Dr. Amy Shah On Hormones, Cortisol & Why You’re So Tired

Key Wellness Strategies & Self-Care Tips (Dr. Amy Shah)

Avoid “magic pill” thinking for hormone balance

• There’s no single supplement/thing that balances hormones for everyone.
• Even hormone therapy isn’t a simple “take one thing and everything fixes itself” situation.

Know the limits of hormone testing

• There’s no truly great, reliable hormone test that definitively proves you’re “imbalanced” versus “normal.”
• Hormones fluctuate across the month, so labs can fall “within range” even when symptoms persist.
• Still consider testing when you feel something is off—fatigue and similar symptoms can also come from:
  • Low B12
  • Iron deficiency (common; up to ~40% in menstruating women)
  • Low vitamin D (very common in the menopause transition)

Treat severe period symptoms as “not normal”

Get evaluated if you have:

• Disabling cramps (missing work/can’t get out of bed)
• Cycle changes, such as:
  • Not getting a period when exercising hard
  • Working too intensely
  • Being very lean

Possible hidden issues mentioned:

• Endometriosis and other treatable conditions

Support menopause/premenopause through lifestyle—especially gut health

• Encouraged to start early, rather than waiting for severe symptoms.
• Gut-hormone link: improving gut health can support hormone health and help reduce symptoms.

Use a simple daily nutrition framework: “30-33-3”

Aim for:

• 30 g protein in the first meal
• 30 g fiber throughout the day
• 3 servings of probiotic foods daily

Notes:

• Works across many eating styles (vegan/carnivore/paleo/etc.); it’s about structure, not restriction.

Fiber-first gut strategy

• Fiber was emphasized as essential because most people don’t get enough.
• Easy fiber options mentioned:
  • Avocados
  • Blueberries, raspberries
  • Chia seeds (1 tbsp ≈ ~5g fiber)
  • Flax seeds
  • Pears, kiwi with skin

Understand “Estrobolom” (gut bacteria + estrogen recirculation)

• Gut bacteria can influence how much estrogen is recirculated vs. cleared.
• Suggested gut-support habits:
  • Get enough fermented foods
  • Eat enough fiber/plant foods
  • Spend time outdoors/nature to support microbial diversity
  • Be cautious with practices that may “starve” or disrupt beneficial bacteria (e.g., over-sanitizing/low microbial exposure)

Address stress/cortisol with timing + nervous system downshifting

• Cortisol is supposed to be high in the morning (to wake you up), then lower by evening for sleep.
• High-achiever pattern: cortisol stays elevated due to:
  • Evening stimulation (work emails, fights, excitement)
  • Blue light/bright lights
  • Late caffeine
  • Late heavy dinners
  • Not enough daylight earlier in the day

Practical “cortisol reset” routine

• Morning

  • Get sunlight soon after waking
  • If limited daylight: use a 10,000 lux sun lamp (~10–15 minutes; ~10–12 inches from your face)

• Daytime

  • Build in nature and calm breaks
  • Aim for ~1 hour of nature time daily (split is fine)
  • Consider replacing intensity workouts with yoga / sunny walks / meditation when resetting cortisol
  • Mentioned energy dip around ~3 p.m.—a nature walk/meditation can help

• Evening (most important for cortisol)

  • Avoid heavy workouts and high-stimulation interactions 2–3 hours before bed
  • Avoid alcohol at night (sleep disruptor)
  • Reduce bright/blue light; use dim/red lighting if possible
  • Read/relax and wind down instead of late stimulation

Meal timing around exercise

• Women can be more cortisol-sensitive, so long fasting + hard exercise may be stressful.
• Guidance given:
  • Consider a protein snack before strenuous workouts (especially for competitive/high intensity)
  • Some women may benefit from eating soon after waking rather than long morning fasts

Weight-loss approach that supports hormones (not extreme restriction)

For weight shifts in the 30s–50s, focus on:

• Protein (from the 30-33-3 framework) for fullness + muscle support
• Low-impact movement (walking, stairs, daily movement)
• Micro-movements while sitting, e.g., mini bodyweight squats between meetings (rather than saving movement for the end of the day)

Carbohydrate strategy (avoid extremes)

• Suggested approach: moderately lower refined carbs, but don’t cut out fruits/vegetables.
• Concern: very high refined carbs can drive blood sugar/insulin spikes → insulin resistance and downstream metabolic issues.
• Extremely low carb wasn’t recommended as a hormone-regulating strategy for most.

Movement + longevity framework: “4-3-2-1”

• 4 days/week: movement you enjoy (joy/mood-friendly—walk, hike, bike, dance)
• 3 days/week: muscle/bone stimulating activity (e.g., Pilates/power yoga; not necessarily heavy lifting)
• 2: hot therapy (sauna/steam/hot yoga for ~20 minutes at a time)
• 1: one weekly sprint session (short, high-intensity; described as ~85% max heart rate)
  • Emphasis on recovery/injury prevention; not everyone tolerates sprinting equally

Supplements: focus on the ones with the strongest evidence

Most supported supplements mentioned:

• Vitamin D
• Magnesium (sleep/relaxation/brain support)
• Omega-3 fatty acids

Magnesium forms recommended:

• Magnesium glycinate (relaxation; often good before bed)
• Magnesium citrate (constipation support)
• Magnesium L-threonate (brain/mood support)
• Avoid/less recommended: magnesium oxide (poor absorption)

Be careful with supplement stacking

• Examples mentioned: ashwagandha and L-theanine.
• Guidance:
  • Check labels to avoid duplicate ingredients across multiple products
  • Get bloodwork quarterly if on supplements (or at least every 6–12 months)

Choose supplements you can trust

• Emphasized third-party testing to ensure label accuracy and reduce risk of contaminants/heavy metals.
• Warned that unverified/random supplement choices (e.g., from Amazon with no verification) can be inconsistent.

Quick yes/no trends addressed

• Carnivore diet: tends to be bad for most (cuts fruits/veg)
• Keto for women: usually harmful (cuts carbs broadly, including beneficial ones)
• Intermittent fasting long-term over age 30: No
• OMAD (one meal a day): No
• Seed oils: not necessarily as bad as TikTok narratives claim (don’t overdo, but not “automatically evil”)
• Cycle syncing as one-size-fits-all: No (individual response matters)
• Raw diets / vegan raw: can be okay, but nutrient sufficiency is difficult—ensure you get what you need

Presenters / Sources

• Dr. Amy Shah — double board-certified medical doctor; nutrition specialist; author of Hormone Havoc
• Radhi Dluka — host of the podcast “A Really Good Cry”