Society Certified Practitioner, Dr. Kirsten has advanced training to support women through perimenopause, menopause, and beyond. This certification reflects her commitment to evidence-based, compassionate care — so you can feel confident you’re getting expert guidance tailored to your unique journey. --- title: "Hormone Replacement Therapy" entity: "page" canonical_url: "https://www.drsmithnd.com/hormone-replacement-therapy" markdown_url: "https://www.drsmithnd.com/llms/page/hormone-replacement-therapy" lastmod: "2026-08-29T08:50:06.396Z" --- # Menopause Hormone Therapy (MHT) ## Are you feeling exhausted, moody, overwhelmed and not in control of your health? Everything is out of balance, sleep is elusive, you’re gaining weight for no reason and feeling low in general? #### You’re not alone; you may be be a good fit for Biodentical Hormone Replacement Therapy (BHRT) otherwise known as Hormone Replacement Therapy (HRT) or Menopause Hormone Therapy . The time period from when you begin [perimenopause](https://drsmithnd.hiveality.com/perimenopause), (in your late 30s) all the way to the other side of menopause itself, can be a really rough road. It’s easy to slip further and further down while getting nowhere when asking your health care providers for help and being offered dated, high risk treatments that don’t feel right. This is what I see every day in my patient community and it is a fact that women are rarely get the medical care they deserve during this challenging and vulnerable phase of life. If you relate to this, you’re very much in the right place because this is my superpower: helping women go from drowning to steering the ship once again. Book Now ## Common Symptoms of Perimenopause and Menopause Weight gain Mood changes Hot flashes Vaginal health/dryness Night sweats Memory loss Difficulty sleeping Decreased interest in sex‌ Insulin spikes Stress, diet and lifestyle all directly impact how our hormones function. If you are experiencing any of these symptoms, your body may be telling you that your hormones are out of balance. Now is the time to make changes, because the sooner you do, the shorter the path back to optimal health. It will improve your quality of life today and prevent serious health problems in the future. E X P L O R I N G T H E A D V A N T A G E S ## What Are the Benefits of Hormone Replacement Therapy? Restores mood & improves memory Promotes lean muscle mass & improves insulin sensitivity Promotes healthy sleep Increases energy Reduces inflammation & body aches Supports collagen & elastin; healthy skin & joints Reduces age-related hair thinning Boosts immune function, improving healing capacity Decreases bad cholesterol & increases good cholesterol Increases bone density; decreasing risk of osteoporosis Increases the desire & stamina for exercise may reduce risk of cardiovascular deterioration Improves libido Most effective treatment for vaginal changes of peri/menopause Book Now ## HRT/MHT Frequently Asked Questions Hormone Replacement Therapy (HRT) & Bioidentical Hormone Replacement Therapy (BHRT): What's the Difference? HRT or hormone replacement therapy is when a licensed medical provider prescribes a hormone product. This could be the birth control pill, a hormone secreting IUD, or any hormone product. But mostly when people refer to HRT, they are referring to the prescription hormones women get when needing support in perimenopause or menopause. BHRT or bioidentical hormone replacement therapy is the same thing as HRT! Most people think “bioidentical” means that the product was made by a special compounding pharmacy, and it doesn’t. Bioidentical/ body identical/human identical mean just that; that the hormone prescribed is molecularly identical to what we make in our bodies (however they are made in a lab). The first thing you should know is that we have FDA approved versions of bioidentical hormones that all healthcare practitioners prescribe. That is why mostly these days we just say “HRT” which means the same thing as “BHRT” because the products are almost all, (in particular when it comes to treating perimenopause or menopause) bio/human identical. The only non-bioidentical synthetic estrogen still in the market place is called premarin and of course there are many non-bioidentical progestin products found in birth control pills and hormone secreting IUDs. Bioidentical hormones are made using natural ingredients and are available through standard FDA prescriptions or through certified compounding pharmacists who must adhere to strict regulations. The types, combinations and dosages of bioidentical hormones are customized to fit each individual patient and will be discussed in the course of your treatment. Hormones are powerful chemical messengers that must be prescribed; thus it is very important to receive a comprehensive individual medical risk assessment before proceeding with treatment. Ongoing monitoring with blood work is important to ensure that patients are optimized and are well within safe limits. The frequency of the monitoring is entirely dependent on the case. Hormone Replacement Therapy’s Role in Prevention Often we think of replacing hormones as  way to balance things, as a way to address immediate nagging symptoms – and it does. However there is a much bigger role that having adequate levels of hormones plays, it helps us not only to age well but also it helps to prevent many of the diseases of aging such as cardiovascular disease, osteoporosis, muscle wasting, gynecological infections and conditions, Alzheimer’s disease dementia, memory loss, and even some cancers. Understanding Hormones And How They Work Hormones are proteins that behave like powerful chemical messengers. They are delivered to body tissues through the blood. Working together like a finely tuned symphony, they regulate everything from reproduction and emotions to general health and well-being. Maintaining the proper balance of hormones in the body is essential to good health. Factors that affect hormone levels include your stage of development (puberty through menopause) as well as sleep, diet, stress, exercise, medications and the environment. Hormone Imbalance Affects Women at Any Age Women of all ages can suffer hormone imbalances. • Do you have PMS, heavy or irregular periods? • Have you suddenly gained weight and are unable to lose it? • Do you have mood swings, hot flashes and night sweats? • Are you feeling stressed, tired and have trouble sleeping? I work with teens who are having challenging periods all the way up to women at the end of their lives; our hormones are our kryptonite, they play a huge role in overall health at every stage of our lives. In young women it is often poor nutrition, emotional stress, an erratic lifestyle, too much alcohol, the use of birth control pills, or the early onset of menopause that leads to hormonal imbalance. In mature women, perimenopause, menopause and untreated postmenopause are the most common causes of hormonal symptoms. Other contributing factors – at any age – include genetics, lack of exercise, obesity, poor quality sleep, trauma, inflammation, thyroid and adrenal problems, ovarian failure, as well as exposure to pesticides, chemicals, environmental pollution and toxins. In most cases, the symptoms of hormonal changes can be improved through lifestyle changes and natural therapies. Often, however, working with a menopause clinic/menopause specialist who has experience working with HRT (hormone replacement therapy which is the same as bioidentical replacement therapy as explained above)  may be required for optimal lasting results. My Process for Providing HRT 1) Assessment: We begin with an initial hour long deep dive assessment, reviewing all your symptoms in detail, your medical and family history, and then discussing your goals. 2) Lab Work: I then order appropriate lab work which leads us to your first follow up. 3) Follow Up: In the first follow-up, I’ll teach you about your lab results, explaining what I think is happening (the diagnosis) and then going over my rationale for the kind of treatment I am proposing: writing out your individualized treatment plan and doing hormone prescriptions (if indicated), and off you go – the beginning of getting back to feeling like yourself again. 3) Treatment Plan: My unique scope of practice means that treatment plans include everything from lifestyle medicine (nutrition, stress management, movement) to botanical medicine, and if indicated, prescribing hormone replacement therapy (same thing as bioidentical). 4) Second Follow Up: The second follow up involves reviewing how the treatment plan/ prescriptions went, how each symptom responded to treatment, going over any questions, and making adjustments as needed. From here, follow ups are on an as-needed basis. If HRT/ hormone replacement therapy is right for you, you will feel like yourself again – vibrant, energetic and on top of your game! With HRT, you are really supporting yourself as you age by reducing much of the physical and mental deterioration that comes with this time in life and paving the way to have some of the best years of your life! What Are the Long-Term Benefits of HRT? Hormone balancing help both in the short and long-term. Hormone replacement therapy helps reduce the risk for the top three diseases associated with aging for women: heart disease, osteoporosis, and dementia. How are Bioidentical Hormones Prepared? Hormones are made in a laboratory and the components are from plants; typically yam or soy, to make a hormone that is structurally identical to those naturally produced in the human body. Does BHRT Require a Prescription? In Canada, hormones require a prescription from a medical doctor, naturopathic doctor WITH a prescribing licence (this is an additional license on top of the regular ND medical license) or a Nurse Practitioner. After a thorough consultation and laboratory testing, Dr. Smith may prescribe a hormone or a combination of hormones to address your unique needs. The prescriptions are filled at a regular pharmacy if you elect to use FDA approved versions of bioidentical hormones, or by a compounding pharmacy if you require a customized formula (compounding pharmacies are useful when women have unique dosing needs). Is BHRT Covered by Insurance? Prescriptions of any hormone product are prescriptions and therefore covered by your insurance. How are Hormones Taken? Depending on many factors, I will help you find an amenable route of administration. The choices are varied and include but are not limited to: gels, patches, creams,  suppositories, injections, capsules. Certain routes of administration work better for certain conditions. Is BHRT Safe? Yes. A lot of research shows that bioidentical/ human identical hormones have little in common with the side effects and risks of the old fashioned “synthetic” hormones. Today, bioidentical hormone replacement therapy is recommended as the standard of care for peri/menopause for this very reason, it’s just that there is a massive delay in getting the word out. The North American Menopause Society (NAMS), the British Menopause Society (BMS) and many others around the world like these organizations, do a complete literature review every 5 years and then comment on HRT and safety in a position statement. The last two position statements have conclusively stated that HRT (which again, is the same as BHRT) is the safest and most effective way to treat symptoms of menopause. There is a growing body of evidence that absolutely supports the safety of HRT showing it can lower a patient’s baseline risks for breast cancer, cardiovascular disease, dementia and osteoporosis. Other research has found that hormones have a favourable action on blood vessels and even decreasing the risk of dementia (which is 3x more common in women!). These positive results have spurred further studies on human identical hormones, and will hopefully fuel the trend for physicians to ONLY use these forms of hormone replacement, and learn how to help patients with immediate symptoms, but also prevent or reduces the risks of certain diseases. Finally, studies of both bioidentical/ human identical estrogen and progesterone are showing that they are not associated with an increased risk of blood clots. Unfortunately it is taking the medical community a long time to separate the body of evidence supporting these human identical hormone products from the old fashion “synthetic” ones which have high risks associated with them. Does Dr. Smith Test Hormone Levels? Most of the time I order blood work because that is what the majority of the research is based on. In some cases I may also use saliva, DUTCH or genetic testing, but this is rare as it is not usually necessary. Is Lab Testing Covered by OHIP? No, but often people have insurance for either my time or labs or both, please contact your insurance provider to find out ahead of your visit. Does BHRT Increase the Risk of Breast Cancer? No. Studies have demonstrated the beneficial effects of bioidentical estrogen and progesterone ## Proudly Certified by The Menopause Society As a Menopause Society Certified Practitioner, Dr. Kirsten has advanced training to support women through perimenopause, menopause, and beyond. This certification reflects her commitment to evidence-based, compassionate care — so you can feel confident you’re getting expert guidance tailored to your unique journey. THE PROCESS ## How to get started ##### Your journey towards a balanced, vibrant life begins with a choice—a choice to prioritize your health and well-being. Let's explore together how natural hormone treatment can unlock your fullest potential. ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. Book Now ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. Book Now ## A Complete Menopause Hormone Therapy Guide [Menopause](https://drsmithnd.hiveality.com/menopause) doesn’t have to feel confusing. My free, evidence-based guide breaks down all the latest research and recommendations on menopause hormone therapy - helping you understand your options and feel confident in your care. DOWNLOAD THE FREE GUIDE --- title: "IV Therapy" entity: "page" canonical_url: "https://www.drsmithnd.com/iv-therapy" markdown_url: "https://www.drsmithnd.com/llms/page/iv-therapy" lastmod: "2026-09-22T00:02:52.341Z" --- # Intravenous Vitamin and Mineral Therapy Welcome to Dr. Smiths practice, where personalized care is our top priority. Dr. Smith creates tailored treatment plans to address your unique needs, with a focus on providing the most beneficial therapy for your situation. If you are located in or around Toronto, Ontario, we invite you to experience our expert care and compassionate approach to healing. Contact us today to start your journey towards improved health and well-being with Dr. Smith. ## About Intravenous (IV) Nutrient Therapy IV Therapy Intravenous (IV) Nutrient Therapy is an effective way to help you achieve faster and better results when it comes to your health and performance. By administering vitamins and minerals directly into the blood stream, we bypass the stomach, overcoming any absorption limitations. This allows us to achieve significant pharmacological doses not attainable by taking oral supplements. When this happens, the cells are saturated with nutrients, promoting the healing and repair process to take place at an accelerated pace. In this way, IV therapy promotes optimal cellular function and also significantly improves the detoxification pathways by eliminating toxins from the body. Book A Consultation ## Conditions That Can Benefit from IV Therapy IV therapy can also be extremely beneficial for people who have compromised digestive systems such as constipation, Chrone’s disease and ulcerative colitis – but it has also been extensively studied to show benefits for the following conditions: Fatigue ( including Adrenal Fatigue ) Migraines & headaches Fibromyalgia & Chronic Fatigue Syndrome Asthma & Allergies Viral and Bacterial infections (Flu, Cold, Mono, Herpes, Shingles, Hepatitis) Macular degeneration Parkinson’s disease Post-surgery recovery Gastrointestinal conditions such a celiac (malabsorption) Crohn’s disease, ulcerative colitis (reduces inflammation) Athletic performance (pre or post race***) ## Available IV Nutrient Blends #### Dr. Smith will determine your personal needs and customize an infusion to help restore your health. See the list of infusions below: OPTI NEURO-BALANCE: Stabilizes mood during times of stress and mental exertion. Also reduces withdrawal effects of certain medications. OPTI-MOOD BALANCE: Supports optimal mood and well-being. Ideal for individuals suffering from low mood and/or irritability. OPTI-BRAIN: Supports brain health. Helps with recovery from post-concussion, head injuries or trauma. OPTI-IMMUNE: A deep immune system booster. Increases white blood cell counts to overcome recurrent viral & bacterial infections and shortens illness time. OPTI-NOURISH BASIC: A starter drip to ease into vitamin drip therapy. Provides foundational nutrients to nourish cells for optimal function. OPTI-CLEANSE: Significantly improves detoxification & clearance of multiple toxins. Protects the liver from damage. Contains the master antioxidant, glutathione. OPTI-ATHLETE: Improves performance & speeds up recovery for sports injuries. Ideal for physically active individuals. OPTI-SURGERY: Significantly improves tissue repair & recovery time. Reduces inflammation and prevents infection. Ideal for all surgeries, especially dental. OPTI-TRAVEL: Optimizes immune system, prevents infections, and reduces exhaustion from jetlag and travel. Ideal for regular travelers and business executives. OPTI-CALM & SLEEP: Reduces anxiety & high stress. Beneficial for insomnia caused by restlessness and mental overactivity. OPTI-ENERGY: Provides optimal nutrients to vitalize cellular energy and function. Recharges one from within. OPTI-ADRENAL: Supports optimal adrenal gland function and overall wellbeing. Especially beneficial for chronic stress and burnout. OPTI-REPLENISH: A well-balanced maintenance formula. Provides nutrients essential for optimal energy, adrenal function, gentle immune support, and detoxification. OPTI-YOUNGEVITY: A vitamin drip specifically formulated for wellness optimization. Provides optimal nutrients, antioxidants, & mitochondrial support. B12 INJECTION: Provides energy, improves mood, reduces anxiety, and important in red blood cell production. I V T H E R A P Y P R O C E S S ## Frequently Asked Questions What to Expect? In order to receive IV therapy from and ND in Ontario, you have to be that doctor’s patient. If you are interested in this type of care, please book an appointment with Dr. Smith. She will review your medical history, family history and current health challenges in the consult and she may ascertain that some lab testing is required. If no testing is required before she prescribes the infusion, you can commence IV therapy right away. You will then be taken to the IV suite, set up in a comfortable chair and the IV will be started. Once the IV is running you are free to read a book, have a cup of tea and a snack, or simply put your feet up and relax. You will be checked on periodically during your treatment. Treatments most commonly take about 30 minutes but may take up to 120 minutes or longer depending on the type of IV prescribed. Treatment frequency varies and is dependant on a number of factors. It can range from weekly to monthly or as needed during times of high stress or immune challenge. Why Not Take Oral Vitamins? Oral supplementation is often a very useful intervention and very effective. There are however, certain conditions or medical situations where getting a much larger dose than one can take orally and getting it directly at the cell level (bypassing digestion and absorption), is an extremely powerful therapy. With IV infusions of vitamins, minerals and amino acids, you can deliver high dose, quickly and get rapid transformations with certain conditions that you simply cannot even remotely achieve with oral dosing. Does It Hurt? The only part that hurts very briefly is the poke at the beginning. Dr. Smith uses flexible angiocatheters, so there is actually no needle sitting in your arm so you can have a painless, relaxed experience and even move your arm if necessary. It is not at all like getting an IV in your hand in the hospital – it is far more relaxed and far less painful. Is This Safe? NDs who administer IVs have an entirely separate and additional license to do so, and to maintain that license they have to do regular continuing education. Our regulatory body ensures that we are highly trained and continue to be. IV trained NDs assess their patients for candidacy and are discerning. There are always some minor risks when injecting into the bloodstream however there are no preservatives in the vitamins so it is very well tolerated.  There are some rare risks of bruising or of an irritated vein, however Dr. Smith will go over this with you in the office. IV therapy is extremely safe and effective. How Should I Prepare for my Session? Feed and water yourself! Hydration is important and having eating within 3 hours also helps stabilize the body. THE PROCESS ## How to get started ##### Your journey towards a balanced, vibrant life begins with a choice—a choice to prioritize your health and well-being. Let's explore together how natural hormone treatment can unlock your fullest potential. ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. Book Now ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. Book Now --- title: "Lab Testing" entity: "page" canonical_url: "https://www.drsmithnd.com/lab-testing" markdown_url: "https://www.drsmithnd.com/llms/page/lab-testing" lastmod: "2026-09-22T00:02:52.083Z" --- # Lab Testing ## Dr. Smith uses various laboratories to assist with clinical assessment and diagnosis. #### Below is a non-exhaustive list: Lifestyle Genomic Testing DNA testing to determine your genetic predispositions as well as customize a treatment plan that works with your body and genes. Metametrix/Genova Testing Detoxification impairment testing, solvents toxicity testing, celiac disease testing, amino acid tests (protein building-blocks that are essential for brain neurochemistry), essential fats Life Labs All the standard blood testing is done with Life Labs (for example iron, progesterone, estradiol, Vitamin D, thyroid markers, cortisol, B12, cholesterol, etc.) as well as specific allergy tests SIBO Diagnostics Lactose intolerance testing and lactulose breath tests for SIBO (Small Intestinal Bacterial Overgrowth) Doctors Data Stool samples of any kind, including urinalysis for toxic heavy metals Rocky Mountain Analytical Food Allergy and Intolerance Testing, environmental pollutants panel, heavy metals (urine) Diagnos Techs Gastrointestinal panels (stool, saliva) and the Adrenal Stress Index Food Sensitivity Testing A blood test is analyzed by a specialized, federally approved laboratory to assess for IgG (immunoglobulin G – one of two antibodies that can be produced during a sensitivity response) ## Questions About Testing? We're Here to Help! If you have any questions regarding other tests Dr. Smith uses, please give us a call or shoot us an email at info@drsmithnd.com THE PROCESS ## How to get started ##### Your journey towards a balanced, vibrant life begins with a choice—a choice to prioritize your health and well-being. Let's explore together how natural hormone treatment can unlock your fullest potential. ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. Book Now ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. Book Now --- title: "Menopause" entity: "page" canonical_url: "https://www.drsmithnd.com/menopause" markdown_url: "https://www.drsmithnd.com/llms/page/menopause" lastmod: "2026-08-29T08:50:05.782Z" --- # What is Menopause? ## Are you feeling exhausted, moody, overwhelmed and not in control of your health? ## Menopause 101 Menopause is the natural, programmed end of fertility that human females experience (as do some mammals like giraffes and certain species of whales). The entry into this phase of life is marked by hitting 12 consecutive months with no period. The average age to enter menopause is 51 years old, but it is normal anywhere between 45 - 55 years of age. It is important to note that many women spend around half of their lives in menopause! At menopause, your ovaries retire and make only very tiny amounts of estrogen, progesterone and testosterone. Because of this, we can experience a wide array of bewildering and challenging symptoms, some of which are temporary and some of which can plague us long term. We have all heard about hot flashes and night sweats, but there are many more symptoms that you may not realize are related to menopause. Did you know that low hormone levels can lead to musculoskeletal problems (frozen shoulder!), changes in your sense of taste, and even heart palpitations? Many of the challenges that come along with menopause are also symptoms of more serious medical conditions so it is important to speak with your healthcare provider to rule out other possibilities. Once we know menopause is the core issue, we can work together to manage these symptoms and get you feeling a whole lot better. ## Symptoms of Menopause Weight gain, especially around the midsection Increase in mood issues (anxiety, depression, panic attacks, rage) Hot flashes and night sweats (vasomotor symptoms) Vaginal changes: dryness, pain, burning, chronic infections, lack of elasticity Night sweats Memory loss Sleep issues/insomnia, trouble falling asleep, waking frequently Decreased libido Fatigue, both physical and mental Urinary changes: having to pee constantly, irritable bladder, chronic UTI's, stress incontinence Tingling in arms, hands, feet, legs or shock-like feelings Digestive issues: acide reflux, diarrhea, constipation, bloating Migraines Cognitive changes: brain fog, lack of focus, trouble with word/fact finding, memory, feeling like you suddenly have ADHD Dizziness Tinnitus Body aches, pains from muscles to tendons to joints Bone loss: osteopenia, osteoporosis Declining nail, hair, skin health, even hair thinning or loss Heart palpitations Burning mouth syndrome, gum inflammation, taste changes Dry eyes, itchy eyes An increase in allergies A change in body odour If you relate to this, you’re very much in the right place because this is my superpower: helping women go from drowning to steering the ship once again. ## What can you do? A discussion with your doctor of your symptoms can lead to answers and possible treatment with hormone therapy, if they are literate about both the current state of the research on hormone therapy and menopause and unfortunately most doctors have received no education in either [hormone replacement therapy](https://drsmithnd.hiveality.com/hormone-replacement-therapy) or even menopause. ## How Does Dr. Smith Treat Menopause? Dr. Smith’s unique scope of practice includes prescribing hormones, nutrition and botanical medicine. Naturopathic doctors who have a prescribing licence can have the greatest impact and ability to support women in this phase of life due to our scope of practice. Why? Because the best way to help women both short and long term is by using a combined approach. Dr. Smith has spent her 15+ long career specializing in treating this population and partnered for 11 years of those years with a MD who ran a busy practice focused entirely on delivering the most current health solutions available per the research. ## Proudly Certified by The Menopause Society As a Menopause Society Certified Practitioner, Dr. Kirsten has advanced training to support women through [perimenopause](https://drsmithnd.hiveality.com/perimenopause), menopause, and beyond. This certification reflects her commitment to evidence-based, compassionate care — so you can feel confident you’re getting expert guidance tailored to your unique journey. ## Dr. Smiths comprehensive, personalized approach to menopause care includes: Nutrition An anti-inflammatory approach to food reduces many symptoms of menopause like weight gain, bone loss, and the risk of chronic diseases such as heart disease and diabetes. Dr. Smith personalizes all aspects of her treatment solutions but there is a strong focus on reducing inflammation, increasing fiber and lean proteins and lowering sugar intake. Movement What does the exercise physiology research say for you at this stage of your life? How can you protect your muscle mass, bone density and prevent cardiovascular disease? With a personalized approach that begins with where you are at. Dr. Smith also separates trends and myths from facts in a simple, impactful approach. Menopause Hormone Therapy (FKA Hormone Replacement Therapy) We may discuss possible treatments to reduce symptoms such as hot flashes, night sweats, bone loss, premature estrogen deficiency, and genitourinary issues like vaginal dryness and frequent urination. Hormone Therapy (HT) has been approved by Health Canada to treat conditions related to menopause, and for many, this is a great option. For those who may not be good candidates for hormone therapy, Dr. Smith will discuss other treatment options that can be very effective in treating your symptoms. It is important to meet with your provider to review your wants, needs and family history, so that together, you can determine what methods and treatments are the best fit. Stress Reduction Stress reduction really does help in menopause as cortisol levels create some of the discomfort related to menopause. Dr Smith will take a look at how you manage stress currently and possibly provide some support in this area as you get to more stable ground. Sleep The quality of your sleep is an essential part of getting health back on track in menopause. Without 7 to 8 hours of sleep a night, cortisol levels increase and cause inflammation in the body potentially leading to lowered defenses in the immune system and an increased risk of developing many chronic conditions such as sleep apnea and insomnia. Dr Smith will work with you to ensure this is working well to prevent all the awful downstream sequelae. Book Now E X P L O R I N G T H E A D V A N T A G E S ## What Are the Benefits of Hormone Replacement Therapy? Reduces brain fog Promotes lean muscle mass & improves insulin sensitivity Promotes healthy sleep Increases energy Reduces inflammation & body aches Supports collagen & elastin; healthy skin & joints Reduces age-related hair thinning Boosts immune function, improving healing capacity Decreases bad cholesterol & increases good cholesterol Increases bone density; decreasing risk of osteoporosis Increases the desire & stamina for exercise may reduce risk of cardiovascular deterioration Improves libido Most effective treatment for vaginal changes of peri/menopause Book Now ## More Information About Menopause Hormone Therapy (MHT) Menopause Hormone Therapy (MHT) & Hormone Replacement Therapy (BHRT): What's the Difference? HRT or hormone replacement therapy is when a licensed medical provider prescribes a hormone product. This could be the birth control pill, a hormone secreting IUD, or any hormone product. But mostly when people refer to HRT, they are referring to the prescription hormones women get when needing support in perimenopause or menopause. BHRT or bioidentical hormone replacement therapy is the same thing as HRT! Most people think “bioidentical” means that the product was made by a special compounding pharmacy, and it doesn’t. Bioidentical/ body identical/human identical mean just that; that the hormone prescribed is molecularly identical to what we make in our bodies (however they are made in a lab). The first thing you should know is that we have FDA approved versions of bioidentical hormones that all healthcare practitioners prescribe. That is why mostly these days we just say “HRT” which means the same thing as “BHRT” because the products are almost all, (in particular when it comes to treating perimenopause or menopause) bio/human identical. The only non-bioidentical synthetic estrogen still in the market place is called premarin and of course there are many non-bioidentical progestin products found in birth control pills and hormone secreting IUDs. Bioidentical hormones are made using natural ingredients and are available through standard FDA prescriptions or through certified compounding pharmacists who must adhere to strict regulations. The types, combinations and dosages of bioidentical hormones are customized to fit each individual patient and will be discussed in the course of your treatment. Hormones are powerful chemical messengers that must be prescribed; thus it is very important to receive a comprehensive individual medical risk assessment before proceeding with treatment. Ongoing monitoring with blood work is important to ensure that patients are optimized and are well within safe limits. The frequency of the monitoring is entirely dependent on the case. Hormone Replacement Therapy’s Role in Prevention Often we think of replacing hormones as  way to balance things, as a way to address immediate nagging symptoms – and it does. However there is a much bigger role that having adequate levels of hormones plays, it helps us not only to age well but also it helps to prevent many of the diseases of aging such as cardiovascular disease, osteoporosis, muscle wasting, gynecological infections and conditions, Alzheimer’s disease dementia, memory loss, and even some cancers. Understanding Hormones And How They Work Hormones are proteins that behave like powerful chemical messengers. They are delivered to body tissues through the blood. Working together like a finely tuned symphony, they regulate everything from reproduction and emotions to general health and well-being. Maintaining the proper balance of hormones in the body is essential to good health. Factors that affect hormone levels include your stage of development (puberty through menopause) as well as sleep, diet, stress, exercise, medications and the environment. Hormone Imbalance Affects Women at Any Age Women of all ages can suffer hormone imbalances. • Do you have PMS, heavy or irregular periods? • Have you suddenly gained weight and are unable to lose it? • Do you have mood swings, hot flashes and night sweats? • Are you feeling stressed, tired and have trouble sleeping? I work with teens who are having challenging periods all the way up to women at the end of their lives; our hormones are our kryptonite, they play a huge role in overall health at every stage of our lives. In young women it is often poor nutrition, emotional stress, an erratic lifestyle, too much alcohol, the use of birth control pills, or the early onset of menopause that leads to hormonal imbalance. In mature women, perimenopause, menopause and untreated postmenopause are the most common causes of hormonal symptoms. Other contributing factors – at any age – include genetics, lack of exercise, obesity, poor quality sleep, trauma, inflammation, thyroid and adrenal problems, ovarian failure, as well as exposure to pesticides, chemicals, environmental pollution and toxins. In most cases, the symptoms of hormonal changes can be improved through lifestyle changes and natural therapies. Often, however, working with a menopause clinic/menopause specialist who has experience working with HRT (hormone replacement therapy which is the same as bioidentical replacement therapy as explained above)  may be required for optimal lasting results. My Process for Providing HRT 1) Assessment: We begin with an initial hour long deep dive assessment, reviewing all your symptoms in detail, your medical and family history, and then discussing your goals. 2) Lab Work: I then order appropriate lab work which leads us to your first follow up. 3) Follow Up: In the first follow-up, I’ll teach you about your lab results, explaining what I think is happening (the diagnosis) and then going over my rationale for the kind of treatment I am proposing: writing out your individualized treatment plan and doing hormone prescriptions (if indicated), and off you go – the beginning of getting back to feeling like yourself again. 3) Treatment Plan: My unique scope of practice means that treatment plans include everything from lifestyle medicine (nutrition, stress management, movement) to botanical medicine, and if indicated, prescribing hormone replacement therapy (same thing as bioidentical). 4) Second Follow Up: The second follow up involves reviewing how the treatment plan/ prescriptions went, how each symptom responded to treatment, going over any questions, and making adjustments as needed. From here, follow ups are on an as-needed basis. If HRT/ hormone replacement therapy is right for you, you will feel like yourself again – vibrant, energetic and on top of your game! With HRT, you are really supporting yourself as you age by reducing much of the physical and mental deterioration that comes with this time in life and paving the way to have some of the best years of your life! What Are the Long-Term Benefits of HRT? Hormone balancing help both in the short and long-term. Hormone replacement therapy helps reduce the risk for the top three diseases associated with aging for women: heart disease, osteoporosis, and dementia. How are Bioidentical Hormones Prepared? Hormones are made in a laboratory and the components are from plants; typically yam or soy, to make a hormone that is structurally identical to those naturally produced in the human body. Does BHRT Require a Prescription? In Canada, hormones require a prescription from a medical doctor, naturopathic doctor WITH a prescribing licence (this is an additional license on top of the regular ND medical license) or a Nurse Practitioner. After a thorough consultation and laboratory testing, Dr. Smith may prescribe a hormone or a combination of hormones to address your unique needs. The prescriptions are filled at a regular pharmacy if you elect to use FDA approved versions of bioidentical hormones, or by a compounding pharmacy if you require a customized formula (compounding pharmacies are useful when women have unique dosing needs). Is BHRT Covered by Insurance? Prescriptions of any hormone product are prescriptions and therefore covered by your insurance. How are Hormones Taken? Depending on many factors, I will help you find an amenable route of administration. The choices are varied and include but are not limited to: gels, patches, creams,  suppositories, injections, capsules. Certain routes of administration work better for certain conditions. Is BHRT Safe? Yes. A lot of research shows that bioidentical/ human identical hormones have little in common with the side effects and risks of the old fashioned “synthetic” hormones. Today, bioidentical hormone replacement therapy is recommended as the standard of care for peri/menopause for this very reason, it’s just that there is a massive delay in getting the word out. The North American Menopause Society (NAMS), the British Menopause Society (BMS) and many others around the world like these organizations, do a complete literature review every 5 years and then comment on HRT and safety in a position statement. The last two position statements have conclusively stated that HRT (which again, is the same as BHRT) is the safest and most effective way to treat symptoms of menopause. There is a growing body of evidence that absolutely supports the safety of HRT showing it can lower a patient’s baseline risks for breast cancer, cardiovascular disease, dementia and osteoporosis. Other research has found that hormones have a favourable action on blood vessels and even decreasing the risk of dementia (which is 3x more common in women!). These positive results have spurred further studies on human identical hormones, and will hopefully fuel the trend for physicians to ONLY use these forms of hormone replacement, and learn how to help patients with immediate symptoms, but also prevent or reduces the risks of certain diseases. Finally, studies of both bioidentical/ human identical estrogen and progesterone are showing that they are not associated with an increased risk of blood clots. Unfortunately it is taking the medical community a long time to separate the body of evidence supporting these human identical hormone products from the old fashion “synthetic” ones which have high risks associated with them. Does Dr. Smith Test Hormone Levels? Most of the time I order blood work because that is what the majority of the research is based on. In some cases I may also use saliva, DUTCH or genetic testing, but this is rare as it is not usually necessary. Is Lab Testing Covered by OHIP? No, but often people have insurance for either my time or labs or both, please contact your insurance provider to find out ahead of your visit. Does BHRT Increase the Risk of Breast Cancer? No. Studies have demonstrated the beneficial effects of bioidentical estrogen and progesterone THE PROCESS ## How to get started ##### Your journey towards a balanced, vibrant life begins with a choice—a choice to prioritize your health and well-being. Let's explore together how natural hormone treatment can unlock your fullest potential. ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. Book Now ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. Book Now --- title: "Mental Health" entity: "page" canonical_url: "https://www.drsmithnd.com/mental-health-treatment" markdown_url: "https://www.drsmithnd.com/llms/page/mental-health-treatment" lastmod: "2026-08-29T08:50:06.553Z" --- # Naturopathic Mental Health Treatment & Support A Holistic Approach to Managing Anxiety and Depression ## There are many sources for mental health issues. Just know that there are equally many natural treatments to help you feel like yourself again. ## Naturopathic Anxiety ## Treatment ## Naturopathic Depression Treatment THE PROCESS ## How to get started ##### Your journey towards a balanced, vibrant life begins with a choice—a choice to prioritize your health and well-being. Let's explore together how natural hormone treatment can unlock your fullest potential. ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. --- title: "Metabolic Balance" entity: "page" canonical_url: "https://www.drsmithnd.com/metabolic-balance" markdown_url: "https://www.drsmithnd.com/llms/page/metabolic-balance" lastmod: "2026-08-29T08:50:07.922Z" --- # Metabolic Balance Program A Personalized Nutrition Program for Optimal Health & Weight Loss Are you eating healthy and working out and simply not getting results? Do you want specific direction and to avoid wasting your time and money on solutions that are general and not necessarily going to deliver? Welcome to... Metabolic Balance: ## A Weight-Loss Plan Customized Entirely to You ## Why this approach over all of all the other programs out there? ##### Why Dr. Smith chooses Metabolic Balance™: She did the program herself with great results (!!!) It is based on whole, organic foods (we wouldn’t have it any other way) There are no extreme restrictions of food groups There is no calorie counting It is evidence-based and hyper-individualized with personal metrics and blood work It outperforms all the other major weight loss programs in independent research that looked at how well participants sustain their weight loss over 3 years after having done the program ## How Metabolic Balance Works It enhances your metabolism By eating particular foods, in specific volumes and combinations you can restore your optimum balance. What's even more exciting is you can rehabilitate a sluggish metabolism as well. You are not broken, you just need the right help for YOU as a individual. It is evidence-based Metabolic Balance™ is based on the most current evidence and it is customized to reset your metabolism, helps you lose weight, reduce inflammation and disrupt old habits that do not serve you. All through the healing power of whole-foods. It is customized and personalized Metabolic Balance™ is a precise nutrition program that is created based on your blood work, health concerns, and weight-loss goals. It balances your hormones Your own physiology will determine how food is combined to optimize your metabolism. The food selected on the plan will help to correct existing hormonal imbalances in your body which results in the acceleration of your metabolism. It relies on the healing benefits of nutrition When we eat food that is suited to our own body, healing can take place which leads to improved mood, less inflammation, glowing skin and incredible energy.Cleaning up your nutrition and learning how to eat right for your body is so much more than how your clothes fit—it’s about vitality, energy, health, longevity and so much more. ## Want to find out if you're a good fit? Book Now T H E S C I E N C E B E H I N D M E T A B O L I C B A L A N C E ™ ## Why Metabolic Balance™ Works This program was developed based on the fact that our food has an enormous influence on the body, which is why Metabolic Balance™ is focused on local, natural and organic foods that are as fresh as possible. We have found that for patients who still are in the habit of consuming processed foods this not only helps them lose weight but completely recreate a relationship with real, whole foods. #### Meal plans are individually tailored to your needs #### and include: Which foods to eat to provide the right nutrients we need The quantities these foods should be eaten in Which combination foods are best for you When and how to consume these foods How to maintain new eating habits for long term sustainable success #### Each plan is unique, because it is created using: Your blood values Your body measurements Your personal data What is realistic for your lifestyle Book Now A S T E P - B Y - S T E P J O U R N E Y T O B A L A N C E D H E A L T H ## Program Phases ### DETOX PHASE This phase begins with elimination and eating simple foods for two days to prepare the body for better absorption and improve digestion. ### STRICT PHASE Your personalized meal plan starts at this phase and continue for a minimum of 14 days. This phase is free of additional oil. Patients report feeling less hungry, more energy, and decreased cravings during this phase. ### RELAXED PHASE Additional foods are added to your daily meal plan. Treat meals, alcohol and the occasional chocolate are also included at this phase. ### MAINTENANCE PHASE You did it! You used the guidelines of the program and listen to the cues of your body to guide your food choices. ## Results Weight-Loss Up to 20lb pounds is the average loss within the first 4–6 weeks of the program, and depending how long a person needs to be on the program, the potential is quite expansive. Hormone Balancing Improves PMS, acne, heavy bleeding, cramping, PCOS, is also great fertility prep. Gut health Clean eating on the program often results in reducing the pressure on your system and allowing for a lot of healing. It is extremely common for participants to see a reduction in bloating, gas, heartburn and other symptoms. Fatty liver will also resolve (or significantly so). Happier mood! Learning to have a healthier relationship to food and alcohol, being more in tune with your body, healing your gut and feeling more confident all contribute to the major mood lifts we see in our participants. Diabetes Support The plan is designed through the use of specific foods and the timing of meals to resensitize our cells to have a better relationship with insulin, the blood sugar hormone, resulting in great improvements with all diabetes metrics (blood sugar markers, cholesterol, high blood pressure, weight, medication needs, etc.) Glowing skin Frequently, eczema and psoriasis, acne and other skin conditions will reduce significantly. Less inflammation & pain If you have aches and pains, they will decrease notably because as your blood sugar lowers and becomes more stable, your inflammation levels drop. More energy & vitality As we are lowering the stress, pressure and inflammation in your body by only eating healthy, whole foods, and by improving your body's ability to manage blood sugar, your energy will float up, your sleep will improve, and you will feel better and better as the weeks roll by. ## The Program is Unique to You Dr. Kirsten Smith runs this program virtually. She has completed the 30+ hours of training and is a certified Metabolic Balance™ coach. Typically, the program is conducted over 12 weeks, with a few coaching consultations peppered throughout. However, it really depends on your needs. We know from extensive research that frequent support and accountability drives better results—we customize Metabolic Balance™ to work for you! ## How to get started ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. Book Now ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. Book Now --- title: "Naturopathic Anxiety Treatment" entity: "page" canonical_url: "https://www.drsmithnd.com/naturopathic-anxiety-treatment" markdown_url: "https://www.drsmithnd.com/llms/page/naturopathic-anxiety-treatment" lastmod: "2026-08-29T08:50:05.691Z" --- # Naturopathic Anxiety Treatment A Holistic Approach to Managing Anxiety The Prevalence of Anxiety in Canada ## It is estimated that at least one in ten Canadians suffer from anxiety ### But based on my experience in clinical practice for the last ten years, these numbers are conservative at best I’d say at least 50% of the population is dealing with anxiety at a level that is disrupting their quality of life, and in many cases making them sick. I am unfortunately treating patients with anxiety many times a day, every day. Thankfully, there area good deal of evidence-based naturopathic approaches to treating anxiety and mental health issues. ## Symptoms of Anxiety There are a number of different kinds of anxiety, including generalized anxiety disorder, post-traumatic stress disorder, obsessive compulsive disorder, and social anxiety disorder however the most common symptoms of anxiety include: U N D E R S T A N D I N G T H E T R I G G E R S O F A N X I E T Y ## What Causes Anxiety? ##### Some forms of anxiety are constant, some intermittent, some have situational triggers, some do not. Typically, the cause can be one or a few of the following: ##### The good news is, that there are MODIFIABLE things which will exacerbate anxiety that can be addressed, such as: A S T E P - B Y - S T E P J O U R N E Y T O B A L A N C E D H E A L T H ## What Are Some Examples of Anxiety Treatments? First and foremost, a thorough investigation screening for the aforementioned causes / exacerbations and risk factors is performed. Depending on the individual case, any number of treatment plans could include any of the following: THE PROCESS ## How to get started ##### Your journey towards a balanced, vibrant life begins with a choice—a choice to prioritize your health and well-being. Let's explore together how natural hormone treatment can unlock your fullest potential. ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. --- title: "Programs" entity: "page" canonical_url: "https://www.drsmithnd.com/naturopathic-programs" markdown_url: "https://www.drsmithnd.com/llms/page/naturopathic-programs" lastmod: "2026-08-29T08:50:06.340Z" --- # Programs Offered by Dr. Smith ## Want to restore your metabolism and return to your optimal body weight? ## Are you 35+ and looking to feel like yourself again? ## Work with Dr. Smith ##### Your journey towards a balanced, vibrant life begins with a choice—a choice to prioritize your health and well-being. Let's explore together how natural hormone treatment can unlock your fullest potential. ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. --- title: "Newsletter" entity: "page" canonical_url: "https://www.drsmithnd.com/newsletter-signup" markdown_url: "https://www.drsmithnd.com/llms/page/newsletter-signup" lastmod: "2026-08-29T08:50:06.679Z" --- # Quality, timely content... Delivered right into your inbox! Receive monthly updates on my practice and services, as well as new blog posts , workshops and events . This is also an important source of news updates in terms of research , product recalls or shortages , and generally important information that could impact my patients and women everywhere! # Newsletter Signup ## This Month's Featured Blog LET ME SUPPORT YOU ON YOUR TRANSFORMATIVE JOURNEY ## To health, harmony, and happiness. ##### Discover the difference of care rooted in current research, customized to your unique needs, and committed to your lifelong wellness. ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. Book Now ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. Book Now --- title: "PCOS Treatment" entity: "page" canonical_url: "https://www.drsmithnd.com/pcos-treatment" markdown_url: "https://www.drsmithnd.com/llms/page/pcos-treatment" lastmod: "2026-08-29T08:50:06.110Z" --- # PCOS Treatment ## Treating Polycystic Ovarian Syndrome (PCOS) with Naturopathic Medicine PCOS is a hormonal disorder that impacts 6 to 10% of women, with symptoms typically emerging at the onset of menstruation or later in a womans 20s or 30s. Dr. Smith frequently addresses this common endocrine imbalance and offers evidence-based treatment options to effectively manage the complex condition. U N D E R S T A N D I N G P C O S ## What is PCOS? The name of this condition is a little misleading as you may or The term PCOS can be misleading because not all women with this condition have multiple cysts on their ovaries. PCOS is actually a combination of symptoms that form a syndrome. While many online portrayals show severely obese women with excessive hair growth, the reality is that some women may only experience symptoms like irregular periods or no menstrual cycle at all. PCOS causes the ovaries to produce higher levels of androgens, which can disrupt egg production and lead to the formation of cysts. These cysts, filled with liquid from old follicles, can accumulate and enlarge the ovaries as ovulations are missed. Additionally, PCOS involves insulin resistance similar to diabetes, which can impact various bodily systems and have long-term health effects due to the complex interaction between sex hormones and blood sugar imbalances. have many cysts in your ovaries. PCOS is really a collection of symptoms that collectively make up a syndrome. Online you will see morbidly obese women with lots of unwanted hair growth, but the truth of it is that there are many women with none of these “text book” presentations with the only presenting symptoms being things like an irregular period or that they aren’t cycling at all. PCOS causes the ovaries to produce higher than normal amounts of androgens such as testosterones, which interfere with egg production. The eggs that the ovaries normally produce monthly to ovulate can then develop into cysts (instead of getting expressed by the ovary). A cyst is a little sacs filled with liquid – in this case an old follicle. As many ovulations are missed and more follicles grow and become cysts, they can build up and enlarge the ovaries. PCOS is also a condition in which there is insulin resistance (like diabetes) which can affect many systems in the body and have long-term health consequences. The complex interplay between the sex hormones and blood sugar imbalances make up the variety of symptoms women may experience. ## Symptoms of PCOS If ovarian cysts exist, very often they are painless and only discovered by ultrasound. Other PCOS symptoms include weight gain, infrequent or absent menstrual periods and signs of increased androgens, male hormones that are normally found in women such as acne and increased hair growth (hirsutism) on the face, around nipples, upper thighs and pubic area. Although many women with PCOS have no trouble getting pregnant, the condition can cause fertility challenges. Increased anxiety and depression are also common in PCOS patients. The other challenge as mentioned previously with PCOS is insulin resistance, which means that the cells resist the hormone’s instruction to allow glucose to enter cells, causing blood sugar levels to rise which can lead to weight gain. Insulin resistance may indicate the early stages of type 2 diabetes, another reason to treat PCOS. ##### The most common symptoms of PCOS are: E X P L O R I N G T H E C A U S E S ## What Causes PCOS No one knows at this point what causes PCOS. Some researchers think that it may be caused by high insulin production. Insulin is a hormone that controls blood sugar levels and when too much insulin is produced this can stimulate the release of testosterone (which ultimately causes acne and hirsutism). Additionally, while the exact genes have not yet been identified, PCOS seems to run in families (as do other blood sugar disorders such as diabetes, interestingly). ## What are the Treatments? The goal of treatment is to balance hormones which results in resolving or greatly reducing some of the symptoms, such as acne, weight gain and irregular cycles. Ultimately, every woman is treated based on her individual case as there are tremendous differences in what women experience with this condition which has a few subtypes. For some women it is only hairloss (LINK), for some women it is more about weight management, for some women their thyroid (LINK) is also involved, for some the only symptom is irregular periods. Dr. Smith creates a treatment plan based on comprehensive blood work and the specific symptoms/ sub type each woman has. #### A typical treatment plan may include some of the following: THE PROCESS ## How to get started ##### Your journey towards a balanced, vibrant life begins with a choice—a choice to prioritize your health and well-being. Let's explore together how natural hormone treatment can unlock your fullest potential. ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. --- title: "Perimenopause" entity: "page" canonical_url: "https://www.drsmithnd.com/perimenopause" markdown_url: "https://www.drsmithnd.com/llms/page/perimenopause" lastmod: "2026-08-29T08:50:05.814Z" --- # What is Perimenopause? ## Are you feeling exhausted, moody, overwhelmed and not in control of your health? ## Everything is out of balance, sleep is elusive, you’re gaining weight for no reason and feeling low in general? #### You might be in perimenopause... And you're in the right place. ## Common Symptoms of Perimenopause Weight gain Mood changes Hot flashes Vaginal dryness Night sweats Memory loss Difficulty sleeping Decreased interest in sex‌ Weight gain If you are experiencing any of these symptoms, your body may be telling you that your hormones are out of balance. Now is the time to make changes, because the sooner you do, the shorter the path back to optimal health. It will improve your quality of life today and prevent serious health problems in the future. Book a Consultation #### Perimenopause is the 10+/- years leading up to actual menopause, which is the day you pass 12 consecutive months with no period, and then the state you will live in for the rest of your life. The average age for menopause in Canada and much of the world is 51 and it is normal to hit menopause between the ages of 45 and 55. #### Perimenopause is a transitional phase of life when many, at times confusing, symptoms appear. Both perimenopausal people and health care providers can overlook and misdiagnose this transition , which can lead to alarming amounts of unnecessary suffering. ## Perimenopause as Metamorphosis During perimenopause, your body is transitioning to menopause, accompanied by an avalanche of physical, cognitive and even spiritual changes. Many women can start with symptoms as young as 35 years old. As health care providers, we do not have accurate or useful testing to diagnose peri[menopause](https://drsmithnd.hiveality.com/menopause) due to these daily hormonal fluctuations. This means that a diagnosis is made by understanding the patient’s symptoms and ruling out other causes. This 10 year perimenopausal phase is marked by fluctuations in estrogen and the decline of progesterone. The amount of estrogen generated by the ovaries begins to erratically decline throughout your 30’s and 40’s, as does your progesterone. Changes in your cycle regularity happens at some point in this transition, as do heavier periods. Your cycle may lengthen or shorten. You may eventually start skipping periods altogether, and the flow weight may change. Even though variability in monthly bleeding is common and even expected during perimenopause, you should still tell your healthcare provider about them. Some cases of abnormal bleeding might indicate a larger problem that needs to be further evaluated (with for example a pelvic /transvaginal ultrasound). Book a Consultation #### How is Perimenopause Diagnosed? Perimenopause is often diagnosed by symptoms alone because there’s no “blood test” to determine if a woman is in perimenopause due to the widely fluctuating hormone levels. Book Now ## How does Dr. Smith treat perimenopause? Dr Smith’s unique scope of practice includes: Prescribing Hormones Nutrition & Lifestyle Changes Botanical Medicine The best way to help women both short and long term is by using a combined approach. Dr. Smith has spent 15+ years specializing in treating this population. She partnered for 11 years with a MD who ran a busy practice focused entirely on delivering the most current health solutions available per the research. Book a Consultation ## Proudly Certified by The Menopause Society As a Menopause Society Certified Practitioner, Dr. Kirsten has advanced training to support women through perimenopause, menopause, and beyond. This certification reflects her commitment to evidence-based, compassionate care — so you can feel confident you’re getting expert guidance tailored to your unique journey. E X P L O R I N G T H E A D V A N T A G E S ## What Are the Benefits of Menopause Hormone Therapy? Reduces brain fog Promotes lean muscle mass & improves insulin sensitivity Promotes healthy sleep Increases energy Reduces inflammation & body aches Supports collagen & elastin; healthy skin & joints Reduces age-related hair thinning Boosts immune function, improving healing capacity Decreases bad cholesterol & increases good cholesterol Increases bone density; decreasing risk of osteoporosis Increases the desire & stamina for exercise may reduce risk of cardiovascular deterioration Improves libido Most effective treatment for vaginal changes of peri/menopause Book Now ## HRT/MHT Frequently Asked Questions Hormone Replacement Therapy (HRT) & Bioidentical Hormone Replacement Therapy (BHRT): What's the Difference? HRT or hormone replacement therapy is when a licensed medical provider prescribes a hormone product. This could be the birth control pill, a hormone secreting IUD, or any hormone product. But mostly when people refer to HRT, they are referring to the prescription hormones women get when needing support in perimenopause or menopause. BHRT or bioidentical hormone replacement therapy is the same thing as HRT! Most people think “bioidentical” means that the product was made by a special compounding pharmacy, and it doesn’t. Bioidentical/ body identical/human identical mean just that; that the hormone prescribed is molecularly identical to what we make in our bodies (however they are made in a lab). The first thing you should know is that we have FDA approved versions of bioidentical hormones that all healthcare practitioners prescribe. That is why mostly these days we just say “HRT” which means the same thing as “BHRT” because the products are almost all, (in particular when it comes to treating perimenopause or menopause) bio/human identical. The only non-bioidentical synthetic estrogen still in the market place is called premarin and of course there are many non-bioidentical progestin products found in birth control pills and hormone secreting IUDs. Bioidentical hormones are made using natural ingredients and are available through standard FDA prescriptions or through certified compounding pharmacists who must adhere to strict regulations. The types, combinations and dosages of bioidentical hormones are customized to fit each individual patient and will be discussed in the course of your treatment. Hormones are powerful chemical messengers that must be prescribed; thus it is very important to receive a comprehensive individual medical risk assessment before proceeding with treatment. Ongoing monitoring with blood work is important to ensure that patients are optimized and are well within safe limits. The frequency of the monitoring is entirely dependent on the case. Hormone Replacement Therapy’s Role in Prevention Often we think of replacing hormones as  way to balance things, as a way to address immediate nagging symptoms – and it does. However there is a much bigger role that having adequate levels of hormones plays, it helps us not only to age well but also it helps to prevent many of the diseases of aging such as cardiovascular disease, osteoporosis, muscle wasting, gynecological infections and conditions, Alzheimer’s disease dementia, memory loss, and even some cancers. Understanding Hormones And How They Work Hormones are proteins that behave like powerful chemical messengers. They are delivered to body tissues through the blood. Working together like a finely tuned symphony, they regulate everything from reproduction and emotions to general health and well-being. Maintaining the proper balance of hormones in the body is essential to good health. Factors that affect hormone levels include your stage of development (puberty through menopause) as well as sleep, diet, stress, exercise, medications and the environment. Hormone Imbalance Affects Women at Any Age Women of all ages can suffer hormone imbalances. • Do you have PMS, heavy or irregular periods? • Have you suddenly gained weight and are unable to lose it? • Do you have mood swings, hot flashes and night sweats? • Are you feeling stressed, tired and have trouble sleeping? I work with teens who are having challenging periods all the way up to women at the end of their lives; our hormones are our kryptonite, they play a huge role in overall health at every stage of our lives. In young women it is often poor nutrition, emotional stress, an erratic lifestyle, too much alcohol, the use of birth control pills, or the early onset of menopause that leads to hormonal imbalance. In mature women, perimenopause, menopause and untreated postmenopause are the most common causes of hormonal symptoms. Other contributing factors – at any age – include genetics, lack of exercise, obesity, poor quality sleep, trauma, inflammation, thyroid and adrenal problems, ovarian failure, as well as exposure to pesticides, chemicals, environmental pollution and toxins. In most cases, the symptoms of hormonal changes can be improved through lifestyle changes and natural therapies. Often, however, working with a menopause clinic/menopause specialist who has experience working with HRT (hormone replacement therapy which is the same as bioidentical replacement therapy as explained above)  may be required for optimal lasting results. My Process for Providing HRT 1) Assessment: We begin with an initial hour long deep dive assessment, reviewing all your symptoms in detail, your medical and family history, and then discussing your goals. 2) Lab Work: I then order appropriate lab work which leads us to your first follow up. 3) Follow Up: In the first follow-up, I’ll teach you about your lab results, explaining what I think is happening (the diagnosis) and then going over my rationale for the kind of treatment I am proposing: writing out your individualized treatment plan and doing hormone prescriptions (if indicated), and off you go – the beginning of getting back to feeling like yourself again. 3) Treatment Plan: My unique scope of practice means that treatment plans include everything from lifestyle medicine (nutrition, stress management, movement) to botanical medicine, and if indicated, prescribing hormone replacement therapy (same thing as bioidentical). 4) Second Follow Up: The second follow up involves reviewing how the treatment plan/ prescriptions went, how each symptom responded to treatment, going over any questions, and making adjustments as needed. From here, follow ups are on an as-needed basis. If HRT/ hormone replacement therapy is right for you, you will feel like yourself again – vibrant, energetic and on top of your game! With HRT, you are really supporting yourself as you age by reducing much of the physical and mental deterioration that comes with this time in life and paving the way to have some of the best years of your life! What Are the Long-Term Benefits of HRT? Hormone balancing help both in the short and long-term. Hormone replacement therapy helps reduce the risk for the top three diseases associated with aging for women: heart disease, osteoporosis, and dementia. How are Bioidentical Hormones Prepared? Hormones are made in a laboratory and the components are from plants; typically yam or soy, to make a hormone that is structurally identical to those naturally produced in the human body. Does BHRT Require a Prescription? In Canada, hormones require a prescription from a medical doctor, naturopathic doctor WITH a prescribing licence (this is an additional license on top of the regular ND medical license) or a Nurse Practitioner. After a thorough consultation and laboratory testing, Dr. Smith may prescribe a hormone or a combination of hormones to address your unique needs. The prescriptions are filled at a regular pharmacy if you elect to use FDA approved versions of bioidentical hormones, or by a compounding pharmacy if you require a customized formula (compounding pharmacies are useful when women have unique dosing needs). Is BHRT Covered by Insurance? Prescriptions of any hormone product are prescriptions and therefore covered by your insurance. How are Hormones Taken? Depending on many factors, I will help you find an amenable route of administration. The choices are varied and include but are not limited to: gels, patches, creams,  suppositories, injections, capsules. Certain routes of administration work better for certain conditions. Is BHRT Safe? Yes. A lot of research shows that bioidentical/ human identical hormones have little in common with the side effects and risks of the old fashioned “synthetic” hormones. Today, bioidentical hormone replacement therapy is recommended as the standard of care for peri/menopause for this very reason, it’s just that there is a massive delay in getting the word out. The North American Menopause Society (NAMS), the British Menopause Society (BMS) and many others around the world like these organizations, do a complete literature review every 5 years and then comment on HRT and safety in a position statement. The last two position statements have conclusively stated that HRT (which again, is the same as BHRT) is the safest and most effective way to treat symptoms of menopause. There is a growing body of evidence that absolutely supports the safety of HRT showing it can lower a patient’s baseline risks for breast cancer, cardiovascular disease, dementia and osteoporosis. Other research has found that hormones have a favourable action on blood vessels and even decreasing the risk of dementia (which is 3x more common in women!). These positive results have spurred further studies on human identical hormones, and will hopefully fuel the trend for physicians to ONLY use these forms of hormone replacement, and learn how to help patients with immediate symptoms, but also prevent or reduces the risks of certain diseases. Finally, studies of both bioidentical/ human identical estrogen and progesterone are showing that they are not associated with an increased risk of blood clots. Unfortunately it is taking the medical community a long time to separate the body of evidence supporting these human identical hormone products from the old fashion “synthetic” ones which have high risks associated with them. Does Dr. Smith Test Hormone Levels? Most of the time I order blood work because that is what the majority of the research is based on. In some cases I may also use saliva, DUTCH or genetic testing, but this is rare as it is not usually necessary. Is Lab Testing Covered by OHIP? No, but often people have insurance for either my time or labs or both, please contact your insurance provider to find out ahead of your visit. Does BHRT Increase the Risk of Breast Cancer? No. Studies have demonstrated the beneficial effects of bioidentical estrogen and progesterone THE PROCESS ## How to get started ##### Your journey towards a balanced, vibrant life begins with a choice—a choice to prioritize your health and well-being. Let's explore together how natural hormone treatment can unlock your fullest potential. ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. Book Now ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and [hormone replacement therapy](https://drsmithnd.hiveality.com/hormone-replacement-therapy) or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. Book Now --- title: "Podcasts" entity: "page" canonical_url: "https://www.drsmithnd.com/podcasts" markdown_url: "https://www.drsmithnd.com/llms/page/podcasts" lastmod: "2026-08-29T08:50:05.988Z" --- # Podcast Features ## Conversations that inspire, educate, and empower women to take charge of their health. Dr. Kirsten Smith, ND, is passionate about making evidence-based, integrative healthcare accessible and relatable. She’s been featured on a variety of podcasts, sharing her expertise on hormone health, metabolic wellness, and the unique challenges women face in midlife. From practical tips you can implement today to in-depth discussions on the latest research, these conversations are designed to help you better understand your body and make informed decisions about your health. Explore the episodes below to hear Dr. Smith’s insights, stories, and strategies — and walk away with tools you can use to create lasting, positive change in your life. ## Why These Discussions Matter Podcasts offer a unique space for real, unfiltered dialogue. In these interviews, Dr. Kirsten Smith dives deep into the topics women aren’t hearing enough about—from hormones and metabolism to mental health and midlife transitions—so you can make informed choices about your health. ##### PODCAST FEATURES ## Conversations on Women’s Health ### The Menopause Playbook You’ve Been Searching For Dr. Kirsten Smith joins the conversation to challenge outdated narratives around menopause and hormone therapy. Drawing on over 15 years of clinical experience, she explores why hormones are just one part of the picture — and how mental health, dosing, and individualized care shape outcomes during midlife and beyond. Listen Here ### We All Deserve Better in Perimenopause In this thoughtful conversation, Dr. Kirsten Smith blends naturopathic insight with modern medicine to unpack the real physiology of perimenopause. Topics include mood changes, weight shifts, vaginal and urinary symptoms, and why many women are underserved by conventional approaches. Listen Here --- title: "Privacy Policy" entity: "page" canonical_url: "https://www.drsmithnd.com/privacy-policy" markdown_url: "https://www.drsmithnd.com/llms/page/privacy-policy" lastmod: "2026-08-29T08:50:05.723Z" --- # Privacy Policy Privacy Policy This privacy policy applies to the website located at drsmithnd.com , which is owned and operated by K.A. Smith Naturopathic Professional Corporation. This policy sets out how we collect, use, disclose and protect the personal information of individuals who visit the Site. Personal Information Collection We may collect personal information from you, such as your name, email address, phone number, and address, when you sign up for our services, create an account, or otherwise interact with the Site. We may also collect information such as your IP address, browser type, operating system, and other information about your use of the Site. Use of Personal Information We use the personal information we collect for the following purposes: - To provide the services you request through the Site. - To respond to your inquiries and provide customer support. - To send you promotional emails, newsletters, or other communications that we believe may be of interest to you. - To personalize your experience on the Site by showing you content that is relevant to your interests. - To improve the Site and our services. Disclosure of Personal Information We may disclose your personal information to third parties for the following purposes: - To service providers who assist us in providing the services you request through the Site. - To comply with legal requirements, such as a law, regulation, search warrant, subpoena, or court order. - In connection with a merger, acquisition, or sale of all or a portion of our assets. - To protect the rights, property, or safety of Dr. Kirsten Smith, ND, our users, or others. Security of Personal Information We take reasonable steps to protect the personal information we collect from unauthorized access, use, disclosure, or destruction. However, no security measures are perfect or impenetrable, and we cannot guarantee the security of your personal information. Access to Personal Information You have the right to access, update, or delete your personal information at any time. If you would like to exercise this right, please contact us at info@drsmithnd.com. Changes to this Privacy Policy We may change this Privacy Policy from time to time, and the changes will be posted on this page. Your continued use of the Site after any changes are made indicates your agreement to the revised Privacy Policy. Contact Information If you have any questions about this Privacy Policy, please contact us at: K.A. Smith Naturopathic Professional Corporation (434)-668-9767 info@drsmithnd.com Date of last update: Mar 24 2025. --- title: "Terms" entity: "page" canonical_url: "https://www.drsmithnd.com/terms" markdown_url: "https://www.drsmithnd.com/llms/page/terms" lastmod: "2026-08-29T08:50:06.524Z" --- # Terms Terms and Conditions This website located at drsmithnd.com (the "Site") is owned and operated by K.A. Smith Naturopathic Professional Corporation ("us" or "we"). Your access to and use of the Site is subject to the following terms and conditions (the "Terms"). By accessing or using the Site, you agree to be bound by these Terms. If you do not agree to these Terms, you are not authorized to access or use the Site. Use of the Site You may use the Site for lawful purposes only. You may not use the Site for any purpose that is illegal or prohibited by these Terms. You may not use the Site in a way that could damage, disable, overburden, or impair the Site or interfere with any other party's use and enjoyment of the Site. You may not attempt to gain unauthorized access to the Site, user accounts, computer systems, or networks connected to the Site, through hacking, password mining, or any other means. Intellectual Property The Site and its content, including but not limited to text, graphics, logos, images, and software, are protected by intellectual property laws. You may not use the Site or its content for commercial purposes without our prior written consent. Third-Party Sites The Site may contain links to third-party websites. We are not responsible for the content or privacy practices of those websites. Your use of those websites is subject to the terms and conditions of those websites. Disclaimers The Site and its content are provided on an "as is" and "as available" basis. We make no representations or warranties of any kind, express or implied, as to the operation of the Site or the content, information, materials, or products included on the Site. Limitation of Liability We will not be liable for any damages of any kind arising from the use of the Site, including but not limited to direct, indirect, incidental, punitive, and consequential damages. Modification of Terms We reserve the right to modify these Terms at any time, and the changes will be posted on this page. Your continued use of the Site after any changes are made indicates your agreement to the revised Terms. Governing Law These Terms will be governed by and construed in accordance with the laws of the jurisdiction in which Dr. Kirsten Smith, ND is located, without giving effect to any principles of conflicts of law. Contact Information If you have any questions about these Terms, please contact us at: K.A. Smith Naturopathic Professional Corporation (343)-668-9767 info@drsmithnd.com Date of last update: Mar 24 2025. --- title: "Thyroid Treatment" entity: "page" canonical_url: "https://www.drsmithnd.com/thyroid-treatment" markdown_url: "https://www.drsmithnd.com/llms/page/thyroid-treatment" lastmod: "2026-08-29T08:50:05.477Z" --- # Naturopathic Thyroid Treatment Personalized Nutrition for Optimal Health ## Your thyroid is the center of your energy and metabolism. When it’s not able to do it’s job, you can feel anything from crippling fatigue to ongoing illness. Naturopathic Thyroid Treatment can help you get your life back. ## Understanding Thyroid Dysfunction Generally, thyroid conditions fall into two categories: either your thyroid is under functioning (hypothyroidism) or over functioning (hyperthyroidism). Diagnosis can usually be done with blood work and a thyroid ultrasound. Depending on the individual trial interventions may be required to see if improvements are made. ## Treating Thyroid Conditions ##### Depending on the situation, Dr. Smith may use the following treatment: ## Understanding Thyroid Conditions Hypothyroidism, by definition, is a clinical state. It is a state of low levels of thyroid hormone in the body. The low levels of thyroid hormone can occur as a result of a variety of different reasons, such as iodine deficiency, surgical removal of the thyroid, excess use of thyroid suppressing medications, pituitary suppression or damage to the thyroid (physical or disease induced). Most cases of hypothyroidism in the United States, Canada, Europe and in most countries that add iodine to their salt supply are caused by Hashimoto’s, an autoimmune condition. Depending on the source, estimates are that between 90-97% of those with hypothyroidism in Canada and the United States actually have Hashimoto’s. #### Some common forms of Hypothyroidism: ## What exactly is Hypothyroidism? Hypothyroidism is a condition that occurs when the thyroid gland does not produce enough thyroid hormones to meet the needs of the body. The thyroid creates two thyroid hormones, triiodothyronine (T3) and thyroxine (T4) that regulate metabolism. The production of thyroid hormones is regulated by thyroid-stimulating hormone (TSH), which is made by the pituitary gland which takes direction from the hypothalamus, in the brain. TSH ensures that enough thyroid hormones are made to meet the body’s needs. #### They also affect the following: ## Symptoms of Hypothyroidism ## Causes of Hypothyroidism There are two fairly common causes of hypothyroidism. The first is a result of previous (or currently ongoing) inflammation of the thyroid gland, which leaves a large percentage of the cells of the thyroid damaged (or dead) and incapable of producing sufficient hormone. The most common cause of thyroid gland failure is called Hashimoto’s thyroiditis or autoimmune thyroiditis, a form of thyroid inflammation caused by the patient’s own immune system. The second major cause is the broad category of “medical treatments.” The treatment of many thyroid conditions warrants surgical removal of a portion or all of the thyroid gland. If the total mass of thyroid producing cells left within the body are not enough to meet the needs of the body, the patient will develop hypothyroidism. Sometimes a surgery will be to remove a worrisome mass or nodule, leaving half of the thyroid undisturbed. Sometimes, the remaining lobe will produce enough hormone to meet the demands of the body. For other patients, however, it may become apparent years later that the remaining part of the gland can’t keep up with demand. Similarly, goiters and some other thyroid conditions can be treated with radioactive iodine therapy. The aim of the radioactive iodine therapy (for benign conditions) is to kill a portion of the thyroid to prevent goiters from growing larger or producing too much hormone (hyperthyroidism). Occasionally, the result of radioactive iodine treatment will be that too many cells are damaged so the patient often becomes hypothyroid within a year or two. However, this is usually greatly preferred over the original problem and is simply a risk with this intervention. There are several other rare causes of hypothyroidism, one of them being a completely “normal” thyroid gland that is not making enough hormone because of a problem in the pituitary gland. If the pituitary does not produce enough thyroid stimulating hormone (TSH) then the thyroid simply does not have the “signal” to make hormone. So it doesn’t. ## How do you diagnose Hypothyroidism? Since hypothyroidism is caused by too little thyroid hormone secreted by the thyroid, the diagnosis of hypothyroidism is based almost exclusively upon measuring the amount of thyroid hormone in the blood. There are normal ranges for all thyroid hormones which have been calculated by computers which measured these hormones in tens of thousands of people. BUT. The reality is that there are plenty of people whom have “normal” lab results but have a raft of symptoms. Depending on the case, Dr. Smith will sometime do a trial intervention to see if the patient sees improvement. These tests are very accurate and reliable and are routine blood work, however, as I mentioned previously there are plenty of people who are well within the reference range whom are functionally hypothyroid,and get better with treatment. ## How do you Treat Hypothyroidism? Dr. Smith uses botanical medicines and or dessicated thyroid to address hypothyroidism in her patients. Often with Hashimoto’s disease, the focus is more on stabilizing the immune system (vs simply giving thyroid medicine), and naturopathic medicine has a lot to offer in this department.​ ## What exactly is Hyperthyroidism? Hyperthyroidism, also known as overactive thyroid, is a medical condition caused by an abnormally high level of thyroid hormones in the bloodstream. In other words, the thyroid gland produces an excessive amount of thyroid hormones. U N D E R S T A N D I N G T H E S I G N S ## Symptoms of Hyperthyroidism ## What causes Hyperthyroidism? ## How is it diagnosed? Usually with blood work and a thyroid ultrasound. ## How Does Dr. Smith treat Hyperthyroidism? Dr. Smith uses botanical medicine primarily to assist in these cases, sometimes along with acupuncture. It depends greatly on what the cause is. THE PROCESS ## How to get started ##### Your journey towards a balanced, vibrant life begins with a choice—a choice to prioritize your health and well-being. Let's explore together how natural hormone treatment can unlock your fullest potential. ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. --- title: "Naturopathic Medicine" entity: "page" canonical_url: "https://www.drsmithnd.com/what-is-naturopathic-medicine" markdown_url: "https://www.drsmithnd.com/llms/page/what-is-naturopathic-medicine" lastmod: "2026-08-29T08:50:06.082Z" --- # Naturopathic Medicine A Holistic Approach to Health and Healing What is Naturopathic Medicine? ## Naturopathic Medicine is the art and science of treating the patient’s underlying causes for illness or disease by supporting the body’s natural healing process. Naturopathic Medicine emphasizes prevention and aids self healing using evidenced based natural therapies. Naturopathic doctors diagnose using a full range of scientific tests to treat mental, physical and emotional conditions helping bring patients back to full health. They also have more expertise than any other health care practitioners in the area of prevention. ## Naturopathic Medicine & Functional Medicine Functional medicine is merger of naturopathic medicine with conventional medicine. Doctors who practice functional medicine seek to identify and address the root causes of disease, and views the body as one integrated system, not a collection of independent organs divided up by medical specialties. It treats the whole system, not just the symptoms – and this is utterly central to the system of naturopathic medicine. Functional medicine and naturopathic medicine are a system of medicine that address the underlying causes of disease, using a systems-oriented approach and engaging both patient and practitioner in a therapeutic partnership. This patient centred approach is an evolution in the practice of medicine that better addresses the healthcare needs of the 21st century. By shifting the traditional disease-centered focus to a more patient-centered focus, functional medicine addresses the whole person, not just their symptoms. Functional medicine practitioners and naturopathic doctors spend time with their patients, listening to their histories and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease. In this way, this integrated model of medicine supports the unique expression of health and vitality for each individual to an optimal level. THE PROCESS ## How to get started ##### Your journey towards a balanced, vibrant life begins with a choice—a choice to prioritize your health and well-being. Let's explore together how natural hormone treatment can unlock your fullest potential. ## 01 #### BOOK A CONSULTATION If you're on the fence about jumping into your naturopathic health journey, feel free to book a free 10-minute consultation call with me. ## 02 #### PERSONAL ASSESSMENT Your initial health assessment is your first appointment which is one hour. We will discuss your medical history, family medical history, lifestyle, discuss your goals, review any lab work you may have sent ahead of time, do a deep dive on your concerns and order lab work if necessary. Then I provide a comprehensive strategic plan which may include nutrition and exercise changes, herbs or supplements, and hormone replacement therapy or other prescriptions as indicated and referrals if indicated. ## 03 #### FOLLOW UP APPOINTMENTS In your follow-up appointments, we will go over any changes you have noticed and make adjustments accordingly to your plan, and do refills as required. These visits vary in length and this depends on what is requried. --- title: "Perimenopause Health Program" entity: "funnel" canonical_url: "https://www.drsmithnd.com/perimenopause-health-program" markdown_url: "https://www.drsmithnd.com/llms/funnel/perimenopause-health-program" lastmod: "2026-08-29T08:50:06.490Z" --- # Peri Collective Program ## Are you feeling off and not like yourself lately? Noticing a growing list of symptoms? ## You might be in perimenopause . ### If you are 35+, still having periods and… You don’t feel at home in your body lately You feel dragged down by weight gain , mood swings , hot flashes , insomnia and fatigue You are frustrated with the lack of support or the outdated recommendations from health professionals Then yes, you are in perimenopause. 85% of women suffer from perimenopause symptoms and most suffer alone. But you don’t have to do it alone. JOIN THE CHALLENGE ## Introducing Peri Collective #### Welcome to Peri Collective! This 5-week online program is designed to help you feel like yourself again during perimenopause. ## What is Peri Collective? #### It is your ticket back to solid health during what will be one of the most tumultuous times (health-wise) of your life. #### Customize it to your schedule, by either completing the 5-week, online, jam-packed program with live weekly coaching or do it at your own pace with just the learning modules. ### The program features: Pre-recorded video lectures for self-paced learning LIVE weekly coaching and Q&A with Dr. Kirsten and your fellow group members LIFETIME ACCESS to learning materials, slides and resource handouts Membership to an alum Facebook group to keep the conversations going JOIN THE WAITLIST ##### Thanks to Peri Collective I now understand exactly what is happening to my brain and body. I know what my options are, have gotten the support I need, and am rapidly getting my health back. I am finally sleeping and motivated again, my anxiety and depression have lifted and I finally feel like myself again. Honestly to learn that the distressing symptoms I had were due to perimenopause, normal, AND treatable… It has completely changed my life. ##### I cannot express how grateful I am to Dr Kirsten and her well designed, jam-packed yet simple program; it cuts through the noise and confusion straight to solutions. I highly recommend it. Sharleen ## How you will get back to YOU, again #### Peri Collective Program is broken down into 9 bite-sized modules that will help you: Learn what is actually happening to your body (and brain) during this transition, and how that translates into the many symptoms. Knowledge = POWER Get back in control of your weight! Learn how to use nutrition to effectively to work with your slowing metabolism and get control of any weight issues Learn how to exercise based on what your body needs (and doesn’t need) and how to get results , based on facts and research about women (we are not just small men!!!) Cut through the confusion with Menopause Hormone Therapy (MHT)/Hormone Replacement Therapy (HRT) , get the facts and research once and for all Navigate the influence of environmental factors on hormones with simple solutions and resources Differentiate between essential and non-essential lab tests Learn why your stress response has changed and what to do about it to regain stamina and a better ability to cope Learn how to use important evidence-based supplements & herbs Experience being part of a community of like-minded women committed to changing the toxic narrative around menopause, who are striving for optimal health and a beautiful, healthy vision of midlife and aging ## Meet Your Guide Through Perimenopause: ## Dr. Kirsten Smith ### I’m Dr. Kirsten Smith ### Women's health warrior, advocate and hormone expert. I’m a board-certified Naturopathic Doctor in Ontario, Canada. For over 15 years I have helped over 1,000 women optimize their health and hormones during the crucial years before menopause. For a decade, I worked with a medical doctor with 30 years of experience in women’s health. Together we offered fully integrated care, merging naturopathic and conventional medical approaches and I developed evidence-based skills in prescribing HRT. In my one-on-one work I have learned so much about the perimenopausal experience that I decided to create an integrative, holistic educational program called Peri Collective. This program aims to provide women with the tools they need to power through perimenopause and regain their sense of self. More About Me ## Essentially, you will leave with both a fantastic education on midlife women’s health and a solid, solutions-driven, evidence-based health plan. #### What’s not to love about that? JOIN THE CHALLENGE ## Why Did I Create This Program? ##### The short answer is that I am desperate to help many more women than I can in a clinical 1:1 setting. There is a massive gap in this area of women’s health care, and I aim to be a part of the solution. I’ve spent years feeling deeply frustrated at the state of women’s health care — specifically when hormones are involved, which drove me to find a way to make a BIGGER IMPACT. Too many women are needlessly suffering for years and I want this to stop. With Peri Collective I am able to convey so much more information than in the traditional 1:1 setting and I can provide a space for perimenopausal women to connect with each other and create a support network (we need it!). And finally, this is my journey too. I say this because I think ultimately what drove me to create this community and program was actually living through it myself. ## The bottom line is that you are not getting the care, attention or direction you need and deserve. If you're ready to level up your health and cut through all then noise, join me. JOIN THE CHALLENGE --- title: "Perimenopause Health Program - Thank You" entity: "funnel" canonical_url: "https://www.drsmithnd.com/perimenopause-health-program/thank-you" markdown_url: "https://www.drsmithnd.com/llms/funnel/perimenopause-health-program/thank-you" lastmod: "2026-08-29T08:50:06.706Z" --- ## HOORAY! YOU’RE BOOKED IN! ##### Your discovery call spot has been reserved! Check your email for all the details about your booking. ### HERE'S WHAT TO DO NEXT ## 01 #### Check Your Email ##### Check your inbox for an email from us, and click on the confirmation link. Once you’ve confirmed, you’ll receive the live webinar link. ## 02 #### JOIN THE FACEBOOK GROUP ##### Our free Facebook group is great for asking questions and like-minded individuals. Click here to join now (it’s free!) JOIN US ON FACEBOOK ## 03 #### Contact Us CONTACT FORM If your email doesn’t arrive, contact us at info@drsmithnd.com --- title: "Perimenopause Health Program - Waitlist" entity: "funnel" canonical_url: "https://www.drsmithnd.com/perimenopause-health-program/waitlist" markdown_url: "https://www.drsmithnd.com/llms/funnel/perimenopause-health-program/waitlist" lastmod: "2026-08-29T08:50:06.368Z" --- ### Join the Peri Collective Waitlist! You’ll be the first to hear about the program’s next dates. We will not send spam messages --- title: "5 Age Old Naturopathic Remedies For Bloating" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/5-age-old-naturopathic-remedies-for-bloating" markdown_url: "https://www.drsmithnd.com/llms/blog/5-age-old-naturopathic-remedies-for-bloating" lastmod: "2017-11-21T22:34:00.000Z" --- When we eat, our bodies produce enzymes that break down food and help us absorb nutrients. Bloating often occurs when we do not have enough enzymes to break those foods down. When that happens, the food sits in the stomach and ferments, producing gas that causes the stomach to bloat. The most common reason patients may not produce enough enzymes is directly due to stress (all secretions made in your gastrointestinal tract are decreased), but more serious causes can be gallstones, chronic or acute pancreatitis or pancreatic cancer. However, it is quite common for people with a healthy gall bladder and a healthy pancreas to just not quite make enough enzymes to digest well. Often bloating is in fact NOT caused by low pancreatic enzyme output but by a condition called SIBO or Small Intestinal Bowel Overgrowth. This is ruled out with a breath test and in fact it is estimated that approximately 80% of those diagnosed with IBS actually have sibo. IF you try some of the items from the list below and do NOT see improvement, see you Naturopathic Doctor to pursue SIBO testing. If you’ve ever felt bloated before (and you most likely have!), don’t fret: here are 5 natural remedies to cure that bloating. But before going into those remedies, here are 9 ways to prevent bloating from occurring in the first place: - Only eat when you’re hungry, leaving at least three hours between meals - Avoid unhealthy food combinations like cheeses, meats and breads - Don’t eat fruit after meals - Use digestion stimulating spices like black pepper, ginger, and cumin when cooking - Take probiotics regularly - Have a glass of warm water with half a lemon squeezed in it every morning. Lemon juice increases digestive juices, cleanses the bowels and kickstarts the liver to detoxify your body. - Pay attention to your body’s reaction to dairy and wheat/flour. You may have to reduce your intake or remove them completely from your diet. - Don’t drink anything cold while eating and up to 30 minutes after eating - Reduce salt ### 5 Naturopathic Remedies To Bloating Now that we know how to prevent the bloating, here are five things you can do right now if you are feeling bloated. ##### Have some (herbal) tea Hot fennel tea is a great way to ease the bloating. Prepare fennel tea by crushing one teaspoon of fennel seed and adding it to one cup of water in a pot. Bring the water to a boil, and cover and steep it for 10 to 15 minutes. Other herbal teas that improve digestion, and reduce bloating are chamomile, ginger, peppermint, and lemon. ##### Get Moving If you’re feeling bloated, go for a brisk 30 minute walk. At the end, do some jumping jacks. All of this helps increase blood circulation, which helps with digestion, and also helps release gas. ##### Try some herbal medicines Herbal medicines can help improve digestion. Read up on how to consume Meadowsweet, Gentian, Dandelion, Cardamom, and Radish seed. All of these will help ease the pain and discomfort associated with bloating. ##### Consider supplements Digestive enzyme supplements that contain papain and bromelain help the digestive system to properly break down foods and reduce bloating. ##### Decrease stress Experts have found that there is correlation between bloating and stress. Doing light yoga or meditating after eating can help reduce stress, and put an end to that uncomfortable bloating. ### Find The Root Of The Issue If you are suffering from regular bloating, I recommend booking a Naturopathic Consultation to assess what is causing the issue. While treating the symptoms can provide relief, you can reduce the risk of long term health issues by addressing what is causing the bloating. Recall that with bloating SIBO must be ruled out. Dr. Kirsten, ND, MSCP --- title: "5 Amazing Benefits of Intravenous Vitamin Therapy" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/5-amazing-benefits-of-intravenous-vitamin-therapy" markdown_url: "https://www.drsmithnd.com/llms/blog/5-amazing-benefits-of-intravenous-vitamin-therapy" lastmod: "2018-12-02T22:03:00.000Z" --- In an ideal world, our diets would provide us with the optimal amount of essential nutrients we need to not just to survive, but thrive. Unfortunately, modern living and agricultural practices make it harder than you’d think. In a time when the average person is truly struggling with the basics such as getting enough fresh air and sleep, eating a balanced diet that is appropriately nutrient dense is challenging, and even when we try chronic stress, environmental pollutants, and nutrient-depleted foods make it nearly impossible for us to get the number of vitamins and minerals we really need. Additionally, there is mounting evidence looking at the mineral density in the soil being gravely poor due to pesticide use and other modern agricultural practices. And what of supplements? Well, of course, there is a role for supplements but issues around compliance and quality often result in people still ultimately being underpowered. Thankfully, Intravenous Vitamin Therapy (IV Therapy) has emerged as a fantastic way to complement our diets and give our bodies optimal vitamin and minerals levels. This allows essential vitamins, minerals, and amino acids to go right into our bloodstreams goes right to the cell, bypassing the digestive process, and delivering faster, more effective and efficient results. At our clinic, we prescribe these often to address myriad health conditions and goals or to amplify the work a patient has already done, and it definitely plays a vital part in how we work to truly optimize our patients. Vitamin infusions have been proven to help prevent illness, treat infections, treat acute or chronic health conditions and give us energy boosts that make us feel rejuvenated and replenished. And the best part is that there are so many, many subsequent benefits to optimizing our vitamin and mineral levels. But how exactly do they work, and why are they so awesome? ## How IV Therapy Works In Ontario and in many other jurisdictions, to receive IV Therapy from a naturopathic doctor, you must first become their patient. To perform or prescribe IVs we must have an additional license to do so, and with it comes a lot of specific training, education and… more board exams(!!). This is done for your own safety. It ensures that someone with high-level training will review your medical history, family history, current health challenges and goals before they prescribe a treatment of any kind. It is also important because there are many formulations (and customization is also frequently done) and success depends on getting the right prescriptions for YOU. If Dr. Smith determines that IV Therapy is appropriate for you, she will assess your personal needs and customize an infusion to help restore your health. The infusion is administered through an intravenous drip, and are usually relaxing. We use an angiocath which means you can move your arm and the experience is pain-free. Treatments most commonly take about 30 minutes but may take up to 120 minutes or longer depending on the type of IV prescribed. Treatment frequency varies and is dependant on many factors. It can range from weekly to monthly or as needed during times of high stress or immune challenge. ## When is IV Vitamin Therapy most prescribed? IV Vitamin Therapy is good for: - Adrenal Fatigue - Stress and burnout - Pre and post-athletic event/ Performance - Chronic Fatigue Syndrome - Acute viral/bacterial illnesses and colds - Detoxification - Anxiety - PMS - Anti-ageing - Parkinson’s disease - Migraines & tension headaches - Macular degeneration - Fibromyalgia - Depression - Chronic disease - Cancer - Allergies - Asthma - Chronic or acute muscle spasms See our [IV Therapy services](https://www.drsmithnd.com/index.cfm@pagePath=Services%252FIV_Therapy&id=66460.html). ## Why should you consider IV Therapy? Many people with immune deficiencies, chronic fatigue and pain are forced to bounce from doctor to doctor without ever receiving concrete answers as to what is wrong with them. Many of these people suffer from nutrient deficiencies and other imbalances that can be helped through IV therapy. This treatment is a unique and powerful option that is very useful for certain conditions because it achieves better results, faster. Whether you want to enhance your energy, improve your overall health, treat specific medical conditions, or maintain optimal health and work on preventing future conditions, IV vitamin therapy can replenish the nutrients your body needs for optimal health. ## 1. Customized, potent treatments for many conditions Naturopathic doctors who provide IV therapy are highly trained and board certified to identify medical conditions and prescribe appropriate IV therapies that address the nutritional deficiencies and treatment goals of each patient. ## 2. It’s fast and effective Most medications including vitamin supplements are taken orally, which means that they go through the digestive system. This process is slow and is entirely contingent on the person having optimal digestion (which sadly is rare these days…), and it limits the impact and access of the nutrients. With IV therapy, we know the vitamins are completely absorbed into your cells so that your body will benefit from them immediately. In other words, you can begin to feel the positive effects almost instantly. Within several hours to a day, you can feel the effect of the IV nutrients, as you’ll have more energy, be able to think more clearly and enjoy an improved mood. ## 3. It reduces your pill load Customized IV therapy allows you to cut back on the supplements reducing cost over time and it’s less of a hassle. ## 4. It’s safe Naturopathic doctors who administer IV Therapy have an entirely separate and additional license to do so. To maintain that license they have to do regular continuing education. Regulatory bodies in Ontario ensure that NDs are trained at the highest level and have the knowledge and skill to assess their patients for candidacy and safely administer the therapies. This is a true area of expertise in the naturopathic medical field. It is extremely rare that any, even minor adverse reaction or event occurs with IV therapy, however, a full discussion about what to expect and safety occurs at the clinic with a doctor. ## 5. It’s THE ideal preventative therapy Modern medicine mostly pivots around reacting to disease but has a little to no use in the prevention of it. This is a sad truth, but you can’t be everything to everyone – so thank god for naturopathic medicine!! IV therapy is different. When the body receives proper amounts of nutrients, it helps treat disease by helping the body do what it is designed to do which is to attain homeostasis. Additionally, due to research, we know that higher doses of certain vitamins and minerals will have a healing effect in certain situations. Therapeutic doses of vitamin C have been shown to be toxic to cancer cells and are well-known for their effectiveness in building immunity and at higher doses can act as an anti-viral. ## Ask about IV Therapy If you live in Toronto and are interested in learning more about IV Therapy feel free to call (416) 929-0707 and book a COMPLIMENTARY 15-MINUTE CONSULTATION with Dr. Smith. Dr. Smith, ND, is a leading expert in the field of Vitamin IV therapy which she has been using in her practice for over 10 years, and she is open to discussing your health goals and any questions you may have regarding this valuable therapy. Dr. Kirsten Smith, ND Dr. Smith is a licensed, board-certified naturopathic doctor in the province of Ontario, a member of the Menopause Society, the Ontario Association of Naturopathic Doctors and the Canadian Association of Naturopathic Doctors. --- title: "5 Healthy Hot Chocolate Hacks to Boost Naturopathic Healing" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/5-healthy-hot-chocolate-hacks-to-boost-naturopathic-healing" markdown_url: "https://www.drsmithnd.com/llms/blog/5-healthy-hot-chocolate-hacks-to-boost-naturopathic-healing" lastmod: "2016-11-22T22:43:00.000Z" --- When I think of hot chocolate, I think of drinking it after skating and skiing when I was young to get warm. Unfortunately, it was always super sugary powdered mix that makes my teeth hurt just thinking about it. Thankfully, you can have the best of both worlds. The warming treat of hot chocolate, with healing properties to make it the perfect thing to enjoy on a cold winter day. ### Cocoa or Cacao? Easily confused, yet the difference in healing potential and flavour is immense and lies in how they are processed. Raw cacao powder is made by cold-pressing unroasted cocoa beans. The process keeps the living enzymes in the cocoa and removes the fat. Cocoa looks the same is raw cacao that’s been roasted at high temperatures. Unfortunately, roasting changes the molecular structure of the cocoa bean, reducing the enzyme content and lowering the overall nutritional value. The good news is that cacao has some tremendous health benefits such as a very high antioxidant value that can: - Lower insulin resistance - Lower your risk of stroke - Protect your nerve cells - Lower blood pressure - Boost your mood - Provide minerals such as magnesium (often those craving chocolate are actually needing this often deficient mineral) With the chilly weather here to stay for the next many months, the best way to keep warm and support healthy immune function is with a warming drinks, soups and stews. I’ve put together 5 hot chocolate hacks that support naturopathic healing. They harness the benefits of botanicals we commonly employ in naturopathic medicine to support optimal immune response so that you can warm up, and deliver some valuable nutrients and support to your body at the same time. A lovely win win. Dr. Kirsten, ND, MSCP Dr. Kirsten Smith, ND Dr. Smith is a licensed, board-certified naturopathic doctor in the province of Ontario, a member of the Menopause Society, the Ontario Association of Naturopathic Doctors and the Canadian Association of Naturopathic Doctors. --- title: "6 Things You Can Do Now To Lower Your Risk of Developing Breast Cancer" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/6-things-you-can-do-now-to-lower-your-risk-of-developing-breast-cancer" markdown_url: "https://www.drsmithnd.com/llms/blog/6-things-you-can-do-now-to-lower-your-risk-of-developing-breast-cancer" lastmod: "2018-10-17T22:09:00.000Z" --- Every October, research and advocacy organizations around the world come together to launch Breast Cancer Awareness Month, a campaign that hopes to increase awareness of the disease and raise much needed funds for research. The need for this campaign is more than evident: although survival rates have increased in the last few decades, breast cancer remains extremely pervasive. ## Breast Cancer Quick Facts According to the Canadian Cancer Society, in 2017: - Today, [1 in 8 Canadian women](http://www.cancer.ca/en/cancer-information/cancer-type/breast/statistics/?region=on) are diagnosed with the disease, making it the most common type of cancer affecting women in this country. - 5,000 women died from breast cancer. This represents 13% of all cancer deaths in women in 2017. - On average, 72 Canadian women were diagnosed with breast cancer every day. - On average, 14 Canadian women died from breast cancer every day. - 5-year-net survival rate for breast cancer is 87%. Okay so enough fear mongering already. What are we going to do about it? LOTS. Because here’s the thing: many of these cases can, in fact, be prevented. Although inherited genetic mutations can elevate risk and possibly cause some breast cancers, certain habits that lie within our control such as drinking, smoking, overeating and being sedentary have been scientifically proven – repeatedly – to increase our risk of developing breast cancer. Additionally, emerging research shows that exposure to certain chemicals in the air, water and soil interfere with hormones and various bodily functions, and can thus act as carcinogens, meaning they can play a role in causing cancer. We can make choices that decrease our exposures to these carcinogenic toxicants, and we must. While I think it’s safe to say that we all find breast cancer really frightening, we have to move our minds to a more empowered position and take action because the fact is, we can actually do things that de-escalate our risk. ## A Brief Review Of What We Can’t Control… Genetics Research has established that some women have a strong genetic predisposition to develop breast cancer. This genetic lottery causes some women to inherit a mutation in genes called BRCA1 and BRCA2, which elevate the risk of developing breast cancers. These mutations, along with others, are found in about 20-25% of all breast cancer cases. It is important to note, however, that having these markers doesn’t mean you will definitely get breast cancer (and conversely, not having them is no guarantee you’re not getting it either), they just elevate risk. ## 6 Things You Can Do Now To Lower Your Risk of Developing Breast Cancer While researchers are still trying to understand exactly what causes breast cancers, the science points to an interplay between genetic and environmental factors that increase our risk. ### 1. Food Glorious Food… Various dietary factors have been highlighted in the research to be of significant interest in terms of impacting risk. According to [one study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5811844/), the consumption of processed food increased the risk of developing breast cancer by 10%. While [another study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5748781/) found that “that grilled meat and high-cholesterol food intake and irregular eating habits may be associated with a higher risk of breast cancer.” Other research has shown that the following dietary changes can decrease your risk of developing this deadly disease: Eat organic, fresh, pesticide-free food - Eat a primarily a Mediterranean diet/ more plant-based* - Eat mindfully and avoid rushing during meal times - Eat with a 12 hour (minimum) fast overnight every night - Eat low-glycemic carbohydrates (blood sugar stabilization is important) - Eat lots of fiber…it helps us detox carcinogenic compounds* - Avoid preservatives and processed foods - Avoid canned food / plastics on foods – plastics are xenoestrogens (which elevate cancer risk). Replace your Tupperware with glass or ceramic. Absolutely no microwaving in plastics or food covered in wrap. So…What Should We Be Eating? - Antioxidants (berries, acai, pomegranate, dark chocolate, all fruits and veggies that are dark in pigment/ colourful) - Legumes – an awesome source of fiber and protein - Quinoa, chia, slow cooked oats, ground flaxseed - Nuts and seeds (raw, unroasted, unflavoured) - Healthy fats (raw coconut oil, avocado, omega 3s, pure dark green bitter olive oil) - Cabbage, brussel sprouts, kale, cauliflower, broccoli – the research on these is particularly amazing**! - Shitake, Reishi, turkey tail mushrooms - Dark leafy greens ### 2. Move that Bod, Lady Regular exercise is an extremely efficient and easy way to decrease your chances of developing breast cancer, as is maintaining a healthy weight.* According to the American Cancer Society, [studies](https://www.cancer.org/latest-news/get-moving-to-help-reduce-your-risk-of-breast-cancer.html) conducted over the past 20 years have shown that an increase in physical activity is directly linked to a lower breast cancer risk. Why this happens is not fully understood, although many experts believe that it has to do with the fact that physical activity regulates hormones including estrogen and insulin, which can fuel breast cancer growth. It also helps us to better detoxify not just our bodies own metabolites, but toxicants that are carcinogenic. Regular exercise also helps us stay lean, which is essential in terms of reducing the potential for having too much estrogen (which can be made in fat) and helps support immune function. This is critical to register in your mind: studies show that even being 10-15lbs over weight greatly increases your risk of developing breast cancer because estrogen develops in fat… ### 3. Smoking. Seriously? (Someone out there still smokes?) According to experts from [breastcancer.org](https://www.breastcancer.org/risk/factors/smoking), cigarettes contain a number of toxins that are linked to a higher risk of breast cancer in younger, premenopausal women. Research is also showing there may be a link between heavy second-hand smoke exposure and breast cancer risk in postmenopausal women. Smoking also can increase complications from breast cancer treatment, including: - damage to the lungs from radiation therapy - difficulty healing after surgery and breast reconstruction - higher risk of blood clots when taking hormonal therapy medicines ### 4. Cap the Booze [Research](https://www.breastcancer.org/risk/factors/alcohol) shows repeatedly that alcohol is an all-cause carcinogen, however, there is also research connecting it directly to breast cancer with over-consumption increasing a woman’s risk of developing breast cancer by up to 15%. This occurs because alcohol increases levels of estrogen and other hormones associated with a type of breast cancer known as hormone-receptor-positive breast cancer. Alcohol also may increase breast cancer risk by damaging DNA in cells. So What is “Over Consumption”? Experts and doctors recommend less than 5 drinks per week (maximum) to reduce your risk, and in some cases, further reduction is recommended if for example you already have a variety of other risks in play*. This will not only allow you to maintain your hormones at a healthy level, but it will also help you maintain your weight and function at your best. ### 5. Stress Management (as ever, is crucial) Researchers are only now starting to look at the connection between stress and breast cancer. While the evidence isn’t completely conclusive at this point, researchers are concerned that due to the impact of stress on the neuroendocrine and immune systems, this could likely escalate risk. Given this relationship, it is wise to regulate stress to allow your immune system to help it fight potential cancer cells and to avoid negatively impacting your hormones. This can be done in a number of ways of course including meditation, yoga, therapy and regular exercise, to name a few. One of the most important reasons to do this is to improve your quality of sleep. A [2012 study](https://link.springer.com/article/10.1007/s10549-012-2144-z/fulltext.html) found that women who chronically lacked sleep developed more aggressive breast cancers. These findings suggested there may be a link between long term sleep deprivation and the development of more aggressive tumors. Sleep deprivation is a major stressor for the body.* ### 6. Screening…? By now, most of us know that early detection is incredibly important. Most doctors suggest that women over the age of 40 get annual mammograms however some recommend longer gaps between imaging. It is wise to have a conversation with your doctor about your individual case and what approach to screening makes sense for you. While imaging is important, it is also valuable for women to get blood tests that promote prevention and optimal health because there are so many ways we can respond to this research. Blood sugar optimization, hormone balancing, nutritional work, lifestyle changes, diagnosing and treating the root of your insomnia, addressing critical vitamin deficiencies (such as Vitamin D which also elevates cancer risk if low), all contribute to not only making you experience a whole new you in the now, it is PREVENTION. In my practice, I order blood work that typically spans well beyond what you may get at your annual physical (if it’s annual), examining a spectrum of hormones, vitamin levels, liver and kidney function, inflammation and blood sugar markers, all of which provide me with key information. When a patient has concerning family or personal medical history pertaining elevating the risk of breast cancer, I will also order DUTCH testing or dry urine testing which shows us not just your hormone levels but if you are pushing towards the types of estrogen metabolites that damage DNA and elevate your risk. In some cases, I will also order environmental toxicant testing after taking a thorough environmental exposure history regarding residential, occupational, food, medical and dental exposures – and when this intake indicates there may be a problem. Once I’ve identified if there are unsafe levels of heavy metals, solvents, pesticides, herbicides, phthalates and other chemicals I create a medically supervised cleansing program and commence detox.. The fabulous news is that you can drastically reduce these levels with a doctor trained in environmental medicine. Since we know that many of these factors are influential in this disease, this working with this approach to your health is a way to be more on top of your game. ## So, What Next? - Keen on prevention? - Want to stay in remission? - Concerned due to breast cancer being in your family? - Concerned about your lifestyle? ## Book an appointment Take care of YOU. (You can’t take care of everybody else unless your oxygen mask is on first.) Not only can I help give you the tools you need to get going with healthy habits, but we will work to get your labs values back into a range that is humming which also typically results in feeling vital and energized. For a complimentary 15-minute consultation with me (in the office or by phone) to discuss your unique situation please call us at EnviroMed Clinic at (416) 929-0707. Dr. Kirsten Smith, ND Dr. Smith is a licensed, board-certified naturopathic doctor in the province of Ontario, a member of the Menopause Society, the Ontario Association of Naturopathic Doctors and the Canadian Association of Naturopathic Doctors. --- title: "7 Ways To Boost Your Immune System" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/7-ways-to-boost-your-immune-system" markdown_url: "https://www.drsmithnd.com/llms/blog/7-ways-to-boost-your-immune-system" lastmod: "2018-11-19T22:06:00.000Z" --- Do you catch colds easily, or get sick a lot? If so, your immune system may be compromised. The cause of depressed immune systems range from an unbalanced diet to exposure to mold and chemicals, or to autoimmune diseases. Boosting your [immune system](https://www.holtorfmed.com/immune-system-army-inside/) is essential to living a healthy life. The immune system plays an important role in fighting off bacterial, parasitic and viral infections while also restricting the growth of tumours inside the body. ## Symptoms of a Suppressed Immune System According to the experts from the prestigious Mayo Clinic in New York, the main symptoms of a suppressed immune system include: - Frequent and recurrent pneumonia, bronchitis, sinus infections, ear infections, meningitis or skin infections - Inflammation and infection of internal organs - Blood disorders, such as low platelet counts or anemia - Digestive problems, such as cramping, loss of appetite, nausea and diarrhea - Delayed growth and development - Autoimmune disorders, such as lupus, rheumatoid arthritis or type 1 diabetes ## How To Boost Your Immune System In recent years, scientists have discovered hundreds of things that suppress our immune systems. While many of these are a result of a genetic lottery (some of us just HAVE more weakened immune systems than others), others can be controlled. In other words, this means that environmental factors and lifestyle choices contribute to weakening our immune systems, causing a number of conditions that range from mere colds to more serious things like cancer. Here are seven things you can start doing right now to boost your immune system: ## 1. Beware of Vitamin Deficiencies In order to function properly, our bodies need the proper amount of vitamins and minerals. These vitamins feed vital cells in our immune system, allowing them to grow. They also give them the energy they need to find and destroy germs. Poor food choices and things like digestive tract issues that hinder good nutrition also deplete our immune system of the energy it needs to work correctly. That’s why a whole foods, organic diet full of healthy fats, low on inflammatory grains, and high on quality protein and vegetables go a long way in terms of supporting us, even at the deepest level. No medicine goes a further distance than what is on your fork. Common vitamin deficiencies that lead to a suppressed immune system include Vitamin D, Vitamin B12 and Iron. Today, we have tests that can easily show if you are lacking these vitamins. We also have easy ways to replenish them — like supplements and diet overhauls — that will help boost your immune system. One of the most potent ways to boost your immune system is by getting [intravenous vitamin infusions](/iv-therapy) that ensure optimal levels of nutrients and help prevent various infections by supporting your immune system on a cellular level. To see the spectrum of unique formulas we work with click here, however, we always customize them to some extent depending on our goals. ## 2. Avoid Exposure to Mold and Chemicals Exposure to certain toxins such as those found in mold spores and other toxins has been proven to have an impact on our immune systems. In 2000, a group of scientists in Washington DC at the Environmental Working Group, spearheaded a series of groundbreaking investigations on the pollution in people, from newborns and grandparents to mothers and teens. They found pollutants in everyone. And they’ve found hundreds altogether, in combinations that have never been tested for safety. The toxins many people have in their bodies revealed by these studies exposes alarming gaps in the scientific understanding of our exposures and in our system of public health protection. In one study conducted they discovered that 457 of 538 chemicals tested were found in the blood, urine, umbilical cord blood of infants, and breast milk from a sample of 94 people. ## 3. Manage Stress Stress has been proven to have a major negative impact on your immune system. When you experience continued stress, your adrenal glands release extra cortisol to help your body cope. These elevated cortisol levels impact the production of prostaglandins, which support healthy immune function, causing inflammation and immune suppression. Studies have shown that during a period of elevated cortisol levels, Natural Killer Cells, which are vital pieces of our immune system, die off, reducing our body’s ability to fight off foreign invaders. In this context, it is evident that managing stress through things like counselling, massage, meditation, yoga, or hobbies is a great way to boost the immune system. ## 4. Create a Regular Sleep Schedule Good sleep is essential for immune system health. A study conducted in 2012 found that sleeping fewer than seven hours each night can significantly impair the ability of the immune system to work properly. That’s because during sleep, the immune system releases proteins called cytokines, which help fight infection and inflammation. The same study found that infection-fighting antibodies and cells were also reduced during periods of reduced sleep, which explains why the researchers observed that immune response in subjects who slept four to six hours per night was much lower than that of those who slept seven to nine hours. Creating a regular sleep schedule that allows you to sleep eight hours a night is a great way to make sure ## 5. Lay Off the Booze Drinking too much alcohol can also reduce the ability of white blood cells in your body to kill germs. Researchers have proven that there is an association between excessive alcohol consumption and adverse immune-related health effects such as susceptibility to pneumonia. In recent decades, this association has been expanded to a greater likelihood of acute respiratory stress syndromes (ARDS), sepsis, alcoholic liver disease (ALD), and certain cancers; a higher incidence of postoperative complications; and slower and less complete recovery from infection and physical trauma, including poor wound healing. Clinicians believe that this occurs because excessive alcohol can impair the ability of the immune cells to function properly, increasing your risk of infectious diseases and cancer. While moderate alcohol consumption is probably not dangerous, making sure you keep your booze in check is a great way to keep your immune system in good shape. ## 6. Exercise More Getting regular exercise has been scientifically proven to boost your immune system. Studies have shown that exercise helps strengthen the cells in your body that attack bacteria. These cells also appear to work more slowly in people who do not exercise, showing a causal relationship between exercise and a healthy immune system. ## 7. Quit Smoking (there are people still smoking?!) We have known for a while that smoking can increase your risk of lung cancer. Did you know that smoking, or even second hand smoke, can weaken or damage your immune system? Cigarettes contain more than 4,000 chemicals, all of which are extremely toxic to the body. ## Can’t Figure Out Why You Have a Weakened Immune System? Come in for a Visit. Many people with poor immune response fail to get concrete answers from medical doctors. These doctors, while invaluable to our health, many times are not trained to determine if your weakened immune system is the result of things like mold or chemical exposure. If this is your case, you should definitely give us a call. If there are aspects of your case that may indicate some kind of toxic exposure, I take a thorough environmental exposure history regarding residential, occupational, medical and dental exposures. I then use urine and blood tests to identify the presence of heavy metals, solvents, pesticides, herbicides and other chemicals that are stored in the body to show evidence of toxic exposures. These tests also allow me to see if there are any vitamin deficiencies leading to a weakened immune system, allowing me to prescribe treatment options that will help get things back on track. These treatment options can include IV therapies, lifestyle and dietary overhauls and other naturopathic options. In other words, I will be able to determine what is causing your immune system to become suppressed, and how to boost it. For a complimentary 15-minute consultation (in office or by phone) to discuss your unique situation, please call the office at (416) 929-0707. Dr. Kirsten Smith, ND Dr. Smith is a licensed, board-certified naturopathic doctor in the province of Ontario, a member of the Menopause Society, the Ontario Association of Naturopathic Doctors and the Canadian Association of Naturopathic Doctors. --- title: "8 Tips for Living with Polycystic Ovarian Syndrome" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/8-tips-for-living-with-polycystic-ovarian-syndrome" markdown_url: "https://www.drsmithnd.com/llms/blog/8-tips-for-living-with-polycystic-ovarian-syndrome" lastmod: "2018-02-21T22:29:00.000Z" --- Polycystic Ovarian Syndrome (PCOS) is a hormonal disorder that affects up to 10% of women worldwide. When left untreated, it can cause health complications and uncomfortable symptoms, such as weight gain, hairloss, acne, irregular menstruation and sometimes, fertility challenges. While no cure exists for it yet, there are natural treatments that help decrease symptoms. ## What Exactly Is Polycystic Ovarian Syndrome? Due to how very common Polycystic Ovarian Syndrome is, it is something I treat every single day. The syndrome results in the ovaries producing higher than normal amounts of androgens (i.e testosterones), which interfere with egg production, increase blood sugar and can lead to various other health concerns. Despite the name, ovarian cysts aren’t necessary to make a diagnosis; sometimes they are there, sometimes they are not, but if the patient has a collection of a few of these symptoms listed below, they are likely to be diagnosed with Polycystic Ovarian Syndrome. Doctors are screening for the most common collection of signs and symptoms including weight gain, infrequent or irregular menstruation, hair loss, infertility and excess hair growth on the face, breasts, abdomen (called hirsutism). Additionally, there is blood work and imaging we can do that can also capture some of the hormonal perturbances that match the symptoms. One of the core challenges with PCOS as mentioned above is that it causes escalating blood sugar levels due to causing insulin resistance, which means weight issues. It’s the complex interplay between the sex hormones and the blood sugar imbalance that is ultimately responsible for the variety of symptoms women may experience. If you imagine an orchestra pit being all of your hormones (insulin is a hormone too); you can then imagine that if one instrument is out of tune, everyone else starts having trouble and gets off key. Hormones operate in a similar manner; if one of them is off, others will follow and PCOS embodies this challenge. This is why it is often a multipronged approach addressing different hormones that ultimately gets PCOS under control. While it is frustrating that no cure exists for PCOS yet, it is so encouraging that there are a number of successful natural treatments that help keep PCOS symptoms to a minimum. ## 8 Tips for Living with Polycystic Ovarian Syndrome There are many naturopathic treatment options and approaches for PCOS, but those need to be discussed in my office for because it must be individualized and based on your lab work, etc. HOWEVER, If you or anyone you know is living with PCOS, here are 8 things you can start doing right now to decrease symptoms. ### 8. BAD CARBS ARE BAD (REALLY BAD) FOR PCOS Studies have shown repeatedly that one of the keys to living comfortably with PCOS is learning to manage insulin levels. Interestingly, even if you work really hard to suppress androgen production, if you don’t also address the malfunctioning insulin sensitivity, you will get absolutely nowhere with your case. This is the *everything* when treating this condition. Abrupt changes in insulin levels (as a result of blood sugar swings) perpetuate the hormonal imbalance that produces the symptoms. In order to manage blood sugar then, we naturally must embrace a diet that’s low on bad quality carbohydrates. That’s why women living with PCOS should avoid things like pop, candy (yes, that includes chocolate), dried fruits, high sugar fruits, juice, refined grains (any flour), and starchy carbohydrates. The bottom line is, you can’t eat sugar, or things that convert into sugar if you have a sugar disease, and PCOS is very much a disordered blood sugar disease – the insulin spiking and dropping effects the androgens; which produces all the symptoms. With my patients, I can’t work with them unless they can commit to working hard on their diet and exercise – because if they don’t, they simply won’t get results. Period. ### 7. DROP THE FLAT WHITE BULLET PROOF HALF SWEET DOUBLE SPECIAL FEELING COFFEE. Sadly, it has to go. Bye bye lovely you. Coffee and other stimulants also cause an increase in the production of insulin production and then later, a big blood sugar drop. That’s why, if you are serious about controlling your insulin levels, you really need to consider giving up coffee, black teas, energy drinks, and pop. If your blood sugar is on a roller coaster ride, it’s awfully hard to lose weight. ### 6. FIBER FIBER FIBER A high fiber diet is extremely important for women wanting to manage PCOS symptoms. Why? Fiber plays a valuable role in balancing blood sugar levels and aids in the removal of excess estrogen, which also can play a role in the unbalanced hormones of women living with PCOS. To ensure your diet is rich in fiber, include foods such as oats, brown rice, quinoa, ground flaxseeds, chia seeds, broccoli, kale, cauliflower, celery, and brussel sprouts. All these foods help to remove harmful estrogens from the body and fight hormonal imbalances. I routinely prescribe 2 heaping tbsps of ground flaxseeds daily to all my PCOS patients – there are even studies showing the hormone balancing effects. ### 5. EMBRACE MINDFULNESS MEDITATION Research has shown that women living with PCOS are more likely to experience depression and other mental health disorders, and this has also been my observation in clinical practice. Although these two conditions may not be physiologically related, it is clear that many women find themselves dealing with the emotional toll associated with PCOS. It can be really hard living with the symptoms, and often women struggle to find a treatment plant that works for them. So why mindfulness? The honest truth is that I prescribe this many, many times a day. It is just a fact at this point (loads of research), that while we can take pharmaceutical or natural medicines for anxiety and depression – we aren’t really getting to the root of the problem. Ultimately, calming and recalibrating our nervous system (and thus mood) is actually a learnable skill. Mindfulness meditation has been proven to help improve wellness and fight depression, calm anxiety, reduce chronic pain and improve sleep, energy, and focus. ### 4. OH DAIRY, HOW WE LOVE LOVE, AND SO HATE YOU…. Dairy has high levels of hormones that are naturally produced by cows. While these hormones aren’t unhealthy per se, it is worth repeating that PCOS is a hormonal imbalance, making it important to avoid adding any extra hormones to your body. It is also inflammatory and you don’t need that if you have acne. Additionally, weight management doesn’t exactly go hand in hand with gobbling dairy. Sigh. ### 3. EXERCISE. IT’S EVERYTHING. Exercise is one of the best things you can do to manage your hormones and insulin levels. It helps the body stabilize blood sugar levels and helps you blow off stress hormones both of which mess with the hormones involved in PCOS. Researchers have repeatedly found that exercising every day for a minimum of 30 minutes delivered excellent results for women living with PCOS. While doing this may not be possible for all women, adding a brisk walk or a quick workout to your daily routine can do much more for than you than you think. Trust me. ### 2. QUIT SMOKING. FULL STOP We all know that smoking is bad for everyone’s health for a zillion reasons…but researchers have recently found that it is especially bad if you have PCOS. So if you’re out there and still smoking and have PCOS stop getting in your own way and find a way to butt out. ASAP. ### 1. COME IN OR CALL IN FOR A COMPLIMENTARY CONSULTATION!! Women living with PCOS can get a free 15-minute consultation (in the office or by phone) to discuss their unique situation with me. To set up this complimentary consultation, please call my reception staff at (416) 929-0707. Dr. Kirsten Smith, ND Dr. Smith is a licensed, board-certified naturopathic doctor in the province of Ontario, a member of the Menopause Society, the Ontario Association of Naturopathic Doctors and the Canadian Association of Naturopathic Doctors. --- title: "Anemia: A Major Theme in Perimenopause" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/anemia-in-perimenopause" markdown_url: "https://www.drsmithnd.com/llms/blog/anemia-in-perimenopause" lastmod: "2023-10-03T16:09:00.000Z" --- During perimenopause (the 10 year span leading up to menopause), periods get heavier due to decreasing progesterone levels and subsequently many women end up anemic. Are you in your late 30s, 40s or early 50s experiencing… - General weakness and fatigue - Depression - Headaches - Poor sleep quality - Trouble concentrating - Heart palpitations - Hair loss - Shortness of breath - Exercise intolerance - Irritability - Loss of appetite - Restless legs syndrome Yes? Well, you may be suffering from iron deficiency anemia. It’s common for women to find themselves with these symptoms and while they can be caused by various things, it is common that low iron is the culprit. A few themes that repeat themselves in clinical practice: - Women don’t know they’re anemic - Women know they are anemic but aren’t aware of what it can cause, how to manage it, or how important it is to correct it - Women try to address it with their healthcare providers but iIt is entirely dismissed This is a bit of a problem given that it is easy to treat and treating it greatly increases quality of life. ### Lesser Known Facts About Low Iron/Anemia: - It puts our thyroid health at risk as our thyroid needs iron along with a bunch of other minerals and vitamins to function properly - It can cause heavier periods - It can cause or worsen anxiety and depression because you need iron to make serotonin, dopamine, and noradrenaline - Eating a lot of dairy (calcium) blocks iron absorption - Drinking coffee & tea slows absorption (due to tannins) ### What is Iron Deficiency Anemia? A lack of healthy red blood cells due to insufficient iron levels. Without enough iron, your body can’t produce enough hemoglobin , a protein in red blood cells that enables them to do their very important job of transporting oxygen around to the body’s tissues. ### Common Causes - Certain medications - Chronic diseases – ulcerative colitis, rheumatoid arthritis, kidney disease - Other forms of anemia - Pregnancy - Underlying gastro-intestinal issues (such as celiac disease); malabsorption - Bone marrow disease/leukemia, lymphoma, multiple myeloma, myelodysplasia, aplastic anemia - Slow blood loss (ie. stomach ulcers or heavy menstrual periods) - Sudden heavy blood loss which can include flooding periods (perimenopause), or post miscarriage, post labour ### Testing for Low Iron Laboratory blood work to consider: a CBC (complete blood count) & ferritin test. This list could expand depending on your individual case If you have any questions about which lab tests are best for you, [schedule an appointment with me](/getintouch) . ### Optimal vs “Normal” Iron Levels Even if you are on the low end of the “normal” range, you can definitely still suffer from low iron symptoms. This is because the normal range is quite broad and as we know, “normal” is different for all of us. I frequently see women who are tired, have poor immune responses, have poor hair health, low mood, fatigue, heavy periods and they are in the “normal” range and get better when we raise their iron levels. ### Treatments for Iron Deficiency Anemia There are a couple ways to tackle iron deficiency. Diet can play a big role in regulating iron levels and balancing overall health and nutrient absorption. Supplements help as well. Good food sources of iron include: red meat, poultry, eggs, fish, legumes, beets, whole grains, dark leafy greens, nuts and seeds Tips for Boosting Absorption: - Consume lots of vitamin C with your iron-rich foods, as vitamin C helps make plant-based iron more easily absorbable - Don’t consume iron with calcium rich foods - Cooking with cast-iron skillets Supplementing with iron: A recent study showed that absorption from iron supplements is optimized when supplements are taken every other day. My observation is that people tolerate chelated iron (such as iron glycinate) as it is gentler on digestion ( [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7193469/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7193469/) ) ### Have questions? Talk to me! If you have any questions regarding your situation, low iron/anemia and you want someone who champions women’s health, I have got your back! You can book a consultation via my [website](/getintouch) . Dr. Kirsten Smith, ND Dr. Smith is a licensed, board-certified naturopathic doctor in the province of Ontario, a member of the Menopause Society, the Ontario Association of Naturopathic Doctors and the Canadian Association of Naturopathic Doctors. --- title: "Are Your Hormones Stopping You From Losing Weight?" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/are-your-hormones-stopping-you-from-losing-weight" markdown_url: "https://www.drsmithnd.com/llms/blog/are-your-hormones-stopping-you-from-losing-weight" lastmod: "2018-09-21T22:13:00.000Z" --- Do you find that no matter how desperately hard you work on calories and exercise, you can barely move the needle? Do you look in the mirror and have negative self talk – often times without even realizing it? Calling yourself… fat? FAT. Many women (and quite a few men frankly) struggle with the F word. Such a powerfully negative three letter word. And the thing is, it truly is such a harmful word. It drips with judgement, contempt and shame because it infers the person who is struggling with their weight is lazy, gluttonous, just doesn’t care, or has failed themselves (and that is almost never the case). One could safely argue that the mental burden of being shrouded in this toxic cloud of potent negativity is a bigger health risk than the fat itself, and the impact on our physical being. But here’s the thing: often when someone can’t lose weight there is a tangible, measurable, metabolic reason…. that is treatable . You read that correctly. What if you are struggling so hard and your impaired ability to get to a healthy weight is, in fact, all because, or partially because of … your hormones? Because this is something I see and treat every single day, this is something you should seriously consider investigating. Many hormonal imbalances make it extremely difficult for people to lose weight, and in some cases can even lead to an increased risk of gaining weight. And in many of these cases, as I’ve already alluded to, you could be running on fumes and working out daily and going exactly nowhere. Here is a list of the five most common hormonal imbalances that affect weight loss, and tips to how to correct them. ## 1. Serotonin – not just about happiness Serotonin is a powerful hormone that influences a ton of natural processes in our bodies. It is infamously known as the “happy hormone”, but it can impact not only our mood and emotions, but cravings, self-esteem, sleep quality and our appetites, all of which impact our ability to lose weight. If serotonin levels are too low, the messages sent by our brains start getting mixed up, which can lead to mood swings and sugar cravings. ### How can we balance serotonin levels? Serotonin levels can be balanced with plenty of sunlight, taking B vitamin supplements, regular exercising and eating more tryptophan-rich foods such as pumpkin seeds, turkey, eggs, lentils – the list goes on. Increasingly both in research and in clinic, we are learning that practicing mindfulness, meditation, and yoga does help deal with mental health symptoms associated with low serotonin levels and will also help remove some of the mental barriers that are working against your ability to lose weight. In some cases, patients require – and greatly benefit from, botanical or prescription medications that increase serotonin – it is crucial to see your ND or GP if you’d like to learn about pursuing this route.* ## 2. Cortisol – not just about stress Cortisol levels rise when we are in high stress situations and a sad fact about modern living is that most people are living in a state of sustained high stress. They never or very rarely get off the ride. This is not a small problem, that we as a society largely face. This escalates cardiovascular risk, digestive problems, insomnia, anxiety and yes, weight gain due to the sugar cravings that come or as many call it, “stress eating”. You see, cortisol is an alpha hormone or as I often say, it’s the conductor of the hormone orchestra. It has a tremendous influence on your other hormones – thyroid, insulin, estrogen, testosterone, progesterone and more. When headlines say high stress will have a global impact on destroying your health, this is really not to be taken lightly. High cortisol can mess you up. Badly. ### How can we balance cortisol levels? While we can’t eliminate stress from our lives the first step in managing our cortisol levels and protecting our health, is to learn to manage how we respond to stress. We can’t control the weather, but we can control how we adjust our sails (said someone once who must’ve been wise). Incorporating daily practices such as yoga, meditation, and deep breathing are essential. I have patients who use apps with 10 minute guided meditations in the morning that report that this alone positively affects how they weather the day. Regular exercise is also crucial. Additionally, melatonin, phosphatidyl serine and magnolia bark have also been proven to help lower cortisol however it is best to see your naturopathic doctor to get effect and safe recommendations when supplementing in this area.* ## 3. Estrogen: not just about reproduction Researchers have identified that high levels of estrogen are a risk factor for obesity for both men and women alike. This is because estrogen receptors in our brains control things like food intake, energy expenditure, and body fat distribution. There are various reasons why we may accumulate estrogen in our bodies: overproduction, over-absorption of xenoestrogens through our diets (read: pesticides, growth hormones) or environment (read: plastics of all kinds), genetics, prescriptions medications of hormones, etc. Although excess estrogen affects both men and women, women suffer the most from it. Women with high levels of estrogen are more likely to have more intense mood swings associated with premenstrual syndrome and have a higher propensity to build up body fat around the hips and tummy areas. On the flip side, having no estrogen causes that post-menopausal 10lb weight gain right around the middle also. So too little is also a contributing factor in weight management. ### How can we balance estrogen levels? There are a few approaches to balancing estrogen naturally including but not limited to acupuncture, regular exercise, certain herbs and definitely dietary overhauls – steering clear of processed foods, refined grains/ flours, sugar and eating lots of fiber and veggies from the brassica family (kale, brussel sprouts, cauliflower, broccoli, cabbage). For those with excess estrogen there are herbs and nutrients that help us clear it quickly, and for those who are menopausal or post-menopausal, there is bioidentical hormone therapy. These options are to be discussed with your naturopathic doctor to review candidacy, safety and monitoring. ## 4. Testosterone: not just about libido Oh, testosterone, how we all love you. Love. You. You crank our libido, improve bone density, muscle mass, strength, motivation, memory, and hell, burn our fat — and in both genders no less!! When testosterone levels sink, fat comes and muscle fades even if you’re exercising up a storm and eating clean. Testosterone levels decrease as we age, which is why most humans are a little more portly as they get into the last couple of decades. And remember, low estrogen will also bring an extra spare tire. (The joys of aging really deserve a whole other post…) And sadly, we are seeing both clinically and in the research that men are showing lower testosterone levels at an earlier age likely due to endocrine disruption from chemical and EMF exposures. Numerous doctors and scientists such as Dr. Mitchell Harman, an endocrinologist at the University of Arizona College of Medicine, blame on the proliferation of endocrine-suppressing, estrogen-like compounds used in pesticides and other farming chemicals. ### How can we balance testosterone levels? Experts suggest that testosterone levels are affected by a number of things, including high sugar diets, high alcohol consumption and high intake of pesticides through consumption of unwashed and non-organic foods. Decreasing alcohol and sugar consumption, and eating organic foods is a great start balancing out testosterone levels and start getting on track to lose that annoying weight. Additionally, building up muscle will also help you make more testosterone – so get into the gym and do some weight training. For those interested in testosterone [hormone therapy](/hormone-replacement-therapy), seek advice from your family doctor or book a complimentary consult with me to discuss this therapy and your options.* ## 5. Thyroid hormone – ALL about metabolism Hypothyroidism is the medical term for an under-functioning thyroid gland. Without enough free T3 (the active metabolite of the thyroid), every system in your body slows down and the symptom list reflects this: exhaustion, brain fog, low mood, [hair loss](/hair-loss-treatment), constipation and of course, weight gain . ### How can we balance the thyroid? You can improve thyroid imbalances to some extent by spending more time in the sun, exercising regularly, and working hard to minimize stress (lower your cortisol!), but at the end of the day this is a medical condition that usually requires medication from a [licensed naturopathic doctor](https://www.drsmithnd.com/about/), family doctor or endocrinologist. This is a condition where the medication and hormones levels must be closely monitored by a doctor. I don’t advise using herbs you’ve read about google on your own, ever. Always consult a naturopathic doctor if you would like to learn more about this route in [thyroid health management](/thyroid-treatment) as there are just as many safety concerns as if you were taking thyroid prescription medicine.* So. ## Are you doing everything right and still having a hard time losing weight? Do you sense something is wrong? If yes then you need to get some blood work done to assess your hormones (among a few other things) and then an individualized treatment plan by someone with experience. Book a complimentary 15-minute consultation (in office or by phone) to discuss your unique situation with me. During this consultation, we will do a brief review of your situation and see if it makes sense for us to work together to get you healthier and happier. To set up this complimentary consultation, please call my reception staff at (416) 929-0707 and they will work to find a time that works for you. Dr. Kirsten Smith, ND Dr. Smith is a licensed, board-certified naturopathic doctor in the province of Ontario, a member of the Menopause Society, the Ontario Association of Naturopathic Doctors and the Canadian Association of Naturopathic Doctors. --- title: "Ashwagandha and Liver Safety: What You Need to Know" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/ashwagandha-and-liver-safety-what-you-need-to-know" markdown_url: "https://www.drsmithnd.com/llms/blog/ashwagandha-and-liver-safety-what-you-need-to-know" lastmod: "2026-09-21T15:54:24.000Z" --- Photo credit: [Grigoriy Konsevich](https://www.pexels.com/@grigoriy-konsevich-3808567/) Dear Reader, If you take ashwagandha or I have prescribed it for you, it’s time I update you on some emerging safety information. Before you storm over to your supplement stash and fling it in the garbage, take a breath. This is not an emergency, but it is something I think you should know about. I have been prescribing botanical medicine for almost two decades. I like, super love herbs. I trained extensively in them (truly the worst exams in ND med school…), I am continually upleveling my knowledge, I use them foundationally in practice, and ashwagandha ( Withania somnifera ) is one I have prescribed and taken many, many times. Oh withania my old sleepy friend, you’re in the headlights now my dear. It has come to my attention that some reports of liver injury following ashwagandha use have accumulated internationally, so health regulators have appropriately started looking more closely at them. Health Canada's 2026 review concluded that there was not sufficient evidence to establish a definite link between oral ashwagandha products and liver injury. But—and this is an important but—it also concluded that a possible association could not be ruled out and will continue monitoring the issue. Australia's Therapeutic Goods Administration has taken a somewhat more precautionary position. It describes liver injury following ashwagandha as very rare but potentially serious and recommends that people with current or previous liver problems avoid it. ### What Do We Actually Know? Published case series from Iceland, the United States and India have documented liver injury following ashwagandha use after other potential causes were investigated. The most commonly reported pattern has been cholestatic or mixed liver injury, often involving jaundice and significant itching. In the Iceland/U.S. series, none of the five patients developed liver failure, and the four followed through recovery had liver enzymes return to normal after stopping ashwagandha. The Indian series was more concerning. Five of the eight patients had underlying chronic liver disease, and three developed acute-on-chronic liver failure and died. Context matters enormously here. These case series cannot tell us how likely this is to happen to someone taking ashwagandha. We don't have the denominator we'd need to calculate that risk. Australia currently describes the reported risk as very rare, while Health Canada has stopped short of establishing a definite causal relationship. Case reports and series sit low on the evidence totem pole and cannot tell us how frequently this occurs or establish causation with the certainty of controlled studies. But when we're looking for rare adverse effects, they do matter. A consistent pattern of serious events can provide a safety signal before a random controlled trial would ever be large enough to detect it. ### Is This Just About Shitty Supplements? If only it were that simple. Product quality matters enormously to me, and it is one of the reasons I am so particular about what I prescribe. But we cannot currently say that these liver injuries were simply the result of contaminated, adulterated or poor-quality products. The products in the published investigations were chemically analyzed, and investigators did not identify contamination or adulteration that adequately explained the injuries. The mechanism itself remains uncertain. ### So What Should You Do? If I have prescribed ashwagandha to you and you feel fine, don't panic or abruptly change your treatment. If you're concerned, we can review whether it still makes sense for you based on your status now and if we want, find a substitute. I do not use it in anyone with current or previous liver disease, or with emerging risk of liver disease as a precaution. If you are taking it and develop yellowing of the skin or eyes, dark urine, significant unexplained itching, nausea or vomiting, unusual fatigue, loss of appetite or abdominal pain, stop taking it and seek medical assessment. I don't tell you this because I expect it to happen, I absolutely don’t. But it is part of my responsibility to update my community. Many of us are now taking far more “stuff” than we used to—powders, gummies, greens, sleep blends, coffee / electrolyte/ smoothie drink blends, usually with multiple active ingredients. There’s a reason I ask my patients to tell me everything they are taking is because it isn’t at all uncommon for me to flag problems. ### And Finally In Sum, About Me Accosting People in Healthfood Stores… I use herbs because they do things. Yea no shit lady. Stay with me here. It just so happens that I have been present a few times (so bizarre!) in a health food store when a staff member has been helping a patron considering St John’s Wort. I apparently could not be cool and mind my own business and awkwardly blurted out: ARE YOU ON THE PILL? ARE YOU ON ANY MENTAL HEALTH MEDICATIONS? There are more questions, but you get the gist. Once my son was there and he was MORTIFIED, in a word. I am unphased. So folks, if something is powerful enough to meaningfully affect our physiology in a beneficial way, we cannot believe that it can’t have contraindications, interactions or adverse effects simply because it came out of the ground. Herbs have plenty of drug interactions and contraindications; they are, of course, the original medicine. Act accordingly. I reserve the right to change my mind. If new, quality evidence emerges showing that I should alter how I prescribe something, then I do. Fullstop. This is the standard I want for me and my family, and it is certainly the standard I want for you and yours. Off to pour myself a cuppa from my cauldron. Happy autumn to all, Dr. Kirsten, ND, MSCP #### References Health Canada. Health Product InfoWatch: August 2026 — Ashwagandha for oral use. Marketed Health Products Directorate, 2026. Therapeutic Goods Administration (Australia). Withania somnifera (Ashwagandha) and very rare risk of liver injury. Medicines Safety Update. July 7, 2026. Björnsson HK, Björnsson ES, Avula B, et al. Ashwagandha-induced liver injury: A case series from Iceland and the US Drug-Induced Liver Injury Network. Liver International. 2020;40(4):825–829. doi:10.1111/liv.14393. Philips CA, Valsan A, Theruvath AH, et al. Ashwagandha-induced liver injury—A case series from India and literature review. Hepatology Communications . 2023;7(10):e0270. doi:10.1097/HC9.0000000000000270. --- title: "BLINDSIDED: A Man’s Field Guide to Perimenopause" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/blindsided-a-mans-field-guide-to-perimenopause" markdown_url: "https://www.drsmithnd.com/llms/blog/blindsided-a-mans-field-guide-to-perimenopause" lastmod: "2026-09-21T14:23:50.000Z" --- Recently one of your husbands stopped me at a restaurant and gave me a huge bear hug. Thank you. Thank you so much for helping my wife. I didn’t know. I didn’t know what to do. I didn’t understand what was happening. I just cannot thank you enough. It has been SO hard. This is almost verbatim, and it’s not the first time one of your husbands has popped out of nowhere to thank me. The time before that, it was at a gas station. Small-town living folks, at its best. The emotion in their eyes always hits me right in the heart. So this one is for them. The men who love women going through perimenopause and have absolutely no idea what hell is going on. Nowadays we have tv shows, comedians, podcasts, healthcare practitioners and all manner of people coming out of the woodwork to discuss the sheer impact of perimenopause. And yet still many of the men living right alongside it are largely in the dark. You may not know why there is suddenly a strange weather system that has moved into your house. You may not know that estrogen acts throughout the brain, including systems involved in mood, cognition, sleep and our response to stress. When hormones begin fluctuating erratically, a woman’s capacity to absorb the ordinary friction of life can decrease dramatically. You're feeling completely stunned by this, yes? You're not alone. Feeling confused, sometimes alienated and having absolutely no clue what to do is the feedback from men folk I hear all the time. And while many default to immediate problem-solving mode, in this case there is no how-to, babe, no YouTube video showing you how to fix it. I by no means know how to save the men folk, to be clear (I’m pretty busy throwing the women back on the beach…), but after nearly two decades of helping women through perimenopause and beyond, I’ve made a few key observations about what may help. ### The Switch Flip Firstly, we have what I call the switch flip. Why did I have a fit in my car when I couldn’t find my keys in my purse and then whip the purse around, flinging the contents everywhere like a complete freak? True story. Funny in retrospect. Considerably less funny when another human happens to be standing in the crosshairs. If you're in the line of fire, these sudden episodes can feel deeply personal and not okay: Is she really this angry with me? Does she even like me anymore? What the hell WAS that? What can be hard to see in the moment is that there is a very real neurobiological component to the intensity of what you’re witnessing. All I can say on this one, dear (male) reader, is: do not match fire with fire. Ever. For one thing, if you double down, it will get worse—and I mean WAY worse. But more importantly, you need to learn to recognize that when her response seems wildly disproportionate, hormonal fluctuations may very well be part of what is amplifying it. Try to depersonalize some of that intensity. I do know this is definitely easier said than done. It’s the pivot from God , she’s really mad at me to Her nervous system is on fire. This doesn’t equate to every disagreement being hormonally driven, or mean that genuinely hurtful behaviour gets a get-out-of-jail-free card every single time. It means understanding that the intensity may not always be about you—even when you feel like a target. ### The Intimacy and Touch Wall The second major theme I see is the intimacy and touch wall . Often there is significant sensory overload combined with physical discomfort and deep exhaustion, all conspiring to make being touched feel like one more demand on her system, a system that has absolutely nothing left to give . And I’m not just talking about sex. I’m talking about being hugged or cuddled, too. If you’re the one standing on the other side of that wall, this can feel like a sudden and bewildering change, so it’s understandable for some dark thoughts to enter stage right: Is she just not into me anymore? Is she interested in someone else? Is there something wrong with me? The reality? Shifting hormones can make sex physically uncomfortable or even quite painful, or simply the absolute last thing on an exhausted, overstimulated nervous system’s to-do list. Desire itself can change too. When you assume that change must be about you , hurt can quickly turn into pressure or defensiveness, creating a painful cycle of emotional withdrawal on both sides that goes nowhere good. This is where the pivot becomes important. This really hurts. What about me? This important part of our relationship is disappearing. Are we doomed? To something more like: This is common. This is hard. And this does not necessarily mean she no longer loves or desires me, or that our relationship is toast. I can take care of my own feelings without turning them into pressure she now has to carry, too. The point isn’t to stop caring about intimacy. It’s to stop treating her current capacity for it as a referendum on your desirability or the state of your marriage. Stay close without crowding her. There is a big difference. ### The Competence Clash The third major issue I hear about is the competence clash. Why is she such a space cadet? What the hell is going on? Major friction can erupt when a woman is struggling with brain fog and you don’t understand that what she is experiencing is very real. You may be baffled and frustrated when your previously sharp, highly organized multitasker partner suddenly starts forgetting things, losing words mid-sentence or dropping balls she almost never dropped before. It does not escape me that women are still carrying a grossly disproportionate share of the invisible labour involved in the daily logistics of running a household and family—which makes struggling with the very cognitive skills required to carry that load particularly brutal. But the point I’m making here is that these cognitive changes are real, and you need to know about them. Perimenopause is a neurological transition as much as it is a reproductive one. Changes in memory and cognition, mood, sleep, temperature regulation and stress tolerance all involve the brain. And, dear male reader, there is something else I really need you to understand: She has noticed, I can assure you. She knows she is forgetting things. She knows she cannot find the word. She knows she walked upstairs and has absolutely no idea why she is standing there. She knows so much it hurts. For a woman who has spent her adult life being sharp, capable and able to manage an astonishing number of moving parts, this can be deeply frightening and disorienting. Your impatience does not make her brain work better. It just makes her feel more alone inside something that may already be scaring the hell out of her. This woman bled for decades and, for many women, that alone involved significant suffering. She may also have gone through the enormous physical demands of pregnancy, birth, breastfeeding and postpartum. You cannot fully know what this has meant for her body to bear. But it is massive, in some ways unnameable, and deserving of far more reverence than we give it. And now, once more with feeling, her body and brain are asking her to navigate another natural but nonetheless profoundly challenging transition. So give her a freaking break, okay? For the love of all things holy, stand DOWN . Do not match fire with fire. Do not diminish what she is experiencing. Do not tell her she is “just hormonal.” And for the love of God, do not weaponize the word hormones in the middle of an argument. Just don’t. This does not mean perimenopause excuses cruelty, contempt or genuinely harmful behaviour. It doesn’t. Both people matter, and both people remain responsible for how they behave. But expecting things to be the same in the relationship when something this massive is happening to your partner is naive and will make things considerably harder. Because you love her, find a way to move through this chapter as someone you will both respect when you look back on it. Be kind. Show some grace. Watching someone you love change in ways neither of you understands can be lonely, confusing and frightening. Your experience matters, too, it truly does. It just cannot become one more thing she is responsible for carrying while she is struggling to find her own footing one day at a time. ### A Few Notes From the Field Learn what is happening . Don’t make her your sole source of information about perimenopause. Read. Listen. Ask questions. Understanding what is happening gives you context—and context changes how you respond. Don't take it so to heart. Learn to make the mental shift from She is doing this to me to Something is happening to her, and I don’t need to make it about me. Not everything is perimenopause, of course. But learning to recognize when it may be driving the intensity can save both of you a lot of unnecessary pain. Build out your own life. Your partner shouldn’t be your social and emotional everything, and if there ever was a time when she may not have much left in the tank for this, brother, it’s now. Read the room, man. Build out your friendships and social life rather than expecting her to meet every social and emotional need. And while you’re at it, do your future self a lifelong solid: community matters enormously as we age. Get this aspect of your proverbial shit together. Stop keeping score . Seriously. Marriage has seasons in which the load is not 50/50. This is surely one of them. This is a long game. Act accordingly. Pick up the slack . Look for opportunities to fix a systemic pain point without asking for a checklist, instructions, or a gold star. This could be coordinating the kids’ extracurriculars, managing aging parents, or taking over meal planning and groceries. The invisible labour she may have quietly carried for years can become the straw that breaks her back during this season of her life. Word to the wise: asking her to tell you what needs doing is not the same as taking something off her plate. Now she is still managing the thing—and managing you doing the thing. Find a pain point and take it on, period. Validate her. Just because you can’t fully understand how something feels, understanding the science gives you a way in. You don’t have to experience something yourself to believe the person you love when she tells you it is happening. Sometimes support sounds less like Here’s what you should do and more like I can see how hard this is. I believe you. I’ve got you. Rushing in with hyper-logical problem-solving and advice-giving has its moments, but this is really not it. I think back to the men who have stopped me in restaurants and gas stations over the years, and what stays with me isn’t the thank you, it’s the relief. I didn’t know what was happening. I didn’t know what to do. I hear you. You are watching someone you love move through something you cannot experience yourself and cannot fix for her. At times you may barely recognize the landscape—or each other. That is hard. But you are not powerless here. There is always a way, my male friends. You don’t need to understand deep physiology or always know the right thing to say. You don’t need to fix it. You need to believe her, learn what is happening, take some weight off her shoulders, and resist making her hardest moments harder. Most of all, keep showing up. Because weather systems move through, and this one will too. Dr. Kirsten, ND, MSCP --- title: "Clarity on Creatine Monohydrate: is it worth the hype?" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/clarity-on-creatine-monohydrate-is-it-worth-the-hype" markdown_url: "https://www.drsmithnd.com/llms/blog/clarity-on-creatine-monohydrate-is-it-worth-the-hype" lastmod: "2025-04-10T15:55:00.000Z" --- Dearest Reader, I have put it off long enough as I get asked about this about 8 times a day these days, so here it is: my assessment of the research; a concise, evidence-based perspective. I don’t embrace wellness trends with a knee jerk reaction in general, but especially with supplements because let’s be honest, none of us need more to add to our list. For the purposes of this missive, I am focused entirely on the research as it pertains to perimenopausal and postmenopausal women. From perimenopause onward, we must be aware that maintaining muscle, bone, and brain health becomes increasingly important and yes, there are decent studies on this population and creatine in terms of how it can positively impact these areas of our health. What is Creatine Monohydrate? Creatine is a naturally occurring compound found in small amounts in foods like meat and fish. It plays a vital role in energy production and cellular function. As we age, our body's creatine stores decline, making supplementation particularly beneficial. It is a fact that we have less creatine production post menopausally which surely is what prompted the research. Benefits of Creatine Monohydrate for Postmenopausal Women 1. Muscle Health - Preserving Muscle Mass: Menopause leads to sarcopenia (age-related muscle loss). Creatine supplementation, when paired with resistance training and taken consistently, can help maintain and even increase muscle mass and strength. - Improved Physical Performance: Studies show that creatine enhances the benefits of exercise, making it easier to stay active and strong as you age[1][2][3]. 2. Bone Health - While creatine alone may not significantly increase bone mineral density, it has been shown to improve bone geometric properties (e.g., femoral neck strength) when combined with resistance training and taken consistently[4][5]. - Preventing Bone Loss: Creatine may help counteract the effects of declining estrogen on bone health by supporting exercise-induced bone remodeling [2]. 3. Brain Health - Cognitive Function: Creatine supplementation has been linked to improved memory and cognitive processing. It may also restore brain energy levels, which can decline with age[1][3]. - Mood and Depression: Some evidence suggests creatine can enhance the effectiveness of antidepressants and improve mood by supporting brain bioenergetics[1][3]. There is also evidence that it can help you fell better, faster if on an SSRI (anti depressant). There are no studies yet using it as a stand alone therapy*. How Much Creatine Should You Take? 3–5 grams daily, which is safe and effective for most women. For real improvements in bone density we are looking for higher doses (up to 0.14 g/kg/day) that may be more beneficial for improving bone-related outcomes when combined with resistance training[4][6]. Additionally, for those lifting weights/ resistance training and looking to more rapidly gain muscle, studies show that doing a loading dose of 20 grams daily for 5-7 days, then decreasing to 5 grams daily can improve lean muscle mass. Given the data, who then might consider creatine supplementation? - women experiencing muscle weakness or loss - those engaging in regular resistance training (ie 3 times a week). - women looking to support cognitive health - women on an antidepressant - those looking to combat age related depression (which is in part due to low brain energy) - in terms of improving bone density, this will only help if you are definitely doing resistance training* Safety and Side Effects Creatine monohydrate is one of the most studied supplements and is considered safe for long-term use at recommended doses. It does not cause weight gain from fat but may lead to slight water retention in muscles—a sign that it’s working! The many myths out there have all been debunked, from kidney or liver damage, to weight gain, to hair loss, to it only being of use to body builders, to you must do a loading phase - all of it is not based in facts. Incorporating Creatine into Your Routine For best results: - Pair creatine supplementation with a consistent resistance training program. - Combine it with a balanced diet rich in protein and calcium. - Stay hydrated to maximize its benefits. - Work up to the dose you are going to stay at over a week.. #### Can We Get Creatine from Food Alone? Y es—but not always enough to make a clinical impact, especially post-menopausally when production declines. Creatine is found naturally in food, particularly in animal products. For example, beef and game meats provide about 1–2 grams per 8 oz cooked, and some fish like herring or salmon offer up to 2.5 grams. Pork and chicken come in a little lower, closer to 0.4–1 gram per 8 oz. Even dairy sources like Parmesan and cheddar contain small amounts, as do eggs—but you’d have to consume them in fairly large quantities to match the doses used in research. Top animal sources and dairy sources: - Parmesan (highest): ~0.3–0.4 g per 3.5 oz - Milk, cheddar, yogurt: ~0.1 g per serving - Eggs: ~0.1 g each - Beef, game meats: ~1–2 g per 8 oz - Herring, salmon, tuna: up to ~2.5 g per 8 oz - Pork, chicken: ~0.4–1 g per 8 oz On the other hand, plant-based diets contain almost no direct creatine, which makes supplementation even more worth considering for vegetarians and vegans. That said, supporting your endogenous creatine production (the kind your body makes on its own) is still possible through amino acid-rich plant foods. Plant-based support for creatine synthesis (via glycine, arginine, and methionine): - Pumpkin seeds, hemp seeds, sunflower seeds - Soy products like tofu and tempeh - Chickpeas, lentils, spinach, quinoa - Almonds, Brazil nuts If you're eating an omnivorous diet rich in high-quality protein, you may already be getting some baseline creatine from food. But remember—most clinical studies showing benefit used amounts far beyond what can realistically be consumed through diet alone. To take...or not to take, Creatine Monohydrate? Creatine monohydrate is worth considering, but as to whether you should take it? It really comes down to your unique health status and your priorities. When I strategize supplements for patients I individualize, prioritize and look for win/wins in an effort to keep it as simple. I want evidence and I want results and I don’t want to overwhelm patients. For products you want to stay with brands that are known for doing third party testing for purity. Quality Canadian brands are: Organika, Thrive Protein, Maple Life Nutrition, PVL and Canadian Protein. Quality American brands are: Thorne, Designs for Health, Metagenics. Go find a forest to take a long walk in, give yourself some solitude and find some spring shoots, a reminder that we always get to turn a new leaf. 🌳 Warm regards, Dr Kirsten References 1. https://creatineforhealth.com/creatine-and-womens-health/ 2. https://thepauselife.com/blogs/the-pause-blog/creatine-benefits-in-menopause 3. https://pmc.ncbi.nlm.nih.gov/articles/PMC7998865/ 4. https://pmc.ncbi.nlm.nih.gov/articles/PMC10487398/ 5. https://pubmed.ncbi.nlm.nih.gov/37144634/ 6. https://pubmed.ncbi.nlm.nih.gov/31257405/ #### Hi, I'm Dr. Kirsten Smith #### Women’s health warrior and advocate with 15+ years of experience in hormonal health My goal is to support women at all stages of their hormonal journey, through pre-perimenopause, perimenopause and post-menopause. --- title: "Courage in the Crossroads: My Journey into Medicine" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/courageinthecrossroadsmyjourneyintomedicine" markdown_url: "https://www.drsmithnd.com/llms/blog/courageinthecrossroadsmyjourneyintomedicine" lastmod: "2025-10-14T00:13:00.000Z" --- My mission has been clear and pretty singular for nearly 20 years going strong: to elevate as many women as possible toward resilient, vibrant health. What most of you don’t know is that I walked away from a successful career in television at age 30. I left the set for the last time—and along with it, the would-be husband, the white-picket fence, and the more traditional path. Both were good decisions, although at the time, it all felt impossibly hard. The truth is that I knew my career—while quite interesting—was not what I was supposed to be doing with my life, I just didn’t know what I was…supposed to be doing with my life. Man I have to say that it gnawed at my heart for years until a collision of events finally brought clarity, though it was difficult to accept initially. It meant going back to school... and back to school again, and….again. I had to do some courses to qualify for premed, do premed, then the 4 year full time program. While my friends were getting married, building careers, and having children, I was staring down years of debt, complete immersion, and feeling totally behind. It was a scary thing to do in many ways, but it was a true crossroads—a climb to somewhere and to someone I had to become, even though it felt both crazy and risky. Several experiences nudged me toward this decision, catching my attention and pulling me to lean in, even when I wasn’t sure what I was leaning in...to. Volunteering for an NGO in Calcutta, my role was filming and interviewing sex trade workers retraining for new lives, but I found myself far more fascinated by the medical providers' work in caring for these women. On another job on a small ship deep up the Amazon, I spent many nights navigating winding tributaries with the ship’s Russian doctor to provide care for indigenous people who paddled out seeking help, waiting patiently for our workday to end. Through broken Portuguese, Spanish, and English, we managed to connect, and what I experienced on those nights changed me forever. The plant medicine in action I witnessed was profound - completely mind blowing. The truth is, the core reason I became a doctor is because of my mom. In her mid-fifties and during a visit to see me in South America, she contracted a tropical infection that spiraled into devastating health issues. This health crisis stole her formidable career, her sense of self and confidence, and nearly her marriage. To this day, she struggles mightily. The weight of that impact on me is hard to fully describe. Having lost my biological father to prolonged illness at age six, then witnessing my mother battle cervical cancer that had spread immediately after that, this latest chapter triggered deep, old fears. For the record, her illness resulted from an abnormal PAP smear that was lost due to human error—never communicated or followed up on. This could have cost her her life and it did shatter her ability to have another child. Get your lab results, always dear reader. A close friend recently found a napkin we’d written on years ago, before I was even actively trying to figure out how to change my career path. She asked me: If you could have one superpower, what would it be? To heal. Throughout her journey, my mother has been gaslit, dismissed, and disrespected by doctors more times than I can count. She did also have a couple of medical doctors who were complete legends, and whom we will never forget. Of note, a naturopathic doctor and traditional Chinese medicine doctor also played incredibly key roles in her health story. My mom is my hero and is the guiding light behind why I chose and continue to choose helping women heal as my north star. I didn’t realize in the beginning that my non-negotiable subconscious need to save my mother would bring me here—to the very heart of the gender and conventional medicine gap. To a place where so often women are told to tough it out—that their pain, hormones, or conditions like PCOS, endometriosis, PMDD, thyroid disease, PMS, or osteoporosis are just “natural,” “normal,” or just “aging.” We’ve been culturally conditioned to tolerate suffering and outdated options, often without even realizing it—until later. Women, you should know, were only included in medical research starting in the mid-1990s. For 18 years now, I have worked at this confluence where hundreds of women have come to me seeking ultimately, a path back to themselves. Now you know the drum that beats in my heart and why I keep growing and striving to learn more and do better. I have built my life’s work around pulling women forward swimming as hard as I can in a kind of soul contract. Keep. Going. I am here to be a part of the movement towards equality in medicine, and be a bridge integrating modern pharmaceutical science with the invaluable original medicines rooted in real, chemical-free food, botanical and energetic therapies, nature connection, movement, and nervous system healing. There are still signs showing me that I am exactly where I’m meant to be—moments with patients, strangers, nature, almost lost memories, my own health experiences and feelings beyond words, but I now know what they mean. Thank you for staying with me, dear reader. Now you know more of me. Dr. Kirsten #### Hi, I'm Dr. Kirsten Smith #### Women’s health warrior and advocate with 15+ years of experience in hormonal health My goal is to support women at all stages of their hormonal journey, through pre-perimenopause, perimenopause and post-menopause. --- title: "Do you really have IBS... or is it actually SIBO?" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/do-you-really-have-ibs-or-is-it-actually-sibo" markdown_url: "https://www.drsmithnd.com/llms/blog/do-you-really-have-ibs-or-is-it-actually-sibo" lastmod: "2019-01-10T21:58:00.000Z" --- ##### When it comes to gastrointestinal conditions, Irritable Bowel Syndrome (IBS) is commonly over diagnosed when the root of the problem is something entirely different that is both diagnosable and treatable. Unfortunately, in recent years, Irritable Bowel Syndrome (IBS) has become a somewhat ubiquitous diagnosis. It seems as though anyone who has gas, stomach pain, diarrhea or constipation gets labelled with it, and is told that all they can do from now on is manage their symptoms or perhaps try food eliminations. This leaves people pecking away on the internet desperately trying to self treat with all manner of diets, probiotics, enemas – you name it. IBS does of course exist, but studies show that a vast portion of those given this diagnosis in fact [30 – 85%](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3752184/) of those diagnosed with IBS, actually have SIBO (small intestinal bacterial overgrowth) which can cause the exact same symptoms. WHAT!!??? Indeed, it is a major new area emerging in gastroenterology. Thus it should then come as no surprise that I recommend you get tested for SIBO if you’ve been diagnosed with IBS, especially if you are having a hard time managing your symptoms and your quality of life is impacted. It’s treatable for goodness sake… life without bloating is in reach!! ## What is SIBO? SIBO is a gastrointestinal condition that arises when an abnormally high number of coliform bacteria appear in the small bowel. While it has the same symptoms as IBS (mainly diarrhea or constipation, gas, abdominal pain and bloating) it is treatable … there actually is a solution. In order to understand SIBO, it helps to get some basics down in terms of how our intestines function. The stomach liquifies food and then the small intestine breaks it down further so that nutrients can be absorbed across the lining into our bloodstream. Once this occurs, the excess waste moves into the large intestine, where the water is reabsorbed and a stool is formed. During this process, fermentation occurs and bacteria play a crucial role in this process. In a healthy gastrointestinal tract, millions of bacteria are found in the large intestine, while only a tiny fraction is meant to be in our small intestines – and of only very specific types of bacteria. In SIBO, bacteria that is not supposed to be in the small intestine is living there and causing symptoms which result from the bacteria off-gassing methane and hydrogen (read: bloating) from munching on fiber and metabolizing it. This leads to the gas, bloating, cramping, diarrhea and/or constipation, even heartburn and stomach pain – all of which (and more) can be present in SIBO. ## What causes SIBO? Currently, we know that the main cause of SIBO is that the Migrating Motility Complex (MMC) is damaged and under-functioning. This is a microscopic movement of food DOWN through the digestive tract, so when damaged we can self inoculate getting bacteria that is normal to be found in the large intestine into the small intestine where it does not belong. A number of factors can damage your MMC – antibiotics, food poisoning, a bad round of stomach flu and possibly other health conditions and genetics. More research is on-going in these crucial areas. ## Why is SIBO under diagnosed? The truth is I don’t know. Naturopathic doctors are educated about it as are many family doctors and gastroenterologists in the US, the UK, Australia, but it is rare that Canadian doctors are SIBO literate. I cannot speak to why, but it has really got to change. On a positive note, I am observing that more and more patients who take their test results to their doctor are finding that their doctor has heard of sibo or is even somewhat informed. This is a great sign that things are starting to evolve in the right direction. ## Getting tested Visiting a licensed naturopathic doctor is the optimal approach when working towards getting a comprehensive diagnosis of your gastrointestinal issues. We play a vital adjunctive role in your care and are often diagnosing conditions and infections. Naturopathic doctors use various functional diagnostics (some out of the US, some Canadian) to assess for gastrointestinal conditions that are very rarely ordered by MDs in our country at this point in time. For SIBO specifically, you need a test kit that includes lactulose breath testing (not glucose) that is ordered by an ND or MD, however, it may be determined by taking a careful history that other tests are indicated. When I work with SIBO patients I prescribe as per the current research typically involving antibiotics, botanical antibiotics and various other interventions that heal your gut. I have my SIBO patients go through a Preparation phase, an Eradication phase, then a gut healing Recovery phase. Sometimes other type of work/ assessment are also indication such as: - Eradicating yeast - Cleansing and restoring homeostasis in the digestive tract - Healing the digestive tract to ensure optimal nutrient absorption - Restoration of digestive enzymes and stomach acid - Customized dietary and lifestyle recommendations ## Consulting with Dr. Smith If you live in Toronto and are unsure whether your IBS diagnosis is correct, book a consultation with Dr. Smith who will take your history and properly ascertain whether it makes sense to test for SIBO, or if your digestive issues may be tied to other conditions such as: - Other types of dysbiosis - Candida / yeast overgrowth - Crohn’s Disease - Ulcerative Colitis - Gastro-esophageal reflux (GERD) - Stomach/Intestinal Ulcers - Colon Cancer - Poor fat digestion/fat malabsorption - True IBS! Call (416) 929-0707 to book a complimentary 15-MINUTE meet and greet discussion with Dr. Smith, ND. Dr. Smith has expertise in the emerging area of treating SIBO (and other gastrointestinal conditions), and is open to discussing your health goals and any questions you may have regarding your situation. Dr. Kirsten Smith, ND Dr. Smith is a licensed, board-certified naturopathic doctor in the province of Ontario, a member of the Menopause Society, the Ontario Association of Naturopathic Doctors and the Canadian Association of Naturopathic Doctors. --- title: "Dr. Smith’s Naturopathic Remedies for the Dreaded Holiday Hangover" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/dr-smiths-naturopathic-remedies-for-the-dreaded-holiday-hangover" markdown_url: "https://www.drsmithnd.com/llms/blog/dr-smiths-naturopathic-remedies-for-the-dreaded-holiday-hangover" lastmod: "2016-12-12T22:42:00.000Z" --- The season of gluttony is upon us. During the holidays we tend to forego our well-balanced diets and will power, to indulge and often times, over-consume. And while gathering with friends and family with food and drink in-hand may be the very thing we look forward to most, the overload on our poor bodies can make for wicked hangovers. The most common culprits tend to be sugar, alcohol and as always, stress. These can leave us experiencing a range of symptoms from gastrointestinal, to headaches and malaise, to mental and emotional. Here’s some of my favourite go-to cures for treating holiday (and other!) hangovers: ### B-Complex with Food Whether taken before or after you’ve indulged this can help get the essential b vitamins back into your system, which will perk you up. Always take B vitamins with food otherwise you’ll get an upset stomach and feel worse! ### Intravenous Vitamin Therapy [Vitamin Infusion Therapy](/iv-therapy) (IV Therapy) provides the vitamins, minerals, and amino acids your body needs, in the most efficient and effective way, powerfully igniting the healing process at a cellular level. In particular, the classic Myer’s Cocktail is the way to go to rid yourself of a hangover – jam packed with B vitamins and of course a bit of saline, and you’ll feel better within the time it infuses (which is 30 minutes). ### Chelidonium Plex by Genestra This stuff is amazing. Full stop. It’s a blend of herbal ingredients that detoxify the body by stimulating your organs in charge of elimination: liver, kidneys and intestines. Take 15-25 drops under the tongue before or after you are over served and you’ll be feeling better for it in the morning. ### Plan C Plan C is a custom blend of electrolytes, ginger, antioxidants, vitamins and more created by my classmate. This hangover formula, which has helped so many recover quickly from a big night out. Definitely worth having on hand! ### Exercise Even a brisk 20 minute walk has tremendous benefits such as aiding digestion, combating fatigue and improving your mood, but it also just gets things moving so that you can clear them faster. ### 6 Bonus Tips To Reduce Holiday Hangovers Small efforts can really reduce the stress on your body during the holidays. Here are some shifts you can make that still allow you to be in the holiday spirit (read: party), without completely overloading your system and then paying for it. - Stay hydrated – drink water in between alcoholic drinks or at least a few glasses before you go to sleep. - Moderate or really cut your sugar intake – this makes a huge difference as this is what gives us profound FOOD hangovers and will really amplify an alcohol hangover. - Swap some cocktails for mocktails – try these [healing hot chocolates](https://www.drsmithnd.com/5-healthy-hot-chocolate-hacks-to-boost-naturopathic-healing) - Include some salt in your food before or after to help you stay hydrated. - Sleep it off! Sleep is when our liver works to digest and breakdown everything we’ve consumed – it helps a lot to allow yourself to sleep it off and give it time to handle the influx. - Do NOT reach for coffee immediately upon waking…alcohol is dehydrating and SO is coffee, hydrate before you dehydrate (again)! Dr. Kirsten, ND, MSCP --- title: "EnviroMed™’s Spring Cleanse 2019!" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/enviromeds-spring-cleanse-2019" markdown_url: "https://www.drsmithnd.com/llms/blog/enviromeds-spring-cleanse-2019" lastmod: "2019-03-18T16:25:00.000Z" --- ## EnviroMed’s 2019 Spring Cleanse! Two of the Most Effective Ways to Detoxify Your Body ### (that if you’re not doing when cleansing, you’re not cleansing…) Feeling sluggish, grey and tired after a long winter? Perhaps feeling you are ready to shake that winter pudge? Up for a major energy boosting, skin revitalizing re-set? If yes (who really would NOT be thinking YES?), we’re in full swing with our Spring Cleansing program at EnviroMed Clinic, and as many of you know, this is where we shine. A spring cleanse can help rid your body of toxins, boost your energy and get your skin glowing. Cleanses come a dime a dozen, but the reality is good results happen when cleanses are customized for individual needs, medical conditions and goals. Many people try to do cleanses that come out of a box from a health food store, which can range from ineffective to dangerous, (oh the stories from patients I could tell you…..). Professional medical cleanses are safe, and actually have the desired effect – detoxifying and rejuvenating your body with proper nutrients. You feel it, (oh you so feel it), and you may even become a committed fan. For the dedicated, we actually recommend doing them in the spring and fall. I always recommend certain herbs and dietary restrictions as the foundation, but the two ways to get next level results are by combining colonic hydrotherapy and Intravenous (IV) Nutrient Therapy. Both are effective individually to treat a range of symptoms and illnesses and aid with cleansing, but when combined – a complete powerhouse. So how do they work?? ## What is Colonic Hydrotherapy? Colonic hydrotherapy, also known as colonics or colonic irrigation, is a process in which water is used to remove accumulated fecal matter (and other toxic buildup) from the colon. The process is safe, respectful and extremely effective. Clearing out all fecal build up from the colon not only eliminates the toxins stored in that fecal matter but also allow other toxins to move out of your body quicker. The quicker these toxins leave, the better you feel: your bowels function better, you look better, and you have increased levels of energy. As crazy as this may sound, patients normally notice positive changes in their energy levels and attitudes after even just one colonic treatment. The treatment has another benefit – it exercises the colon’s muscle tissue. This helps patients have cleaner and stronger colons, improving the colon’s functioning as an organ for vital nutrient absorption and proper elimination, and helping fight the causes of chronic fatigue and brain fog. ## What is Intravenous (IV) Nutrient Therapy? Intravenous nutrient therapy, also known as IV Therapy, is a treatment in which vitamins, minerals, and other nutrients are given to a patient intravenously. By administering nutrients directly into the bloodstream, they are absorbed faster and at higher concentrations than in oral supplements, helping prevent illness, treat chronic health conditions or bring you back to your vibrant self more quickly and efficiently. For cleansing purposes we have an IV formula for this specific purpose called Remove & Clear. Different nutrients are used to treat different symptoms (you can see a full list [here](https://www.drsmithnd.com/index.cfm@pagePath=Services%252FIV_Therapy&id=66460.html)), and but they all help restore your health by reintroducing vital nutrients into your body. ## The Powerful Combination of Colonic Hydrotherapy And IV Therapy? Evidence suggests that this combination can be of benefit in the following conditions: - Acute or Chronic fatigue - Brain fog - Acute colds and flu - Acute muscle spasm and chronic muscle pain - Anxiety or fatigue - Fibromyalgia - Chronic digestive concerns such as Ulcerative Colitis, Crohn’s or Irritable Bowel Syndrome - And many more… ### Our Spring Cleansing Deals for 2019: (please note, for patients who would like a more comprehensive detoxification program that also includes diet and herbs, please book a consultation with me) We have 2 special Cleansing Packages: ### Colonics Only This includes 4 colonic sessions for only $325 (normally $400) ### Colonics & IV Treatments This includes 4 colonic sessions and 2 spring IV Nutrient Therapy treatments (including detoxification nutrients and Glutathione) for $545 (regular price $680). Call the clinic at (416) 929-0707 to book your sessions. Happy spring! Dr. Kirsten Smith, ND Dr. Smith is a licensed, board-certified naturopathic doctor in the province of Ontario, a member of the Menopause Society, the Ontario Association of Naturopathic Doctors and the Canadian Association of Naturopathic Doctors. --- title: "Fiber: The Key to Women's Hormonal Health" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/fiber-and-womens-hormonal-health" markdown_url: "https://www.drsmithnd.com/llms/blog/fiber-and-womens-hormonal-health" lastmod: "2024-07-16T18:12:00.000Z" --- It honestly can’t be overstated how crucial a role fiber plays in our diet, especially for women. The average woman gets 10-15 grams a day which directly impacts our health. Increasing fiber has so many positive effects on our health from improving digestion, reducing blood sugar, cholesterol and inflammation, to improving skin health. Interesting Benefits of Fiber 1. Fiber helps you detox, including pesky estrogen metabolites that can cause many hormone-induced symptoms Fiber improves the health of your gut flora and your estrobolome (read more about the estrobolome [here](/blog/the-unexpected-connection-between-the-gut-and-hormones) ), the bacteria in your gut which is responsible for metabolizing your estrogen. With the help of fiber, the estrobolome essentially packs toxic estrogen metabolites up into a little box for your body to detox through your bowel movements. The magic of brassica vegetables for the estrobolome… Brassica or cruciferous vegetables are high in diindolylmethane or DIM which supports efficient estrogen metabolism and detoxification. This then helps reduce the symptoms impacted by high estrogen such as endometriosis, fibroids, fibrocystic breasts, and PMS. A great goal is to consume 1.5 – 2.5 cups a day of brassica veggies daily. These include broccoli, brussel sprouts, kale, cabbage, mustard greens/seeds, turnips, cauliflower and arugula. 2. Fiber reduces inflammation Since fiber decreases beta-glucuronidase, allowing for healthy elimination of estrogen this also means it helps reduce inflammation. Beta-glucuronidase is the enzyme responsible for “opening” the estrogen metabolite boxes that the estrobolome prepares. The estrogen is then released and re-absorbed, leading to all kinds of inflammation and hormone symptoms. Fiber also promotes many other components that make up a healthy gut microbiome which contributes to lower inflammation (and cholesterol!). 3. Fiber promotes bowel regularity You cannot have good hormonal health if you are constipated! Fiber increases the bulk and frequency of your stools so you can eliminate hormone-related metabolites that if not excreted can cause symptoms. It also binds up all kinds of other toxins that are supposed to leave our bodies and it is crucial that they do so. 4. Fiber reduces bloating Through eating more fiber, the good bacteria in your gut increases and so does the bulk of your stool, effectively reducing bloating. Regular bowel movements and increasing the bulk of stools and good gut bacteria will definitely pull down your bloat. 😀 How do I increase my fiber intake? The general goal is to consume 25-35 grams of fiber a day. Increase it SLOWLY and over the course of a few weeks because increasing fiber quickly can increase gas, bloating and cramping. Easy ways to boost your fiber intake: - Eat fruit and veggie skins. Much of the fruit and vegetable’s fiber and antioxidants are found in the skin. - Eat legumes – these are both high in soluble and insoluble fiber. - Supplement ! There’s no shame in supplementing when you have doubts about getting enough fiber from your diet. High fiber foods: - Fruit – highest amounts are found in apples, berries, guava, citrus - Vegetables – broccoli, carrots, artichokes are loaded - Nuts & seeds (raw) - Legumes – especially lentils and chickpeas - Whole grains – oats / oatmeal (even pulls down cholesterol) Hot Tip for PMS Reduction: A carrot a day keeps the cramps away! Eating a carrot with its skin means you’re getting vitamins A, B, C, D, E and K and vitamin E specifically helps block the production of prostaglandin , the hormone that affects period cramps. If you’re in perimenopause (or think you might be) and are keen to learn more about solutions to manage your symptoms, check out my [Peri Collective Program](https://www.drsmithnd.com/perimenopause-health-program/) . We’ve got an entire module on metabolic management and nutrition, along with a plethora of other key information to help you take control of your health. Dr. Kirsten Smith 🦋 Dr. Kirsten Smith, ND Dr. Smith is a licensed, board-certified naturopathic doctor in the province of Ontario, a member of the Menopause Society, the Ontario Association of Naturopathic Doctors and the Canadian Association of Naturopathic Doctors. --- title: "Fragrance is Toxic; Who knew?" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/fragrance-is-toxic-who-knew" markdown_url: "https://www.drsmithnd.com/llms/blog/fragrance-is-toxic-who-knew" lastmod: "2018-05-28T22:27:00.000Z" --- Some of you savvy folks are already aware of this fact, some of you will find this completely unsurprising, and for some of the ladies out there………. well, damn , this is just really bad news. Chanel No 5 needs to hit the bin folks. (As does your DO for the BO, your super smelly shampoo, and that luscious body cream). Time to part ways and move on to greener pastures…or products. The effects of manufactured scents have an immediate effect on lots and lots of people: headaches, congestion, nausea, itchiness – all are common symptoms. These heady chemical scents are found in perfumes, colognes, air fresheners, laundry detergent, sanitary pads, personal care products, diapers, baby wipes, cleaning products – they are literally everywhere. The key is, however, even if you don’t have an immediate reaction to scents, they are still really REALLY not good for you. The chemicals being used in scent manufacturing are linked to: - Nervous disorders - Kidney issues - Respiratory problems - Digestion issues - Chronic Fatigue - Autoimmune diseases - Fibromyalgia - Neurological conditions - Allergies And these are just some of the ones we know. Toxicity is often the cause of undiagnosed illnesses. Many people who have been unable to find a diagnosis in conventional medicine get better when treated for toxicant overload by someone who knows how to assess, diagnose and treat it. Many of the substances that are put into our everyday products are not tested for safety. In some cases, companies aren’t required to share some of the patented “secret” ingredients of the products and chemicals they use. The Bottom Line: - Fragrances contain chemicals that can cause reactions ranging from allergic reactions and weight gain, to severe conditions or illnesses. - Many substances that have been discovered in fragrances have not specifically been tested for human safety. - Fragrance contains phthalates which disrupt hormones (weight, fertility**) - Companies are not required to list or reveal all the chemicals they do have in their products . ## 4 Tips for lowering your exposure to toxic perfumes ### 1. Avoid products with mystery ingredients If it says “fragrance” or “perfume” never buy it. Also absolutely avoid anything that includes: - Acetone - Benzaldehyde - Benzyl acetate - Benzyl alcoholamphor - Ethanol - Ethyl acetate - Limonene - Linalool - Methylene chloride ### 2. Look for personal care products that use 100% natural essential oils for the scent component Essential oils aren’t cheap, so if a product is very cheap, likely it’s not natural. Look for natural, and organic deodorants, hair products, and perfumes. Please put your personal care products into these amazing resources to see if they are safe for you, and to find some that are: - [madesafe.org](https://madesafe.org/) - [ewg.org/skindeep](https://www.ewg.org/skindeep/#.WwxKIcgh1-U) ### 3. Choose natural household products Cleaning products are often filled with cheap chemical perfumes and can be substituted very cheaply for homemade products. Some locally available products that are clean – EcoMax, Nature Clean. ### 4. Avoid scented air products Febreeze is a nasty piece of business. Don’t let this cocktail of toxic chemicals anywhere near your home or car. If you want to keep the air smelling fresh, add more plants, use an air purifier, and get an essential oil mist or aromatizer. Never use “plug ins”, never have “air fresheners” in your car- again unless purely derived from essential oils. Most scented candles are also full of chemicals. Opt for a slow burning candle that uses essential oil (only) for scent, or for unscented beeswax candles. ## Do you have mystery symptoms or suspect you may be suffering from toxicity? While everyone can benefit from eliminating toxic scents from their lives, your body will need help if you are already suffering from the effects of toxicity. Book a complimentary 15-minute consultation (in the office or by phone) to discuss your unique situation with me. To set up this complimentary consultation, please call my reception staff at (416) 929-0707. Dr. Kirsten Smith, ND Dr. Smith is a licensed, board-certified naturopathic doctor in the province of Ontario, a member of the Menopause Society, the Ontario Association of Naturopathic Doctors and the Canadian Association of Naturopathic Doctors. --- title: "Hair Loss In Women" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/hair-loss-in-women-why-is-my-hair-falling-out" markdown_url: "https://www.drsmithnd.com/llms/blog/hair-loss-in-women-why-is-my-hair-falling-out" lastmod: "2018-07-24T22:25:00.000Z" --- While a little hair loss in the shower or when brushing your hair is completely normal, losing large amounts is not. When a woman’s hair starts to fall out, it causes anxiety and crushes self esteem. Our hair is a symbol of health, femininity, youth and is a part of what makes us feel like ourselves. Often people are in tears with worry and despair in my office with this not so uncommon problem. Hair loss is something I see a lot of in my practice which is no surprise seeing as I see a lot of patients with hormonal disorders. It is, in a word, catastrophic for these women and I feel so much compassion for them. ## The Most Common Cause of Hair Loss In Women: Androgenic Alopecia When sex hormones are out of balance it can cause a condition called androgenic alopecia. In women, this begins as a gradual thinning of the parting line and then radiates out from the top of the head. This essentially means that hormones are the root issue, and you are converting some of your hormones into a form of testosterone that is causing the hair to fall out in a diffuse pattern. Androgenic alopecia can be caused by an array of hormonal disorders such as: - PCOS - Adrenal fatigue - Congenitial adrenal hyperplasia - Hypopituitarism - Prolactinomas - Male pattern baldness - Adrenal or ovarian tumours, - Hypothalamic pituitary adrenal (HPA) axis disorders. To effectively diagnosis and treat this, a solid knowledge of the endocrine (hormone) system is critical and comprehensive lab work must be ordered. In addition to the above conditions, thyroid conditions must also be ruled out in a comprehensive hormonal assessment.* ## How Do You Treat Androgenic Hair Loss? There are various potential causes of hair loss but with thorough assessment and laboratory testing we can most often get to the root cause which dictates treatment. Often women are trying a “throw as much mud at the wall and see what sticks” approach – taking loads of supplements and medications, and yet many of the things they’re using they don’t need for the type of hair loss they have. Sadly, it is often the case that the assessment women are getting is incomplete, so it is out of desperation that women are swallowing loads of supplements and using potions all on their own, without professional direction. Almost without exception I order lab work to fill in the holes and get the information required to get a clear picture of what is happening, so that I can fix it with targeted, individualized treatment. Almost always with hormones it is never as basic as simply blocking this pathway or replacing that hormone but thankfully there is a way to get the hair loss to stop. Usually this involves working on a few different hormonal pathways simultaneously to get back into balance. Sometimes this involves blocking certain hormones, sometimes it involves hormone replacement, and sometimes it involves supporting hormone production; it is always highly individual. A great example is the issue of managing blood sugar levels as being core to treatment with androgenic alopecia. A lot of people don’t realize it, but it is vital to address insulin resistance when treating androgenic alopecia and this in turn requires assessing adrenal health, diet, stress management and sleep. In my practice treatment involves using a variety of interventions to arrest the hair loss through balancing the hormones including any combination of prescribing again herbs, to nutritional changes, to hormone replacement, to lifestyle changes. Between detailed analysis of a comprehensive lab work up, taking a good history with my patients and spending the time to customize their treatment plans, usually this can make a world of difference. Dr. Kirsten Smith, ND Dr. Smith is a licensed, board-certified naturopathic doctor in the province of Ontario, a member of the Menopause Society, the Ontario Association of Naturopathic Doctors and the Canadian Association of Naturopathic Doctors. --- title: "Hair Loss in Midlife: What is Happening & Are There Functional Solutions?" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/hairlossinmidlifewhatishappeningandaretherefunctionalsolutions" markdown_url: "https://www.drsmithnd.com/llms/blog/hairlossinmidlifewhatishappeningandaretherefunctionalsolutions" lastmod: "2025-06-11T20:32:00.000Z" --- #### Why Can Hair Thinning Happen in Perimenopause and Menopause? ### Hormonal Shifts: The Main Culprit During perimenopause and menopause, your ovaries produce much less estrogen and progesterone—hormones that keep hair in its growth phase longer. As these hormones decline, hair grows more slowly, becomes finer, and sheds more easily. Additionally, in some women during perimenopause the relative effect of androgens (i.e. testosterone) increases and androgens can shrink hair follicles, leading to the hairs having a smaller diameter, so finer, shorter hairs and sometimes as a real slap to the face, increased facial hair. ### Genetics & Other Contributors - Genetics: Many women have a genetic predisposition to this rise in androgens which is called female pattern hair loss or androgenic alopecia, which menopause can trigger or worsen. This is extremely common (unfortunately). - Stress: Physical or emotional stress and trauma can push more hair into the shedding phase which is called telogen effluvium. This typically occurs 2-4 months after the stressful event. - Nutrition: Deficiencies in iron (anemia), vitamin D, zinc, or protein can contribute to hair loss. I see these deficiencies involved in hair loss ALL the time; they are very common. - Thyroid Disorders: Both overactive and underactive thyroid can disrupt hair cycles which I also see in practice frequently. - Medications: Some medications can also trigger hair loss. ### What Types of Hair Loss Are Most Common? - Female Pattern Hair Loss (FPHL): The most common type, causing diffuse thinning on the top and front of the scalp, often with a widening part but preserved hairline. Studies show that approximately 52% of healthy postmenopausal women experience some degree of FPHL, with prevalence increasing with age. - Telogen Effluvium: Temporary, stress-related shedding that usually resolves when the stressor is removed and time has passed for new growth cycles to begin. ### The Hair Growth Cycle: Why Shedding Happens Your hair naturally cycles through four phases: - Anagen (Growth): 2–7 years, most hair is here when healthy. - Catagen (Transition): About 3 weeks. - Telogen (Resting): About 3 months; 10–15% of hair at any time. - Exogen (Shedding): 2–5 months, old hair is released and new growth begins. Stress, illness, or hormonal changes can push more hair into the resting or shedding phases, causing noticeable thinning (telogen effluvium). ### Evidence-Based Solutions for Hair Loss Health Canada Approved Treatments - Minoxidil : AKA Rogaine, the only Health Canada approved topical treatment for female pattern hair loss. Available over the counter (up to 5% strength), it can slow loss and promote regrowth. Be patient—results take 3–6 months and note that if you stop the product you will not hold the result. Potential relatively common side effects: greasy scalp, irritation, changes in texture, colour, dandruff-like flaking. - Spironolactone : this drug is not approved by Health Canada for the treatment of female pattern hair loss (FPHL) but it is widely used off-label for it due to its anti-androgen properties, which can help reduce hair loss and improve hair density in women by blocking androgen receptors and decreasing androgen effects on hair follicles. Spironolactone is prescribed off-label by dermatologists when other treatments are insufficient or contraindicated but is contraindicated in those with low blood pressure. - Platelet-Rich Plasma (PRP): Injections of your own plasma to stimulate hair growth. Early studies show potential promise, for recent or mild thinning, but this is not yet validated with enough studies to be Health Canada approved. - Red Light Therapy: Uses specific light wavelengths to stimulate follicles and improve hair density. Many well designed studies show this to be effective as part of a comprehensive plan in particular for female pattern hair loss. This is not Health Canada approved, but it is well documented that these devices have strong merit. - MHT : menopause hormone therapy: progesterone and estrogen seem to have a role in this - as we know they clearly do due to the timing of how hair thinning happens, but of course we don’t have studies to verify this. In practice, I do frequently see women in my practice reporting that thinning slows or stops frequently when they begin hormone therapy, but it is not consistent. - What about supplements & herbs? Saw palmetto, biotin, collagen, maca, astaxanthin, curcumin, tocotrianols, zinc, iron, omega 3, vitamin D andashwaghanda all have some evidence and a potential role in treating hair loss, however, more research is needed. Note that often a “hair health/loss” supplement has ALL of these in it when a woman may not need iron, or Vitamin D or other things - so one and done supplements for hair loss are very rarely how to manage this - treatment usually requires personalization. - Rosemary oil is a well-researched as topical support for hair loss, as it reduces inflammation and improves circulation of the scalp, promoting nutrient delivery and hair growth. Lifestyle Interventions - Balanced Diet: Ensure adequate protein, iron, zinc and vitamin D. Restrictive diets can worsen shedding, as does extreme fasting or caloric deficit. - Stress Management: Chronic stress raises cortisol, which can exacerbate hair loss. Mindfulness, yoga, or regular movement can help. - Gentle Hair Care: Avoid harsh treatments (relaxants, colour, perms), tight hairstyles, and excessive heat. - Hair re-growth shampoos: Those containing active ingredients such as caffeine and adenosine have shown promising results in reducing hair loss and improving hair strength and thickness in controlled studies. - Products containing ketoconazole, zinc pyrithione, and piroctone olamine common in anti-dandruff shampoos may improve scalp health by reducing inflammation and fungal overgrowth, which can indirectly support hair health, but they do not directly prevent or reverse FPHL. ### Assessment & Lab Testing If your hair loss is sudden, patchy, or accompanied by other symptoms (such as fatigue, brain fog, or changes in your nails or skin), see your healthcare provider. It’s important to rule out thyroid disease, severe nutritional deficiencies, or autoimmune conditions like alopecia areata. As a general rule, even if the hair loss isn’t tied to other symptoms and is gradual, it really is of value to get a good history taken, and a complete set of labs done as sometimes the cause is singular and sometimes it’s multifactorial. ### Key Takeaways - Early intervention (assessment, appropriate lab work up) is important; time is of the essence! - You are not alone and you have every right to find it extremely distressing - There ARE options for treatment that are effective Can you figure this out? YES. You definitely can. With the right information and support, you can take proactive steps to protect your hair and get your big bad ass self esteem back where up where she belongs. If you have questions, don’t hesitate to reach out to me at [info@drsmithnd.com](mailto:info@drsmithnd.com). Wishing you fantastic forever luscious locks, Dr. Kirsten, ND, MSCP References Birch MP, Lalla SC, Messenger AG. Female pattern hair loss. Clin Exp Dermatol. 2002;27(5):383-388. [https://pubmed.ncbi.nlm.nih.gov/12190640/](https://pubmed.ncbi.nlm.nih.gov/12190640/) Trüeb RM. Molecular mechanisms of androgenetic alopecia. Exp Gerontol. 2002;37(8-9):981-990. [https://pubmed.ncbi.nlm.nih.gov/12470852/](https://pubmed.ncbi.nlm.nih.gov/12470852/) Malkud S. Telogen Effluvium: A Review. J Clin Diagn Res. 2015 Sep;9(9):WE01-WE03. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606322/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606322/) Malkud S. Telogen Effluvium: A Review. J Clin Diagn Res. 2015 Sep;9(9):WE01-WE03. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606322/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606322/) Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. The Role of Vitamins and Minerals in Hair Loss: A Review. Dermatol Ther (Heidelb). 2019;9(1):51-70. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380979/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380979/) Strazzulla LC, Wang EHC, Avila L, et al. Alopecia areata: Disease characteristics, clinical evaluation, and new perspectives on pathogenesis. J Am Acad Dermatol. 2018;78(1):1-12. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5736134/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5736134/) Hay RJ. Tinea capitis: current status. Mycopathologia. 2017;182(1-2):87-93. [https://pubmed.ncbi.nlm.nih.gov/28281097/](https://pubmed.ncbi.nlm.nih.gov/28281097/) Khumalo NP, Jessop S, Gumedze F, Ehrlich R. Hair care practices and traction alopecia among women in South Africa. Clin Exp Dermatol. 2007;32(4):370-376. [https://pubmed.ncbi.nlm.nih.gov/17305802/](https://pubmed.ncbi.nlm.nih.gov/17305802/) Olsen EA, Dunlap FE, Funicella T, et al. A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in women. J Am Acad Dermatol. 2007;57(5):767-774. [https://pubmed.ncbi.nlm.nih.gov/17681236/](https://pubmed.ncbi.nlm.nih.gov/17681236/) Yeon JH, Kim BJ, Kim MN, et al. Finasteride 1 mg in the treatment of female pattern hair loss: a randomized, double-blind, placebo-controlled study. J Dermatol. 2011;38(4):285-289. [https://pubmed.ncbi.nlm.nih.gov/21447169/](https://pubmed.ncbi.nlm.nih.gov/21447169/) Trüeb RM. Treatment of endocrine-induced alopecia. Dermatol Ther. 2008;21(5):350-359. [https://pubmed.ncbi.nlm.nih.gov/19076661/](https://pubmed.ncbi.nlm.nih.gov/19076661/) Gentile P, Garcovich S, Bielli A, et al. The Effect of Platelet-Rich Plasma in Hair Regrowth: A Randomized Placebo-Controlled Trial. Stem Cells Transl Med. 2015;4(11):1317-1323. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4675634](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4675634) Farris PK, Rogers N, McMichael A, et al. A Nutraceutical Supplement for Promoting Hair Growth in Women with Thinning Hair: A Randomized, Double-Blind, Placebo-Controlled Study. J Drugs Dermatol. 2012;11(5):643-646. [https://pubmed.ncbi.nlm.nih.gov/22672271/](https://pubmed.ncbi.nlm.nih.gov/22672271/) Panahi Y, Taghizadeh M, Marzony ET, Sahebkar A. Rosemary oil vs minoxidil 2% for the treatment of androgenetic alopecia: a randomized comparative trial. Skinmed. 2015;13(1):15-21. [https://pubmed.ncbi.nlm.nih.gov/25842469/](https://pubmed.ncbi.nlm.nih.gov/25842469/) Dhurat R, Sukesh M, Avhad G, et al. A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: A pilot study. Int J Trichology. 2013;5(1):6-11. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746236/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746236/) Lanzafame RJ, Blanche RR, Bodian AB, et al. The growth of human scalp hair mediated by visible red light laser and LED sources in males. Lasers Surg Med. 2013;45(8):487-495. [https://pubmed.ncbi.nlm.nih.gov/24155230/](https://pubmed.ncbi.nlm.nih.gov/24155230/) #### Hi, I'm Dr. Kirsten Smith #### Women’s health warrior and advocate with 15+ years of experience in hormonal health My goal is to support women at all stages of their hormonal journey, through pre-perimenopause, perimenopause and post-menopause. Work With Me --- title: "Healthy Aging Spotlight: Estrogen Face Cream & Your Skin" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/healthyagingspotlightestrogenfacecream" markdown_url: "https://www.drsmithnd.com/llms/blog/healthyagingspotlightestrogenfacecream" lastmod: "2025-07-29T13:12:00.000Z" --- Dear Community, Increasin gly I’m getting questions about estrogen cream for the face — can it actually reduce wrinkles and other signs of skin aging for women in midlife and beyond? As always, my mission is to boil down the science and separate out the marketing hype so that you can make up your own mind as to whether this is something you’d like to consider Why the spike in interest? Recently there have been hormone doctor influencers promoting estrogen creams for the face on social media, so it’s no surprise there’s curiosity popping up in my patient visits, DMs and inbox, because if it’s safe and effective, why not consider this new-to-the-scene option for reducing signs of aging? The thing is, it’s critical to look at the evidence—and any conflicts of interest—before recommending such products. So let’s crack at it! #### Hi, I'm Dr. Kirsten Smith #### Women’s health warrior and advocate with 15+ years of experience in hormonal health My goal is to support women at all stages of their hormonal journey, through pre-perimenopause, perimenopause and post-menopause. --- title: "How Is Perimenopause or Menopause Affecting Your Brain?" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/how-is-perimenopause-or-menopause-affecting-your-brain" markdown_url: "https://www.drsmithnd.com/llms/blog/how-is-perimenopause-or-menopause-affecting-your-brain" lastmod: "2019-07-12T16:06:00.000Z" --- Over the years I’ve had hundreds of perimenopausal and menopausal women walk into my practice desperate to get rid of the hot flashes and most urgently – address the insomnia that comes in tow, but I won’t be focusing on those annoying symptoms today. Nope, today is all about BRAIN health and hormones. A few other symptoms emerge during these years that are perhaps more subtle, but also more concerning than any others: mood swings, memory loss and brain fog. Women today are often at the peak of their careers, sandwiched between elderly parents and small children and they are under pressure to perform, and they want to perform. Cognitive changes are very much tied to estrogen loss (or decreasing levels), and they are very noticeable, once you realize it’s all apart of this under addressed river of change that every single woman has to cross. This is very clear in what is reported by patients in clinical practice and what is also emerging in the research. Unfortunately, these changes aren’t discussed in a direct way, and often women end up on sleeping pills, anti-depressants and other medications. Our culture simply hasn’t found a useful, honest and gracious way to dialogue about this crucial issue. It’s like the old days when nobody warned girls about their periods or talked about postpartum depression. I have no idea why, but sadly perimenopause and menopause are swept under the rug and really not addressed at all. We’re supposed to just tough it out and suck it up, …seriously?!? Well not in my life and not for the women in my practice because there are in fact safe, useful interventions we can and should use. We’re not going out to pasture just yet ladies. We’re going to rock this middle age thing. First a few basics: ## It’s All About Estrogen (And a Bit About Her Sister Hormone, Progesterone Too) Menopause is, of course, a normal consequence of being lucky enough to be alive beyond middle life. We launch ourselves at the future, throw ourselves into work and carry on like it’s nothing, but really, in no uncertain terms, it was extremely recently in human history that we have lived much beyond middle age. Hell if you made it to 50 you were considered a sage, ancient miracle of a being. And now we want to rocket on through these years but we have a problem – there’s no gas in the tank. Hormones – and not just estrogen and progesterone – are all, well, not working as well or not there at all. It’s ageing folks and nobody escapes it. But there is a way to go through it more gracefully and more healthfully, and this is what I dedicate a lot of time to in my practice. So, menopause. The term is used to describe the changes a woman goes through as she stops menstruating, marking the end of her reproductive period. Technically, you are “in menopause” once you haven’t had a period for one year. The 10 (or so) years leading up to this time, is perimenopause. These years are characterized by more pronounced PMS, sleep starts to get disturbed, mood and memory are already changing and eventually, menstruation becomes irregular until it finally stops. The process is essentially governed by a hormone called estrogen, and to some extent also progesterone. As women age, their ovaries stop producing regular amounts of these hormones, which essentially control the reproductive system. This process can start at different times for different women, but normally begins during a woman’s mid-40s and ends in the early 50s. Throughout perimenopause and into menopause, the levels of estrogen and progesterone in a woman’s body begin to fluctuate. On any given day, the body may not produce enough estrogen, while the next day it may produce too much. This is what causes the irregularities in periods. When the body stops producing estrogen, menstruation ceases. For decades, research has shown that these fluctuations in estrogen levels are a normal part of perimenopause and menopause, but it hasn’t been until more recently that medical research has started understanding the significant connection of estrogen levels to women’s mental health. This link is now well documented, although researchers are still trying to figure out exactly why it occurs and the mechanism. The essential hypothesis currently is that cognitive disruptions occur because estrogen plays an important role in the brain’s internal signalling system because it participates in communicating what parts of the brain need blood flow. This is hugely significant given that estrogen levels fluctuate wildly, and eventually, we have none at all. * ## Cognitive Changes Linked to Menopause Amongst the many conditions that researchers have now linked to menopause (but will begin in perimenopause), the most well-documented are: - Mood swings: Studies have shown that mood changes have been observed in up to 23% of peri- and postmenopausal women. Additionally, symptoms of anxiety—tension, nervousness, panic, and worry—are reported more frequently during perimenopause than before it. Thus this becomes particularly concerning if you have a pre-existing condition. - Brain fog: Brain fog is a term that lumps together different components that stem from mental fatigue, including confusion and attention issues. According to one study, researchers found that 60 percent of middle-aged women report difficulty concentrating and other issues with cognition. These issues spike in women going through perimenopause.* - Memory loss: Researchers have discovered that areas of the brain involved in memory are estrogen-sensitive. In addition to this, other studies show that women taking estrogen demonstrate more activity in brain areas associated with memory and performed better on memory tests than those not on hormone replacement therapy. - Alzheimer’s: A recent study by a team at the University of Arizona found that menopause causes metabolic changes in the brain that may increase the risk of Alzheimer’s disease. This occurs because estrogen is apparently a key neuroprotective element in the female brain and losing it leads to a higher vulnerability to brain ageing and Alzheimer’s disease. ## Can These Changes Be Reversed? YES THANK GOD, ladies there is indeed hope. Most of the changes caused by menopause on the brain can be reversed, at least it for most women. While this doesn’t mean that estrogen levels can be magically fixed, our bodies are resilient and eventually adjust to functioning at high-capacity despite hormonal changes. This is shown beautifully in a study published in the Journal of Neurology. The study followed a group of 800 women over six years, testing them each year. What the data showed was amazing: while cognitive decline worsened as menopause progressed, none of the cognitive effects were permanent. In fact, by the end of menopause, cognitive decline had stopped, cognitive levels were restored, and there was no evidence of structural damage to the brain. While this is promising, it’s also important to note that it doesn’t apply to all women. Unfortunately, for the few women whose estrogen deficiency contributes to leading to Alzheimer’s, there may be no way to stop the decline. ## Natural Treatments to Support Cognitive Health in Perimenopause and Menopause As you know by now, my first strategy is to use nutrition and lifestyle as the foundation for treating hormonal conditions. Alcohol, food, toxins, exercise and stress play a HUGE role in impacting hormones so this foundational approach tends to take pressure off of my patient’s systems so that I can see what else remains and accurately assess how to treat it. Ultimately naturopathic medicine has various useful ways to help reduce brain fog, memory loss and other mental health-related symptoms tied to menopause. In practicing personalized medicine, I use a unique approach with each patient that may include botanical medicine (herbs), supplements and possibly bioidentical hormone replacement therapy to get hormonal balance restored in my patients. ## Bioidentical Hormone Replacement Therapy as a Safe Supportive Therapy in Perimenopause and Menopause There is absolutely a role for bioidentical hormone replacement in terms of helping manage these cognitive changes. This requires a very individualized approach in medical practice as some women may not be appropriate candidates. Things that escalate your risk are (most of these escalate your risk even more than even being on hormone replacement therapy itself) are: having had breast cancer or an immediate family member who has had it, drinking more than 4 units of alcohol a week, not exercising 3-4 times (at minimum) a week, being more than 10lb overweight, smoking or having a long history of smoking, a diet high in processed food, having been on birth control pills for many years. So the take home is: see a doctor who is trained in this specialized area of women’s health and thus knows how to assess your candidacy and treat you safely. I do this every day in my practice and women are feeling SO much better for this extremely supportive therapy. ## Consulting with Dr. Smith If you are undergoing perimenopause or menopause and are experiencing brain fog, memory loss or depression, consider booking a consultation with me. I will take a comprehensive medical history, possibly order lab tests and properly ascertain whether your state may be linked to fluctuating estrogen levels. Dr. Kirsten Smith, ND Dr. Smith is a licensed, board-certified naturopathic doctor in the province of Ontario, a member of the Menopause Society, the Ontario Association of Naturopathic Doctors and the Canadian Association of Naturopathic Doctors. --- title: "Is It A Painful Period? Or Endometriosis?" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/is-it-a-painful-period-or-endometriosis" markdown_url: "https://www.drsmithnd.com/llms/blog/is-it-a-painful-period-or-endometriosis" lastmod: "2019-05-05T16:20:00.000Z" --- ##### When it comes to their period, most women know that some mild pain can be normal. But what if the pain you’re experiencing is extreme? What if, for a couple of days every month, you are crippled with an excruciating sensation that leaves you struggling to get out of bed, or even worse, vomiting? If that is the case, you could be experiencing something way beyond normal period pain and may be suffering from a condition known as endometriosis. ## What is Endometriosis? Endometriosis typically occurs in women of reproductive age and effects 5-10% of women. It is a painful disorder that arises when the tissue that lines the inside of the uterus (aka the endometrial tissue) starts growing outside of the uterus. When this happens, the tissue becomes inflamed and causes a world of pain for women. This pain is exacerbated during menstruation, as the endometrial tissue growing outside of the uterus tries to do exactly what it would if it were inside: it thickens, breaks down, and tries to bleed away. But because this occurs outside of the uterus, the tissue cannot exit the body during menstruation, becoming trapped and putting even more pressure on the nerves that line the outside of the uterus. This can cause extreme pain that may have some women wondering if what they are experiencing is normal. ## What Causes Endometriosis? Researchers are still trying to figure out exactly what causes endometriosis. So far, they have a number of theories regarding factors that may contribute to the development of this painful condition, a few of which are linked to hormonal imbalances caused by high estrogen levels. These factors include: - Retrograde menstruation – where menstrual blood reluxes back through the fallopian tubes and into the pelvic cavity - Metaplasia – changing one type of tissue to another - Transportation of endometrial cells into the outside of the uterus through blood vessels - Immunologic – inflammatory products are out of control, autoimmunity - Slow liver detoxification of estrogen or pollutants that mimic estrogen – research shows specific toxins can be a major contributor** - Nutrition – diary and meat products - Genetic factors – women with first degree relatives with endometriosis are predisposed to have the disease ## How do I know if I have Endometriosis? If you experience extreme pain during menstruation that gets worse over the years and prevents you from living a normal life, you may be suffering from endometriosis. The gold standard for diagnosis is laparoscopy which is a surgical procedure where a scope with a lens and light is inserted via the abdominal wall (tiny incision) to visualize what is going on and to look for the displaced tissue. This is done by a gynecologist. Symptoms of endometriosis include but are not limited to: - Severe pelvic pain during menstruation - Pelvic pain - Back pain and lower abdominal pain during menstruation - Pain with exercise - Pain with intercourse - Difficulty conceiving - Painful urination and painful bowel movements If you are experiencing one or all of these symptoms you should consider booking an appointment with a naturopathic doctor to discuss assessment for an endometriosis diagnosis and learn about natural treatment options that may reduce your pain. ## Natural Treatments for Endometriosis As you know by now, my first strategy is to use nutrition and lifestyle as the foundation for treating hormonal conditions. Alcohol, food, toxins, exercise and stress play a HUGE role in impacting hormones so this foundational approach tends to take pressure off of my patient’s systems so that I can see what else remains and accurately assess how to treat it. Ultimately naturopathic medicine has various useful ways to help reduce the pain, so it is well worth pursuing. In practicing personalized medicine, I use a unique approach with each patient that may include botanical medicine (herbs), supplements and possibly bioidentical hormone replacement therapy to get hormonal balance restored in my patients. The end goal for me – always- is to coach my patients to get their lifestyle dialled up to the point that they require fewer supplements and medicines, and learn how to manage menstrual pain through changes in their day-to-day lives. ## Consulting with Dr. Smith If you are experiencing severe menstrual pain that you suspect may be linked to endometriosis, consider booking a consultation with me. I will take your history and properly ascertain whether it makes sense to assess for endometriosis, or if your period pain may be caused by other issues. Dr. Kirsten Smith, ND Dr. Smith is a licensed, board-certified naturopathic doctor in the province of Ontario, a member of the Menopause Society, the Ontario Association of Naturopathic Doctors and the Canadian Association of Naturopathic Doctors. --- title: "Let’s Talk About Poop: The Downlow On IBS" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/lets-talk-about-poop-the-downlow-on-ibs" markdown_url: "https://www.drsmithnd.com/llms/blog/lets-talk-about-poop-the-downlow-on-ibs" lastmod: "2018-01-04T22:32:00.000Z" --- Although the topic of poop is cringe-worthy for most, our stools can tell us a lot about what is going on with our overall health and so, yes, it is in fact something I talk about with people often. And by that I mean Every. Single. Day. Hippocrates said that all disease begins in the gut, and by God the man was probably right! Our stool is still a very useful tool that provides valuable if not critical clues about our digestive (and other) wellness or lack thereof. The digestive tract contains more bacteria than there are cells in the entire body, so it’s important that this delicate microbiome environment is kept in balance, as it is here that we absorb nutrients and where we keep out toxins or germs that could potentially harm us. Some of the most common digestive and gastrointestinal issues I see fall under the umbrella term of Irritable Bowel Syndrome . Most who suffer from IBS experience much milder symptoms than those with inflammatory bowel diseases (IBD) – ulcerative colitis or Crohn’s disease. IBS tends to be a catch-all phrase with the primary symptom of “gastrointestinal disturbances”. This includes changes that occur in your bowel movements, differences in the frequency or consistency of stools, the presence of pain, bloating or cramping, etc. Digestive disorders like lactose intolerance, diverticulosis, Crohn’s and colon cancer can have similar symptoms to IBS also. It is currently estimated that approximately 80% IBS is actually an infection or overgrowth of bad bacteria such as SIBO or an imbalance of good to bad bacteria, or sometimes it is a food sensitivity. The nuances of knowing how to interpret the signs and symptoms and then knowing what type of testing is indicated can be diagnostically tricky, so it is important to have a complete evaluation by your naturopathic doctor to determine if what you have is indeed IBS or if it worth ruling other possibilities out. The status of our gut is always changing and can affect everything from our immune system and digestion all the way to how our mood is and how our brain functions. It can also let us know when the body is fighting an infection or dealing with a serious condition. If you have concerns about your digestive health, it is wise to pursue getting to the bottom of it due to how much potential there is for collateral damage and long-term health consequences. Dr. Kirsten, ND, MSCP --- title: "Like, Forever?" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/likeforevermenopausehormonetherapy" markdown_url: "https://www.drsmithnd.com/llms/blog/likeforevermenopausehormonetherapy" lastmod: "2026-02-23T23:39:00.000Z" --- Many women remain uneasy about what appears to be a reversal in messaging about menopausal hormone therapy. After the initial 2002 publication of the Women’s Health Initiative, headlines suggested hormone therapy was broadly dangerous. Two decades later, major menopause societies do support individualized, potentially long-term use. This is not an arbitrary flip in science, it reflects refinement of interpretation and the emergence of evolving data. In the original WHI study, the average participant was 63 years old. Many had already been in menopause for over a decade before starting hormones. When researchers later separated the data by age and followed women for more than 20 years, a clearer pattern emerged. Women who begin hormone therapy before age 60, or within 10 years of menopause, tend to have more benefit and lower overall risk. The earlier headlines did not account for how strongly timing of initiating use of MHT and age influences outcomes.¹ This evolution reflects better analysis, not contradiction. Is There a Mandatory Stop Age? There is no fixed age at which MHT must be discontinued. The most recent Position Statement from The Menopause Society (2022) states that therapy may continue as long as benefits outweigh risks, with annual reassessment.² There is no evidence-based five-year expiration rule or that everyone after 60 must stop. Professional societies including The Menopause Society, the Australian Menopause Society, and the British Menopause Society explicitly reject arbitrary age cutoffs. Continuation beyond age 65 is appropriate for persistent menopause symptoms or bone protection in well-screened women, using the lowest effective dose, (topical estrogen not oral) and reassessing yearly.³ In clinical practice, shared decision-making guides continuation, prioritizing quality of life alongside quantified risk.⁴ What Changed Since the Early Cancer and Stroke Concerns? Early concerns focused on breast cancer, stroke, and thromboembolism (clot). Longer-term data clarify several points: - Risks are smaller than originally reported when age stratified - Cardiovascular risk is strongly dependent on timing of initiation - Transdermal routes are associated with lower clot risk than oral estrogen - Lower modern dosing improves safety profiles Women initiating MHT before age 60 generally demonstrate neutral or favourable cardiovascular outcomes, while initiation after 60 carries approximately a 20 to 30 percent relative increase in stroke and clot risk, particularly with oral formulations .⁵ All-cause mortality has not been shown to increase with appropriately timed initiation.⁵ Key Benefits of Ongoing Therapy MHT remains one of the most effective interventions for: - Reduction of vasomotor symptoms - Prevention of bone loss - Reduction in osteoporotic fracture risk - Treatment of genitourinary syndrome of menopause Estrogen therapy reduces fracture risk and slows bone density decline. Early use may improve lipid profiles and has neutral to mildly favourable metabolic effects.⁶ These benefits are clinically significant and must be weighed alongside risk. When Should MHT Be Discontinued? Clear contraindications include: - Active or recent breast cancer - Estrogen-dependent malignancy - Active thromboembolic disease - Prior stroke - Unexplained vaginal bleeding - Significant liver disease These remain consistent across endocrine and primary care guidelines.⁷ Annual review of personal and family history is standard. What about Vaginal Estrogen though? Major menopause society guidelines support the continued use of low-dose vaginal estrogen for genitourinary syndrome of menopause, even in women with contraindications to systemic hormone therapy, given its minimal systemic absorption; in cases of estrogen-dependent breast cancer, management should be coordinated with oncology.* What Happens After Stopping MHT? Between 44 and 82 percent of women experience recurrence of vasomotor (hot flashes) and other symptoms after discontinuation, regardless of age, including women in their seventies. Gradual tapering may reduce symptom rebound.⁸ What do I observe clinically when people stop MHT? I typically see a return of things like poor sleep, fatigue, low mood, worse memory (could be poor sleep, we don’t know), a return/ worsening of body aches, and in some women hot flashes return but are not as strong. In some women this is very, very mild, in some women this is pronounced (the return of some symptoms), but never are they as intense as when they were in perimenopause. What about Bone Density After Discontinuation? Bone density does not collapse immediately after stopping MHT, but loss resumes. Without MHT, spinal bone density may decline 3 - 5% in the first year of menopause, then 1-3% annually thereafter.⁹ After stopping MHT, bone loss typically resumes at approximately 1-2% per year at the hip and spine. Protective gains may persist for two or more years but gradually diminish over 5-10 years.¹⁰ Hip and femoral bone mineral density declines approximately 1% annually after discontinuation. Longer duration of prior therapy may leave a residual density advantage of up to 20% compared with never-users. Gains of 5-10% acquired during therapy fade over 5-10 years.¹¹ Fracture risk correlates directly with bone density. Every 10 percent decline in bone mineral density approximately doubles fracture risk. Some data suggest hip fracture odds increase 20 to 30 percent within five years of discontinuation. Prior MHT use remains associated with a 30 to 50 percent reduction in lifetime fracture risk compared with never use.¹² Breast Cancer Risk Simplified Combined estrogen–progestin therapy is associated with a small increase in breast cancer diagnosis after more than five years of use in women over 60. For perspective, among 1,000 healthy women over age 55 not using MHT, the baseline risk of developing breast cancer over 10 years is 25-35 women. With combined estrogen–progestin therapy, that increases to approximately 30-40 cases per 1,000 over 10 years, representing roughly five additional cases per 1,000 women .¹⁴ Risk declines after discontinuation. Mortality impact remains less clear. For the savvy amongst my readers, yes it is true that much of the historical data reflects synthetic progestins while the modern approach mostly uses micronized progesterone, and so it may well be that emerging data looking at use with micronized progesterone may clarify different risks.¹ ⁴ Key Take Aways There is no mandatory stop age for menopausal hormone therapy. Continuation is appropriate when symptoms persist, bone protection remains necessary, and individualized risk assessment supports ongoing use with annual review. The modern approach to MHT is evidence-based, stratified by age and timing, and is grounded in long-term follow-up data. For many of us, the medically accurate answer to “Like, forever?” is straightforward: as long as the benefits outweigh the risks. This is not about blind reassurance, and it is not a directive to continue MHT indefinitely. It is about understanding the implications of the scientific data we currently have and applying it thoughtfully to our individual risk profiles. As both a primary care provider and a Menopause Society Certified Practitioner, I have pursued the highest level of formal menopause training available. My role is to interpret the evolving literature, guideline statements, and long-term outcome data, and to translate that evidence into individualized medical decision-making. Midlife women’s health has been underrepresented and inconsistently applied in clinical practice which is why we must uplevel your education. Midlife care is evolving and requires clarity, thoughtful reassessment, and partnership. We deserve accurate data and care that reflects current science. As many of you know, I am in this phase of life as well, and that only strengthens my commitment to staying current with the evidence so that the guidance I bring to the table remains clear, rigorous, and relevant. We are all in this together ladies. Dr. Kirsten This content is intended for educational purposes only and does not establish a physician–patient relationship. It is not a substitute for individualized medical advice, diagnosis, or treatment. All decisions regarding menopausal hormone therapy should be made in consultation with a licensed healthcare provider who can evaluate your specific medical history and risk profile. References The Menopause Society. 2022 Hormone Therapy Position Statement. PubMed 35797481. 2022 NAMS Position Statement. British Menopause Society 2020 HRT Recommendations. Cleveland Clinic Journal of Medicine. 2016;83(8):605. PubMed 25962085. PMC10752002. AAFP Guidelines for MHT. PMC4011401. PMC6362761. JCEM 2016;101(12):5004. PMC10721581. PMC12137504. PubMed 34119418. PMC6891893. #### Hi, I'm Dr. Kirsten Smith #### Women’s health warrior and advocate with 15+ years of experience in hormonal health My goal is to support women at all stages of their hormonal journey, through pre-perimenopause, perimenopause and post-menopause. --- title: "LIQUID GOLD: Gut-Healing & Mineral-Rich BONE BROTH" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/liquid-gold-gut-healing-mineral-rich-bone-broth" markdown_url: "https://www.drsmithnd.com/llms/blog/liquid-gold-gut-healing-mineral-rich-bone-broth" lastmod: "2017-03-14T22:39:00.000Z" --- If you haven’t already incorporated bone broth into your cooking routine, you’re missing out on the tremendous health benefits of this incredibly healing and nutritious powerhouse, and no, it’s not just a new food trend. Used for centuries around the globe, bone broth has long been incorporated into diets to stimulate healing and also provide a simple, yet very nutrient-dense food source. ### The History of Bone Broth Bone broth in it’s essence has been around for centuries. From hunter-gatherers to Chinese Medicine to your Grandmother’s kitchen it stands the test of time. Unfortunately however, due to the advent of processed foods and the lack of time for traditional cooking in our modern society, real bone broth has been lost to many households. The healing power of this broth is hard to beat, which is why I’m so pleased that it has come into the spotlight. There’s nothing like a warming bowl of broth to ‘fix’ you up when you’re a little under the whether this time of year, or anytime for that matter. ### What are the Benefits of Bone Broth? Chicken soup isn’t just good for the soul, a bone broth is a true powerhouse containing healing compounds like collagen, glutamine, glycine and proline all of which help to heal the gut lining. It is also packed with almost every mineral. Bone broth can aid in everything from digestion and gut-health to immunity, joint-health and even act as a beauty boost! ### Top 3 Benefits: - Gut Health = Immune health. It is becoming more well known that gastrointestinal health is key to over-all health. It is, after all, where we absorb our nutrients. As mentioned above, many of the major substances found in this broth (glutamine, collagen, etc.) speed the healing of the gut lining, reduce inflammation and keep it in top form. - Stronger Joints & Bones. The mineral density in this broth means that it is a great way to get extra calcium into your diet, along with almost every other mineral! It is frankly a superior way of getting ALL minerals. Additionally, it contains substances well known to help keep joints lubricated – glucosamine, chondroitin, collagen – they all play a valuable role in maintaining joint integrity. - Skin, Hair & Nails. For all the same reasons that it is great for joint and bone health, it is a superior addition to your beauty routine….As all naturopathic doctors will say, you’ll get FAR more out of what you put IN your body than what you put ON it. This super food will do wonders for your skin, hair and nails, because it’s both packed with all the nutrients they need to be healthy and strong, but also because it keeps our gut lining healthy so we are properly absorbing what we consume. ### So, How do You Make Bone Broth? Bone broth is easily made by boiling bones, typically beef or chicken, although fish bones can be used. Combining water and an acid, such as apple cider vinegar, the bones can boil for as little as 4 hours or up to 48. The longer the broth simmers, the more minerals and nutrients are drawn out from the bones. For added nutrients and flavour most bone broths are made with vegetables and herbs such as carrots, celery, onion and fresh rosemary. Keep in mind that store-bought broth is NOT a substitute for the real deal. There is no comparison with store-bought versions often containing MSG or other chemicals and lacking gelatin and some of the other health-boosting properties of homemade broth. The base recipe: Ingredients: - 2lbs organic, hormone-free bones (grass-fed beef or chicken) - 2tbs apple cider vinegar - 2 celery stalks - 2 carrots - 1 onion Various herbs are optional such as parsley, garlic and sea salt but I strongly recommend using them as they bring out the flavour. Instructions: - It’s preferable to pre-roast your bones (especially beef). Place them in the oven for 30 minutes at 350. - Place the bones into a large stock pot with water and vinegar. I like to let this sit for 20-30 mins before cooking as the acid allows the nutrients to become more available. - Add in desired veggies and herbs - Bring all of the ingredients to a vigorous boil then let simmer until done. - Skim the top of your broth for foam and impurities that will rise to the top. This should be discarded. - Remove from heat and let cool. Once cooled use a strainer to remove any bone or vegetable pieces. When cooled throughout, pour into glass containers for storage. If you own a crockpot this can also be used and is super easy as you can walk away and come home at the end of the day and POW!!! It’s ready. 🙂 Bone broth will stay for up to 5-6 days in the fridge, or can be frozen for later. ### When to Use Bone Broth? - As a base for soups or stews - Just on it’s own as a warm drink - As a base for gravy and sauces - Used as a liquid to cook vegetables or quinoa/lentils to add extra nutrients - Add to mashed potatoes or sweet potato mash, cauliflower rice, etc. Dr. Kirsten, ND, MSCP --- title: "Low Energy: is it poor sleep or... something else?" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/low-energy-is-it-poor-sleep-or-something-else" markdown_url: "https://www.drsmithnd.com/llms/blog/low-energy-is-it-poor-sleep-or-something-else" lastmod: "2018-04-24T22:28:00.000Z" --- This post is not about various forms and causes of insomnia – a practically epidemic and important issue that deserves a post all on its own. This is about OTHER causes of fatigue that so very often are not discovered in a conventional medical work up, and which I encounter frequently in clinic. I’d venture that about 40-50% of my patients have fatigue at the top of their hit list. A recent survey conducted by the Conference Board of Canada showed that nearly one third of Canadian workers feel tired throughout the day. The report that accompanied the survey confirmed that constant fatigue has a dramatic effect on a person’s daytime productivity and their overall health. Well indeed!! Of course it does. While many studies have tackled the issue of fatigue, the Conference Board of Canada survey is great for two reasons: it paints an accurate picture of the state of fatigue amongst Canadians and it does a great job in explaining how it affects our productivity and health. You don’t sleep, you don’t recover, your immune system can’t do its surveillance and repair, you slowly gain weight, lose cognitive power…in short: you are “battery low”, as my five year old son would say. It becomes a serious health issue when compounded over time. So, do you often feel tired even after having slept well? ## What in the heck is causing this fatigue? Unsurprisingly, the survey doesn’t fully answer WHAT is causing this growing feeling of tiredness amongst Canadians. To be clear, today I’m writing about fatigue, not sleepiness – which is the result of not getting enough sleep. Fatigue is something else entirely. Individuals who deal with fatigue often feel tired, weak and unmotivated, and have issues with memory and productivity. They also tend to want to stay away from social situations, avoid making commitments (for fear of breaking them) and struggle to get through normal daily activities. Commonly, people with fatigue feel tired all the time but actually have a really tough time falling asleep. Fatigue can be a symptom of chronic infection, hormonal imbalances, stress, inability to clear toxins, allergies, or lowered immune function. It is also a common symptom in a number of other illnesses such as: - Chronic Fatigue Syndrome - Fibromyalgia - Depression - Generalized Anxiety Disorder - Celiac disease - Menopause - Andropause - Perimenopause - Dysbiosis - Anemia - Lyme disease - Gluten intolerance - Sub-optimal adrenal function / “adrenal fatigue” - Obesity - Mononucleosis (aka “Mono”) or other viruses - Autoimmune diseases such as lupus or Hashimoto’s - Mold exposure - Chemical sensitivity/ toxic burden - Electromagnetic hypersensitivity Being tired all the time can dramatically affect your life Apart from feeling run down, there can be some other significant risks. Your focus and performance decreases and your chances of being in an accident increases. You risk developing mental health issues like depression, anxiety or substance abuse. Chronic fatigue can also lead to various serious conditions such as stroke, heart disease, obesity, high blood pressure and diabetes. ## Why See an ND if you have fatigue? Because we actually take the time to diagnose the root cause, delve deeply into the physiology participating in the imbalance, and are excellent at sorting through which labs are logical for YOU after taking a detailed history of your case and all corroborating factors. Additionally, and also importantly, because when required we go beyond regular blood work with various useful types of functional testing that can help illuminate what is going on. Good examples of these types of testing are adrenal health salivary panels or stool tests looking at your gut microbiome. Whether you suffer from insomnia and are sleepy or are suffering from fatigue, I am offering a complimentary 15 minute consult to review your unique situation, see if my approach to practicing medicine is a fit for you, and for me to establish if I am able to help. To book this consultation please call my reception staff at 416.929.0707 or email them at [info.enviromed@gmail.com](mailto:info.enviromed@gmail.com) Dr. Smith Dr. Kirsten Smith, ND Dr. Smith is a licensed, board-certified naturopathic doctor in the province of Ontario, a member of the Menopause Society, the Ontario Association of Naturopathic Doctors and the Canadian Association of Naturopathic Doctors. --- title: "The Power of Words: clarifying the language of HRT/MHT" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/menopausehormonetherapy" markdown_url: "https://www.drsmithnd.com/llms/blog/menopausehormonetherapy" lastmod: "2025-02-26T19:52:00.000Z" --- I know the terminology around hormone therapy is super confusing for women and I see this reflected in the questions my patients ask me all the time... So I hope this list of definitions is helpful! Bioidentical Hormones are products that are created such that the hormone in the product is molecularly identical to human hormone. Most (but not all) of modern menopause hormone therapy is, in fact, bioidentical. This is a term still commonly used for compounded hormone products (read below) which creates a lot of confusion. Body Identical Hormones are the exact same as bioidentical; these are synonyms. Natural Hormones are hormones that are endogenous, that our bodies make. Perhaps some people are using “natural” as a synonym for body/bio identical hormones, but technically this is not correct because these products are entirely made in a lab from various plants, they are not squeezed from a human! Synthetic Hormones …Often people use this term when referencing hormone products that are not bioidentical such as the progestin in a birth control pill that is not molecularly identical to the progesterone our body makes. Compounded Hormones are hormones that are made at a compounding pharmacy, where the pharmacist has taken additional training to be able to make medicines. This can be useful when someone needs a dose not available in the pharmaceutical market, or a person requires a product without certain adjuvants, emulsifiers or fillers. Historically, bioidentical was the term used to refer to compounded hormones because there were times when that was the only way to obtain bioidentical hormone products. For many years now however, in Canada and in most countries, the national health agencies (Health Canada, or for the US the FDA), have approved and put to market numerous bioidentical hormone products. This is important as often these products will be covered by insurance while compounded hormone products often are not. Interestingly, most medical doctors still refer to compounded hormones as “bioidentical”, not realizing that the Health Canada approved products they’re prescribing regularly are actually….”bioidentical”. This is largely due to history of using the word bioidentical to refer to compounded products, the twisty history of HRT, the lack of critical focus, guidelines and support for this tool (hormone therapy) that can play a vital role in women’s lives. It is still the case that many medical providers are very leery of compounded hormones, but why? This is because there is concern that there is not the level of measured controls and standardization to ensure exactly what is in the final product, every single time the product is made and which could be a safety issue. For example, oral progesterone capsules, which are responsible for ensuring that the uterine lining doesn’t overgrow, precipitating the risk for uterine (endometrial) cancer due to being on estrogen therapy (estrogen makes uterine lining grow). Because progesterone plays a crucial role in the safety of the uterine lining, many providers are nervous about compounded product. There is debate around whether these concerns are still relevant with the technologies, licensing and practices of the regulated compounding pharmacists of today. Is Bioidentical Hormone Therapy Safer? The short answer is yes. Hormone products that are identical to our endogenous hormones are better for us, however there are times when other products for an individual case may perform better and be the wiser choice. The crucial point here is: everyone deserves to have a proper risk-benefits ratio conversation per their individual situation with a perimenopause or menopause literate health care provider. This is not a one size fits all situation; not even remotely. There are times when a non bioidentical product IS the best choice, it just all depends. Pocket Guide from the Canadian Menopause Society To look up products available in Canada, the Canadian Menopause Society created a handy little pocket guide, at the bottom of which is a chart. For bioidentical progesterone you are looking for the word micronized progesterone, for bioidentical estrogen you’re looking for estradiol or estrone (for vaginal cream). You can check it out [here](https://www.canadianmenopausesociety.org/sites/default/files/pdf/publications/Final-Pocket%20Guide.pdf). Spread the Word! I hope this was clarifying. You are officially more literate than your girlfriends (and sadly the vast majority of all types of medical and health care providers) about the ridiculous confusion regarding the semantics around hormone therapy! Feel free to share this blog with anyone you know who might be in need of it. If you have any more questions or want to work with me and you're located in Ontario, Canada, check out my [online booking platform. ](https://drsmithnd.janeapp.com/#staff_member/1) To sign up for my newsletter where we cover breaking news, tips, bust myths and generally provide really valuable and fun content for midlife women, click [HERE.](/newsletter-signup) And don't forget to follow me on [Instagram](https://www.instagram.com/drkirstensmithnd) where I often post fun reels on various women's health-related topics! Dr. Kirsten Smith, ND Dr. Smith is a licensed, board-certified naturopathic doctor in the province of Ontario, a member of the Menopause Society, the Ontario Association of Naturopathic Doctors and the Canadian Association of Naturopathic Doctors. --- title: "From Neglect to Dogma: What Happened to Menopause Care?" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/neglectdogmanmenopausecare" markdown_url: "https://www.drsmithnd.com/llms/blog/neglectdogmanmenopausecare" lastmod: "2026-06-12T01:20:00.000Z" --- How we moved from dismissing women to drowning them in certainty. Recently I have become increasingly aware of scar tissue that I've developed over the last many years. It's ropey and stubborn, woven thread by thread into hidden parts of me. I’m not talking about the kind left behind by surgery, I’m talking about the kind that accumulates when you spend decades carrying responsibility for parts of other people's suffering. It forms when you make difficult decisions repeatedly, knowing there are no guarantees, knowing real people will live with the consequences, and that sometimes there is no definite right answer. When I chose women's health, I knew it would be meaningful work and I expected endless learning and intellectual challenge. What I absolutely did NOT know, is that I was walking right into a storm. To say I’d have to learn quickly to function with a lot of uncertainty is an understatement. For most of my professional life, the conversations we now have about menopause existed at the very edges of medicine. Long before menopause became mainstream, before celebrities, podcasters, and social media transformed it into both a topic of public discourse and a market valued in the billions, I worked alongside a physician prescribing hormone therapy to women who were suffering while the vast majority of practitioners didn’t. Almost all doctors were very hesitant to prescribe hormone therapy but more importantly, they also usually failed to recognize menopause when it was sitting right in front of them. We weren't trying to go rogue, god no. It was really hard doing what we did. We made the clinical decision to respond to the women in front of us and to the growing body of evidence suggesting the story had become far more nuanced than the headlines showed. The research that would eventually reshape guidelines was emerging, some of it already existed. It simply took many years for institutions to catch up and for that, we have paid dearly in trust. Women’s trust. The shadow of the Women's Health Initiative loomed large. Fear had settled heavily over women's healthcare. The study's (mis)interpretation reshaped practice overnight, and although the truth eventually proved more layered than the headlines suggested, the damage was done. Women who had found relief in hormone therapy were pulled off treatment. Others were denied therapies that would have improved the quality of their lives. Clinicians found themselves caught between emerging evidence, professional guidelines, and women imploring for help. We reviewed the literature constantly, documented well and followed our patients closely. We did our best to make thoughtful decisions in a landscape shaped more by fear than certainty or science. We carried the weight of choices that felt both necessary and risky because we had witnessed what the alternative looked like, and it was simply not an option we were able to live with. Women arrived exhausted from years of existing with an unnamable sense of loss. They came frightened by anxiety that felt foreign, shattered by sleeplessness they could not solve, grieving the erosion of confidence and feeling in many ways deeply lost. Many were told their symptoms were normal, some were told they were psychiatric, almost all were prescribed medications for the collateral damage, never coming close to the actual root. A natural, predictable, complex change that, despite impacting half the humans on the planet, didn’t exist. Until it did. The evidence evolved, guidelines were updated, media latched on, and the conversation changed. Menopause became mainstream, and for that I am grateful. But if the first part of my career was defined by neglect, this chapter has been shaped by something else entirely. Women went from being gaslit to being catapulted into a polarized, highly emotional landscape pregnant with dogma and “hills people will die on”. (Lord, let it end…) The old guard insisted that the guidelines were the guidelines, that questioning consensus was reckless, that the safest path was strict adherence to the prevailing narrative. Today's evangelists often sound equally certain and are also ever so…. loud. Everything you've been told is wrong. This is the only answer. Everyone needs hormones. Everyone needs higher doses of hormones. No one needs hormones. Conventional medicine has failed you. Conventional medicine is now here to save you! And for the love of all things holy eat your goddamn protein. And fiber. You’ve seen it all rolling past your feed on the daily ladies, the astonishing amount of people - including those who can’t prescribe hormones or practice medicine - hawking their wares, they have the fix you need . Many of these individuals, it bears noting, have not sat medical board exams and are not held to account by regulatory bodies, so indeed, what do they care …about what or how they sell?. And what of the women? They have marched forward with not so much as a glance back over their shoulders. They got the message loud and clear: your aging issues are not a medical priority. Good luck, sisters. Vaja con Dios. The thing about certainty is, it is so …comforting . It quiets our anxiety offering the illusion that complex problems can have simple solutions. It also performs exceptionally well in a landscape where attention is monetized, confidence is rewarded, and nuance truly has no chance at virality. The old guard taught me that institutions can be too slow to acknowledge when they are failing. The new evangelists are teaching me that conviction untethered from humility can become its own form of dogma. Can trust grow in either type of soil? It does beg the question. As a naturopathic doctor I was trained with a broad and deep scope of practice: to consider nutrition, lifestyle, botanical medicine, hormone therapy, and the many interconnected systems that shape a woman's experience of health. Long before personalized medicine became a buzzword, this was simply how we were trained. Because all of these modalities are in my direct scope and training, I don’t have to have a bias or a “hill I will die on” because I don’t need one. All of it is available to me, to use as I see it being the most effective, for each individual patient. In the end I’ve realized that my scar tissue is in fact not cynicism or burnout, but rather a residue that's been left behind from years of holding complexity: witnessing women pay the price for institutional failures and now watching them struggle beneath the weight of endless information and competing certainties being chucked at them morning, noon and night. The noise of it all at this point, is frankly almost deafening. There are days, (many, many days) when I wish I could lift the fog entirely, and reassure the woman sitting across from me that it will all be okay, and deliver a simple, algorithmic solution on repeat. But I can't. Nothing touches as many aspects of a woman's body, mind and life like perimenopause and menopause do, and no two women experience them in the same way or will benefit from the same treatment approach. What I do have is the perspective that comes from almost 20 years of doing this work: helping women sort through complexity, making sense of conflicting information, finding solid ground and a path forward that honours both the evidence and the reality of the human being in front of me. I won’t offer certainty. But I can offer clarity. Dr. Kirsten, ND, MSCP #### Hi, I'm Dr. Kirsten Smith #### Women’s health warrior and advocate with 18+ years of experience in hormonal health My goal is to support women at all stages of their hormonal journey, through pre-perimenopause, perimenopause and post-menopause. --- title: "Octopus Dreams and the Mysteries of Transformation" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/octopus-dreams-and-the-mysteries-of-transformation" markdown_url: "https://www.drsmithnd.com/llms/blog/octopus-dreams-and-the-mysteries-of-transformation" lastmod: "2026-08-18T16:12:53.000Z" --- On science, spirit, and the parts of healing that we cannot measure Photo credit: me! She climbed up into the hand and was very curious. Changed colours rapidly, was beautiful. I very nearly didn’t write this. It makes me feel kind of… queasy. I suppose because it feels so deeply personal. It belongs to one of the truest, most singularly me parts of me that I have never before really articulated. And then, rather inconveniently, my subconscious decided to weigh in. Last night my dreams were stalked by an octopus. She was everywhere in the odd, scattered vignettes that make up dreams, and at one point—the most vivid point—I was the octopus . I could feel three hearts beating. I was exploring with eight arms, experiencing so many sensations at once. It was incredible and bizarre and has stuck with me all day. (How many people, I wonder, had a similar dream after finishing Remarkably Bright Creatures late at night? If you haven’t picked it up yet, it’s a sweet read.) It left me with some unexpected introspection, including the realization that part of me does, in fact, feel a little like an octopus. Why? Because as each unique woman who is my patient sits in front of me and tells me her story, I change colour and shape. I am a deep empath, it’s true, but this is more than that. It’s an ability and perhaps a willingness to adapt to the kind of clinician the woman sitting in front of me actually needs. The truth of it is, I am both a woman of science and of spirit, and I will not amputate one side of myself. I will not choose. I can and do go from citing a study on a medication to talking about energy, subconscious belief patterns or prayer in under 60 seconds. I’m comfortable with, trained in, and regularly use old energetic systems of medicine when I believe they’re the right tool. I am also trained to interpret scientific evidence and work in the space we call evidence-based medicine, which is a constant foundational pillar supporting my work. And I do very much enjoy the golden star of evidence-based medicine: a proper, well-designed, randomized, double-blind study. Seriously, who in medicine doesn’t? It is so… comforting. I chose naturopathic medicine because it straddles this spectrum and, to me, feels like the right home for my work in this world. It has meant, well, many things. But certainly it has meant being comfortable in the grey. Comfortable with intuition. With really listening to the patient. With complexity and uncertainty. And with acknowledging the fact that, even with the extraordinary advances happening in medicine, we have barely scratched the surface of understanding the intelligence of our bodies and minds. Why do women’s bodies sometimes seem to break down after years of holding everything together? Why does inflammation sometimes appear alongside years of swallowed resentment? Why can exhaustion linger like a ghost in a woman who has spent decades shrinking herself to fit the needs of everyone around her? I don’t pretend to know. But I do know what I observe in practice. I know what I can measure, and I know what I cannot. I’ve been doing this long enough to believe that what we cannot yet measure should not automatically be dismissed from the picture. I know it in my cells. Buried feelings. Love lost. Grief. Unspoken longing. Loneliness. Swallowed anger. Carried fear. Dragging shame. Fragmenting ourselves in order to belong. There is always a cost, dear reader , and we cannot search it up on PubMed. Yet. My patients will tell you that I sometimes veer straight toward the unspoken elephant in the room. That heavy fog. The thing sitting on you that seems to make change almost impossible. The part of your story that tells you very convincingly, that staying exactly where you are is safer. I am, in the end, very much in the business of transformation. And sometimes the inability to follow an excellent health strategy is information in and of itself. Few things reveal our deeper patterns faster than being handed an excellent strategy for getting where we say we want to go and watching ourselves remain in essentially the same place. You just can’t …unsee it. We tend to label that stuckness as failure but my interpretation tells a different story. I think that something deeper in us, perhaps from the soul level, is trying to communicate with us and override our ego - the part of us committed life or death - to our old, stuck narrative. A part of us has reached a boundary, and we feel extremely uncomfortable going beyond it. Either we sit and metabolize it, (What is trying to move through me here?) or we deny and distract (How do I move past this?). We get to choose. And yes, one choice is more confronting. But it is also where the rubber meets the road ladies. Call it what you will, but if we want to reach for a higher elevation in our lives and in our health we have to cast out an intention, be awake at the switch when something floats by that might help us change, and then have the grit to act on it. Go! They say there is no luck, only opportunity met with preparation. I don’t know who “they” are, but I do think they’re right. Courage, my love. Dr. Kirsten ND, MSCP --- title: "Our Daughters, Ourselves" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/ourdaughtersourselves" markdown_url: "https://www.drsmithnd.com/llms/blog/ourdaughtersourselves" lastmod: "2025-11-02T23:02:00.000Z" --- I am increasingly seeing a generation of girls growing up exhausted, anxious, and disconnected from their own bodies and it’s not because they’re doing anything wrong. It’s because the world around them has changed faster than their biology can keep up. When we step back and look at the whole picture, hormonal health isn’t just about estrogen and progesterone. It’s about the ecosystem those hormones live in — the food, sleep, movement, screens, stress, and chemicals that shape how a young woman’s body functions day to day. And our culture? It isn’t doing us any favours, I can assure you. We have normalized frenetic lifestyles with no down time, huge chemical exposures, not eating whole foods, and all of us are addicted to devices. Our bodies and brains just can’t keep up. That’s why I talk about the cluster of factors that shape hormonal health — because no single habit explains the symptoms I see. It’s the overlap that matters, and in this visual you can see that we have to unwind some of these pieces, to get back into balance. The real life case that I showcase here (with permission) highlights this interplay well, and also reveals that while it may seem like a big mess, we can with a bit of know-how and support, unwind things and help our girls reach better health. Case Study: A 15-Year-Old Rebuilding Her Foundations She was 15 — bright, athletic, and attending a sports-focused high school. She had a close family, a solid peer group, and a full plate. By all accounts, she was doing everything right. But her body was saying otherwise. Her and her mom’s concerns: - Painful, cystic acne - Late-night screen time and short sleep - Erratic eating, heavy on processed food - Fatigue and worsening mood - Debilitating cramps and very heavy periods - In the middle of an ADHD assessment What We Found After a full intake, I asked them to keep a food and symptom diary and ordered blood work. Here’s what came back: - Anemia - Vitamin D deficiency - Low B12 - Early blood sugar dysregulation - Low progesterone Her diet told the rest of the story — skipping breakfast, fast food for lunch five days a week, healthy family dinners, and consistent late-night snacking and late bedtime. This wasn’t pathology; it was a pattern. Her body wasn’t broken — it was simply polluted, under-fueled and over-stimulated. The Plan We started with what mattered most: rebuilding her foundations. - Protein-forward breakfast every day — to steady energy, mood, and focus. - Pack leftovers for lunch — real food over fast food. - Screens off by 9 PM — a non-negotiable. Sleep first, dopamine later. Devices taken from room, so no temptation. - Targeted nutrients: Vitamin D, B12, omega-3, multi, and iron (with dinner, away from dairy). - Switch out ALL personal care products for low-tox alternatives (see below for resources) - Parental support: I advised Mom to join forces with her. They synced breakfast time, took their vitamins together, and built new routines as a team No detoxes. No extreme protocols. No medications or herbs. Just consistency with a couple new habits. The Results 6 weeks: - Acne down by 80% - PMS and cramps down by 50% - Mood brighter, sleep deeper - Focus in school remarkably improved - Slightly lighter periods 3 weeks: - Acne down 90% - PMS down 70% - No more low mood - Energy and motivation normalized - ADHD assessment deferred — symptoms resolved - Periods lighter and more manageable The Takeaway I didn’t reach for herbs, medications or hormone support because medicine wasn’t what she needed. Her hormonal symptoms were a reflection of depletion, lack of downtime and sleep, pollution with a bad diet and toxic personal care products. If she’d gone to her pediatrician, she would have been prescribed birth control for acne and cramps (which often worsens mental health), and possibly stimulants for ADHD — without ever addressing what was driving her imbalance. In the old ways of practicing naturopathic medicine the first rule was: what needs to be removed? What are the obstacles to cure? The body will right itself if given the right conditions, most of the time. Still stands the test of time. Was she perfect at the plan? Of course not. Most adults wouldn’t be. But her mom stayed engaged — role modelling, reminding, cheering her on and they probably stayed on track 85% of the time which was what it took to take the pressure off her system and get change. That partnership was the true medicine. Over time, their family began slowing down, prioritizing quality food, and taking time to eat together. These changes precipitated a ripple effect that reshaped not just this girl’s health, but the family’s rhythm. We can help our girls learn self-care early and I don’t mean pedicures and make up, but the kind that builds energy, stability, and confidence from the inside out. When they start to connect those dots between how they eat, rest, and feel we’re not just treating symptoms, we’re getting into true life skills. We’re teaching them how to steer their own ship. Learning to prioritize taking care of yourself young - I honestly don’t know what could be more valuable. 🌿 If you have questions about pediatric care under my wing, feel free to email me: info@drsmithnd.com To book an appointment, scroll down to the [Pediatric Intake section and book directly HERE.](https://drsmithnd.janeapp.com/#staff_member/1) Resources for learning how to decrease hormone disrupting toxin load through changing personal care products: - This tool is to establish whether the make up, shampoo, sunscreen, deodorant etc. that you use is safe for you. You simply enter a product name in the search bar to see its safety rating from 1 to 10 and review detailed ingredient risk information. [Click HERE](https://www.ewg.org/skindeep/) [ https://www.ewg.org/skindeep/] - To skip the step of researching the products you’re currently using, you can hit the one stop shop (no COI) at the Detox Market where every product line in there is clean so no research needed. [Click HERE](https://www.thedetoxmarket.ca/?srsltid=AfmBOorO2guAauEEMVgukNMWTtOLdS3igvw24o_b7R74n-3mZayyC7QO) [https://www.thedetoxmarket.ca] Dr. Kirsten, ND, MSCP #### Hi, I'm Dr. Kirsten Smith #### Women’s health warrior and advocate with 15+ years of experience in hormonal health My goal is to support women at all stages of their hormonal journey, through pre-perimenopause, perimenopause and post-menopause. --- title: "Ozempic May Be Changing More Than Appetite: a Question About Progesterone Absorption" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/ozempicandprogesteroneabsorption" markdown_url: "https://www.drsmithnd.com/llms/blog/ozempicandprogesteroneabsorption" lastmod: "2026-05-11T12:19:00.000Z" --- Sudden heavy bleeding in a menopause patient means I make room in my schedule relatively quickly. So recently when a long-time patient came in for a follow-up reporting five days of heavy bleeding, I asked a lot of questions, reviewed her medications, explained possible causes, and referred her for a prompt transvaginal pelvic ultrasound. Most commonly, postmenopausal bleeding is related to an imbalance in menopause hormone therapy, so that’s where we started: Did you change how you take your hormones or alter your dose? No. Any new medications? Major stressors? Bleeding triggered by intercourse? Vaginal discharge? No, no, no, and no. Did I have her on an appropriate dose of micronized progesterone to protect the uterine lining (from overgrowth caused by estrogen)? Yes — 200 mg. Was she on an excessive dose of estrogen? No. She had remained on 0.5 mg topical estradiol gel, which is actually a below-average dose. Fibroids, polyps, adenomyosis, cysts — all of these remain possible in menopause whether you are on hormone therapy or not. I know you’re thinking of the C word and you’re right to, because while cancer isn’t likely, it is still on the table. Postmenopausal bleeding can signal various gynecological cancers and most commonly endometrial cancer which is why these cases require timely investigation with imaging and sometimes an endometrial biopsy. Then I asked one more question. Any signs of high estrogen lately? Actually, yes. Breast tenderness, some irritability. Later that day I circled back and reviewed her chart again because something just did not sit right with me. Nobody develops significant endometrial overgrowth on that dose combination unless something else is happening. Then I saw it. Six months earlier, just before her previous follow-up, she had started Ozempic under the care of another doctor. My subsequent trip down the research rabbit hole turned up increasing discussion around GLP-1 medications potentially reducing the absorption of oral progesterone. What’s the big deal? Because progesterone protects the uterine lining. Without enough of it onboard, estrogen can stimulate the lining unchecked over time, increasing the risk of endometrial overgrowth and potentially cancer, that’s why it’s a big deal. GLP-1 medications work in part by slowing gastric emptying. Helpful metabolically, yes, but this may also alter how some oral medications are absorbed. Oral progesterone already has somewhat poor absorption, and delayed gastric emptying may make that even less reliable in some women. Of note, the population most frequently prescribed GLP-1 medications is already at a higher baseline risk for endometrial cancer. Obesity is a primary risk factor because adipose (fat) tissue acts as an active endocrine organ, producing and storing estrone. As GLP-1s trigger rapid weight loss, shrinking fat cells can cause fluctuations in circulating estrogen. When paired with delayed gastric emptying—which may interfere with the absorption of oral progesterone—this may create a period of unopposed estrogen. This hormonal imbalance is a documented driver of uterine thickening and requires careful clinical monitoring. So while my patient was taking her progesterone consistently, the question is whether she was adequately absorbing it. And ultimately, her ultrasound findings supported that concern. Her endometrial lining measured 6 mm - abnormal in a postmenopausal woman with bleeding and enough to warrant further investigation (endometrial biopsy, which was negative). That finding mattered because she was not on a high dose of estrogen nor too low a dose of progesterone. While one case does not prove causation, it raises an important clinical question about whether delayed gastric emptying from GLP-1 medications could reduce progesterone absorption enough to compromise endometrial protection in some women. Importantly, emerging evidence suggests GLP-1 receptor agonists may actually reduce overall endometrial cancer risk at a population level, very likely through improvements in obesity and metabolic health. C’est what? Well, as is often the case in life, both things can be true at the same time. GLP-1 medications may reduce overall risk through weight loss and improved metabolic health but while busy losing weight if progesterone absorption is compromised then the protective balance may be lost. What ...do we do with this conundrum? Well, we definitely do not freak out. We pay closer attention. We do not yet have strong long-term data guiding management in women using both GLP-1 medications and oral progesterone as part of menopause hormone therapy. The British Menopause Society however, has acknowledged the potential for altered oral progesterone absorption with GLP-1 agonists and recommends a lower threshold for investigation when bleeding occurs. This means considering strategies that bypass the gastrointestinal tract entirely such as a Mirena IUD, more frequent ultrasound monitoring, or sometimes vaginal progesterone, though the evidence confirming adequate endometrial protection with vaginal use remains limited. This is the job. It’s not about dramatic headlines or wild pendulum swings but careful pattern recognition, thoughtful observation, and researchers asking better questions about how therapies interact inside real human bodies. Warmly, Dr. Kirsten References - British Menopause Society. Progestogens and Endometrial Protection. British Menopause Society Tool for Clinicians, 2023. - The Menopause Society. Hormone Therapy Position Statement, 2022. - Endocrine Society. Clinical Practice Guideline on Treatment of Symptoms of the Menopause. - Postmenopausal Bleeding. American College of Obstetricians and Gynecologists Committee Opinion. - Crosbie EJ, et al. Obesity and endometrial cancer risk: mechanistic and epidemiological insights. Nature Reviews Endocrinology. - JAMA Network Open, 2026. Cohort study evaluating GLP-1 receptor agonist use and endometrial cancer risk. - Prescribing information for semaglutide notes delayed gastric emptying and potential impact on absorption of oral medications. Novo Nordisk #### Hi, I'm Dr. Kirsten Smith #### Women’s health warrior and advocate with 15+ years of experience in hormonal health My goal is to support women at all stages of their hormonal journey, through pre-perimenopause, perimenopause and post-menopause. --- title: "Progesterone: Your Perimenopause Hero" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/progesterone-perimenopause-hero" markdown_url: "https://www.drsmithnd.com/llms/blog/progesterone-perimenopause-hero" lastmod: "2024-05-22T12:00:00.000Z" --- #### Did you know that bio-identical/body identical progesterone is a star performer in managing perimenopause symptoms? Bio-identical progesterone can also be used to treat conditions such as PCOS, PMDD, migraines, endometriosis and adenomyosis. #### Semantics matter: When we use the word, “ progesterone ” we are referring to oral micronized progesterone which requires a naturopathic doctor, medical doctor, or nurse practitioner’s prescription. In Canada and the US, the brand name is PrometriumⓇ. Progesterone can also be prescribed as a cream, vaginal suppository or even injection, but here we are referring to oral progesterone. Progestogen: refers to any progesterone-type product. Progesterone: refers specifically to bio-identical micronized progesterone. Progestins: refers to “synthetic”, non bio-identical types such as levonorgestrel, drospirenone, norethisterone. Progestins are in hormonal IUD’s (ie. Mirena) and birth control pills. Don’t lump progestogens together because they have different side effects and risk profiles. For example, if you experienced weight gain, anxiety or any other side effect from the pill or IUD, it does NOT mean you will have the same experience on progesterone. It’s important to learn the difference between bio-identical progesterone and progestins, so that you can make the most informed decision for your health. Let’s compare Progesterone and Progestin: #### Progesterone - Stimulates hair growth - Reduces androgen symptoms (acne, unwanted hair growth/hirsutism) - Reduces anxiety Improves sleep - May reduce risk of breast cancer #### Progestin - Can cause hair loss - Can cause androgenic symptoms - Can cause anxiety - Can cause depression - [May increase the risk of breast cancer](https://www.cemcor.ca/resources/does-taking-progesterone-alone-or-estrogen-increase-women%E2%80%99s-risk-breast-cancer) Dr. Kirsten Smith, ND Dr. Smith is a licensed, board-certified naturopathic doctor in the province of Ontario, a member of the Menopause Society, the Ontario Association of Naturopathic Doctors and the Canadian Association of Naturopathic Doctors. --- title: "Remembering Wonder" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/rememberingwonder" markdown_url: "https://www.drsmithnd.com/llms/blog/rememberingwonder" lastmod: "2026-05-27T00:16:00.000Z" --- Dear Reader, Once on a long, rainy car ride north, my then tiny son and I listened to a podcast and learned about Suzanne Simard’s ground breaking research on the “wood wide web”. For the rest of his early childhood my son’s memory of it impacted his ideas about the forest he was so lucky to grow up with in northern Ontario. “They are talking, Mama.” Trees, as it turns out, have an intelligent underground network of fungal threads connecting their roots allowing them to communicate, share nutrients, and warn each other of danger. A cooperative world beneath our feet where forests act as a single, intelligent superorganism rather than just individual trees competing for survival. This should really give you pause. We live on a planet where whales sing songs that travel for miles underwater and lightning can turn sand into glass for a brief moment before disappearing entirely. Where stars we see may not even exist anymore and where grief changes the nervous system and love changes it back. And yet. Most of us spend our days staring at calendars, answering emails, rushing between obligations, and trying to outrun the quiet feeling that life is becoming increasingly mechanical. (Is this life now?) I worry sometimes that one of the great costs of adulthood is how profoundly it narrows our attention. Not because we stop caring about wonder, but because survival becomes so damn loud. We are consumed by schedules, productivity, caretaking, logistics, and the constant low (or high) grade pressure of trying to hold it all together. Our nervous system adapts accordingly. It learns to scan for problems instead of noticing magic. We must resist. I have been both lucky and created a life where I have spent a lot of time living and working deep in nature, in places where when the wind changes and the smell in the air shifts, your body registers the signal before your brain does. I have always felt the most fully myself in nature, the ultimate grounding force. It helps me to remember because like everyone else, I get consumed by the needs of the day and press on. But what of the women I orbit around, helping them regain health, joy, a sense of self? Most are functioning at an absolutely extraordinary level while feeling some level of disconnection from themselves. They are managing households, careers, aging parents, children, relationships, changing hormones, the endless invisible labor, and bodies that no longer tolerate chronic depletion the way they once did. By the time you finally pause long enough to ask yourself how you actually feel, the answer is often: a kind of tiredness for which there really are no words. I know what you mean, even without the words. As you reach forward in your journey looking for better health, remember that medicine comes in many, many forms dear Reader. Be the person who notices light moving across the floor, the tiniest frog, the smell of the pine needles baked by the sun, and the quiet moment when your body exhales. We are still very much a part of a living world that operates with astonishing intelligence and beauty so staggering it deserves deep reverence. My son said in passing the other day as the air suddenly became metallic, “Smells like lightning”. Remember. Dr Kirsten #### Hi, I'm Dr. Kirsten Smith #### Women’s health warrior and advocate with 15+ years of experience in hormonal health My goal is to support women at all stages of their hormonal journey, through pre-perimenopause, perimenopause and post-menopause. --- title: "Testosterone Therapy in Women: Separating Facts from Myths" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/testosteronetherapyinwomenseparatingfactsfrommyths" markdown_url: "https://www.drsmithnd.com/llms/blog/testosteronetherapyinwomenseparatingfactsfrommyths" lastmod: "2025-09-23T13:33:00.000Z" --- To cut to the chase: yes I can now provide this therapy through my practice and yes, I have lots of experience with it (scroll to the bottom).* MYTHS VS FACTS per the peer reviewed scientific literature to date - Testosterone is a hormone that drops in perimenopause contributing to our symptoms. ❌ Nope. Our testosterone levels gradually decline starting around age 18, then do another drop in the early /mid 30s and then actually rise again as we approach our 60s (there’s a reason some elderly women have that chin hair!). Testosterone is not the key hormone changing in menopause; that role belongs to estrogen and progesterone [1]. - Testosterone is an important female hormone that converts into estrogen that deserves more high quality studies examining more aspects of female aging. ✅ Hell YES, of course it does. While there are many studies on this, there are not nearly enough and they need to expand the end markers they are looking for to look to be focused on the claims we are seeing emerge such as muscle gain, bone health, mood, etc. - Testosterone therapy has been proven with quality studies to help with symptoms of menopause and aging in general. ❌ Not true…yet. The only proven benefit of testosterone therapy in women (so far) is for Hypo Sexual Desire (HSDD), or low libido. Extensive research, including a landmark meta-analysis of over 8,400 women led by Dr. Susan Davis, has shown testosterone can improve sexual desire, pleasure, arousal, and satisfaction in postmenopausal women diagnosed with hypoactive sexual desire disorder (HSDD) [3] However, it is important to understand a few facts subsequent to that result: Only about 50-60% of women experience a meaningful improvement in sexual function after testosterone treatment [7]. The improvements generally appear after a slow burn of 4–6 weeks or more [8]. Testosterone therapy should only be considered after estrogen deficiency symptoms due to the genitourinary syndrome of menopause such as vaginal dryness, have been addressed with a local estrogen prescription and other potential causes (medical, psychological, relationship) have been explored [1]. - HSDD / low libido / low sexual desire in women is biopsychosocial problem that requires integrating biological, psychological, interpersonal, and sociocultural factors as a complex biopsychosocial issue, ensuring a comprehensive understanding and effective, multidimensional treatment approach rather than attributing it simply to low testosterone. ✅ Absolutely. This means that there are MANY inputs that do impact female sexual desire. Biological impacts could be hormones, medication side effects, chronic diseases, untreated GSM, as a few examples. Psychological impacts could be depression, anxiety, high stress, low self esteem, poor body images, etc. Interpersonal impacts are relational -so issues with your partner, communication, sexual satisfaction, boredom, etc. Sociocultural impacts can be derived from religious beliefs or cultural norms driving negative ideas around sex and desire. - Testosterone improves mood, self esteem, energy, muscle mass, brain fog & cognitive function. ❌ Refer back to #3. Despite social media claims, high-quality clinical trials have not found consistent benefits of testosterone therapy for mood, fatigue, muscle strength, bone density, or cognitive health in menopausal women [1]. We need and deserve quality studies!! - The placebo effect in testosterone trials for women has been shown to be profound. ✅ Fascinatingly…yes, a fact. Research on low sexual desire in women reveals a staggering placebo effect in testosterone trials. Dr. Susan Davis, PhD world renowned testosterone expert and someone who has run over 20 high quality studies on it, emphasized that in a key double-blind study, a substantial percentage of women receiving placebo reported improvements in sexual function comparable to those on actual testosterone—highlighting the strong influence of belief and expectancy factors. Her commentary about this topic in various publications and platforms is subsequent to numerous studies: a 2008 trial of transdermal testosterone which showed significant placebo improvements alongside modest benefits from testosterone [2], and a 2019 meta-analysis of 36 trials with over 8,000 women found similar results, confirming that while testosterone can help with libido, placebo effects play a major role [5]. These findings show us that while about 50-60% of women may respond to testosterone therapy for low sexual desire, it is a complex biopsychosocial issue that involves many different inputs that have to be considered in clinical practice. - Testosterone therapy for women is done at a low dose and doesn’t cause side effects. ✅ ❌ Yes it’s done at a much lower dose than in men, but some women have side effects such as acne, facial hair, hair loss, and at higher doses (that nobody should be prescribing) some experience voice deepening and clitoral enlargement [1]. In my practice, women who got side effects had experienced side effects prior from their own endogenous testosterone - this was quite a consistent observation. - The long-term safety profile, especially regarding cardiovascular and breast health, remains unclear [9]. ✅ True. We don’t have enough studies yet to understand long-term use and safety. - Testosterone is approved by the Menopause Society, Heath Canada and the FDA for use in perimenopausal or menopausal women. ❌ It is not recommended for use in perimenopause or menopause due to lack of evidence of benefit and proven safety. There is no Health Canada or FDA (American) approved product for women at this time, even for HSDD/ low libido. What is prescribed and who can prescribe testosterone therapy in Canada? #### Hi, I'm Dr. Kirsten Smith #### Women’s health warrior and advocate with 15+ years of experience in hormonal health My goal is to support women at all stages of their hormonal journey, through pre-perimenopause, perimenopause and post-menopause. --- title: "The Power Of Pumpkin Seeds" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/the-power-of-pumpkin-seeds" markdown_url: "https://www.drsmithnd.com/llms/blog/the-power-of-pumpkin-seeds" lastmod: "2017-10-31T22:36:00.000Z" --- Pumpkin seeds, also known as pepitas, are now consumed widely all over the world but are native to the Americas. The word “pepita” is consistent with this heritage, since it comes from Mexico, where the Spanish phrase “pepita de calabaza” means “little seed of squash.” Pumpkin seeds were a celebrated food among many Indigenous/ First Nations tribes, who treasured them both for their dietary and medicinal properties. Pepitas truly pack the punch; these little seeds are antioxidant, antimicrobial and mineral powerhouses – which explains the valuable role they’ve played in natural medicine. Today Naturopathic Doctors use an evidence base to prescribe them as a part of treatment plans for conditions ranging from prostate issues, to testosterone deficiency, to parasitic infections, for skin health and frequently as whole foods based way of directly increasing mineral density in our patient’s diets. Delicious ways to incorporate them into your diet: - Add pumpkin seeds to healthy sautéed vegetables. - Sprinkle on top of mixed green salads. - Grind with fresh garlic, parsley and cilantro leaves. Mix with olive oil and lemon juice for a tasty salad dressing. - Add to your favorite hot or cold cereal. - Add to your oatmeal raisin cookie or granola recipe, or sprinkle on top of muffins. - Next time you make burgers, whether it be from vegetables, turkey or beef, add some ground pumpkin seeds. Or try these these recipes to spice up the seeds for snacking. Dr. Kirsten, ND, MSCP --- title: "The Unexpected Connection Between The Gut And Hormones" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/the-unexpected-connection-between-the-gut-and-hormones" markdown_url: "https://www.drsmithnd.com/llms/blog/the-unexpected-connection-between-the-gut-and-hormones" lastmod: "2019-02-21T21:54:00.000Z" --- Most of us don’t need an expert to tell us that the food we eat has an impact on our health at least in the most basic way: you eat crap you get a food hangover and gut rot, but the fact is, the impact is actually much, much bigger than that. What you put on your fork will have the single most significant impact on your health. Period. In recent years we have gained more insight into the ways that food affects health because scientists have been delving into the vast world deep in our intestines…: the gut microbiome. So far we’ve really just seen the tip of the proverbial iceberg, but what we do know so far is that it plays a HUGE role in our mood, immune function and yes, ….even hormones. ## So… what is the gut microbiome? If you grew up in Canada when you hear the word “biome” you’re probably transported back to grade 4 science class. That’s when we typically started learning about habitats such as a rain forest or a desert, where particular plants and animals are found and live in symbiotic relationships. The gastrointestinal microbiome is not so different than the biome of any other habitat in that it is home to millons of different species but in this case of bacteria, viruses, fungi and other microbes — that feed off of the food we eat and thrive in certain conditions, and get unbalanced in certain conditions. Advances in genomic sequencing have allowed researchers to start identifying more microbes and studying them in greater detail allowing them to start determining what they do and what they require to thrive. Most importantly, it is allowing them to ascertain what a healthy gut microbiome actually is — with the right species of bacteria and in the right amounts — and how it is absolutely central to our health . ## So how can a dysfunctional gut microbiome affect my health and hormones? Studies published in the world’s top scientific journals show that when people have an unhealthy diet, are extremely stressed or take too many antibiotics, their gut microbiome becomes disrupted and unbalanced. This imbalance is called dysbiosis, and can have pretty radical effects on your health and wellbeing. It is something I am dealing with all day every day in practice because it impacts just about everything. While scientists are only starting to understand the mechanisms around how the gut microbiome impacts hormones, at this point there is mounting evidence that it can contribute to causing various conditions. In clinical practice I see this evidence play out daily. A good example of this is that women who have plant-based (this doesn’t mean vegetarian incidentally), nutrient rich, whole foods diets who are well hydrated, don’t drink much alcohol or caffeine, manage stress well and exercise regularly, have FAR less hormonal symptoms through perimenopause and menopause. FAR less. Without exception. I also have patients who manage 80-100% of their PCOS just with their lifestyle. Think about that for a minute.*** To date, the following conditions have been linked to dysbiosis with the list continuing to grow as scientists learn more about the relationship between our gut and hormones: - [Obesity](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5082693/) - [Irritable Bowel Syndrome (IBS)](https://www.nhs.uk/conditions/probiotics/) - [Leaky gut syndrome](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604320/) - [Depression](https://www.ctvnews.ca/health/two-types-of-gut-bacteria-are-consistently-depleted-in-people-with-depression-study-1.4282025) - [Endometriosis and Polycystic ovary syndrome (PCOS)](https://www.sciencedirect.com/science/article/pii/S0378512217306503) - [Breast and ovarian cancers](https://www.ncbi.nlm.nih.gov/pubmed/27107051) ## Enter: the Estrobolome… Within your gut’s microbiome there are a sub-set of proteins that are able to interact with estrogens in the body otherwise known as, the “estrobolome”. The estrobolome is capable of detoxifying estrogens which is important to hormone balance. An enzyme called beta glucuronidase disturbs this process resulting in impaired ability to detoxify estrogen, resulting in higher circulating levels. The implication here is that higher estrogen levels lay the foundation for the potential development of various estrogen dominant conditions such as polycystic ovarian syndrome (PCOS), endometriosis, painful periods (dysmenorrhea), or estrogen related cancers. The goal is, as ever, to find balance. The great news is that there are things we can do that decrease the levels of beta glucuronidase in our gut which can help to mitigate the levels of estrogen in your body. ### What INCREASES beta glucuronidase and thus estrogen? - alcohol - antibiotics - oral contraceptive pills - higher amounts of adipose tissue (ie fat cells) - high cholesterol (measured in the blood) - eating processed food and thus not enough fiber* ### What DECREASES beta glucuronidase and thus estrogen restoring hormone balance? - Eat a diverse range of fiber containing plant foods including legumes, beans and fruit - Eat fermented foods like yogurt, sauerkraut, kimchi, kefir - Limit your intake of sugar, refined flour (bread, pasta), and artificial sweeteners that stimulate growth of unhealthy bacteria - Eat whole grains but not too much (decrease these and up the veg) - Try a plant-based diet which does not mean becoming a vegetarian it simply means GREATLY increasing your veggie intake (so happy the new Canada Food Guide has ½ the plate covered in veggies!!) - Take antibiotics only when necessary as antibiotics kill bad and good bacteria alike - Use probiotics to add certain microbes to your gut, in particular lactobacillus probiotic strains (reuteri, gasseri, and acidophilus) - Exercise - Decrease alcohol intake ## Concerned that dysbiosis may be impacting your estrogen levels? Are you dealing with any of these conditions? - Perimenopause - Menopause - PMS - Stress and depression - Insomnia - Urinary incontinence - Sexual health and libido - Fibrocystic breasts - Breast cancer prevention/ remission optimization - Weight gain challenges Consider coming to see me and learn about what I do to get my patients back into balance. As you now know, I use nutrition and lifestyle as the foundation for treating hormonal conditions but the fact is, in reality it is hard. Getting people to change their habits around food, exercise, alcohol intake, etc. is deep level work, is about the long game and is the most important thing I probably do in my work, but it takes time. In the short term to get things rolling and people feeling better, I often will use a combined approach that may include botanical medicine (herbs), supplements and [bioidentical hormone replacement therapy](/hormone-replacement-therapy) to get hormonal balance restored in my patients. The end goal for me – always-, is to coach my patients to get their lifestyle dialed up to the point that they require less supplements and medicines. ## Consulting with Dr. Smith If you are suffering and dealing with estrogen-related conditions or are concerned you may be, call the clinic at (416) 929-0707 to book either a 15 minute (complimentary) meet and greet appointment or become a patient and book your initial appointment (one hour) with Dr. Smith. Dr. Smith has expertise in dysbiosis and other hormone-related conditions and is open to discuss your health goals and any questions you may have regarding your situation. Dr. Kirsten Smith, ND Dr. Smith is a licensed, board-certified naturopathic doctor in the province of Ontario, a member of the Menopause Society, the Ontario Association of Naturopathic Doctors and the Canadian Association of Naturopathic Doctors. --- title: "The Cortisol Loophole: Why Midlife Stress Mimics and Multiplies Menopause Symptoms" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/thecortisolloophole" markdown_url: "https://www.drsmithnd.com/llms/blog/thecortisolloophole" lastmod: "2026-06-18T22:06:00.000Z" --- Dear Reader, A patient said yesterday, “...It’s like I’m in a snowsuit trying to climb up an icy slide. I’m sweating and scrambling and getting almost nowhere, so I give up and slump down to the bottom. I just cannot do this anymore.” I thought she totally nailed it. I hear versions of this every week in practice, and the slide analogy slices straight to my Canadian childhood. For the love of god do NOT stick your tongue on that slide!!! I know that you have done it all, or are certainly trying your damndest to. Eating better, exercising better, taking vitamins better, HRTing better, doing and trying, trying and doing. And yet. It is maddening beyond the beyond to try all the right things and still come up utterly defeated. It is understandable that at some point you let go and slither down to the bottom of the slide in a sweaty, enraged, sad and worried heap and think to yourself, What in the actual F is this? What should I do? What do I need? And perhaps worst of all: Is something really wrong with me? This predicament isn’t for the faint of heart, but so much of being a woman isn’t. What you see peppering your feed about cortisol is - as usual - oversimplified and overcooked. But the fact of the problem is very real and we have quality evidence that validates it. Like most things in endocrinology it is nuanced, there are testing options (sometimes warranted, sometimes overkill), and there are various treatment approaches that should be personalized. Yet beneath all of this sits something that doesn't get nearly enough attention. Longitudinal data from the landmark Seattle Midlife Women's Health Study suggests that changes in cortisol regulation may be an important piece of the puzzle for many women moving through perimenopause and early menopause. How Perimenopause and Early Menopause Destabilize Cortisol Estrogen and progesterone have many roles, one of which is that they are neurological shock absorbers. Estradiol stabilizes the HPA axis and keeps the brain’s fear center, the amygdala, highly resilient to stressors. Progesterone breaks down into allopregnanolone, a neurosteroid that actively primes your ever so calming GABA receptors. Together, they act as a biological buffer against the friction of daily life. During perimenopause, this buffering system erodes . As your ovaries retire and estrogen and progesterone production becomes increasingly erratic and eventually declines, the brain loses its chemical cushions. This withdrawal means your nervous system can over react to stress in ways that feel distinctly foreign. Crucially, clinical evidence demonstrates that during late perimenopause, overnight and 24-hour baseline cortisol levels naturally rise. This isn't just because your life is extra demanding; it is a profound, underlying neuro-endocrine shift. So no, dear Reader, you’re not losing your marbles at the bottom of your slide. As ovarian hormone production declines, the adrenal glands become a relatively more important source of hormone precursors. Could it be that your adrenals are already taxed from decades of high achievement, career demands, family care ... and that this may be part of why you're lying in the slush at the bottom of the slide? What Is Going On Under the Hood? - Why Hormone Therapy Sometimes Doesn't Seem To Work: High cortisol may downregulate and desensitize estrogen and progesterone receptors. You can be on the right dose and the right products but if your cells are flooded with stress signaling, they become functionally "deaf" to those hormones. - The 3:00 AM Awakening: Cortisol and melatonin exist on an inverse curve. Cortisol should be at its lowest point around midnight. However, because a dropping estrogen baseline disrupts sleep architecture, the resulting sleep fragmentation can trigger a nighttime cortisol spike. This mimics a subtle adrenaline rush, waking you in a cold sweat with a racing heart. No amount of evening progesterone will help you much if this is part of the problem. - Weight gain: When cortisol is high, it signals the liver to release glucose into the bloodstream, driving up insulin. This cascade drives preferential fat storage around your midsection while simultaneously blunting the thyroid conversion pathways needed to maintain your baseline metabolic rate. Where Do We Go From Here? Based on symptoms alone, I can sometimes make an educated guess on what to use to treat this (18 years in practice helps with that), sometimes I use a blood spot test and sometimes I do find a 4 Point Salivary test extremely useful. By collecting samples at four specific times throughout a single day (waking, noon, afternoon, and right before bed), we get to look under the hood to see what your cortisol curve is doing, which helps me tailor treatment to what your body is actually doing. This can be incredibly helpful for restoring energy, improving sleep, reducing anxiety, and supporting healthy metabolism. This is one area where naturopathic medicine shines. We spend years training in the nutritional, botanical and lifestyle interventions that can meaningfully influence cortisol regulation. The goal is not to eliminate stress—which is impossible—but to help the body regain flexibility and resilience. - Precision Botanical Medicine: Utilizing specific adaptogens (there are many, and they are quite nuanced) based on your results to either blunt a chaotic evening spike or support a flattened morning awakening response. - Targeted Micronutrients: appropriate doses of phosphatidylserine, magnesium and specific B-vitamin cofactors to directly calm hyper-reactive adrenal signaling and protect cellular receptor sensitivity. - Nervous System Support: using strategies to help the nervous system move out of a perpetual high-alert state can go a long way toward restoring a healthier cortisol rhythm - Changing how you exercise: it is in fact true that if someone is spending too much time in a high cortisol state that it helps tremendously to temporarily stop high intensity forms of exercise. You cannot rehabilitate a normal cortisol curve if you’re trying to pull blood from a stone. - Adjustments to Nutrition : eating 3 meals a day and avoiding fasting, does help. Ensuring that you are eating enough protein, carbohydrate and fat matters. Carbohydrate restriction will backfire. If your body’s stress signaling is erratic, does it not make sense to do what we can to make it feel safe and calm? Regular, balanced meals help communicate safety to the nervous system. Eating poorly is a very real stress. One of the most important lessons I have learned after 18 years of caring for women in midlife is that symptoms rarely have a single cause. Hormones almost never operate in isolation. When we listen to all of them, rather than focusing on only one area of the puzzle, we often find the missing clues. If this sounds familiar, it may be worth looking beyond reproductive hormones alone. Sometimes the missing piece is not more estrogen or progesterone, but a better understanding of how the stress response system is influencing the entire picture. If you'd like help untangling that picture, I'd be happy to help and you can book a consultation below. Warmly, Dr. Kirsten Smith, ND, MSCP Link to [BOOK AN APPOINTMENT](https://drsmithnd.janeapp.com/#staff_member/1) Disclaimer This article is intended for educational purposes only and should not be considered medical advice. It discusses changes in stress physiology during perimenopause and menopause and is not referring to adrenal diseases such as Addison's disease, Cushing's syndrome, or other endocrine disorders. References - Seattle Midlife Women's Health Study: Cortisol, Menopausal Status, and Depressive Symptoms in Midlife Women https://pmc.ncbi.nlm.nih.gov/articles/PMC2749064/ - Association Between Menopausal Hot Flashes and the Cortisol Awakening Response (CAR) (Menopause) https://pubmed.ncbi.nlm.nih.gov/33110049/ - Baker FC, de Zambotti M, Colrain IM, Bei B. Sleep Problems During the Menopausal Transition (Sleep, 2018) - The Role of Estrogen in Regulating Stress Responsivity During the Menopausal Transition (Frontiers in Global Women's Health) https://www.frontiersin.org/journals/global-womens-health/articles/10.3389/fgwh.2021.774308/full #### Hi, I'm Dr. Kirsten Smith #### Women’s health warrior and advocate with 18+ years of experience in hormonal health My goal is to support women at all stages of their hormonal journey, through pre-perimenopause, perimenopause and post-menopause. --- title: "The “Test, Don’t Guess” Trope: What We’re Getting Wrong About Hormone Testing" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/thetestingtropehormonetesting" markdown_url: "https://www.drsmithnd.com/llms/blog/thetestingtropehormonetesting" lastmod: "2026-04-23T20:02:00.000Z" --- That blank stare paired with the pregnant pause. I can see the bubble plainly above my patient’s head… Is she f@#$%^& serious? I have just recommended starting menopausal hormone therapy without testing her hormones. The horror!!!! At best this lands as unsettling, at worst … ludicrous. I’ve just said something that goes against everything you’ve been told to believe about high quality mid-life menopause care. RED FLAG!!!! To be completely frank, I’ve thought more times than I can count: It would be SO much easier if I just tested everyone. Before. During. After. Every year. For the rest of their freaking lives. It would make my job simpler, I would meet expectations, I would make more money. “Test, don’t guess” has become a shorthand for good medicine in the menopause space. Responsible. Measured. Reassuring in a time of life where absolutely nothing feels normal—your body, your mind, even your medical care. Testing? Hell YES! Finally something will make sense! You’re not alone in wanting something to anchor to, in wanting answers. DUTCH, blood, saliva, genetics —all of it, hundreds and hundreds of times. For over 15 years now I am frequently referred complex cases, which has meant I have gone down every rabbit hole and have spent a lot of time with all manner of testing. I have studied and used every type of testing we’ve got in search of meaning and answers that could help me, help YOU. Subsequently, I now know when these tests will be useful or useless. I do order tests—of course—but only when I need more puzzle pieces that will actually change clinical management. I will not push you through an expensive and largely senseless array of testing and pretend it means something to make you feel better. At this point—to be very clear—we do not have evidence to support routine measurement of estradiol or progesterone to guide treatment in midlife or beyond . There is no established level for symptom control, “optimization,” or what is framed as “balance.” Two women can have the same estradiol level—one feels well, the other feels horrible. I've seen dozens shift from "tested but still suffering" to thriving on symptom-guided MHT—no labs needed. The number alone doesn’t tell us how the body is experiencing the hormone. Are there scenarios where I test hormone levels? Of course, too many to list here. In perimenopause, hormones fluctuate within days, hell, within the hour. A single lab value is a snapshot of a moment, not a pattern—and it is in the pattern that the answer lies. In postmenopause, estrogen levels are expected to be low, and if on MHT and there is confusion about dose or absorption, then testing is wise. Despite what you see on Instagram, the gold standard when prescribing menopausal hormone therapy—per both The Menopause Society and the European Society of Endocrinology—is that we are not titrating to a number. We are treating symptoms, function, and quality of life. I will absolutely be the first to let you know if there is a rational, evidence-based reason to change this approach. This is critical in terms of bone health . The Instagram narrative? "Hit xxxpg/mL estradiol to save your bones." Logical. Proactive. Unsupported by data . As the brand new 2025 European Society of Endocrinology guideline confirms, we do not have an agreed-upon serum estradiol threshold that confers bone protection, nor do we have data showing that adjusting therapy to reach a specific number improves fracture outcomes. We know estrogen plays an important role in bone physiology, and we know that appropriately prescribed hormone therapy will reduce bone loss and fracture risk. Even ultra-low-dose topical estrogen slashes fracture risk—no target number required. The reality is that extensive testing is easy to package and … sell . It looks thorough, feels scientific, and positions the clinician as specialized and data-driven—avoiding the complex conversation about why testing isn’t always, in reality… helpful. And yes, it can meet a real emotional need. It helps women feel seen, validated, and more in control. So, what to do? I handle it on a case-by-case basis and to this point have opted out of blanket testing. I test when I need a puzzle piece (or if the patient wants to test) and use listening to patients and 20+ years of pattern recognition as core to problem solving. This area of medicine is truly not for the faint of heart. It asks a lot more of us as clinicians on the front line than most women realize. Y ou have to be willing to listen to patients, and that takes time. You have to be comfortable working in a space that isn’t clean or algorithm-driven, where there isn’t always a clear protocol to lean on, and where a lot of women are in rough shape emotionally and physically. We are working with incomplete research and guidelines that are evolving too slowly and are too narrow in what they address. The highest-quality data we do have doesn’t always answer the questions that matter most to the woman sitting in front of you. We are very much in the wild, dear sisters. Meanwhile… there’s a massive glut of information—some of it helpful, much of it not—that she, YOU , are grappling with. My patients? Yeah well, they aren’t exactly coming in feeling even medium. They arrive feeling confused, dismissed, or minimized at some point along the way. Why would they trust the system, the evidence, the guidelines, or even the person sitting across from them, or even… me ? It does beg the question. Being a woman, as far as I can tell, is extra. Wouldn’t trade it for the world, but also, let’s just be honest here people. Experience matters. Discernment matters. Labs and intuition matter. A willingness to be okay with being in the wild is a prerequisite of doing this work, or frankly you won’t be working here for long. Dr. Kirsten Smith, ND, MSCP References Personal clinical experience with DUTCH, saliva, blood, and genetic hormone testing (2009–2026). The Menopause Society (formerly NAMS) 2022 Hormone Therapy Position Statement. Menopause. 2022;29(7):767-794. European Society of Endocrinology clinical practice guideline for evaluation and management of menopause and the perimenopause. European Journal of Endocrinology. 2025;193(4):G49–G71. Santoro N. Declining ovarian function and the pathophysiology of menopausal symptoms. Best Practice & Research Clinical Endocrinology & Metabolism. 2016;30(4):473-484. Writing Group for the Women's Health Initiative Investigators. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy. JAMA. 2004;291(14):1701-1712. Cauley JA. Estrogen and bone health in men and women. Steroids. 2011;76(12):1349-1354. The PEPI Trial: Postmenopausal Estrogen/Progestin Interventions. JAMA. 1995;273(3):199-208. #### Hi, I'm Dr. Kirsten Smith #### Women’s health warrior and advocate with 15+ years of experience in hormonal health My goal is to support women at all stages of their hormonal journey, through pre-perimenopause, perimenopause and post-menopause. --- title: "Top Tips to Prevent & Lose Belly Fat" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/top-tips-to-lose-belly-fat" markdown_url: "https://www.drsmithnd.com/llms/blog/top-tips-to-lose-belly-fat" lastmod: "2024-02-16T19:47:00.000Z" --- With all the changes in our bodies during the menopause transition, there is one that raises so many questions, frustrations and self-doubt: BELLY FAT. Belly fat is the excessive tissue that often develops around the midsection at the onset of [perimenopause](https://galvestondiet.com/menopause-symptoms/perimenopause-why-doctors-often-miss-the-diagnosis/) (which begins 10 years before menopause, so as early as your late 30s.) ### Why?!? Why Does This Happen? As estrogen decreases during this transition, testosterone increases, and fat distribution begins to shift from the hips and thighs to the abdomen in the form of visceral, or “belly fat.” It is important to know that belly fat isn’t just a huge annoyance; it’s also a risk. Studies show that increased visceral fat raises the risk of heart disease, diabetes, dementia, and breast cancer. ### The Two Main Types Of Fat - Subcutaneous fat , the fat underneath our skin, is found throughout the body, and often pinchable. It is usually more equally distributed, can be adapted through lifestyle modifications and in excess can lead to other health issues as well. - Visceral fat, aka belly fat, is the adipose tissue internal to and surrounding vital organs including the liver, stomach, and intestines. To some degree we need visceral fat to support those organs, however too much can lead to insulin resistance, increased inflammation and heightened risk of metabolic syndromes, diabetes, hypertension, and cardiovascular disease. Women experiencing menopause and post-menopause often fight with this type of belly fat the most. There is a close relationship between higher amounts of visceral fat, insulin resistance and inflammation. For women in perimenopause, it’s crucial to have good information and a strategy to address your health. The good news is, visceral fat responds to lifestyle changes! ## Top Tips To Prevent and/or Lose Visceral Fat ### 1. Exercise As you transition into menopause, exercise will support good bone and joint health, produce endorphins, promote good sleep AND support good lean body mass to fat (visceral fat) mass ratios. You need a good balance of moderate [cardiovascular exercise and strength training](https://galvestondiet.com/menopause-weight-loss/benefits-of-physical-activity-in-menopause/) . It is important during this time to start to learn about and incorporate strength training if it is not yet in your routine. ### 2. Anti-Inflammatory Nutrition A vibrant and strong diet full of complex carbohydrates, lean proteins, and healthy fats (nuts, seeds, avocados, olive/avocado oils, fatty fish etc.) will lower inflammation, support hormone production and improve your overall health. Cut down on sugars, consuming no more than 25 grams of added sugar per day. Increase your fibre intake to at least 25 grams or more per day. Eat more protein. Studies have shown that people who eat at least 1 – 1.5 g of protein for every kg of lean body mass have less belly fat than people who eat less. Try increasing your intake of [high protein foods](https://www.healthline.com/nutrition/20-delicious-high-protein-foods) such as whole eggs, fish, legumes, nuts, meat, and dairy products. ### 3. Reduce Stress Find new tools, skills, and support to help you with family, work, and your health. What might have worked in your 20-30s might not fully support the life transitions that come with menopause ages and stages. Find new ways to bring moments of joy, peace, and calm in your day. Small walks, fresh air, journaling, using a meditation app, yoga, breath work, or working with a therapist can really help. ### 4. Find a Community Finding a group of women who are going through it and embracing the same approach during this time makes a huge difference. This could be online, friends, or a structured educational group (like my [Peri Collective community](https://go.healthandwellness.io/peri-collective-1#) for example: an online educational series where I provide you with all the tools you need to tackle your perimenopause years!). Learning from others on how they are supporting their bodies during all these changes and finding joy in common ground and goals is super helpful. ### 5. Improve Sleep The best defence and tool to reduce belly fat is getting good sleep. For real! Look at your sleep patterns, quality of sleep, and overall sleep hygiene (room temperature must be cold, no screens, noise, comfort of clothing and bedding). Many women in perimenopause and beyond experience fluctuations in body temperature resulting in night sweats, making sleep almost impossible. Making nutritional and lifestyle changes, and consulting your healthcare provider to discuss other treatment options such as [HRT](/hormone-replacement-therapy) during this transition can help with sleep. You cannot manage your weight during this time if you’re not sleeping. ### 6. Support Through Supplements Yes, they do indeed have a role. Some great studies have emerged helping showing what can help us through perimenopause. The essential summary is that a good source of [omega-3 fish oil](https://shop.galvestondiet.com/products/omega-3-d?variant=31115439964250) , probiotics, and a [fibre](https://shop.galvestondiet.com/products/fiber-gdx?variant=31115389370458) supplement can help a great deal. There are other supplements that I advise but on an individual basis, based on individual needs. Studies show that people who consume more soluble fibre have a greater variety of bacteria and have less hormonal symptoms. Individuals with a varied gut microbiome have a lower chance of belly fat. Probiotics are healthy bacteria found in food and supplements that support gut health, and we can improve our gut bacteria by eating more fibre. Foods rich in probiotics include yogurt, kefir, sauerkraut, kimchi, miso soup, soft cheeses, sourdough bread, acidophilus milk, and sour pickles (not made with vinegar – real, fermented pickles). ### 7. Try HRT Yes it is a safe and important piece of the puzzle. You might be a great candidate for [hormone replacement therapy (HRT)](/hormone-replacement-therapy). Educate yourself and work with your healthcare provider to identify your unique needs. We have come a long way in understanding estrogen and progesterone HRT. Do not be afraid to [start this conversation](/getintouch) and get the care that you need. ### 8. Quit Smoking This one change can lead to [significant changes](https://galvestondiet.com/menopause-symptoms/menopause-and-cardiovascular-risk/) in visceral fat loss and overall decreased risk of cardiovascular disease, stroke, and other metabolic disorders. ### 9. Consider Stopping or Reducing Alcohol This absolutely will be an obstruction to both quality sleep which is where we started – and of course, alcohol is a sugar and our ability to keep our blood sugar both low and stable is not the same from perimenopause and beyond. Alcohol can make weight management very challenging even if we are doing the rest of it right. I strongly advise all my patients to drop it completely or get much more selective / reduce intake as much as they can. ### 10. Try a Customized Approach For those at the end of their rope and in need of a more hands-on, custom approach, that’s okay! There is a time and place where we all need that. With clients seeking a specific plan, I use the invaluable [Metabolic Balance™️](/metabolic-balance) program which is absolutely effective, efficient and personalized. And as always, don’t hesitate to reach out to our team at [info.enviromed@gmail.com](mailto:info.enviromed@gmail.com) Warmly, Dr. Kirsten 🦋 Dr. Kirsten Smith, ND Dr. Smith is a licensed, board-certified naturopathic doctor in the province of Ontario, a member of the Menopause Society, the Ontario Association of Naturopathic Doctors and the Canadian Association of Naturopathic Doctors. --- title: "Vaginal Changes Over 40: What to Look Out For" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/vaginal-changes-over-40" markdown_url: "https://www.drsmithnd.com/llms/blog/vaginal-changes-over-40" lastmod: "2024-09-23T11:33:00.000Z" --- I cannot tell you how often women almost fall over when they learn about what happens to their lady parts starting in mid life in my clinical practice… Everyone knows what’s coming with puberty but to this day, most women are just completely steam rolled in the perimenopausal transition. Like, mind-blown! I am doing my bit in the sea-change of the menopause narrative both by educating but also by contributing to reframing how we think, feel and act about it. We didn’t come this far just to feel demoralized ladies, we truly didn’t. To that end, knowledge is power and this piece puts a much needed spotlight on vaginal & bladder changes that you need to know about so that you do NOT suffer. ### Understanding the Genitourinary Syndrome of Menopause (GSM) Genitourinary syndrome of menopause (GSM) is the medical term used to define changes arising from decreased estrogen in the vaginal area, pelvic floor and urinary tract. These changes can start well before menopause or well after menopause; it is different for everyone. ### Symptoms of GSM - Vaginal dryness, irritation, itching, burning, or discharge - Decreased lubrication - Pain during sex, bleeding after sex - Delayed or diminished orgasm - Urinating frequently, urgency, peeing more at night, recurrent UTIs - Thinning pubic hair, decreased volume of labia - Thinning or fusion of labia minora (inner lips) - Clitoral hood shrinkage, retraction - Vaginal canal becomes thin, less hydrated Of all the challenges that menopause can bring, vulvovaginal atrophy (VVA), which falls under GSM, is among the most common, impacting [up to 90 percent of women](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9580828/) . And unlike other symptoms that can abate over time, vaginal pain, dryness, and irritation doesn’t disappear and often worsens because it results from physical changes in those tissues. Our vulvar tissues lose elasticity, collagen and hydration resulting in some shrinkage, tissue laxity and dryness resulting in pain. For some women this is just with sex, for some they cannot get a PAP or pelvic exam, for some it is so bad that they can’t even wear jeans. ### Don’t Fret… There are Treatments: #### Estrogen Vaginal estrogen is the gold standard treatment for GSM because it is the loss of estrogen that is the root cause of these changes. It improves the quality of the tissues in and around the vagina, thickens the skin of the canal, increases natural lubrication, restores normal pH of the vagina and reduces the risk of UTIs. It is safe for ALL women, even those who have had breast cancer. Note, you will likely need local estrogen even if you’re already on systemic estrogen aka menopause hormone therapy. #### Hyaluronic Acid (HLA) For women who need extra hydration and support in addition to local estrogen therapy, HLA-based products are your best bet. They can also help reduce vulvovaginal symptoms like itching, burning, and dryness. ### Work With Me If you are struggling with GSM and other peri and menopause-related symptoms, I am a board-certified Naturopathic Doctor with 15+ years of experience in women’s health and hormones. I can help! [Book a consultation with me today.](/getintouch) Helpful articles : [https://www.acog.org/news/news-releases/2016/02/acog-supports-the-use-of-estrogen-for-breast-cancer-survivors](https://www.acog.org/news/news-releases/2016/02/acog-supports-the-use-of-estrogen-for-breast-cancer-survivors) https://menopause.org/wp-content/uploads/for-women/mn-vaginal-dryness_4e454569-8d3c-4346-a00b-515f46b378c9.pdf --- title: "What Is An Autoimmune Disease?" entity: "blog" canonical_url: "https://www.drsmithnd.com/blog/what-is-an-autoimmune-disease" markdown_url: "https://www.drsmithnd.com/llms/blog/what-is-an-autoimmune-disease" lastmod: "2018-01-26T22:30:00.000Z" --- An Autoimmune Disease is a condition in which the immune system attacks a part of its own body. This is an anomaly. Normally, the immune system is intelligent, vigilant and primed to protect the body as soon as it detects a foreign substance, abnormal cell, or tissues by producing an immune response. These responses vary depending on what our immune system detects, but generally, this involves plasma fighter cells creating antibodies, which specifically tag the foreign invaders so the rest of the immune system can identify it and then be able to fight it. This battle usually results in inflammation which is the common denominator of all autoimmune conditions. It is also why so often it can take a long time to diagnose an autoimmune disease, as they can look like many other types of conditions as they are developing. When our immune system is healthy, it can easily tell the difference between foreign cells or material, and our own cells. But when an autoimmune disease develops our immune system becomes misdirected and targets us, resulting in an inflammatory process involving one or various organ systems depending on the type of autoimmune condition. Scientists have identified more than 80 types of autoimmune diseases, all of which have different symptoms. In some of these diseases, like Type 1 Diabetes, the immune system targets a specific part of the body (in this case the pancreas). While in other conditions, like lupus, the whole body is affected. ### What Causes Autoimmune Diseases? Researchers aren’t yet completely clear on the various potential triggers but they are making huge strides to determine who is most at risk of contracting autoimmune diseases. One confirmed and unfortunate fact is that women are more than twice as likely to get an autoimmune disease than men, with prevalence rates reaching 6.4% of the population. Additionally, depending on the disease, autoimmune conditions tend to affect some ethnic groups more than others. Below are a few scenarios which may potentially make us more vulnerable to developing an autoimmune condition (in particular if they happen in combination of course): - Emotional stress (i.e. death, divorce, etc.) - Physical stress (i.e. surgery, a big bout of viral or bacterial illness, a car accident, etc.) - Familial genetics (if others in your family have autoimmune condition, there is a higher chance you may develop one) - Dysbiosis/ gut health - i f you have an imbalance of good to bad bacteria that is significant enough, this can impact your immune system negatively. - Toxic burden - many people are exposed to mold or other toxins that for them as individuals is more than their body can bear which will cause immune confusion. Thankfully now there are good genetic tests to screen for impaired detoxification pathways which make us more vulnerable to building up too many toxins in our bodies. Additionally, there are some excellent environmental toxin panels we can use to accurately assess exposures and toxic. ### The 6 Most Common Autoimmune diseases Medical researchers believe that there are more than 80 different autoimmune diseases. Their symptoms overlap, making them hard to diagnose and for many of them, and furthermore, we still don’t have the testing we need to diagnose many of them. Here are six most common ones. ##### 1. Type 1 Diabetes In type 1 diabetes, the immune system attacks and destroys insulin-producing cells in the pancreas, an organ that helps regulate blood sugar levels. This damages blood vessels, and organs like the heart, kidneys, and eyes. ##### 2. Rheumatoid Arthritis In rheumatoid arthritis, the immune system attacks the joints, causing pain and stiffness. ##### 3. Psoriasis and Psoriatic Arthritis Psoriasis is an autoimmune disease that causes skin cells to multiply too quickly. This causes red, scaly patches called scales to form on the skin. About one-third of the people who suffer from psoriasis also develop swelling, stiffness, and pain in their joints. This form of the disease is called psoriatic arthritis. ##### 4. Multiple Sclerosis Multiple sclerosis (MS) is a degenerative autoimmune disease that damages something known as the myelin sheath, which is a protective coating that surrounds nerve cells. This damage affects the transmission of messages between the brain and the body and leads to numbness, weakness, balance issues, and eventually severe physical impairment. ##### 5. Lupus Lupus is a severe autoimmune disease that affects skin, joints, kidneys, brain, and heart ##### 6. Inflammatory Bowel Disease Inflammatory bowel disease is a term used to describe a series of autoimmune diseases that affect the lining of the intestines. These diseases include Crohn’s disease and Ulcerative colitis, both of with affect parts of the gastrointestinal tract. ##### Other Autoimmune Diseases Other autoimmune diseases include [Addison’s disease](https://www.healthline.com/health/addisons-disease), [Graves’ disease](https://www.healthline.com/health/graves-disease), [Sjögren’s syndrome](https://www.healthline.com/health/sjogren-syndrome) and [Hashimoto’s thyroiditis](https://www.healthline.com/health/chronic-thyroiditis-hashimotos-disease) ### Common Symptoms Of Autoimmune Diseases The early symptoms of many autoimmune diseases are very similar, which is why they are so difficult to diagnose. If you are feeling any of these symptoms, consult a medical or naturopathic doctor immediately. - fatigue - achy muscles - swelling and redness - low-grade fever - trouble concentrating - numbness and tingling in the hands and feet - hair loss - skin rashes If you are suffering from any of these symptoms, definitely consider booking a [Naturopathic Consultation](https://www.drsmithnd.com/about/) to assess what may be causing the issue or contributing to the condition in a negative way. ### What is Naturopathic Treatment for Autoimmune Disease? Of course this varies dramatically depending on the specific condition, but fortunately, Naturopathic Doctors truly do have a lot to offer in this area of medicine. We have numerous ways of reducing inflammation through diet, through safe use of herbs, through proper assessment of lifestyle and appropriate lifestyles changes, sometimes with acupuncture, and by identifying if there are exposures that are contributing to the problem. Our holistic way of assessing and treating patients often bring benefit in these cases. Additionally, NDs are experts at assessing and testing for gastrointestinal dysbiosis and rebuilding a robust gut microbiome. Understand that this is NOT an “either or” situation. NDs are working in adjunctive care capacities in most of these cases and that is the whole point: specialists play a vital role as do medications, but so do we. Naturopathic doctors can help you reduce your pain, or help you reduce side effects of essential medications and often help you get more benefit from them. In some cases, patients experience so much symptom resolution that they can decrease their medications and some even get off of them completely. It is important to note however that people respond differently to treatment and the progression of each patient’s condition is individual. NDs also take the time to teach their patients how to optimize their chances of getting into remission and how to mitigate having another flare up. The bottom line is, across Canada and the United States NDs are playing a much needed, vital role in this area of health care. If you’re concerned you have an autoimmune problem or are wanting to learn more about our type of care/testing/ medicine – please call to book a short complimentary consult as I would be happy to talk with you about it. Dr. Kirsten, ND, MSCP