My Best Friend Has a Frozen Shoulder: Here's How I Am Helping Her as a Leading Perimenopause Expert

I love my best friend. She's a brilliant, leading Podiatric Physician with a big heart & ambition that's always been unstoppable... until now.  

Enter perimenopause metabolic & musculoskeletal changes.

When I met her in John Carroll University's pre-medicine program, I knew we'd be great friends. And to this day, 20+ years later, we still are.

So why, when she's meticulously wellness-minded & hyper-educated, is she suffering from a frozen shoulder at age 41? Well, the mechanisms of perimenopause, of course!

Let's break this down: What all women should know about frozen shoulder, why it happens & what we can do about it. Here are the texts I sent one of my besties this morning:

Morning! One of the other perimenopause leaders who’s work I follow wrote this article today: It’s a good read about the evidence-based theories of why frozen shoulder & other musculoskeletal injuries happens during perimenopause "Defrosting the Frozen Shoulder: Why It Strikes After 40 & What It's Trying To Tell You", by Dr. Sara Szal, found here.

A few things to consider, that I’ve found especially effective: 

1. Collagen supplement - taken in the right form, at the right dose & at the right time. Evidence shows we want 20 grams of collagen made of type 1, 2 & 3 fibers. It’s most effective to take it before, during or after exercise, paired with vitamin C to maximize absorption. I personally have found Vital Proteins Advanced Formula to be the most effective & so did most of my clients when we compared brands. If you do PT exercises or yoga, that would be a good time to take it so it’s more likely to help repair of the impacted joint. (My friend is a yogi - not a runner or a lifter :)

2. Upregulating natural collagen synthesis in the body - Some people are using BP-157, but its mechanism is considered too high risk for me to recommend it. Thus, I go with the Lifewave x39 patch instead, which you can watch a free masterclass about & order here. Many of my clients & their husbands have avoided surgeries using these amazing natural patch solutions! Yes, Lifewave is an MLM company, which I don't love. However, the results of these patches I do love, thus I will continue to recommend them for their massive, robust benefits in supporting our longevity & expediting the injury recovery process. 

3. Upregulating natural hormone production in the body - This can be done with DHEA, but also needs to be at the right dose, at the right time of day & in the right form to counteract stress & cortisol in the body. It's best to go off of adrenocortex lab results, not just take it & guess. Expert oversight is strongly recommended. Optimally, we want DHEA to be around 200 for most women over 40. The mechanism is that stress/high cortisol downregulates DHEA & thus, downregulates estrogen & testosterone production in the female body. That’s likely a mechanism worth addressing, given all the things you take on in life (hence, Dr. Sara's point about slowing down a bit in life & really looking at everything we take on as women). DHEA should be taken in a liquid, spread throughout the day. Pill formats & taken all at once are not very effective. My Functional Medicine residency has me nerding out about this right now with all my clients & we’ve seen massive success! And just feel better in general 😊. If you wonder why testosterone therapy isn't a great place to start, my recent blog video here breaks down what the evidence currently says.

Important context: My bestie just had her first child at age 40. She & her husband not only started multiple podiatry clinics immediately out of med school, but they went on to franchise & sell their practices. They are currently Dean & Assistant Dean of a medical school AND they just built a local wellness-themed coffee shop, of which they are managing... alongside a toddler.  Hello adrenal system burnout!  Giving birth alone can promote adrenal & HPA axis dysfunction (which you will learn about on my upcoming podcast episodes #155 & 156 here)... Add in all of this beautiful, wonderful high-achieving life stress + midlife stressors like aging parents & wow - we can see why my friend's cortisol/stress levels, adrenal system & hormone production is likely suffering.

Other things I said in my texts to my friend:

I don’t necessarily recommend running to estrogen patches or testosterone therapy for women our age, as supplementing with DHEA can often address the root cause of why our hormones are declining too fast in the first place (which is stress - both good stress of doing things we love, being high-achieving & typical “bad” life stress). 

I just thought I’d send this your way, as it’s likely your shoulder is still a real SOB for you.

But then I just had to share more, as I do know exactly how to help!  Why not send exact steps I've found clinically effective in my practice, right?!  So I sent these additional texts:

And finally, because I’m on a tangent here 🤣, the other things we talked recently as still valid & are needed to build hormones in the first place:

1. Kion essential amino acids taken daily + 2. a high-quality Creatine in the form of Creapure (Kion or Momentus are the best brands) - I mix my aminos with my creatine so I never forget it. I take it around exercise sessions & if not exercising, I take it mid-day for a natural energy & brain boost. Our hormones, muscles, joints & tendons are made from amino acids, as well as brain neurotransmitters - so with these 2 supplements we support physical & mental health. I break down the science of why this matters for both males & females in upcoming podcast episode #145.

3. A high quality omega, best taken at night with dinner to help balance blood sugar at dinner. A few small studies show this time of day helps fat burning at night & improves next day insulin sensitivity. I use Kion’s omega to keep it simple (save with promo code LOUISE here). Omega is also shown to be a foundational supplement to mitigate the musculoskeletal syndrome of menopause, of which frozen shoulder is part of. You can read more about that in Dr. Vonda Wright's paper here. I also break the science of this down & why it matters on my podcast episode #145.

Finally, 4. vitamin D paired with K in a fat soluble liquid if you need it (go based on your labs, aiming for a female-specific optimal range of 60-80) & 5. a high quality multivitamin taken daily. Thorne is the best brand I have found for both vitamin D & the MV, shown to upregulate natural hormone production in my client labs. I have tested many brands & recommend Thorne Elite AM & PM. If you test too high in B vitamins, go with Thorne 2 a Day.  

Thorne & my other recommended supplements (beyond Kion) can be founds in my FullScript here paired with a beautiful 25% off discount. When you purchase supplements through my FullScript, I also get a small % of the sale, which goes back to support my work in the world. Thank you!

When I send my best friends these types of texts, I often wonder, "Am I too much?"  If you are reading this blog, you may often wonder the same.

Wellness-minded women like us are not too much. We care deeply for the world, for our families, our friends & we are relentless when it comes to protecting our best health & fitness. If that's your vibe, Welcome to Breaking Through Wellness - You're in the right place!

We're not settling for B.S. health, fitness & performance decline anymore. We're not settling for "wait out the pain" as an option when it comes to the impacts of our changing hormones on our body. 

So, let's all continue to be "too much" - fierce & feisty as we spread the word about the mechanisms of perimenopause. When we know better, we can do better. Share this article with a wellness-minded, ambitious active friend who needs this information.

Yours in all things fighting for optimal health & fitness DESPITE changing hormones, 

Louise