Electrolytes, Hydration and Energy

If you often find that your energy dips during the summer months, it can be easy to assume it’s just because you are busy, tired from the heat or not sleeping well. And, yes of course, those things could be part of the picture. But there may be another basic factor that you have missed: hydration.

In warmer weather, during travel, after exercise, or on days when you are rushing around and drinking less than usual, your fluid and electrolyte balance can shift. This can leave you feeling tired, headachy, light-headed, sluggish, constipated, foggy or even more prone to cravings.

It’s good to note that hydration is not just about drinking lots of plain water. Your body also relies on electrolytes, these are minerals such as sodium, potassium, magnesium, calcium and chloride, to help regulate fluid balance, nerve signalling, muscle function and normal cellular processes.

That doesn’t mean everyone needs to be popping expensive electrolyte powders every day. For most of us, the best place to start is much simpler: regular fluids, water-rich foods, balanced meals and a little more attention to salt and minerals when the weather is hot, you are sweating more, travelling, exercising (or losing fluid through diarrhoea or vomiting!).

Why Hydration Affects Energy and Digestion

Water is involved in almost every system in the body. It helps regulate body temperature, supports circulation, carries nutrients, helps remove waste products, supports concentration and helps keep the digestive system moving.

So when your fluid intake drops, your body has to work much harder. Blood volume may reduce slightly, which can contribute to feeling light-headed, tired or less able to concentrate. Your mouth may feel dry, your urine may become darker, and you may notice headaches or a general sense of feeling below par.

Digestion can also be affected. If you are prone to constipation, dehydration can make stools harder and more difficult to pass. The bowel draws water back into the body when fluid intake is low, which can leave stools drier and slower moving.

Hydration also matters if you are prone to diarrhoea. Loose stools do not just mean water loss. They can also mean loss of electrolytes, particularly sodium and potassium. This is one reason why oral rehydration salts are often recommended when diarrhoea is more than mild, especially when travelling, in hot weather, or if you are at higher risk of dehydration.

This is where the “just drink more water” advice can be too simplistic. Water matters, but if you are losing fluid through sweat or diarrhoea, you may also need to think about the minerals being lost alongside it.

Signs You May Need More Electrolytes

Electrolytes are minerals that carry an electrical charge when dissolved in fluid. They help your body maintain fluid balance and support normal nerve and muscle function.

The main electrolytes people tend to hear about are sodium and potassium, but magnesium, calcium, chloride, phosphate and bicarbonate are also part of the picture. You get these through food and fluids, and your kidneys play a major role in keeping levels balanced.

You may need to pay more attention to electrolytes if you are sweating heavily, exercising for longer periods, spending time in hot weather, travelling in a hot climate, drinking more alcohol than usual, or losing fluid through vomiting or diarrhoea.

That does not automatically mean you need a sports drink. It means your hydration strategy may need to be more than a few sips of water.

Sweating, Fatigue and Dizziness

Sweat contains water and electrolytes, especially sodium. Some people lose more salt through sweat than others. You may notice this if your clothes have white marks after exercise, your skin tastes salty, or you feel unusually wiped out after sweating heavily.

The NHS advises that heat exhaustion can happen during hot weather or exercise. Symptoms may include tiredness, dizziness, headache, feeling sick, excessive sweating, cramps and intense thirst. If someone does not improve after cooling down, or symptoms become more serious, medical help is needed.

This is particularly important for older adults, children, pregnant women, people with heart or kidney conditions, those taking certain medications, and anyone who is unwell. In these situations, dehydration and heat illness can become more serious more quickly.

For most healthy adults, prevention is practical rather than complicated. Drink regularly across the day, keep an eye on urine colour, increase fluids in hot weather or after sweating, and include mineral-rich foods rather than relying on coffee, alcohol or occasional large glasses of water.

Food-First Hydration Strategies

For most people, hydration support should start with food and routine, rather than supplements.

The NHS recommends aiming for around 6 to 8 cups or glasses of fluid per day, although you may need more if you are in a hot environment, physically active, pregnant or breastfeeding. Water is the obvious choice, but it is not the only one. Herbal teas, milk, smoothies, soups and water-rich foods can all contribute to fluid intake. Tea and coffee can contribute too, although relying heavily on caffeine may not be ideal if you are anxious, sleep deprived or prone to reflux or loose stools.

Water-rich foods can be particularly helpful in summer. Cucumber, tomatoes, courgettes, lettuce, watermelon, strawberries, citrus fruits, peppers, soups, yoghurt and smoothies all provide fluid as well as nutrients.

Electrolyte-rich foods can also be built into normal meals:

• Potassium is found in foods such as:
  • potatoes, bananas, avocado, spinach, beans, lentils, yoghurt, fish and dried fruit. 
• Magnesium is found in:
  • nuts, seeds, wholegrains, dark chocolate, leafy greens and legumes. 
• Calcium comes from:
  • dairy foods, calcium-set tofu, fortified plant milks, tinned fish with bones and some leafy greens. 
• Sodium is usually easy to obtain from the diet, but if you are sweating heavily or losing fluid, you may need a little salt with meals rather than eating very low salt all the time.

A practical summer hydration day might look like this:

Have water on waking, then breakfast with fluid and minerals, such as Greek yoghurt with berries and seeds, or eggs with sourdough and spinach.

Keep a bottle with you during the day, especially if travelling, commuting or spending time outdoors.

Include a water-rich lunch, such as a chicken and avocado salad with potatoes, a lentil and vegetable soup, or a salmon rice bowl with cucumber and peppers.

Add mineral-rich snacks where needed, such as fruit with yoghurt, oatcakes with hummus, a handful of nuts and seeds, or watermelon with feta.

This is simple, but it can make a real difference. Many people do not need a complicated hydration plan. They need regular fluids, enough minerals, enough food and a better awareness of when their needs increase.

When Electrolyte Drinks May Be Useful

Electrolyte drinks can be useful, but they are not all created equal and they are not automatically needed every day.

For general hydration, most people can meet their fluid and mineral needs through regular drinks, balanced meals and electrolyte-rich foods. But there are situations where electrolytes may be genuinely helpful, particularly when fluid losses are higher.

This includes endurance exercise, such as long runs, cycling, hiking, triathlon training or events lasting longer than around 60 minutes. It can also include exercising in hot or humid weather, heavy sweating, long travel days in hot climates, diarrhoea or vomiting, working outdoors, or feeling light-headed, headachy or unusually wiped out after sweating.

During endurance exercise, you are not just losing water. Sweat contains electrolytes, particularly sodium, and the longer you exercise, the more relevant this becomes. This is why plain water may not always be enough for longer or hotter sessions. If you are sweating heavily and drinking lots of plain water, but not replacing electrolytes, you may still feel flat, headachy or depleted.

I generally recommend a mineral-only electrolyte rather than a sugary sports drink for most clients. Many sports drinks and electrolyte powders contain added sugars, dextrose, glucose syrups, artificial sweeteners, flavourings, colourings or other additives that may not suit a sensitive gut. For some people, especially those with IBS, bloating, reflux, diarrhoea tendency, PCOS or blood sugar instability, these ingredients can be unhelpful.

This does not mean carbohydrate is not relevant for endurance exercise. It can be. But in practice, I often prefer clients to get their fuelling from real food wherever possible and use electrolytes separately for mineral replacement. This allows you to tailor hydration and fuelling more carefully, rather than relying on a brightly coloured sports drink that may not be right for your gut or your blood sugar.

For example, someone doing a long walk, run, cycle or hike might use a mineral-only electrolyte in water, then fuel with tolerated foods such as a oatcakes or rice cakes with nut butter, potatoes with salt, a simple homemade flapjack, sourdough with nut butter, or another carbohydrate-rich food that suits their digestion. For people with IBS, this can be much easier to personalise than using a standard sports drink.

For a short gym session, gentle walk, Pilates class or easy 30-minute jog, you probably do not need a special electrolyte drink. Water and normal meals are usually enough. But for longer runs, long bike rides, hot-weather training, races, long hikes or heavy sweat sessions, a more structured hydration plan may be useful.

How to Choose a Good-Quality Electrolyte Supplement

If you do decide to use an electrolyte product, it is worth reading the label carefully rather than assuming all products are created equal.

Some electrolyte supplements are good quality and can be genuinely useful in the right context. Others are little more than sugary flavoured drinks, or contain sweeteners, colours and additives that may aggravate bloating, reflux or loose stools.

A good-quality electrolyte product is usually one that has:

• A simple ingredient list
  Ideally, you want minerals without lots of flavourings, colourings, sweeteners, preservatives or “wellness” extras. The more sensitive your gut, the more important this becomes.
• Meaningful mineral content
  Sodium is often the most relevant electrolyte for sweat losses, but potassium, magnesium and chloride may also be included. Be aware that some products are marketed as electrolytes but contain very small amounts of minerals.
• No unnecessary sugar or dextrose
  Dextrose and glucose can be useful in specific oral rehydration products for diarrhoea, where the glucose-sodium ratio helps absorption. But for everyday hydration or mineral replacement during summer activity, many people do not need added sugar in their electrolyte drink. If you need carbohydrate for endurance exercise, it may be better to add this from food that suits you.
• No gut-irritating sweeteners or sugar alcohols
  Some products contain sorbitol, xylitol, mannitol or other polyols, which can aggravate bloating or diarrhoea in people with IBS. Some also contain high-dose vitamin C, caffeine, strong acids or flavourings that may not suit reflux-prone clients.
• A format that works for real life
  Drops, sachets or powders can all work. Liquids such as mineral electrolyte drops can be useful because they are easy to add to water and do not necessarily contain flavourings or sweeteners. The best product is the one you tolerate and will actually use.

It is also important to be wary of exaggerated “wellness” claims. You do not need an electrolyte drink to detox, cleanse, alkalise or magically fix fatigue. Electrolytes support normal fluid balance, nerve signalling and muscle function. That is useful and important, but it should not be overpromised.

Electrolyte products are not appropriate for everyone to use regularly without advice. If you have kidney disease, heart failure, high blood pressure requiring salt restriction, are on fluid restriction, or take medications that affect fluid or potassium balance, such as some diuretics, ACE inhibitors or ARBs, check with your GP or pharmacist before using electrolyte supplements regularly.

A Simple Summer Hydration Reset

If you suspect you are not drinking enough, keep it simple for a week.

How to Protect Your Gut While Travelling

If you have a sensitive gut, travelling can feel like a gamble. You might feel fairly fine at home, then suddenly find that a flight, a hotel breakfast buffet, a few late nights, or a change in water is enough to trigger bloating, constipation, loose stools, reflux or that familiar “my digestion has gone off the rails again” feeling.

This is especially common if you experience IBS-type symptoms, have a history of SIBO, react to certain foods, or know that stress affects your digestion. The real frustration is that holidays are supposed to be relaxing, but for many people, the lack of routine can make their guts feel unpredictable.

The aim is not to eat perfectly while you are away. I don’t think holidays should revolve around rigid food rules! Instead, let’s see what it takes to build a little digestive resilience before you travel, work on understanding your likely triggers, and have a calm plan for what to do if symptoms flare – so that your gut doesn’t spoil your holiday.

Why Travel Can Trigger Gut Symptoms

Your gut *loves* routine more than we often realise. At home, your digestive system has its cues. You may generally wake up at a similar time, drink your usual morning drink, eat familiar meals with familiar foods, move around during the day, and then go to bed at a predictable time. When you travel, many of those cues disappear.

Long journeys can slow bowel motility because you are sitting for hours, moving less, and often delaying going to the loo. Flights can also add to dehydration as cabin air is dry and many of us drink less to avoid needing a wee. Add in airport food, more caffeine, alcohol, later meals and a different sleep pattern, and your gut has to adapt fairly swiftly.

For someone with IBS, this can be enough to get symptoms going. IBS is not simply a “food problem”. It involves the gut-brain axis, gut motility, visceral sensitivity, the microbiome, immune signalling and stress response. This is why your symptoms may flare on holiday even if you have not eaten anything obviously “wrong”.

It also explains why a purely restrictive approach often doesn’t work. If you only focus on avoiding foods, but ignore hydration, stress, sleep, meal timing and bowel routine, you may miss some of the bigger drivers.

Hydration, Routine and Digestive Resilience

Hydration sounds basic, but it is one of the most useful foundations for travel digestion.

When you are dehydrated, stools can become harder and more difficult to pass. If you are prone to diarrhoea, dehydration can also make you feel weak, headachy and wiped out more quickly. Hot weather, sweating, alcohol, salty meals, vomiting and loose stools all increase your need for fluids.

For most people, the simplest approach is to start hydrating before the journey, not once you already feel unwell. Have a drink before you leave home, take an empty bottle through airport security and refill it before boarding, and keep sipping during the journey. If you are somewhere hot, walking a lot, sweating heavily or have loose stools, oral rehydration salts can be useful because they replace electrolytes as well as fluid.

I would also think about your “gut anchors”. These are the small routines that tell your digestive system that not everything has changed. This might be having breakfast within a reasonable window, taking a short walk in the morning, drinking water before coffee, or keeping one familiar meal each day.

It does not need to be complicated. For some people, a familiar breakfast makes all the difference. Something like Greek yoghurt with berries and seeds, porridge with ground flaxseed, eggs with sourdough, or a simple protein-rich smoothie can give the gut a more predictable start to the day.

Food Hygiene and Gut Health

When we talk about gut symptoms on holiday, there are two separate issues to think about.

The first is your own gut sensitivity: IBS, bloating, constipation, reflux or food reactions. The second is exposure to unfamiliar bacteria, viruses or parasites through food and water.

Travellers’ diarrhoea is most often linked to contaminated food or water. The risk varies depending on where you are travelling, the local sanitation infrastructure and how food is prepared. It is not always possible to avoid every risk, and even careful travellers can become unwell, but sensible food hygiene still matters.

If you are travelling somewhere where water safety is uncertain, be cautious with tap water, ice, salads washed in local water and food that has been sitting around for a long time. Food that is cooked thoroughly and served hot is usually a safer option than lukewarm buffet food. Fruit you can peel yourself may be a better choice than pre-cut fruit. Handwashing before eating is still one of the simplest and most overlooked forms of gut support.

That does not mean becoming frightened of food! It simply means being more discerning in situations where your gut is more exposed.

If you do develop diarrhoea, the priority is fluid and electrolyte replacement. Seek medical help if you have blood in the stool, a high fever, severe pain, signs of dehydration, persistent vomiting, or symptoms that do not settle.

Managing IBS and Bloating Abroad

If bloating is your main issue, it is worth thinking about the “stacking effect”. Many people can tolerate one trigger, but not five at once. For example, you may be fine with a glass of wine at home, but not when it comes after a long flight, a salty airport meal, poor sleep, fizzy drinks, a rich restaurant dinner and very little water.

This is where a more flexible approach can be helpful. Rather than trying to avoid everything, you can choose which digestive load matters most to you. If you know onions and garlic trigger bloating, you might keep those lower while still enjoying a pudding. If alcohol affects your gut, you might alternate with water or keep it to earlier in the evening. If raw salads make you balloon, cooked vegetables, rice, potatoes, fish, chicken or eggs may be easier options.

Meal timing can also matter. Skipping breakfast, grazing all day and then eating a very large late dinner can be difficult for IBS. The migrating motor complex, often described as the gut’s cleansing wave, works best when there are gaps between meals. Constant snacking can make some people feel more bloated, especially if they are prone to SIBO-type symptoms.

Constipation needs a slightly different strategy. Travel constipation is often driven by reduced movement, dehydration, ignoring the urge to go, and a lack of familiar fibre. Soluble fibre is usually the gentler place to start. Oats, ground flaxseed, chia, peeled potatoes, carrots, berries and stewed fruit are often better tolerated than suddenly loading up on bran, raw salads or large portions of beans.

For diarrhoea-prone IBS, the focus may be on calming the gut rather than pushing fibre higher. This may mean reducing very high-fat meals, limiting caffeine, avoiding sugar-free sweets or chewing gum containing polyols, and being cautious with large amounts of fruit juice, alcohol or spicy food.

This is why generic IBS advice can fall short. The right travel strategy depends on your pattern.

Simple Nutrition Strategies Before and During Travel

The best time to support your gut is before you travel, not once symptoms have already taken over. In the week before you go away, try to keep food steady and familiar. This is not the moment to start a new gut protocol, suddenly double your fibre intake, or trial several new supplements. A sensitive gut usually responds better to consistency.

A helpful pre-travel plate might include protein, cooked veggies, a carb you tolerate well and some healthy fats. For example, salmon with potatoes and greens, chicken with rice and roasted vegetables, eggs with sourdough and spinach, or a simple lentil soup if you tolerate legumes. This kind of meal supports blood sugar balance, bowel regularity and energy without overloading the digestive system.

Food-wise, aim for familiarity with flexibility. If breakfast buffets overwhelm you, look for protein first. Eggs, yoghurt, smoked salmon, cheese, nuts or seeds can help steady energy and appetite. Then add a carb you tolerate, such as oats, potatoes, sourdough or fruit. At lunch and dinner, the simplest gut-friendly structure is usually protein, cooked plants, a starchy carbohydrate and olive oil or another fat you tolerate well.

This also helps reduce the classic holiday pattern of coffee and pastries for breakfast, snacks through the day, then a very large evening meal. There is nothing wrong with enjoying local foods, but your gut may cope better if you give it some structure around the edges.

Your Travel Gut Support Kit

It can be helpful to pack a small gut support kit, especially if you know your digestion is easily thrown off when you travel. This doesn’t need to be complicated, and it does not mean taking lots of supplements “just in case”. The aim is to have a few sensible, familiar tools with you so that you are not trying to solve gut symptoms in a pharmacy abroad when you are tired, bloated or unwell.

A useful travel gut support kit might include:

• Oral rehydration salts
  These can be very useful if you develop diarrhoea, are sweating more than usual, or are travelling somewhere hot. Water alone doesn’t replace the electrolytes lost through loose stools, vomiting or heavy sweating. Oral rehydration salts help replace both fluid and key minerals such as sodium and potassium. They are particularly important if diarrhoea is persistent, although you should seek medical advice if symptoms are severe, bloody, associated with fever, or if you feel dehydrated or very unwell.
• Your usual medications and any prescribed digestive support
  Pack these in your hand luggage rather than your checked suitcase. This is especially important if you take regular medication, use prescribed reflux medication, have antispasmodics, have been advised to use loperamide in certain situations, or need medication for another health condition. Keep them in their original packaging where possible, and check travel rules if you are taking medicines across borders.
• A few familiar snacks you already tolerate well
  Travel often means long gaps between meals, limited food choices and lots of beige convenience food. Packing familiar snacks can help you avoid getting over-hungry, which may lead to eating quickly or choosing foods that are more likely to trigger symptoms. Good options might include oatcakes, plain nuts or seeds, a simple protein bar, rice cakes, nut butter sachets, plain crackers, or fruit you know suits you. The key is familiarity. Do not pack something “healthy” that you rarely eat if you do not know how your gut responds to it.
• A soluble fibre option, if this is already part of your routine
  Soluble fibre can help some people with bowel regularity and stool consistency, but it should be introduced carefully. If you already tolerate ground flaxseed, chia seeds, oats, PHGG or another soluble fibre, it may be worth taking a small amount with you. However, travel is not the best time to start a new fibre powder or suddenly increase your fibre intake, as this can worsen bloating or gas in sensitive people.
• Saccharomyces boulardii, if it is suitable for you and you have trialled it before travelling
  Saccharomyces boulardii is a probiotic yeast rather than a bacterial probiotic. It has been studied in relation to diarrhoea, including antibiotic-associated diarrhoea and travellers’ diarrhoea. Research suggests that specific strains, particularly Saccharomyces boulardii CNCM I-745, may help reduce the risk of travellers’ diarrhoea in adults. 

However, it should not be introduced for the first time on the day of travel, and it should not replace food hygiene, safe water choices or oral rehydration salts if diarrhoea occurs. It is also not suitable for everyone. Anyone who is immunocompromised, seriously unwell, has a central venous catheter, is pregnant, is taking complex medication, or has been advised to avoid probiotics should speak to their GP, pharmacist or medical team before using it.

• Herbal teas or simple digestive drinks you know you tolerate
  Peppermint tea, ginger tea or chamomile tea may be soothing for some people, although peppermint can aggravate reflux in others. Taking a few tea bags can be a simple way to create a calming evening routine, especially if your gut is affected by stress, poor sleep or late meals.

I would also avoid introducing lots of new products just before travelling. A common mistake is to panic-buy probiotics, enzymes, fibre powders, magnesium or herbal supplements the week before a holiday. Even useful products can cause bloating, looser stools or discomfort if they are not right for you or if the dose is too high. The safest travel strategy is usually to stick with what your body already knows.

What To Do If Symptoms Flare

Even with the best planning, digestive symptoms can still happen. That does not mean you have failed. It means your gut has met a lot of change at once. If you feel bloated, constipated or sluggish, come back to the basics. Choose simple meals, drink regularly, walk gently, avoid grazing all day, and allow yourself time to use the bathroom rather than rushing straight into the next activity.

If you develop loose stools, the priority is hydration. Use oral rehydration salts if needed, keep food simple for 24 hours, avoid alcohol temporarily and seek medical help if symptoms are severe, persistent, bloody, associated with fever, or you feel very unwell.

And if bloating, urgency, constipation or diarrhoea regularly affect your holidays, work trips or social life, it may be worth looking more deeply at what is driving your symptoms. Gut issues can be influenced by food, stress, motility, the microbiome, infections, medications, hormones and underlying medical conditions. You do not have to keep guessing.

If you would like personalised support with IBS-type symptoms, bloating, SIBO concerns or digestive flare-ups, you can book a free 30-minute call and we can talk through what might be contributing to your symptoms and what your next steps could look like.

DUTCH Testing for Midlife Women

If you are in your 40s or 50s and feel as though your body has changed almost overnight, you are not alone.

You may be sleeping less well, feeling more anxious or irritable, gaining weight around the middle, waking at 3am, craving sugar, struggling with brain fog, or noticing changes to your periods. This is often the point where many women start asking: “Is this my hormones?”

The answer is: quite possibly. But hormones do not work in isolation. They are influenced by blood sugar balance, stress, sleep, gut health, liver function, inflammation, alcohol intake, exercise, nutrient status, and the natural hormonal shifts of perimenopause and menopause.

This is where the DUTCH test can be helpful. Not because it gives you a simple label, diagnoses menopause, or explains everything. But because it can provide a more detailed picture of how your hormones are being produced, metabolised and cleared, alongside your daily cortisol pattern.

For many midlife women, that can be a useful starting point for a more personalised nutrition and lifestyle plan.

What is the DUTCH test?

DUTCH stands for Dried Urine Test for Comprehensive Hormones.

Instead of relying on a single blood sample, the DUTCH test uses dried urine samples collected at different points across the day. These are analysed to look at sex hormones, hormone metabolites and cortisol patterns.

Depending on the panel used, the test may include information on oestrogen metabolites, progesterone metabolites, androgens such as testosterone and DHEA, cortisol and cortisone patterns, melatonin markers, and some nutrient or organic acid markers.

The reason this can be useful in midlife is that symptoms are not always explained by whether hormones are simply “high” or “low”. Sometimes the more useful question is: what is your body doing with those hormones?

For example, two women may both have symptoms of oestrogen fluctuation, but their patterns may look quite different. One may have signs of lower progesterone output. Another may show a pattern that suggests less favourable oestrogen metabolism. Another may have a disrupted cortisol rhythm affecting sleep, energy, cravings and resilience.

Why not just do a standard blood test?

Standard blood testing absolutely has its place. It can be important for assessing thyroid function, iron status, B12, folate, vitamin D, inflammation, glucose regulation, cholesterol, and liver and kidney function.

When it comes to diagnosing perimenopause or menopause, however, UK guidance is clear that women over 45 with typical symptoms are usually diagnosed based on symptoms, not hormone testing. Hormones such as FSH and oestradiol can fluctuate significantly during perimenopause, so a single blood test may not give the full picture.

So, the DUTCH test should not be seen as a menopause diagnosis test.

Instead, I see it as a functional hormone insight tool. It can help us explore patterns that may be relevant to how you feel, especially when considered alongside your symptoms, health history, diet, lifestyle, cycle pattern, medications, stress load and other markers. For example:

Oestrogen metabolism

Oestrogen is not just produced and then switched off. It has to be metabolised and cleared from the body.

The DUTCH test looks at different oestrogen metabolites, which can give insight into how your body is processing oestrogen. This may be relevant for women with symptoms such as heavy periods, breast tenderness, cyclical headaches, PMS-type symptoms, bloating or worsening perimenopausal symptoms.

From a nutrition perspective, this may guide support around fibre intake, cruciferous vegetables, gut health, alcohol reduction, protein adequacy and overall metabolic health.

This does not mean “detoxing” in the trendy sense. Your body already has detoxification pathways. The question is whether you are giving those pathways what they need to work well.

Progesterone patterns

Progesterone may become more variable in perimenopause as ovulation becomes less consistent.

Lower or fluctuating progesterone may be relevant for women experiencing shorter cycles, heavier periods, premenstrual anxiety, poor sleep, night waking or feeling more emotionally reactive than usual.

The DUTCH test does not replace a full clinical picture, but it can give us useful information about progesterone metabolites and whether your symptoms fit with that pattern.

Cortisol rhythm

This is one of the areas I find most useful.

Many midlife women are not just dealing with changing sex hormones. They are also dealing with years of chronic stress, poor sleep, blood sugar swings and nervous system overload.

Cortisol should follow a natural rhythm. It is usually higher in the morning to help you wake up and gradually falls across the day so that you can wind down at night.

When this rhythm is disrupted, you may wake feeling unrefreshed, rely on caffeine to get going, experience afternoon energy crashes, feel wired but tired at night, wake around 3am, crave sugar or carbohydrates, feel less resilient to stress, or struggle to recover from exercise.

The DUTCH test can show the pattern of free cortisol and cortisone across the day, as well as cortisol metabolites. This is not about diagnosing “adrenal fatigue”, which is not a recognised medical diagnosis. It is about understanding stress physiology and using nutrition and lifestyle strategies to support better regulation.

Androgens

Androgens such as testosterone and DHEA can also change in midlife. For some women, this may be relevant to acne, facial hair, hair thinning or changes in body composition. For others, low libido, low motivation, low mood or reduced muscle strength may be part of the picture.

The DUTCH test can provide information about androgen metabolites, which may be useful when symptoms suggest that androgen balance could be involved.

What can you actually do with the results?

This is the most important question. Testing is only useful if it changes the plan.

With the DUTCH test, the goal is not to chase perfect hormone numbers. The goal is to understand your patterns and build a realistic plan around them.

Depending on your results and symptoms, we may focus on blood sugar balance, protein and fibre intake, gut health and regular bowel movements, plant foods to support oestrogen metabolism, alcohol and caffeine habits, sleep timing, stress resilience, strength training, food-first liver support, and supplements if appropriate.

We may also identify whether further GP blood testing or medical review would be helpful.

This is where the DUTCH test can be empowering. It can help move you away from guesswork and towards a more targeted plan.

Who might benefit from a DUTCH test?

The DUTCH test may be useful if you are a midlife woman experiencing symptoms such as worsening PMS, mood changes, heavy or irregular periods, breast tenderness, cyclical headaches, sleep disruption, fatigue, feeling wired but tired, low libido, midlife weight gain, brain fog, stress-related symptoms, or symptoms that do not seem to match standard blood test results.  Or for post-menopausal women who are still having symptoms. It can be taken whether or not you are on HRT (including the Mirena coil). But it is not so relevant if you are on the oral contraceptive pill.

It may also be useful if you have been told “everything is normal”, but you still do not feel like yourself.

Who does not need it?

The DUTCH test is not essential for everyone.

You do not need a DUTCH test to confirm that you are perimenopausal if you are over 45 and have typical symptoms. You do not need it before speaking to your GP about menopause symptoms, HRT or other medical options. And you do not need it if you are looking for an emergency answer to severe or sudden symptoms.

Please speak to your GP if you have very heavy bleeding, bleeding after sex, bleeding after menopause, unexplained weight loss, severe pain, new headaches, chest pain, significant depression, or any symptom that feels unusual or concerning.

As a Nutritional Therapist, I do not diagnose or treat medical conditions, and I do not advise on medication. My role is to help you understand how nutrition, lifestyle, stress, sleep, gut health and metabolic health may be influencing how you feel, and to work alongside appropriate medical care where needed.

The Annual Hormone MOT

If you feel as though your hormones, energy and resilience have changed in midlife, my Annual Hormone MOT has been designed to give you a deeper understanding of what may be going on.

It includes a DUTCH hormone test, one 75-minute consultation, and one 45-minute follow-up consultation.

We take a full look at your symptoms, health history, cycle patterns, diet, lifestyle, stress, sleep, digestion and goals. We then go through your results and create a clear, personalised nutrition and lifestyle plan.

This is not about handing you a complicated protocol or overwhelming you with supplements. It is about helping you understand your body and giving you practical, evidence-informed steps that fit into real life.

If you are ready to take a deeper look at your hormones, stress response and midlife health, my Annual Hormone MOT includes the DUTCH test and two personalised consultations. Click here to view the full details and book.

Why Midlife Hormones Feel So Chaotic 

Many women reach their 40s feeling as though their body has suddenly started behaving differently.

The coffee that once felt energising now triggers anxiety. A small amount of alcohol affects sleep for days on end. Energy crashes appear out of nowhere. Weight settles around the middle despite eating the same as before. Cravings become harder to ignore. Sleep becomes lighter, mood becomes more unpredictable, and stress suddenly feels far less manageable.

Women often tell me: “I feel like my body can’t cope with things it used to.”

And honestly, they are often right.

One of the biggest misconceptions about hormone health is that symptoms are purely caused by “low hormones” or that women simply need to eat more salads, avoid sugar or buy expensive supplements.

In reality, hormones respond constantly to signals from the brain, gut, nervous system, immune system, liver and metabolic system. During perimenopause and midlife, those systems often become more sensitive to stress, blood sugar fluctuations, poor sleep and under-fuelling.

This is why women can feel exhausted, anxious and inflamed despite trying incredibly hard to “be healthy”.

The good news is that nutrition can play a meaningful role in supporting resilience during this stage of life. Not through perfection or restriction, but by helping the body feel safer, steadier and better nourished.

Why Food Matters for Hormones

Hormones are not isolated messengers floating around independently. They are deeply influenced by:

• Blood sugar regulation
• Stress signalling
• Sleep quality
• Gut health
• Inflammation
• Nutrient intake
• Energy availability
• Muscle mass
• Nervous system regulation

This is one reason why highly restrictive dieting often backfires during midlife.

Women frequently start eating less in response to weight gain while simultaneously exercising harder and sleeping worse. The body then perceives this combination as stress. In clinic, I commonly see women skipping breakfast, surviving on caffeine, eating very lightly during the day and then wondering why they feel ravenous, emotional or desperate for sugar at 9pm. That is not lack of willpower. That is physiology.

Research increasingly shows that fluctuating oestrogen levels during perimenopause may affect insulin sensitivity, appetite regulation and body fat distribution. At the same time, sleep disruption and chronic stress can worsen blood sugar instability and cravings further. Many women are not “failing”. Their body is simply becoming less tolerant of habits that previously went unnoticed.

Protein, Fibre and Healthy Fats Explained

When women feel overwhelmed by nutrition advice, I often encourage them to stop focusing on restriction and start focusing on what their body may genuinely need more of. Three of the most important foundations are protein, fibre and healthy fats. These are not trendy or glamorous recommendations, but they are often transformative.

Protein: The Nutrient Many Midlife Women Are Missing

One of the most common patterns I see is women under-eating protein, particularly earlier in the day. Breakfasts built around toast, cereal, pastries or fruit alone may leave women feeling hungry, shaky or craving sugar within hours.

Protein becomes increasingly important during midlife because it supports: muscle maintenance, blood sugar regulation, satiety, recovery, neurotransmitter production and metabolic health.

This matters because women naturally begin losing muscle mass with age, particularly during perimenopause and after menopause. Lower muscle mass may reduce metabolic flexibility and insulin sensitivity over time.

Many women think they have a “slow metabolism” when in reality they are often chronically stressed, sleeping poorly or under-eating protein and losing muscle mass. Including protein more consistently can help many women feel calmer, fuller and more energised.

Fibre: One of the Most Overlooked Hormone Supporters

Fibre is not just about digestion. Higher fibre intakes are associated with improved blood sugar balance, cardiovascular health, gut health and metabolic function. Fibre may also support hormone metabolism by influencing how oestrogen is processed and excreted from the body. Many women are eating far less fibre than they realise, especially when relying heavily on ultra-processed convenience foods.

At the same time, the gut microbiome appears to play a role in hormone regulation through something known as the estrobolome, the collection of gut bacteria involved in oestrogen metabolism. Emerging research suggests microbiome diversity may influence inflammatory and hormonal pathways during midlife.

Women often assume hormone health is about removing foods. Very often, it is actually about adding more nourishment and diversity back in.

Healthy Fats: The Missing Piece for Satiety and Hormone Health

After decades of low-fat messaging, many women still fear fats. But healthy fats are essential for hormone production, brain health, cell membrane health, nervous system regulation, satiety and absorption of fat-soluble vitamins.

Meals that are excessively low in fat often leave women hungry and unsatisfied, particularly during stressful periods. Useful sources include:

• Extra virgin olive oil
• Avocado
• Walnuts
• Chia seeds
• Flaxseeds
• Oily fish

Omega-3 Fats and Inflammation

One thing many women notice during perimenopause is that their body feels more inflamed. Joints ache more. Recovery is slower. Skin changes. Brain fog worsens. Sleep becomes less restorative.

While inflammation is complex, omega-3 fats have been widely researched for their role in supporting inflammatory balance, cardiovascular health and cognitive function.

Good sources include:

• Salmon
• Sardines
• Mackerel
• Anchovies
• Walnuts
• Flaxseeds
• Chia seeds

If you'd like to discuss this further, why not get in touch? You can book a free call with me here.

There is often a point during perimenopause and midlife where women realise salads are no longer keeping them full. I frequently hear women say they are “trying to be good” by eating light lunches, only to find themselves exhausted, craving sugar or reaching for caffeine by mid-afternoon.

Many women in midlife are unintentionally under-fuelling, particularly earlier in the day. Meals that are too low in protein, fibre or healthy fats can leave blood sugar unstable and energy levels all over the place.

This salad is designed to do the opposite.

It combines protein, omega-3 fats, fibre, colour and healthy fats in a way that feels satisfying, nourishing and realistic for real life. It is quick enough for a weekday lunch but substantial enough to support energy, blood sugar balance and fullness properly. And importantly, it actually tastes good.

Serves 2

Ingredients

• 2 salmon fillets
• 1 large handful mixed leaves
• 1 large handful rocket
• ½ avocado, sliced
• ½ cucumber, chopped
• 10 cherry tomatoes, halved
• ¼ red onion, finely sliced
• 1 tbsp pumpkin seeds
• 1 tbsp flaxseeds
• 1 tbsp extra virgin olive oil
• Juice of ½ lemon
• Black pepper
• Fresh herbs such as parsley or dill

Method

1. Preheat the oven to 180°C fan.
2. Place the salmon fillets on a baking tray, brush with olive oil and season, and cook for approximately 12–15 minutes until cooked through.
3. Meanwhile, prepare the salad vegetables and divide between two bowls.
4. Top with avocado, pumpkin seeds and flaxseeds.
5. Flake the cooked salmon over the salad.
6. Drizzle with olive oil and lemon juice.
7. Finish with black pepper and fresh herbs.
8. Enjoy!

Easy Ingredient Swaps

One of the most important things for sustainable healthy eating is flexibility.

Some easy swaps include:

• Swap salmon for mackerel, trout or grilled chicken
• Use tofu or tempeh for a veggie version
• Add quinoa or lentils for additional fibre and carbohydrates
• Replace pumpkin seeds with walnuts or sunflower seeds
• Add roasted vegetables for a more substantial evening meal
• Include feta or olives for a more Mediterranean-style flavour

This is often how I encourage women to think about meals in clinic, not rigid recipes, but balanced templates they can adapt to real life.

How to Turn This into a Balanced Summer Meal

One of the biggest mistakes I see women make with salads is building meals that are too small or too low in protein. A balanced meal should ideally help you feel:

• Full for several hours
• Mentally clearer
• More energised rather than sleepy
• Less likely to crave sugar later

If you find yourself hungry an hour after lunch, that is often useful feedback rather than a sign you lack willpower. Depending on your needs and activity levels, you could make this salad more substantial by adding:

• Quinoa
• Chickpeas or lentils
• New potatoes
• Extra salmon
• Sourdough bread on the side

Many women feel significantly better when they stop trying to eat the smallest possible meal and instead focus on eating meals that genuinely support energy and resilience.

Exhausted, Foggy and Gaining Weight? Thyroid Health in Midlife

There is a particular kind of exhaustion that many women in midlife describe.

Not just feeling tired after a busy week but waking up exhausted despite sleeping. Struggling to concentrate. Feeling cold all the time. Watching weight creep up despite eating “healthily”. Finding exercise harder to recover from. Losing motivation because nothing seems to work the way it used to.

For many women, these symptoms develop gradually enough that they begin to normalise them.

They blame stress. Ageing. Being busy. Perimenopause.

And while hormonal changes during midlife absolutely matter, thyroid health is often part of the wider picture too.

The thyroid is a small butterfly-shaped gland in the neck, but its effects are far-reaching. Thyroid hormones influence metabolism, energy production, temperature regulation, digestion, mood, menstrual health and cardiovascular function.

When thyroid function becomes suboptimal, women can feel as though their entire system has slowed down.

What makes this especially challenging is that thyroid symptoms are often dismissed, misunderstood or attributed solely to ageing or stress. Many women are told their results are “fine” despite clearly struggling with fatigue, brain fog, poor resilience and unexplained weight changes.

Nutrition cannot diagnose or treat thyroid conditions, and it is important to speak to your GP about ongoing symptoms. However, nutrition and lifestyle may play a valuable supportive role alongside appropriate medical care.

Why Thyroid Symptoms Are Often Missed

One of the reasons thyroid issues can feel so frustrating is that symptoms overlap with many other health concerns.

Symptoms may include:

• Fatigue
• Weight gain
• Brain fog
• Low mood
• Poor concentration
• Hair thinning
• Dry skin
• Constipation
• Feeling cold
• Heavy periods
• Reduced exercise tolerance
• Muscle aches

Many of these symptoms are also common during perimenopause, chronic stress, iron deficiency and burnout. As a result, women often spend years feeling unlike themselves before joining the dots.

I frequently hear women say things like: “I thought I was just getting lazy.”

Or: “I kept being told it was normal for my age.”

Unfortunately, many women end up feeling dismissed or doubting themselves.

Research suggests that women are disproportionately affected by thyroid disorders, particularly during midlife, and autoimmune thyroid conditions such as Hashimoto’s thyroiditis become increasingly common with age.

At the same time, stress, sleep disruption, under-fuelling and chronic dieting may all affect how resilient women feel during this stage of life, even without a formal thyroid diagnosis.

The Link Between Thyroid Health, Energy and Metabolism

Thyroid hormones help regulate how the body produces and uses energy. When thyroid hormone levels are insufficient, metabolism can slow down. This may affect everything from body temperature and digestion to muscle recovery and cognitive function.

Women often describe feeling as though they are “running on low battery” all the time.

One particularly frustrating aspect is the relationship between thyroid function and weight. Many women are told they simply need to eat less and move more. But thyroid hormones influence resting metabolic rate, appetite signalling, muscle mass and energy expenditure. This does not mean weight changes are entirely caused by the thyroid alone, but it does help explain why women can feel as though their body suddenly responds differently during midlife.

At the same time, poor sleep, stress, low protein intake and blood sugar instability can all compound fatigue and make metabolic health feel even more challenging.

Nutrients Important for Thyroid Function

The thyroid relies on a range of nutrients for normal hormone production, conversion and regulation. A restrictive diet, poor digestion or long-term stress may increase the risk of nutrient insufficiencies over time. Some nutrients commonly discussed in relation to thyroid health include:

Selenium
Selenium plays a role in thyroid hormone metabolism and antioxidant protection within the thyroid gland itself.

Foods rich in selenium include:

• Brazil nuts
• Seafood
• Eggs
• Poultry

Iodine
Iodine is required for thyroid hormone production, although both deficiency and excess intake may be problematic, so be very careful about overdoing it. Useful food sources include:

• Seafood
• Dairy products
• Eggs

It is important not to self-prescribe high-dose iodine supplements without professional guidance, particularly where autoimmune thyroid conditions may be present.

Iron
Low iron status may affect thyroid hormone production and energy levels. This is particularly relevant for women with heavy periods, digestive issues or restrictive eating patterns.

Zinc and Tyrosine
Zinc and the amino acid tyrosine are also involved in thyroid hormone synthesis and broader metabolic processes. Useful food sources include:

• Meat
• Fish
• Pumpkin seeds
• Dairy products
• Legumes, where tolerated

Everyday Nutrition Strategies for Midlife Thyroid Support
There is no single thyroid “superfood” or miracle diet.

However, many women benefit from returning to simple foundational habits that support energy, blood sugar balance and overall resilience.

Prioritise Protein
Protein supports muscle maintenance, satiety and blood sugar regulation. Many women in midlife are unintentionally under-eating protein, particularly earlier in the day. Including protein regularly may help support steadier energy and reduce cravings.

Eat Regularly
Skipping meals can worsen energy crashes, particularly in women already struggling with fatigue or stress. Balanced meals containing protein, fibre and healthy fats may help support more stable energy throughout the day.

Avoid the “All or Nothing” Trap
One of the biggest challenges I see in clinic is women swinging between restriction and exhaustion. They attempt highly restrictive diets, feel worse, lose motivation and then blame themselves. Midlife health often responds better to consistency than intensity.

Focus on Recovery, Not Punishment
Sleep, stress management, strength training and realistic movement all matter enormously.Many women do not need to push harder. They need more support.

If you feel exhausted, foggy, unlike yourself or frustrated by unexplained weight changes, it is important to know that these experiences are common and valid. And you should definitely get these things checked with your GP

Thyroid health, perimenopause, stress, sleep and nutrition are deeply interconnected during midlife. While nutrition cannot replace appropriate medical investigation or treatment, supportive nutrition and lifestyle strategies may help women feel more resilient, energised and supported during this stage of life.

Most importantly, struggling does not mean you are lazy, failing or lacking willpower. Your body may simply be asking for a different kind of support than it needed ten years ago.

If you would like personalised support with fatigue, thyroid health, perimenopause or midlife nutrition, why not book in for a free call with me to discuss options?