Sandra Ishkanes is a Functional Medicine specialist. She takes a whole-body approach to healthcare, combining nutrition, lifestyle and cutting-edge medical testing.
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The only other time that the body has a requirement for ketosis occurs in newborn babies and they are fed breast milk which is very high in fat. Babies are born with a fully formed brain but the nerves are naked - they don't have the fatty myelin coating. Myelination of nerves in babies requires ketosis and a range of nutrients which have a parallel with those required in the menopausal transition.
It seems that in menopause, the female brain is rewiring and is actively building up the myelin sheaths around nerves. When carbohydrate intake is high and ketone supplies are low, the brain cannibalises myelin for fuel and loses functionality. Historically, myelin has been thought of as nothing more than insulation but recent research indicates that myelin is far more actively involved in brain activity than previously thought, in that it organises the structure of brain circuits and can regulate the timing of information as it flows through them. Alterations in the thickness of myelin can potentially increase or decrease the synchronicity of brain regions that work together, making them process information more or less efficiently.
Pre-menopause and during the childbearing years, women are built to be sensitive to their environments, their emotions, and the emotions of others, as guardians of children, family and social units. Women's brains differ from men's brains in that their brains have less nerve insulation and this may partly lead to their increased sensitivity and all that that brings. Menopause may be a process that increasingly insulates women from sensitivity to their environment and allows them to gain time for themselves for the decades to come - if they can master their menopause.