What are the top 5 best weight loss programs and the worst 5 weight loss programs?

While there are all sorts of weight loss plans on the market, experts agree that the best plan for you is one that works for your lifestyle and personal health history, and that you feel like you can stick with.

It can take a while to go through the different programs out there and sift through all the marketing hype to get to the nitty gritty of what is going to be the best fit for you. Talking with a health care professional such as a nutritionist or dietitian is a great first step in the process. But if you want to do it on your own then here are a few things to consider.

Here are some questions to consider when choosing a weight loss plan.

• Does the plan include foods I like to eat?
• What is an appropriate weight loss plan for my age?
• What is an appropriate weight loss plan that may also help to support my other health issues or could it be potentially detrimental to my other health issues?
• Does the approach work for my lifestyle and preferences?
• Are the meals on this weight loss plan affordable?
• Do I have to spend extra time to shop and prepare the recommended meals?
• What other support and resources are provided to help me?
• Is there accountability and support?
• Is this sustainable long term?

No matter what weight loss plan you decide on, what truly helps with weight management in the long run are small lifestyle changes—such as increasing vegetable and fruit intake, staying physically active and limiting processed foods. These types of small changes build a positive, cumulative effect for long-term weight control and overall health as opposed to aggressive all or none approaches.

It is also important for you to understand the pros and cons of the diet. No one weight loss plan is likely going to tick off all your boxes so it is important to do the research to find out if this will be a good fit. One weight loss plan could have amazing pros but the cons are high and follow through might just be too difficult or too expensive.

Committing to a Weight Loss Plan

To actually stick to a weight loss plan, you need to think about your why. Why do you want to do it? What’s in it for you? And how committed are you to adopting this new eating and healthy lifestyle approach? Having this information top of mind can rekindle your motivation when it wanes.

Consistency is the key The best plan is the one you can stick with long term and personal fit matters. You need to take into consideration your lifestyle, food preferences, and schedule influence to determine if you will be successful with the program. Programs with coaching or education usually outperform quick‑fix diets. So having support can go along way to your success.

Most successful weight loss programs provide built-in strategies like these to help you go the distance.

• Tracking Your Progress. Weight loss programs give you meal and exercise tracking tools in the form of diaries or handy mobile apps. Using my fitness pal to track what you are eating and learning how what foods quickly add up calories or certain other nutrients or compounds such as sugar
• Creating mini goals. Most weight loss plans help you map out specific changes to make on your way to your goal, such as exercising each day or cutting back on alcohol intake. Checking off “mini-goals” along the way helps boost your motivation, keeps you on-track and builds healthier habits.
• Sidestepping weight loss fatigue. Most weight loss plans provide enough meal variety and other support systems to keep you motivated after the novelty of starting a weight loss program wears off.

“Treat Meals” Some programs offer the option to have a treat meal which can be great to allow more flexibility in social situations and help avoid binge eating and feeling deprived. There are pros and cons to treat meals. To find out more check out this article, Can I Have a Cheat Day?

Top 5 Worst Weight Loss Diets to Avoid

Before talking about the best weight loss program it is also important to talk about the worst ones, why they go wrong and are often detrimental to your health. Losing weight can be challenging, and with countless diet trends every year, it’s easy to fall for the promise of rapid results. But not all diets are safe or effective. In fact, some popular weight loss diets can do more harm than good. Here are the top 5 worst weight loss diets, why they fail, and the risks associated with them.

1. Starvation Diets: Extreme Calorie Restriction

Starvation diets, often under 800 calories per day, promise quick weight loss but come at a serious cost. Very Low‑Calorie Commercial Programs such as Optifast, Medifast and HMR.

These branded programs often rely on very low‑calorie meal replacements (sometimes ≤800–1,000 calories/day) and are marketed as fast weight‑loss solutions. Although they can lead to short‑term weight loss, they also come with potential side effects, and little evidence they lead to lasting, meaningful weight maintenance after the program ends unless paired with robust lifestyle changes.

Why they fail:

This kind of diet causes muscle loss and slows metabolism, it can lead to nutrient deficiencies, disrupts hormones, including thyroid and sex hormones and almost always results in rebound weight gain often more than what you had originally started with. They also have high drop out rates and are not sustainable long term.

2. Juice Cleanses and Detox Diets

Juice cleanses, detox teas, and liquid-only diets claim to “flush toxins” and reset your body.

Why they fail:

These are “ok” as a short term (2 days) approach to help detox and cleanse the body but not as an approach for sustained long term weight loss. These diets if implemented more as a weight loss program are extremely low in protein, fiber, and healthy fats. It can causes blood sugar spikes, fatigue, and cravings and more importantly the weight loss is mostly water and muscle, not from fat.

3. Mono Diets: Eating Only One Food

Cabbage soup, grapefruit, carnivore or egg-only diets promise simplicity but are highly restrictive.

Why they fail:

Not only do these diets fail but they can be detrimental to your health. They lack nutritional diversity of foods and nutrients that can lead to deficiencies, they can cause gut health issues and are hard to maintain, often leading to binge eating. Weight loss is short-term and unsustainable.

4. Ultra Low-Fat Diets

Low-fat diets were once the go-to weight loss trend but removing healthy fats is a mistake.

Why they fail:

We need fats – 60% of our brain is made up of fats and they are extremely important for brain structure and function. Healthy fats are essential for hormone regulation, satiety, bowel regularity and mood. These diets are often high in refined carbs and added sugar, leads to constant hunger and poor blood sugar control and can worsen insulin resistance over time.

5. Supplement or Meal replacement – Based Weight Loss Diets

Diet pills, teas, shakes and fat-burning supplements promise effortless weight loss but are largely ineffective.

SlimFast is a branded meal‑replacement system (shakes, bars, snacks) heavily marketed as a “simple weight‑loss solution.” Research shows mixed and often minimal results — and while calorie control can lead to weight loss, replacing whole meals with processed shakes doesn’t necessarily build long‑term healthy eating habits.  Results are inconsistent and may be no better than simple calorie counting. 

Why they fail:

It can cause dehydration, electrolyte imbalances, and digestive issues, some contains stimulants may increase anxiety, heart rate, and cortisol levels. It is often expensive and once a person finishes the program weight loss stops. It may also encourage disordered eating patterns.

The Best Weight Loss Diets

• Intermittent fasting
• Metabolic Balance Program
• Ketogenic Diet
• Mediterranean Diet
• Low Carb (whole foods) Diet

To find out more about these diets and their pros and cons, check out this article.

If following a structured weight loss program is not for you, then you may want to try to incorporate some healthy weight loss nutrition strategies into your current eating habits. Check out Tips to Shedding Weight.

Summary

Weight loss is a billion-dollar industry and at times can be complicated. You may have tried numerous diets out there and had varying success but often not achieving sustained weight loss over time. The common thread among the worst weight diets include extreme restriction, unsustainable habits, and potential health risks, and are often expensive and unable to be sustained long term.

If your goal is long-term weight loss, focus on balanced nutrition, high protein, fiber-rich foods, and lifestyle changes instead of dangerous shortcuts. Do your research and/or speak to a health professional such as a dietitian or nutritionist to find the best approach for you.

Top 5 Weight Loss Diets of 2026: Pros and Cons

Are you struggling with the extra weight from summer and even more so struggling to lose that weight despite your best efforts. There are so many diets out there, but it can be overwhelming, unsustainable and unrealistic. The best weight loss diet is going to be based on the individuals lifestyle, age, metabolism, food preferences and culture. For example, if you are a vegetarian and want to explore the ketogenic diet you are significantly limiting a huge amount of food groups and potentially causing more harm than good.

In 2026, weight loss continues to be a significant health focus, and various diets and weight loss program offer unique benefits for individuals seeking to shed pounds. Here’s a look at the top five weight loss diets, along with their pros and cons.

1. Intermittent Fasting (IF)

Intermittent Fasting is a time-restricted eating approach where people alternate between periods of fasting and eating. Popular variations include the 16:8 method (16 hours of fasting, 8 hours of eating), 5:2 diet (5 days of normal eating, 2 days of severe calorie restriction), and alternate-day fasting. Many people have incorporated this eating pattern and have lost significant amount of weight without disruption in their lifestyle.

How much weight are you expected to lose when doing Intermittent Fasting?

A systematic review of 40 studies found that intermittent fasting was effective for weight loss, with a typical loss of 7-11 pounds over 10 weeks. (1)

Check out this article to dive into the extensive research on intermittent fasting and learn how to implement it correctly.

Pros:

• Simplicity: No need to count calories or restrict certain food groups. Saves money, time and energy.
• Improved metabolism: Supports fat burning by encouraging the body to use fat stores for energy during fasting periods.
• Potential health benefits: Studies show that it helps to lose weight, improve heart health, reduce inflammation, and enhance longevity. 

Cons:

• Difficult adjustment: Some people find it challenging to adapt, especially when fasting for long periods.
• Risk of overeating: Some may compensate by overeating during eating windows, negating the calorie deficit.
• Not suitable for all: May not be ideal for people with certain health conditions, such as diabetes, or for those who are pregnant or need to take medications with food at breakfast.

2. Mediterranean Diet

The Mediterranean diet is the most researched diet out there and focuses on plant-based foods, healthy fats (like olive oil), whole grains, lean proteins (especially fish), and moderate wine consumption. It’s known more for promoting heart health than strict weight loss, but its balance can lead to steady and sustainable fat loss.

How much weight are you expected to lose on the Mediterranean Diet?

One review of 5 studies found that the Mediterranean diet was as effective as other popular diets like the low carb diet for weight loss, resulting in up to 22 pounds (10 kg) of weight loss over 1 year. (2) 

Pros:

• Metabolic health: It’s one of the best diets for cardiovascular health and is linked to reduced cholesterol, blood pressure, reduced inflammation and can help to reduce depression. 
• Sustainable: It’s more of a lifestyle than a diet, making it easier to stick to long term. It has a high compliance rate. 
• Rich in nutrients: Emphasizes whole, nutrient-dense foods, promoting overall well-being.

Cons:

• Slower weight loss: It’s not as rapid in delivering results as more restrictive diets.
• No clear calorie guidelines: The focus is more on food quality than portion control, which can make it hard for some people to lose weight.
• Expensive ingredients: High-quality oils, fish, and produce can be costly.

Check out our Mediterranean Pasta recipe  

Want to learn more about the different diets out there? Check out our article comparing 4 common diets: Mediterranean, Vegetarian, Flexitarian and Paleo

3. Ketogenic Diet (Keto)

The keto diet is a low-carb, high-fat diet that shifts the body into ketosis, a state where it burns fat for energy instead of carbs. It emphasizes foods like meat, fish, eggs, hard cheese, oils, nuts, and low-carb vegetables, while limiting or avoiding grains, sugars, and starchy vegetables.

Check out this article to learn more about the growing body of research on the health benefits of keto, including its impact on mental health issues such as depression, anxiety, and bipolar disorder.

How much weight are you expected to low on the Ketogenic Diet?

During the adjustment phase, you can expect to lose a lot of weight, usually between 3 to 7 lbs. Most of it will be water weight, as each gram of glycogen is bound to at least 3 grams of water, and you’ll be rapidly depleting your glycogen stores when you initially start the keto diet. (3) Once fat adapted and you are in ketosis, depending on your caloric deficit, the weight loss you can expect can be around 1 to 2 lbs per week. Some weeks might be slightly more.

People that have more body fat to lose usually see a more rapid weight loss, while people who are already relatively lean might struggle to lose the last few pounds.

Pros:

• Rapid weight loss: Many people experience fast weight loss, especially in the initial stages.
• Appetite suppression: High-fat meals can keep you feeling full longer, reduces sugar and carb cravings.
• Blood sugar control: May improve insulin sensitivity and help manage Type 2 diabetes.
• Digestion improvements: Although fiber is reduced a lot of people notice improvements with their digestive issues.

Cons:

• Difficult to maintain: The restrictive nature can make it hard to stick to long-term and can be easy to do it the wrong way. Check out our article on common mistakes with doing keto.
• Potential nutrient deficiencies: Limiting carbs can result in lower intake of essential nutrients like fiber, vitamins, and minerals.
• Keto flu: Some people experience flu-like symptoms as their bodies adjust to ketosis but this does resolve when ketosis has been established.

Check out some of our keto friendly recipes

• Keto sugar cookie bars
• Keto coconut chicken curry zoodles
• Keto electrolyte lemonade 

4. Low-Carb Diet (Non-Keto)

A traditional low-carb diet focuses on reducing carbohydrates while allowing more protein and fat. Unlike keto, it does not aim to reach ketosis. Popular examples include the Atkins diet and the South Beach diet. Low-carb diets typically produce noticeable weight loss during the first few weeks, in part because limiting food choices generally leads to reduced calorie intake. 

However, guidelines for low-carb diets vary, depending on the program you follow. Low-carb diets typically limit carbohydrate intake to 50 grams to 150 grams daily. Since each gram of carbohydrate provides 4 calories, that translates to 200 to 600 calories from carbohydrates a day. 

How much weight are you expected to low on a low carb diet?

Research on 850,000 people who did the low carb diet. The most common result is losing between 3 and 6 pounds (around 2 kilos) during the two weeks. Even though some of it, of course, is likely water weight. One person in ten lost more than 9 pounds (over 4 kilos) in the two weeks. (4)

Pros:

• Effective for weight loss: Limiting carbs can help reduce body fat quickly.
• Less restrictive than keto: Allows a wider range of foods, including more protein and non-starchy vegetables.
• Blood sugar benefits: Can help manage blood sugar levels, especially in those with insulin resistance.

Cons:

• Limited food variety: Restricting carbs can limit food options and lead to boredom.
• Possible nutrient gaps: Some people may not get enough fiber, vitamins, or minerals without careful planning.
• Short-term results: Weight loss can plateau as the body adapts, requiring more effort to maintain progress.

5. The Metabolic Balance Diet

Metabolic Balance was developed in Germany and is based on the premise that our daily food has an enormous influence on the body chemistry and hormones.

The Metabolic Balance Program is based on your unique blood work, body measurements and personal information. You need to get specific blood work done and a food list and meal plan is created based on this. It is individualised to the specific person so not to plans are the same. This program really focusses on reducing inflammation and insulin and works extremely well individuals with metabolic issues including inflammation, diabetes, high blood pressure, high cholesterol, sleep issues, digestive issues and hormonal imbalances. 

How much weight are you expected to lose on the Metabolic Balance program?

You will expect to lose 5-8% of your total body weight during the 16 day reset period. Then, 1-2% of your total body weight per week past that until an optimal body weight has been achieved. (5)

Example: Starting weight of 180lbs = 9-14lbs weight loss during the 16 day reset period and then roughly 1.5-3.5lbs per week thereafter. 

Pros:

• Graduated program to allow more flexibility as time progresses: Four phases with each phase creating more freedom and increased options for food and meals. 
• Sustained weight loss: People find that when they are reach the maintenance phase they often only follow the plan loosely but continue to stick with the simple 8 rules and weight remains off
• Easy to follow: It is very simple and quick to prepare meals, no recipes or complicated meal plans. Based on whole food.
• Treat meal: After Phase 2 you are allowed one treat meal a week which allows you the freedom and flexibility for socialising.

Cons

• Can feel restrictive: This can be dependant on your food list as some can be quite restrictive, or you can get bored with the food options.
• Have to weigh your food: This wasn’t as big of an issue but if you are out a lot and socialising this can be a difficult diet to sustain.
• May feel hungry: In the initial stages as your body adjusts to the diet and insulin changes.

Conclusion

Choosing the best diet depends on individual preferences, health goals, and lifestyle. While some diets like keto and intermittent fasting promise quick results, others, like the Mediterranean and low carb diets, focus on long-term health benefits. Understanding the pros and cons of each can help you make an informed decision about which one is right for you in 2026. 

If you would like to lose weight but not sure what would be the best approach to take is then please reach out at us at Koru Nutrition. We would love to support you on your health and weight loss goals. 

References

1. https://nutritionsource.hsph.harvard.edu/healthy-weight/diet-reviews/intermittent-fasting/
2. https://pubmed.ncbi.nlm.nih.gov/26721635/
3. https://pubmed.ncbi.nlm.nih.gov/25911631/
4. https://www.dietdoctor.com/how-much-weight-do-people-lose-on-the-low-carb-challenge https://onlinelibrary.wiley.com/doi/10.1155/2010/197656study
5. Program Adherence and Effectiveness of a Commercial Nutrition Program: The Metabolic Balance Study – Meffert – 2010 – Journal of Nutrition and Metabolism – Wiley Online Library

Constipation affects millions of people, it can be uncomfortable, even painful, it can impact appetite, cause bloating and if persists can contribute to haemorrhoids, anal fissures, fecal impaction and a whole host of other problems.

We all think that constipation can be caused by lack of water and fiber in our diets. Although these are common causes there are so many other reasons it can be a problem for you.

Globally, constipation is quite common. Estimates vary depending on the population studied and the definition used, but generally About 12–19% of the general population report chronic constipation.

Women are affected more than men, with prevalence around 16–25% in women versus 5–15% in men and older adults have higher rates, with up to 25–30% of those over 60 experiencing constipation. In children, prevalence ranges from 3–16%.

What Causes Constipation?

From a diet perspective common contributors include low fiber intake, inadequate fluid consumption, dehydration, and a high intake of processed or refined foods. Of course, low intake of fruits and vegetables, excessive dairy for some individuals, inadequate dietary fat, and electrolyte imbalances such as low magnesium or potassium can also be a factor.

Certain lifestyle and behaviors can also be a contributing factor such as a sedentary lifestyle, lack of physical activity, poor sleep quality, changes in routine or travel, and ignoring the urge to have a bowel movement can also disrupt normal bowel habits.

Digestive and gut-related factors play a significant role as well. These include slow gut motility, weak intestinal or abdominal muscle tone, pelvic floor dysfunction, low stomach acid, low bile flow, gut microbiome imbalances, food sensitivities or intolerances, chronic inflammation, infections or post-infectious gut changes, and pain with bowel movements such as hemorrhoids or fissures. Overuse of laxatives can further impair the body’s natural bowel signaling over time. If you find you are consuming enough fluids and fiber then you may need to explore the above to see if these are issues too.

Hormonal, medical, and neurological factors may also contribute to constipation. Aging, pregnancy, menopause, thyroid dysfunction (especially hypothyroidism), blood sugar imbalances, stress and anxiety, and neurological conditions such as Parkinson’s disease or multiple sclerosis can all affect bowel function. Certain medications, including opioids, antidepressants, antacids, iron, and calcium, as well as structural issues like strictures or adhesions, can further interfere with regular bowel movements.

What are Common Symptoms of Constipation?

• Infrequent bowel movements (typically fewer than three per week)
• Hard, dry, or lumpy stools
• Straining or pain during bowel movements
• Feeling of incomplete evacuation after a bowel movement
• Abdominal bloating or discomfort
• Cramping or stomach pain
• Rectal blockage or a sensation of blockage
• Need for manual maneuvers to pass stool (in severe cases)
• Reduced appetite
• Nausea (occasionally)

Discover the top 8 natural, science-supported remedies to relieve constipation without medications. Simple strategies, easy habits, and evidence-based home treatments that really work.

1) Add More Soluble Fiber (Especially Psyllium)

Why it works:
Soluble fiber absorbs water, creating a gel-like texture that softens stool and makes it easier to pass. Psyllium is the most researched natural fiber and is consistently shown to improve stool frequency and comfort. Psyllium is one of the most effective non-pharmacological treatments for chronic constipation in clinical trials. Increase slowly to prevent gas. Always pair fiber with extra fluids.

Best natural options:

1. Psyllium husk (1–2 tsp daily, gradually increased)
2. Ground flaxseed (1–2 tbsp daily)
3. Chia seeds
4. Oats
5. Lentils and beans
6. Fruits like apples, pears, berries

2) Boost Hydration — Water + Electrolytes Work Better Than Water Alone

Why it works:
Stool becomes hard and difficult to pass when the colon pulls too much water out of it. Proper hydration is essential for soft, easy-to-pass stools. Studies show low fluid intake is strongly associated with constipation, especially when fiber intake is also low. You need to aim for consistent daily intake rather than a large amount at once.

Natural ways to increase hydration:

• Water infused with lemon
• Warm herbal teas (ginger, peppermint, chamomile)
• Coconut water (natural electrolytes)
• Fruits with high water content (melon, oranges, grapes, cucumber)

3) Eat More Natural Prebiotics and Probiotics

Why it works:
Gut bacteria influence stool consistency, gut motility, and bowel frequency. Natural probiotic foods and prebiotic fibers can improve regularity. Multiple studies show probiotic foods can reduce intestinal transit time and increase stool frequency.

Natural probiotic sources:

• Kefir
• Yogurt with live cultures
• Sauerkraut
• Kimchi
• Miso
• Kombucha

Natural prebiotic sources:

• Garlic
• Onions
• Leeks
• Bananas
• Asparagus
• Oats
• Flaxseed

Use Natural GI-Stimulating Herbs:

Several herbs have mild, natural stimulating effects on digestion — gentler than stimulant laxatives and backed by research. Botanical medicine research supports the motility-enhancing effects of ginger, peppermint oil, and several bitter herbs. Start with 1 cup of herbal tea daily and adjust based on your body’s response.

Most effective natural herbs:

• Aloe vera juice (inner fillet only) — helps soften stool
• Ginger — increases gastric emptying and motility
• Peppermint — relaxes intestinal muscles and eases cramping
• Dandelion root tea — mild natural digestive bitter
• Slippery elm — adds mucilage, soothing the digestive tract

5) Increase Magnesium-Rich Foods (or Use Natural Magnesium Forms)

Why it works:
Magnesium helps relax intestinal muscles and draws water into the stool — a natural softening effect. Magnesium intake is associated with improved stool frequency and softer stools in dietary studies. You need to choose Magnesium citrate (a naturally occurring mineral compound) as this is the magnesium that helps to relax the intestinal muscles. Natural calm is a great option to add in water and take

Best food sources:

• Pumpkin seeds
• Almonds
• Spinach
• Avocado
• Quinoa
• Black beans
• Dark chocolate

6) Move Your Body in Ways That Stimulate Gut Motility

Why it works:
Movement activates the digestive tract and reduces sluggish bowel transit time. Physical activity significantly reduces constipation risk and improves bowel motility in clinical reviews.

Best natural activities for constipation:

• A 10–20 minute walk after meals
• Light yoga (especially twisting poses)
• Rebounding on a mini-trampoline
• Core-strengthening exercises
• Squatting stretches

7) Support Healthy Bowel Reflexes With Daily Rhythm + Proper Toilet Positioning

Why it works:
Your colon has a built-in reflex in the morning (gastrocolic reflex). Using it daily trains your bowels to stay regular — naturally. Toileting posture and regular timing significantly improve stool passage and ease of evacuation.

Do this daily:

• Sit on the toilet 15–30 minutes after breakfast
• Do not rush or strain
• Use a footstool (like a “squatty potty”) to raise your knees above hips
• Practice deep belly breathing to relax pelvic muscles

8) Address Pelvic-Floor Dysfunction Naturally

Why it works:
Up to 30% of chronic constipation comes from pelvic-floor muscles not relaxing properly during a bowel movement. Pelvic-floor therapy and relaxation exercises are among the most effective natural treatments for functional constipation.

Natural strategies:

• Diaphragmatic breathing
• Pelvic-floor relaxation (reverse Kegels)
• Stretching the hips, low back, and abdominal area
• Belly-massage techniques (clockwise large-circle abdominal massage)
• Working with a pelvic-floor physiotherapist

Your Simple 7-Day Natural Relief Plan

Day 1–2: Add psyllium or ground flax + increase water
Day 3–4: Add probiotic foods and a daily walk
Day 5: Try herbal teas (ginger or peppermint)
Day 6: Introduce magnesium-rich foods
Day 7: Focus on morning toilet rhythm + a footstool

Many people feel relief within the first week using this stepwise approach.

Summary

Constipation can be a pain in the butt, literally! About 12–19% of the general population experience chronic constipation, with women and older adults struggling more with this. Causes of constipation can be varied and not just limited to lack of fiber and fluid intake, lifestyle factors, various digestive and gut imbalances, hormone imbalances, and medications can all influence how easy or not it is to have that regular daily bowel movement.

Following the 8 strategies above to help relieve your constipation can be very helpful. But if you are still struggling with going after implementing the above then there may be other factors at play that you may want to explore. Getting to the root cause of your constipation can help create a more individualised and targeted treatment approach.

Completing gut microbiome testing might be one option. Reach out to us today for a 10 minute free consult to see if we can help.

In just five years, North America has fallen head-over-heels for GLP-1 drugs. Once reserved for diabetes, they’ve become the new gold standard for weight loss. Today, 1 in 8 U.S. adults and nearly 1 in 5 women aged 50 to 64 use GLP-1 receptor agonists like Ozempic or Wegovy. But here’s the twist: while drug-induced GLP-1 signaling is reshaping waistlines across the nation, your gut microbes have been doing it naturally all along.

Our gut microbiome, can significantly support healthy weight loss through its influence on GLP-1 production.

What Are GLP-1 Drugs verus our GLP-1 hormone ?

GLP-1 drugs mimic a hormone that your gut already makes called glucagon-like peptide-1 (GLP-1). This natural hormone:

• Helps the pancreas release insulin when blood sugar is high
• Slows down stomach emptying (so you feel full sooner and longer)
• Suppresses appetite by acting on brain pathways.
• Lowers glucagon (which otherwise raises blood sugar)

Given how GLP-1 drugs work (as listed above), it is obvious why they are popular treatments for diabetes and obesity.

While these drugs have their place in a persons weight loss journey, your gut microbiome, when healthy and nourished, can achieve similar effects without having to pay for expensive medication.

How Your Microbiome Influences GLP-1 and Weight Health

Your gut influences your eating habits and weight management through multiple biological routes, including:

1. Short-chain fatty acids (SCFAs)
2. The Prevotella-to-Bacteroides (P/B) ratio
3. Secondary bile acids
4. Lipopolysaccharides (LPS) 

Short-Chain Fatty Acids (SCFAs): Your Gut’s Hidden Hormone Hackers

When you eat food rich in soluble fiber (such as carrots, green beans, brussel sprouts, and sweet potatoes) the beneficial bacteria in your large intestine (colon) ferment them into compounds called short-chain fatty acids.  The 3 main ones include: acetate, propionate, and butyrate. All three stimulate GLP-1 production, but propionate stands out as the most potent for weight loss.

Propionate triggers GLP-1 release by binding to receptors on specialized hormone-secreting gut cells called L cells. These L cells are “smart sensors” that line our lower intestine. When they “taste” propionate, they respond by releasing GLP-1 into the bloodstream.

Knowing this, you might assume taking propionate supplements would boost GLP-1 but it’s not that simple. Propionate taken orally is quickly absorbed in the small intestine, never reaching the colon where it’s most needed. That’s why feeding the right gut bacteria with the right fibers such as inulin remains the most effective approach at supporting propionate.

The Prevotella/Bacteroides Ratio: This Could Be The Reason Why Some People Lose Weight Faster Than Others

Ever wonder why two people can follow the same “healthy” diet but only one loses weight or one loses significantly more weight than the other person? The answer may lie in their Prevotella-to-Bacteroides ratio (P/B ratio). People with a Prevotella-dominant microbiome (high P/B ratio) tend to lose more weight on high-fiber, plant-based diets than those dominated by Bacteroides (low P/B ratio).

To clarify, Prevotella is a bacteria species that thrives on complex carbohydrates and fibers, produces SCFAs like propionate and acetate that boost GLP-1 and helps improve satiety. Bacteroides, on the other hand, are more common in western-style diets which are high in fat and animal protein, they specialize in breaking down proteins and fats, yielding fewer beneficial SCFAs.

Why a High P/B Ratio Promotes Weight Loss

1. Superior Fiber Fermentation
   Prevotella species efficiently break down resistant starches, pectins, and β-glucans, generating more propionate which is the same GLP-1-boosting metabolite discussed earlier.
2. Reduced Energy Harvest
   Prevotella-driven fermentation tends to produce metabolites that are linked to lower energy extraction efficiency, which means fewer calories are being absorbed from the same amount of food. People with high amounts of Bacteroides  may derive more usable calories from more high protein/fat diets, reducing weight loss potential under high-fiber dietary interventions.

How to Cultivate the “Lean Prevotella-Propionate Axis”

• Increase soluble fiber intake: Prioritize inulin, resistant starches, pectins, arabinoxylans, and β-glucans.
• Add prebiotics that enrich propionate producers: Incorporate foods like rye, barley, legumes, and Jerusalem artichoke (rich in FOS and inulin).
• Balance protein intake: Too much animal protein promotes proteolytic fermentation; so to avoid this combine moderate protein with complex carbs and fiber.
• Avoid broad-spectrum antibiotics when unnecessary: These can deplete anaerobic propionate producers and with less propionate comes more hunger and difficulty losing weight.
• Limit ultra-processed foods and excessive saturated fats: These favor Bacteroides dominance and reduce SCFA diversity.
• Encourage cross-feeding: Combine fermented foods (rich in Lactobacillus) such as sour dough bread, yoghurt, kefir, sauerkraut and kimchi with high fiber foods such as fruits and vegetables to support bacteria like Veillonella which helps to convert lactate into propionate. 

Rethinking the Weight-Loss Narrative

Weight loss has long been framed as a battle of willpower, calories, and hormones. But the truth is, it’s also a story of our gut microbiome including the types and levels of bacteria in our gut.

Your gut microbiome is an active participant in how your body senses food, regulates hunger, stores fat, and generates energy. While GLP-1 drugs may have given medicine a revolutionary tool, they are, in essence, imitating what a healthy gut has done for millennia.

So perhaps the next frontier of sustainable weight management isn’t just about stronger drugs or stricter diets. It is about restoring a healthy gut environment that keeps our biology in rhythm. Because when your gut bacteria thrive, your metabolism listens which ultimately supports a healty weight or goal for healthy weight loss .

If you are interested in you or your client having a gut microbiome test completed then we offer a comprehensive deep gut test.

If you want to assess your natural GLP-1 regulators including Akkermansia, propionate, short chain fatty acids including acetate, propionate, and butyrate to see if this is the missing link to achieving your weight loss goals. Then please reach out to us today!

Here is an example of the test results and what is covered.

Our gut microbiome consists of trillions of bacteria, fungi, viruses, and other microorganisms that live in our digestive tract. Often overlooked in conventional medicine the gut microbiome has a huge role in many of our body systems above and beyond just supporting digestion. This includes our brain/nervous system, mood, immune health and infections, cardiovascular health and cholesterol, weight loss and metabolism, hormonal imbalances, inflammation, prevention of chronic disease, skin health, detoxification/liver health and even longevity.

Certain bacteria in our gut are responsible for making short chain fatty acids (SCFAs) such as propionate, butyrate and acetate and these play a key role in metabolism, reducing inflammation, neurological protection, cognitive function and appetite regulation but to name a few.

Often doctors will complete various tests, but rarely (if any) do they complete a comprehensive analysis of their client’s gut microbiome. That is just not a typical part of their training and it might be that you need to explore health professionals that specialize or offer this service such as Naturopath Doctors, specialized doctors and certain nutritionists and dietitians.

Brain and Nervous System (Gut–Brain Axis)

Our gut microbiome plays a pivotal role in our brain and can heavily influence our mood, behaviors, motivation and cognition.  It does this in many ways. Firstly it can help with neurotransmitter production: Gut microbes help make and influence serotonin, dopamine, GABA, acetylcholine, and melatonin which are all crucial for attention, motivation, mood, memory, focus, relaxation and sleep. (1) Growing research shows that a balanced microbiome helps to support emotional stability and can reduce the risk of anxiety and depression. Microbes such as Lactobacillus and Bifidobacterium species are able to produce the neurotransmitter GABA which interacts with the hypothalamic-pituitary-adrenal (HPA) axis, affecting cortisol and stress resilience helping us to feel relaxed and calm. (2)

Healthy gut bacteria has also been shown to help improve memory, learning, and reduce risk of neurodegenerative diseases such as Alzheimer’s, and Parkinson’s disease. (3)

Do you want to check if your gut microbiome environment and level of short chain fatty acids is set up to make neurotransmitters effectively or if you have enough lactobacillus and bifidobacterium to help support healthy GABA levels and better manage stress?… then keep reading…

Immune System

Our gut is an open system from our mouth to our anus making it the entry point for pathogens such as viruses, bacteria and fungi to enter our bodies. Therefore our microbiome has to play a pivotal role in supporting the gut to help fight of these foreign invaders. It does this by “teaching” our immune cells on how to distinguish between harmful and harmless microbes. (4)  

A healthy gut flora helps to strengthen our intestinal wall, preventing intestinal permeability otherwise known as “leaky gut”. Leaky gut can create systemic inflammation, autoimmune problems, malabsorption and nutrient deficiencies as well as keeping the blood brain barrier open and exposing it to toxins and other harmful chemicals. Butyrate is a short chain fatty acid made by certain bacteria in our gut that’s helps maintain the  integrity of our gut lining (tight junctions, mucus production) and avoid these issues from occurring. (5)

Anti-inflammatory Signaling: fiber-fermenting bacteria such as Faecalibacterium prausnitzii, Roseburia spp., Eubacterium spp. help produce short-chain fatty acids like acetate, propionate, and butyrate that all help calm gut, boost the immune system and reduce systemic inflammation. (6) Good bacteria in the gut competes with harmful microbes for nutrients and space, producing natural antibiotics (bacteriocins).

Digestive Health

Gut microbiome is most commonly known for it’s role in supporting healthy digestion.  Many gut bacteria (such as Roseburia intestinalis, Eubacterium rectale, Clostridium leptum group, Akkermansia muciniphila, Bifidobacterium) ferment indigestible polysaccharides such as dietary fiber, resistant starch, and oligosaccharides which help produce short chain fatty acids such as acetate, propionate, butyrate. These all help to nourish and support colon cells, supporting an overall healthy digestion. (7)

Having a healthy gut with good levels of healthy bacteria can help to absorb minerals like calcium, magnesium, and iron more effectively and specific bacteria such as Clostridium scindens help with bile acid metabolism to support fat digestion and regulate our cholesterol. (8)

Metabolism and Weight Regulation

Often overlooked as a tool for weight loss and weight management our gut microbiome plays a role in our metabolism and weight loss goals. It does this through a number of different ways. Firstly our microbiome feeds off the food that we eat and as such it can extract additional calories from food through fermentation, that means less calories for our body to process.

It supports blood sugar balance as short chain fatty acids (which certain gut bacteria can make) can help improve insulin sensitivity and glucose metabolism supporting weight loss and reducing the risk of type 2 diabetes. (9) If someone has unstable blood sugars they have 3 times more difficulty losing weight.

Some microbes influence how much fat your body stores and how it uses energy. Roseburia spp. and Faecalibacterium prausnitzii have been negatively correlated with metabolic disorders; their depletion is often seen in obesity or type 2 diabetes. (10) Certain microbes in our gut affects hunger hormones like ghrelin, leptin, and peptide YY, influencing cravings and satiety.

The compound propionate which is made from certain bacteria in our gut such as Bacteroides, Prevotella, Veillonella, etc. can stimulate satiety via the gut–brain axis and reduce the amount of food a person will eat. (11) Akkermansia is a bacteria that acts as a GLP1 regulator similar to that of Ozempic. If you have low levels then you may be struggling to lose weight despite your best efforts with exercise and diet.

Do you want to know if you have healthy Akkermansia in your gut?

I have seen firsthand a client that could not lose weight despite their best efforts to follow a weight loss plan.  It turned out after microbiome testing she had absolutely no Akkermansia in her gut and a number of high pathogens that were contributing to her inflammation and high cholesterol.

If you want to find out more about key microorganism the their by products that help support weight loss (or hinder it) check out our article, Is Your Gut Microbiome The Reason Why You’re Not Losing Weight?

Skin Health

Many skins problems are a result of issues inside of us and often issues in relation to our gut health. Specific gut microbes can reduce systemic inflammation which influences skin conditions linked to psoriasis, eczema, rosacea, acne, and atopic dermatitis, while others can contribute to it. (14) A healthy gut flora helps support vitamin synthesis (especially B vitamins, and vitamin K) which are vital for skin health. (15)

Signals from the gut microbiome influence skin barrier strength and hydration. Some microbes produce metabolites (e.g. SCFAs) that can reduce oxidative stress and influence skin barrier function supporting healthy skin.(16)

Vitamin and Nutrient Synthesis

Believe it or not but certain gut bacteria can influence our nutrient profile by helping to make vitamins or making minerals more bioavailable. For example Bifidobacterium, Lactobacillus, and others can synthesize certain B vitamins (B2, B12, folate, biotin, niacin, riboflavin) and vitamin K2 (menaquinone). This goes above and beyond what we get from food sources. (17) Bacteria in our gut can help liberate minerals such as calcium, magnesium, iron (e.g. via deconjugation, acidification) more bioavailable. (18)

Inflammation and Chronic Disease Prevention

Inflammation is a root cause of some many health issues and diseases. Although diet can increase or decrease inflammation in the body so to can our gut microbiome. Butyrate and other SCFAs produced by our gut bacteria can help reduce systemic inflammation. Conversely, gut dysbiosis is associated with increased inflammation and numerous chronic diseases such as IBD, metabolic syndrome, autoimmune disease, and even cancer. (19) A diverse microbiome can also help to reduce the risk of autoimmune diseases such as rheumatoid arthritis, type 1 diabetes and multiple sclerosis. (20)

Our gut bacteria can also provide cancer protection. Certain microbes prevent DNA damage, support detoxification, and regulate cell growth which are all important to minimizing cancer risk. In colorectal cancer models, certain bacteria (e.g. F. prausnitzii) may inhibit tumor growth through anti-inflammatory and barrier-protective mechanisms. (21)

Development and Longevity

Early life colonization by specific microbes (e.g. Bifidobacterium spp., Akkermansia, Bacteroides) helps shape a healthy microbiome composition in infancy which helps shape  the babies immune, metabolic, and brain development. That is why babies born through the vaginal canal are able to pick up a lot of their mothers microbes and tend to have better immune systems than those delivered via C-section. (22)

A diverse microbiome correlates with healthier aging, reduced frailty, and improved longevity. It contributes to maintaining metabolism regulation, keeping inflammation low, and ensuring barrier integrity. This can help support lifespan and reduce many age-associated disease risk. (23,24)

Summary

Our gut microbiome plays a critical role in our health from birth to old age. Often our gut health gets overlooked in conventional medical practice and can be the missing piece to ongoing health struggles that you may have. Our gut microbiome plays a role in making neurotransmitters to support our mood, attention, motivation and memory. It can be a missing link in people with depression that have not been successful with anti-depressants. It plays a role in weight loss, appetite regulation and glucose metabolism and having imbalances may be a reason for unwanted weight gain or to being unable to lose weight despite your best efforts with diet and exercise.

Having unhealthy balance or over population of certain bacteria can contribute to inflammation, chronic fatigue, high cholesterol, hypertension, autoimmune disease, and certain skin issues such as acne, eczema, and psoriasis. But this is still only a glimpse into the extensive role that our gut microbiome has on our overall physical and mental health.

Interested in finding out more about your gut microbiome?

At Koru Nutrition, we complete gut microbiome testing.

This helps to identify levels of various healthy bacteria as well as certain bad bacteria, and other inflammatory pathogens including but not limited to candida, fungi, protozoa and parasitic infections. It also looks at neurotransmitter producers in your gut (dopamine, serotonin, Gaba, acetylcholine, norepinephrine) vitamin producers, inflammation and toxic producers, short chain fatty acid producers, digestive markers, and longevity markers.

Click here to see the sample of the report.

Interested in getting the test? Please reach out to us at info@korunutrition.com to find out more.

References

1. https://www.sciencedirect.com/science/article/pii/S2667242125001216/
2. https://pubmed.ncbi.nlm.nih.gov/40360779/
3. https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2018.01835/
4. https://pmc.ncbi.nlm.nih.gov/articles/PMC8608412/
5. https://pubmed.ncbi.nlm.nih.gov/39284033/
6. https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2020.00025
7. https://pmc.ncbi.nlm.nih.gov/articles/PMC10180739/
8. https://www.nature.com/articles/s41392-024-01946-6
9. https://pmc.ncbi.nlm.nih.gov/articles/PMC6244749/
10. https://pmc.ncbi.nlm.nih.gov/articles/PMC10180739/
11. https://www.nature.com/articles/s41392-024-01946-6
12. https://pmc.ncbi.nlm.nih.gov/articles/PMC6244749/
13. https://pmc.ncbi.nlm.nih.gov/articles/PMC8729913/
14. https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2018.01835/
15. https://pubmed.ncbi.nlm.nih.gov/40360779/
16. https://www.nature.com/articles/s41422-020-0332-7
17. https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2018.01835/
18. https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2018.01835/
19. https://pmc.ncbi.nlm.nih.gov/articles/PMC10180739/
20. https://pmc.ncbi.nlm.nih.gov/articles/PMC10180739/
21. https://www.nature.com/articles/s41392-022-00974-4
22. https://www.nature.com/articles/s41392-022-00974-4
23. https://www.nature.com/articles/s41392-024-01946-6

Magnesium deficiency has become a silent epidemic in Canada, with most people completely unaware they’re lacking this crucial mineral. Despite its involvement in over 300 enzymatic reactions in the body, magnesium often goes overlooked in routine health assessments. This is a problem since almost 80% of Canadians have a magnesium deficiency. People with diabetes, low absorption, chronic diarrhea, high alcohol use and celiac disease are associated with magnesium loss and increased risk of deficiency. Magnesium deficiency is often underdiagnosed since the signs commonly don’t appear until levels become severely low and is not typically checked by your family doctor.

Health Benefits of Magnesium

Magnesium is important for your body’s day-to-day functions, too. The National Institute of Health (NIH) reports your body uses magnesium for a whole host of duties such as:

• Blood pressure regulation
• Blood sugar regulation
• Making protein, bone and DNA
• Muscle function
• Nerve function

Multiple factors unique to modern Canadian life have converged to create this nutritional perfect storm of magnesium deficeincey. Understanding these root causes can help explain why supplementation is important but alone sometimes isn’t enough to solve the problem.

Depleted Soil, Depleted Food

Farming changes have resulted in significant mineral depletion over the past century. Intensive farming practices, combined with the use of synthetic fertilizers that don’t replace trace minerals, have resulted in produce with substantially lower magnesium content than our grandparents consumed. For example a head of broccoli today contains approximately 25% less magnesium than it did in the 1950’s.

The Processed Food Problem

With the fast paced lives that we live in, our diets have  increasingly shifted towards quick, grab and go highly processed meals and take out food. These foods have been stripped of their naturally occurring magnesium for example during grain refinement, up to 80% of magnesium is lost. When you consider that many Canadians get the majority of their calories from processed sources, the magnitude of the problem becomes clear.

Lifestyle Factors Depleting Magnesium

Chronic stress, which is a major problem in this day and age, triggers the release of stress hormones that cause cells to dump magnesium, creating a vicious cycle where stress depletes magnesium, and low magnesium makes us more susceptible to stress. Additionally, common substances like caffeine, alcohol, and many prescription medications increase magnesium excretion through the kidneys.

During the long winter months with limited sun exposure, many Canadians become deficient in vitamin D. This vitamin is necessary for proper magnesium absorption. This creates a double deficiency that compounds this problem even further.

Water Supply Changes

Municipal water treatment has improved safety but reduced mineral content. Unlike well water which naturally contains minerals from underground sources, most urban Canadian tap water has been stripped of its magnesium content during treatment processes. This seemingly small change removes what was once a significant daily source of magnesium for previous generations.

Do You Have a Magnesium Deficiency?

Magnesium deficiency rarely announces itself with obvious symptoms. Instead, it tends to manifest through a collection of seemingly unrelated issues that many people attribute to stress, aging, or something else. Understanding these warning signs can help you identify whether magnesium deficiency might be affecting your health.

The Initial Symptoms of Magnesium Deficiency 

Intial signs and symptoms that you may have a magnesium deficiencey can include:

• Persistent fatigue that doesn’t improve with rest 
• Difficulty falling asleep despite exhaustion 
• Muscle twitches or cramps—particularly in the calves at night
• Muscle weakness 
• Increased anxiety or a feeling of being “wired but tired”
• Headaches, particularly tension headaches and migraines 

The mineral’s role in regulating blood vessel function and neurotransmitter release makes it crucial for preventing these painful episodes. If you notice your headaches increasing in frequency or intensity, magnesium status deserves investigation.

Progressive Symptoms

As deficiency deepens, symptoms become more pronounced and disruptive and mental health symptoms often intensify with prolonged deficiency. This can include

• Heart palpitations or irregular heartbeat 
• Chronic constipation, despite adequate fiber and water intake
• Increased irritability
• Difficulty concentrating
• Depression 

Severe Deficiency Indicators

When magnesium deficiency becomes severe, serious health consequences can develop. 

• Persistent high blood pressure that doesn’t respond well to lifestyle changes 
• Severe mood disturbances
• Chronic pain syndromes
• Restless leg syndrome

Foods High in Magnesium

Foods rich in magnesium include leafy green vegetables like spinach, kale, and Swiss chard, which are also packed with antioxidants and fiber. Nuts and seeds, such as almonds, cashews, pumpkin seeds, and chia seeds, are another excellent source, as well as legumes like black beans, chickpeas, and lentils not only supply magnesium but also offer protein and fiber, making them great for blood sugar balance and digestive health.

Whole grains such as quinoa, brown rice, and oats are also high in magnesium while providing steady energy due to their complex carbohydrate content. Dark chocolate is another magnesium-rich option that offers antioxidants and can help reduce cravings when enjoyed in moderation. Infact a sign you might have a magnesium defciencey is chcolate cravings. For those who prefer fruit, bananas and avocados contribute a good amount of magnesium along with potassium and fiber. 

Incorporating a variety of these foods into daily meals can help support adequate magnesium intake.

Choosing the Right Magnesium to Supplement

• Magnesium threonate – crosses the blood brain barrier for brain health and migraines
• Magnesium citrate – for constipation
• Magnesium bisglycinate – for relaxation, anxiety and sleep
• Magnesium taurate – for blood sugar regulation and heart health 
• Magnesium chloride and sulfate – for sore muscles 
• Magnesium malate – for stamina, fatigue and sore muscles

Go to our Fullscript account and get your magnesium now.

Summary

Magnesium is a crucial mineral that is involved in over 300 enzymatic reactions in the body, unfortunately almost 80% of Canadians have a magnesium deficiency. Magnesium is crucial for blood sugar regulation, promoting a sense of calmness and relaxation, helps with migraines, sleep and brain function and supports healthy blood pressure and muscle heath and muscle pain. Unfortunately factors such as stress, lack of vitamin D, poor farming practices and poor food and water quality all impact how much magnesium we are actually getting.

Increasing your intake of foods high in magnesium as well as supplementation may be a big step in the right direction to help get the levels that you need. If you struggle with certain symptoms then selecting the right kind of magnesium (as identified above) can help. Follow up with your family doctor or naturopath to see if you have a magnesium deficiency.

Perimenopause and menopause are defined by large, sometimes chaotic falls in ovarian hormones — primarily estradiol (estrogen) and progesterone. When this happens these hormone changes have measurable downstream effects on our brain chemistry. This can result in mood changes, anxiety, sleep problems, hot flashes, and memory/attention issues. 

Women typically go through perimenopause in their mid 40’s and this can last on average 4 years but can be as long as 8 years. Menopause (when periods have fully stopped typically occurs around 51 but obviously there are huge fluctuations with that). Many people are surprised to learn that the drop in hormones has a huge impact on the brain’s chemical messengers — called neurotransmitters.

Understanding which brain chemicals are impacted — and what you can do about it — can make this transition easier.

Why Hormones Matter for Your Brain

Estrogen and progesterone aren’t just reproductive hormones. They play powerful roles in the brain, where they interact with neurotransmitters that regulate mood, thinking, energy, and sleep.

Estrogen 

• boosts serotonin (the “feel-good” chemical)
• boosts dopamine (motivation, focus and reward)
• boosts acetylcholine (memory and focus).

Progesterone 

• is converted into a substance called allopregnanolone, which helps the neurotransmitter GABA to calm the mind and promote a sense of relaxation.

When these hormones decline in perimenopause and menopause, the balance of brain chemistry shifts — often in ways that make people feel more anxious, moody, forgetful, and tired.

The Neurotransmitters Most Affected

1. Serotonin — mood, sleep, and thermoregulation

What changes: Estrogen helps the brain make and use serotonin when estrogen drops, serotonin levels can fall too. Clinically, this is linked to higher rates of depression, mood swings, irritability, sleep problems, and even hot flashes (since serotonin helps regulate body temperature). (1)

Research shows that perimenopausal women have a 40% higher risk of experiencing depression than premenopausal women.

2. GABA (gamma-aminobutyric acid) — inhibition, anxiety, and sleep

What changes: Progesterone is metabolized in the brain to allopregnanolone, which helps GABA calm the nervous system. With falling progesterone in perimenopause/menopause, levels of allopregnanolone fall so, there’s less of this calming effect. This results in increased anxiety, irritability, hypervigilance, difficulty managing stress and trouble sleeping. (1)

3. Dopamine — motivation, reward, and attention

What changes: Estrogen supports dopamine synthesis, release, and receptor expression in brain regions responsible for feelings of reward, focus and cognitive functioning. Loss of estrogen can cause dopamine to drop, which may contribute to feelings of apathy, reduced motivation, concentration difficulties, and “brain fog.” Imaging and clinical studies connect estrogen fluctuations/deficiency with modest declines in cognitive domains and with functional changes in dopamine-linked circuits. (1)

4. Norepinephrine — Arousal and the thermoregulatory “set point”

What changes: When estrogen falls, hypothalamic regulation of autonomic and thermoregulatory circuits becomes more sensitive and this can result in norepinephrine becoming overactive. Norepinephrine helps to keep us alert. This dysregulation is a major component of vasomotor symptoms (hot flashes and night sweats) and night-time awakenings. The serotonin–norepinephrine balance is also important (lower serotonin can also contribute to norepinephrine over-activity). (2) 

5. Acetylcholine — memory and attention

What changes: Estrogen supports acetylcholine which is a neurotransmitter important for attention and episodic memory, especially in the hippocampus (our memory centre). Decreased estrogen is associated with decreases in verbal memory, memory lapses and difficulty with new learning; this pattern is complex and varies by timing (perimenopause vs years after menopause), age, vascular health, and other factors. (3)

How Big is the Effect Clinically?

Not every person experiences marked changes in mood, cognition, or sleep — genetics, prior psychiatric history, life stressors, nutrition, sleep quality, comorbid medical conditions, and the pattern/timing of hormonal change all influence risk. Large cohort and meta-analytic work show increased risk for depressive and anxiety symptoms during the perimenopause transition and more subjective cognitive complaints during the transition and early post menopause. Still, the effects vary considerably: some people experience large, disabling symptoms; others experience little change. (4) 

Summary

Perimenopause and menopause change brain chemistry because estrogen and progesterone directly modulate serotonin, dopamine, GABA, norepinephrine, and acetylcholine systems. These changes can explain increased rates of mood symptoms, anxiety, sleep disruption, vasomotor symptoms, and cognitive complaints for many people in the menopause transition. 

The best approach depends on symptom type, severity, personal medical history (including cardiovascular risk, clotting risk), and preferences. Discuss options with a clinician experienced in menopause care. It is important to note (and I have heard this my so many woman) that their doctors do not know how to address their menopause symptoms and often refer to “its just a part of getting older” despite symptoms being frustrating, and even disabling. These horomal changes and subsequent symptoms can significantly impact a women’s ability to engage in work activities, parenting, interefer with their relationships, impact their self esteem, body image and overall enjoyment in life. It is important to do your due diligence to find health care professionals that specialise in peri-menopause and menopause to get the right help that you need.

To find out more about what you can do please check out our other helpful articles on nutrition, supplements, herbs and exercise for perimenopause and menopause women as well as a couple of delicious recipes designed with you specifically in mind:

Selected scientific references (key reviews & trials cited above)

1. https://pmc.ncbi.nlm.nih.gov/articles/PMC2943238/
2. https://journals.lww.com/jomh/fulltext/2019/10010/menopausal_hot_flashes__a_concise_review.3.aspx?utm
3. https://pmc.ncbi.nlm.nih.gov/articles/PMC8394691/
4. https://www.theguardian.com/society/2024/may/01/perimenopausal-women-have-40-higher-risk-of-depression-study-suggests