What’s New in Metabolic energy switch

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    Menopause and Alzheimer’s disease susceptibility: Exploring the potential mechanisms

    This review looks at how menopause may increase the chance of developing Alzheimer’s disease, and which biological changes might be responsible. It notes that most people with Alzheimer’s are women, that earlier menopause is linked…

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    Postmenopausal sarcopenia and Alzheimer’s disease: The interplay of mitochondria, insulin resistance, and myokines

    Postmenopausal sarcopenia and Alzheimer’s disease (AD) are linked through a shared muscle–brain metabolic pathway. It highlights that women make up around two‑thirds of AD cases and that more than 60% are postmenopausal, then argues that…

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    Brain aging shows nonlinear transitions, suggesting a midlife “critical window” for metabolic intervention

    This study used MRI and body measures from more than 19,000 people to show that brain activity does not age in a straight line but goes through sharper “turning points,” with a key shift starting…

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    Adjusting diet can help women through menopause

    Researchers found key differences in inflammation and blood sugar levels after eating in post-menopausal versus pre-menopausal women. The unfavourable effect of menopause on blood sugar control, which is a key risk factor for cardiovascular disease…

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    Roles for osteocalcin in brain signalling: implications in cognition- and motor-related disorders

    A hormone made by bone, osteocalcin, helps regulate blood sugar, mood, memory and movement by acting on the brain as well as the rest of the body. In animal and human data, low osteocalcin is…

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    Endocrinal metabolic regulation on the skeletal system in post-menopausal women

    Loss of estrogen results in reduced osteoblast mediated bone formation and enhanced osteoclastic resorption (Emmanuelle et al., 2021). Given the recent expansion of interest in understanding how these cellular processes are regulated via metabolic flux and bioenergetic…

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    How does menopause affect the brain?

    In post-menopausal women, the earliest change in the brain appears to be a fall in the amount of glucose used by the brain, indicating reduced brain activity. This is due to falling estrogen levels, this…

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    Lupron, Brain Function, and the Keto Diet

    In the absence of estradiol, brain glucose transport diminishes significantly. This effectively starves the brain for energy inducing severe bioenergetic deficiencies with all of the concordant neuronal damage one might expect. The reduction in glucose…

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    Estrogen: A master regulator of bioenergetic systems in the brain and body

    Estrogen is a fundamental regulator of the metabolic system of the female brain and body. Within the brain, estrogen regulates glucose transport, aerobic glycolysis, and mitochondrial function to generate ATP. In the body, estrogen protects…

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    Mitochondria, Estrogen and Female Brain Aging

    During perimenopause, the drop in oestrogen leads to reduced glucose metabolism and increased ketogenic (fat burning) metabolism in the brain.

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    Tank Estradiol and Lose Metabolic Flexibility: Pitfalls of Lupron and Oophorectomy

    Steroid hormones regulate metabolic flexibility at the level of the mitochondria. Estradiol, the most frequently studied among the steroid hormones, plays a pivotal role in determining how food fuel is converted into cellular fuel or…

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    Carbohydrate Intake and Risk of Metabolic Syndrome.

    Metabolic syndrome is a cluster of conditions that occur together, including – increased blood pressure – high blood sugar – excess body fat around the waist, and – abnormal cholesterol or triglyceride levels. Having just…

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    Study suggests hot flashes could be precursor to diabetes

    Hot flashes, undoubtedly the most common symptom of menopause, are not just uncomfortable and inconvenient, but numerous studies demonstrate they may increase the risk of serious health problems, including heart disease. A new study suggests…

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  • I now understand and can control the flushes! And on top of this I have shifted 16lbs and feel better than ever.

  • I couldn’t believe how Sandra resolved my vaginal dryness so quickly and easily.

  • Menopausal symptoms can be resolved, there are many roads. I am eternally grateful as now I know how to take care of my health.

  • I have lost 2 stone, and haven’t had a migraine for 11 weeks! That has not happened since I was 15.

  • Sandra provided a detailed health review, testing and a healthy eating guide. I found it inspiring to work with her, I felt better almost within a week and 4 weeks later all my symptoms almost gone!

  • I’d recommend it to any woman – not as a diet, but as a way of rethinking how your body works, and how to fuel it properly.

  • Within just a week I was feeling much healthier, clearer headed, and energised.

  • I was amazed at how quickly my weight started dropping and soon my migraines all but disappeared.

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The deficiency is not in you. It’s in the medical model.

Mainstream medicine is still working with a 1950s framework — one that treats oestrogen deficiency as the root cause of everything you’re feeling, which is why HRT makes sense for them. But there is one powerful dissenting voice.

Dr Nanette Santoro is a menopause scientist elected to the US National Academy of Medicine and chair at the University of Colorado School of Medicine. As lead investigator on the Study of Women’s Health Across the Nation (SWAN), she has followed more than 3,000 women aged 42–54 since the mid-1990s to understand the menopause transition and its consequences on women’s health. She has concluded that:

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Women need a sophisticated understanding of the root cause of symptoms and health risks – otherwise they will forever be stuck with an oversimplified model that blames low oestrogen for everything.

—Dr Nanette Santoro, lead investigator SWAN

In the last decade, the science of menopause has moved significantly. We now understand that symptoms are driven by far more than oestrogen decline — by metabolic shifts, nervous system load, inflammation, and the conditions in which this transition has to happen. Dr Santoro is clear: symptoms cluster together — hot flushes, brain fog, low mood, and broken sleep don’t arrive randomly. They share root causes. Which means they can be addressed at the root. My practice is built on that research.

If you’ve been told your symptoms are just low oestrogen — or that HRT is your only option — there is another way. It doesn’t matter where you are with HRT. The work is the same: your biology, your root causes, your protocol.

The discovery call is free, 30 minutes, and no obligation. Let’s have that conversation.

From my Substack

I write regularly about menopause, symptoms, biology, and the wider story women are so often not told. Some of the articles will be part of my book. If you want to go deeper into the thinking behind my work, you can start here.

Book a discovery call and in 30 minutes you can:

  • Understand the root causes behind your specific symptoms
  • Learn whether functional medicine is right for your situation
  • Get a clear picture of what testing and treatment could look like
  • Ask any questions — no commitment, no pressure
  • Leave with actionable clarity, regardless of next steps
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As featured in

Sandra Ishkanes  Natural Menopause Specialist based in Brighton, serving clients worldwide via Online Consultations   
BSc Molecular Biology (King’s College London) | DipION | Functional Medicine Practitioner
Registered member, Association of Naturopathic Practitioners (ANP) – the UK professional body for accredited naturopathic and functional medicine practitioners. ANP members hold accredited qualifications, carry professional indemnity insurance, and follow a strict code of ethics.

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The information provided on this website is for educational and informational purposes only and is not intended as medical advice, diagnosis, or treatment. Sandra Ishkanes is a Functional Medicine Practitioner and Molecular Biologist, not a medical doctor. Always seek the advice of your GP or other qualified healthcare provider with any questions you may have regarding a medical condition or before making any changes to your diet, lifestyle, or supplement regimen—especially if you are currently taking prescription medication or HRT. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.