S1 E18: Stress & Building Resiliency with Kaely, RD


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Amanda: Hey, this is Amanda, women’s health dietitian.
Emily: And I’m Emily, nutritional therapy practitioner.
Amanda: And this is the Are You Menstrual? podcast where we help you navigate the confusing world of women’s hormones and teach you how to have healthy periods.
Emily: Each week we will be diving into a different topic on women’s health and sharing our perspective using nutrition, female physiology, and metabolic health.
Amanda: Our goal is to help you wade through conflicting health information and empower you on your healing journey.
Emily: We hope you enjoy it.

Amanda: In this episode, I am joined by my friend and colleague Kaely McDevitt, also known as @kaelyrd if you follow her on Instagram. Kaely is a registered dietitian specializing in women’s health. She owns a virtual private practice where she and her team help their clients overcome hormone and digestive issues through personalized nutrition. Having experienced the pitfalls of a conventional approach to women’s health firsthand, Kaely is super passionate about empowering women to take the driver’s seat over their health and well-being. So I’m really excited to have you here today, Kaely. We are friends in real life, too, which I feel like is rare because I meet everyone online.

Kaely: I know it’s so nice. 

Amanda: We’re separated now because I no longer live in Texas, but we’ll will reunite soon. So our topic today is really, stress. And the goal of this podcast episode is to help everyone kind of understand the body’s stress response and how to build resiliency so that you have a healthy stress response. I think it’s just so common today to focus on eliminating stressors constantly and not really focusing enough on why can’t you handle that stress in the first place. We want to help you build your body’s resiliency and respond to stress better, and that’s what we’re going to dig into today. But I picked Kaely for this topic, because she, this is a very big part of her health journey. So do you want to tell everyone kind of how you got so interested in women’s health?

Kaely: Yeah. So I mean, I was always interested in nutrition, like, I grew up being an athlete, sports nutrition is where I thought I was going to be existing, which I know we share that in our past. And I started having really, really symptomatic periods, like all the way back in high school. Pretty much as soon as I got my period, it was miserable, like super heavy, really painful, I would miss days of school. And I went in saw my doctor and was like, hey, I’m miserable. And they were like, hey, here’s birth control, it’ll solve your problem. And I was like, great, sign me up. And so I took it, it did solve my period problems for that moment in time. I didn’t have symptomatic periods anymore. But as the years progressed, and it was really a full decade of use, I was feeling less and less like myself.

And I was at the same time going through schooling to become a dietitian. And I’m like frantically trying to apply everything I’m being taught to myself and like making no change. I was having a lot of mood swings, I was feeling really fatigued, and brain fog. I was always an athlete and super active and energetic and like that was not me anymore. And I just didn’t feel like myself. And I would see my doctors and explain these symptoms. And it was always dismissed. I tried every pill that was on the market, because I kept thinking like there’d be one that was better for me. And it wasn’t until I started to dig into some of this research on my own—because it wasn’t being provided at my doctor’s appointments—that I realized that I, one, knew nothing about how my body worked even though this was like seven years of formal education and health. And two, like, I wasn’t giving myself a chance to actually function the way that I was designed. So ended up taking myself off birth control, navigating that whole mess of symptoms. And when I got to the other side of feeling like myself again, I realized there were a lot of other people hungry for that info. And it really wasn’t there. I remember feeling like I was on really obscure blogs when I was trying to find info. So I just originally started with a blog to try to share that info for other women. And it just progressed from there. I realized sports nutrition is not what I was passionate about. It was about helping women navigate similar hormone issues.

Amanda: That’s really cool. I didn’t know you started with a blog.

Kaely: Yeah, it was like an accidental private practice. 

Amanda: That’s so funny. I, all I can think of is like forums. Do you remember going… I remember going on like forums. I also didn’t realize that you were on the pill for a decade.

Kaely: Mmhmm, yep.

Amanda: That’s a very long time.

Kaely:  Sure was.

Amanda: And how old are you when you came off?

Kaely: I was 22? Oh wait. No, that would have been 24. Getting my years mixed up. So from like the start of my period really like only had a couple of cycles before I went on it which was part of why it was so difficult.

Amanda: I was gonna say… So how was that transition for you?

Kaely: Not great. I was hoping that as soon as I pulled the pills out of my regimen, it was going to be like rainbows and butterflies and everything would be fine. My cycle did come back within two months, which I was kind of surprised about, but I dealt with a lot of acne, a lot of hair loss, like really symptomatic periods. And you know what I had come to learn was that because I had went on birth control so soon after ever menstruating I really hadn’t had like proper brain-ovary communication established I really hadn’t learned how to make progesterone. So it took me like an entire year after coming off birth control to get that supported again.

Amanda: I’m not surprised at all. I started it after I’d had my period for like four or five years. So I didn’t do it immediate, but I was like, I got my period very young. So I feel like that’s the only reason why. It’s just interesting how like, even though like, it took me a year to get my period back after the pill, but we still have the same symptoms, you know, it’s like, it’s still very similar. Very, very interesting. I think a lot of women will relate to that.

And before we dig into like stress, I just want to highlight one thing that you said. You said, like you want to, because you never gave your body the chance to function like it’s supposed to. And I was just like, oof, that like, punched me in the stomach. But I think that that’s a, something that we don’t always realize, as women, you know, we’re so focused on trying to feel better, like fixing symptoms, but it’s like, are you just letting your body be in the way that it’s supposed to be? If we’re constantly trying to manipulate it, of course, it’s going to push back against you. So very, very…I was like, ooh, that was good, Kaely.

So we’re gonna dig into the actual stress response. And I think it’s important for people to understand this, I know you talked about this on your Instagram a lot, you’ve got a lot of great graphics to kind of give examples. But do you want to walk us through like what actually happens in the body when we’re confronted with a stressor?

Kaely: So we got to preface this with there’s a lot of different types of stress. I know, we’ll get into this, because I think this is the point that a lot of us are missing. And I certainly was too back in the day, but we’ve got a lot of different things that can be contributing to this overall stress burden. But regardless of the type, whether it’s an actual physical stress or something going on just in your brain from the work day ahead, your body’s gonna respond in the same way. And the focus of the body in response to a stress is to ready you to survive that instance. So what happens is we get a rise in cortisol, which is our stress hormone, and cortisol enables all the other physiological changes to help us survive that stress, namely raising blood sugar levels, so that we have quick energy to be able to run away from the tiger that is our stress—even if it’s not physical. So we get that same response, like seated in an office chair on a stressful work call that we do like literally running from a predator in the wild. So we get cortisol going up, we get blood sugar going up, and we get the breaking down, or the catabolism, of our own tissues in order to keep that glucose up for the duration of that stress. We burn through a lot of nutrients at this time, too, which I know we’ll talk I’m sure extensively about, but we’re just trying to survive. So fight or flight is a survival mechanism. And then everything else that’s more rest and digest gets put on the backburner. So not only are we burning through a lot of nutrients to keep this stress response going, but we’re also not able to absorb them anymore either through digestion. So just having this state of survival, of keeping blood sugar up, of breaking things down in favor of survival and not promoting rest and digest.

Amanda: Yeah, and I, it’s, I think people don’t realize that when you are more stressed, like your energy needs increase, because you’re breaking stuff down. I’m like, no, like, if you’re more stressed, like that’s, why do you think you get like cravings and stuff like that? But are there any like physical…Because I think, I do think it’s hard to kind of like say you’re having more mental or emotional stress. Do you think there’s any, like physical signs that people would be able to tell like, if they’re in that stressed out state?

Kaely: For sure a lot of like GI symptoms, at least in my clients and myself, I noticed. And it’s because all of the digestive capabilities are really downregulated during this time. So you might find, like literally feeling a knot in your stomach. Or when you do eat, it sits heavy, you’ve got a lot of like discomfort because you’re not able to digest it. Elevated heart rate, sometimes it’s going on during at least this acute phase of stress. You can also have like headaches, brain fog sometimes during this point of stress, like unable to really focus on the task at hand, because it’s not inherently related to survival. Sometimes you’ll notice like an increase in perspiration during this first phase of stress, but the ones that I see most often, at least acutely, are usually digestive.

Amanda: Yeah, and I think it’s, obviously there’s ways it’s going to impact us in the long term if we have like chronic stress. But I think those are good to recognize, because sometimes we don’t always know like, what does it mean to be stressed? Like, how do I know if I’m stressed? The reason why we’re focusing on stress in this episode is, part of like the foundations of this whole podcast series is because stress…it doesn’t happen in isolation, right? It’s going to impact other areas of the body. So how does this stress directly impact our female sex hormones? And like what might this look like for people on like, day to day hormone cycle or like your whole monthly cycle?

Kaely: For sure. So with an increase in stress and that increase in cortisol, and the depletion of nutrients…and the ones we’re really talking about are things like magnesium, which is a heavy hitter for hormone health, your B vitamins, but especially B6, and that comes into play when we talk about progesterone. Vitamin C, sodium, and potassium are like the big things that we’re talking about depletion during times of stress, and those are all involved in making our sex hormones and utilizing our sex hormones appropriately. So what we typically see from a hormone standpoint is progesterone is going to be utilized a lot more during times of stress. We also are going to be using a lot of the building blocks that could have been used for progesterone production too. And when we don’t have the ability to make as much progesterone or we’re using a ton of it, we’re going to have more symptomatic periods because progesterone is the hormone that’s keeping your estrogen in check. And when we have PMS or painful symptomatic cycles, it’s usually because either progesterone is not high enough or estrogen is significantly higher. And excessive amounts of cortisol is putting you in that state. We’re also going to see an increase in estrogen if that stress gets prolonged too. And that in turn is going to mess with even thyroid hormone. So we have this whole cascade, moving us from that state of resiliency and calm and rest and repair to breaking things down, higher estrogen, lower ability to use and uptake thyroid hormone, and various symptomatic cycles is what we typically see.

Amanda: Yeah. and I think it’s, it’s so hard because a lot of women are focused on their actual sex hormones. Like, I want to get my hormones tested, right, I see I have estrogen dominance—it’s not really the issue. It’s that we have to look beyond that. So do you typically recommend when working with women, or even you know, you’ve got a great community online. Like, do you often get questions about like, which lab test should I do first? And like, what do I focus on first? 

Kaely: For sure. And that’s even been like an evolving practice of mine as a practitioner. I think when I was first in this space, I was really obsessed with testing hormones. I think we all are. And there’s some really cool tests out there that are definitely still useful. But I don’t think that that’s where we need to start. Because like you said, the hormones are not causing problems. Like that’s not the issue. The issue is what prompted those to get out of whack in the first place. And that is stress and the nutrient depletions related to that. So I do think lab testing on a routine basis is great, because we should be keeping tabs on our health. But I don’t think with hormone symptoms, we need to immediately start with like an advanced hormone panel, I think we’ve got a ton of things that are a lot less expensive that we can utilize before we get there.

Amanda: Yeah, I know, that’s, I’m like I mean, they’re like, I love Dutch hormone tests. I know you use that as well. It’s great. But I’m like that’s a very expensive lab test. And it’s like, do you want to invest in that? Or do you want to invest in things more focused on, like, your basic nutrient requirements, what minerals we know that you’re deficient in, vitamins, stuff like that. So I totally get that. And I, the whole reason why we’re even talking about this, and especially when it comes to women’s health specifically, is because I feel like, and I know we’ve had many conversations about this, like we’re living in a world of burnout, right? And it’s kind of like, I’m very curious of your thoughts of, like, why we’re in this place. Like why do you think so many women are in that burned out state and why it’s so common for people today?

Kaely: Yeah. Oh man, I feel like I’m gonna have to not get on a soapbox with this question. I think it’s a lot of things. So, one, I mean, other than the fact that we’re living in some pretty strange times right now, so base level of stress is just higher for people, we also have women in the workforce in a much greater capacity than we did historically, like boss women running things. So they’ve got that stress, they usually take on the full burden of like, child care and raising kids and maintaining a household. Or I shouldn’t say full, but at least a bigger percentage of that burden in most instances. And then at the same time, we’re also inundated with so much health information that’s working against, like, how a female body should work optimally. So we’re being told we need to maintain a certain size of clothes and a certain weight on the scale, and in order to do that, we’ve got to restrict our calories. And hey, you’re not doing enough if you’re not doing HIIT workouts six or seven days a week. And how about keto? And how about we try intuitive fasting? Like, we just have so much information that’s keeping us in this chronic stressed out state on top of general life stressors.

And then we’ve got a lot of chemical stress, like, from our environment, in our food that we didn’t used to have either that’s compounding this issue. So we’re kind of getting attacked from all sides. And then we don’t have the same priorities to offload that stress or create that resiliency. You know, instead of doing things that would help fill our cup, we’re on our phone with social media pinging us and keeping us in a stress response. We’re watching the news and keeping us in a stress response. And there’s very, very little emphasis on relaxing and filling your own cup. I mean, there’s hardly any of that in a day to day.

Amanda: Yeah or just like rest to be you know, like there’s not exactly and we, I feel like I’ve talked about that a lot lately with people but I totally agree. And I think that’s just important to lay this groundwork before we dig into this, because it’s, I think people are sick of hearing about stress and I get it, but it’s like we’re expecting ourselves to like show up, be super healthy, not have any hormone imbalances in this world that just is not created to actually support the female body.

Kaely: Yeah, and to even have that expectation for the same level of performance every single day of your, of your cycle is not accurate. And I think a lot of people are striving to always feel like the amazing energy we typically feel in the first half of our cycle, and to never ever have a symptom, and that if you have a symptom it’s a sign you’re doing something wrong, but that’s not the case at all. I think we have unrealistic expectations on ourselves and it adds to this whole stress picture.

Amanda: And you know, a symptom is because your, our bodies, like Kaely explained in the beginning, they’re always compensating. They’re always compensating to the outside environment. So eventually, they’re going to have imbalances whether that, usually it’s from like vitamins and minerals, hormones start to get out of balance because they’ve been compensating for so long. I think the, the next best place to go is to talk about being addicted to stress. I know we both talked about this on Instagram. But that post, like so many people were like, I feel called out reading this post. I’m like, so do I, okay, we’re all addicted to stress, because of like, for all the reasons that you just listed with the world that we live in. But can you kind of go through what does it mean to be addicted to stress or the cortisol stress hormone? And how does someone know if maybe that might be the case for them?

Kaely: Yeah. So when we are addicted to stress, that means that our body is liking this chemical cocktail of lots of cortisol in our system. And cortisol is anti-inflammatory, it keeps blood sugar up, like, there are some reasons why cortisol can feel good initially. I mean, it’s not all bad. But it’s a prolonged exposure to that that causes all the things that we’ve been talking about. And I feel like I can describe the addicted to stress persona so well, because hello, that was me. And I know it was you too. So the, the textbook addicted to stress is somebody that usually is waking up super early to get in some kind of a really intense training in. For me, this was either like marathon training back in my grad school days, I had a stint of, like, HIIT, CrossFit, bootcamp type workouts. And like feeling really good during those, like I was craving that cortisol rush from that type of workout. Either needing coffee all day, or like, only feeling human when we drink coffee, because that’s giving us a rise in cortisol. Actively seeking out stressful situations or events. And that may not be super obvious, but it could be that we love looking at the news because we get like a rush of stress from seeing what’s going on, or maybe stuff on social media. Or maybe we are like procrastinating a project because getting it down to the deadline gives us that surge of cortisol that we’re looking for. And I guess those would be more of the positive things where we actually feel good. But you’ll probably also notice, like if you go too long between meals, like even more than an hour or o we’ve got hanger coming in, blood sugar crashing, not staying asleep throughout the night, usually waking, like, anytime between one and three with the same stuff going on. And that is me to a T while I was in grad school.

Amanda: It’s, I think everyone can relate to that. I think of people, like people that thrive, they feel better on low carb or keto. You know, they’re just like, I need to be running off. I mean, you’re running off of cortisol, like that’s why after a certain time your sleep is just terrible. Like you mentioned, you don’t even have to have like, go through that whole low carb process to experience poor sleep, but it usually exacerbates it. And then people that like fasting, they’re like, oh, I can’t focus or do any work or anything if I’m not doing fasting. I’m like, okay, that’s because your body is addicted to cortisol.

Kaely: Yeah, it’s, and then it’s hard to come off of that too, because you’re so used to that like high functioning, like, adrenaline type thing that usually when they first try, they feel so much worse that they’re like, oh, clearly, that’s not for me, this is what’s for me. And that’s where we get stuck.

Amanda: And wanting those instant results, like thinking that you’re going to try a way of eating, and if it doesn’t immediately make you feel better than it’s, like, not going to work for you. Yeah, I think a lot of people can relate to that. What are you think are the biggest contributors to stress on like a day to day basis for women? And I know, we’ve kind of talked about some of them with like working and stuff. And I definitely think that but like outside of that. What do you think, you know, we have more control over?

Kaely: The main ones in our control are how we eat. So the amount, the type, the structure of eating, like, how frequently we’re eating. And I see this, whether it’s intentional or not, there’s a ton of undereating going on for women, like it’s rampant. And I know you see it in your clients too. And I think that comes back to all the really terrible advice that’s surrounding us all the time about how we should eat. And so that could look like an under intake of calories or it could look like you mentioned really low carb eating or really low-fat eating. Like under representing a macronutrient can cause the same stress response. I think exercise is another controllable stress input. And I’m very much pro-exercise, like, we can’t get away from the fact that that’s going to be good for you. I just think we mostly are going about it the wrong way. Big on like weights and walking over here, like, maximum benefit, minimum stress on the body. Sleep is another really big input that we have more control over. Like, the schedule of our sleep is supporting our circadian rhythm. And then also like the amount and the quality of that sleep, and then also keeping blood sugar balance throughout the day. I think that’s a really underrated way to offload that stress burden.

Amanda: So it’s like, I mean, you think about it, you’re just trying to think of what is going to kick off that cortisol response in your body. And that’s, that’s kind of the whole point is we’re never going to eliminate all stress—there’s literally no way, especially in the world that we live in today. So it’s like, what are those little things that we could work on. And that’s what helps make your body more resilient to stress. When you are paying attention to your nutrition, looking at is my exercise adding more stress to my life or reducing the amount of stress in my life. And I know that that’s a very touchy subject for a lot of people because we get attached to the type of exercise that we like. But I think it’s important to kind of face all those types of things. So if someone was listening to this podcast, and they’re like, okay, you definitely described me, I was Kaely when she was in college. What, what are the things that you think would be the most helpful for them as far as like making their bodies more resilient to stress?

Kaely: Yeah, I’d say first, we need to look at food, I mean, to make sure that we’re eating enough and we’re eating at consistent intervals throughout the day to keep blood sugar steady—that’s going to decrease so much of the workload on our adrenals. Like, it makes a world of difference to just do that. And then the next thing I would say is, let’s look at that exercise and make sure, like you said, it’s not adding insult to injury here. I think we have this mentality around stress being alleviated through exercise, or even like having to earn rest because we’ve been working really hard. And we really have to earn the ability to do intense exercise. And I think there’s a lot of like, un-training we have to do about the way we think about it. But, so food first. Talked about exercise…scale way back on intensity or even total volume. Especially if we’re in this burnt out state we just don’t have the reserves to play with. And then I’d say looking at sleep and making sure we’re getting our circadian rhythm taken care of both in terms of like sleep schedule and then also light exposure during the day. And that’s where really all of our clients start is with those three things. And then from there, we can do more things, but we can’t move forward unless that’s squared away. 

Amanda: And I think a lot of people like to think that they are different, you know, but I have this going on, and I have this specific, like, part of my health history. But at the end of the day, if you are someone that aligns with a lot of those signs of burnout, of being addicted to cortisol, it’s like you still…if you don’t have the basics in place, you’re never going to be able to get a handle on those symptoms, which could be hormone imbalances, sleep issues, gut issues, all that kind of stuff. I know that meal timing is very controversial. And I’m just curious, like, how, basically like, how important do you think that is for someone if they’re in that place of like, complete burnout, where they’re fatigued all the time, they have their various symptomatic cycles, or maybe they have irregular cycles?

Kaely: Extremely important, extremely important.

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Kaely: I think nutrition is probably our biggest opportunity to mitigate stressors on the body. And if we are burnt out, really, lots of hormone symptoms going on, we don’t have a choice but to be as gentle as possible with our nutrition. And 100% of our goal is to make sure that we’re not relying on cortisol to keep blood sugar up. Otherwise, we just keep this revolving door of stress going. So I’m a big fan of eating like within an hour of waking if not closer to 30 minutes, because that’s our first opportunity to tell the body hey, we’re good. We’re breaking our fast, we’re not in a survival situation, there’s going to be ample food coming in. And then every three to four hours after that, like a nice macro-balanced meal or snack to help keep blood sugar steady. You may have flexibility to go a little longer between meals as you come out of this burnt out state. But a lot of people just feel their best there and there’s no reason why you can’t continue. Again it’s just like gentle nutrition is typically how we describe it. And when you’re experiencing burnout, we have to be really, really gentle and intentional with fueling.

Amanda: Do you find that there’s ever a time where people need to take a complete break from exercise? Like, obviously, like I think movements i a little different, but like exercise in general.

Kaely: Yeah. formal exercise. Yes, movement, like you said will always be important, like walking, mobility, that kind of stuff, I think is really important. But, you know, if we’ve got no reserves to pull from, like no resiliency to stress anymore, and we can offload exercise as a big input for that stress, then we have to take that opportunity.

Amanda: Yeah, I think that’s like a hard one. Some people are kind of like, well, how do I know if I need a break from that exercise? And so like, what, what are some of the signs you think that someone is in that complete burnout state where they need to be very gentle with nutrition, and even with their exercise?

Kaely: Yeah, really, symptomatic cycles, like we talked about. If you’re not sleeping through the night, that is a huge, huge sign from your body that something is not being supported right. Feeling really depleted during or after your training session is another clue. Seeing a decrease in your drive to train is another big thing that your body is trying to do to help get your attention, and then not seeing the results you would expect to see with the effort being put in. So when you’re in this stressed out state, and we’ve talked about that being catabolic, like breaking down body tissues and reserves to keep blood sugar up, we’re going to break down lean muscle mass. So a lot of times, you’ll notice that you’re really, really sore from your workouts, and it doesn’t seem to match the type of work

Amanda Montalvo

Amanda Montalvo is a women's health dietitian who helps women find the root cause of hormone imbalances and regain healthy menstrual cycles.

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