Episode 147

Published March 31, 2026

Join Dr. Allison Smith and Dr. Jaclyn Smeaton for this episode as they share expert insights into how hormones, the HPA axis, and lifestyle factors influence immune health, injury risk, sleep, and overall well-being during perimenopause and menopause.

Dr. Smeaton and Dr. Smith also discuss: 

• The relationship between hormonal changes, stress, and inflammation 
• How cortisol and estrogen can impact sleep quality and inflammation in perimenopausal women 
• Patterns seen on DUTCH tests indicating inflammation, immune overactivation, or hormone resistance 
• Inflammation markers like quinolinate and melatonin and how they can help assess immune health 
• How hormonal fluctuations alter immune responses, leading to symptoms like itchy ears, joint pain, and autoimmunity

Key Moments

0:34 Episode Introduction

2:58 Physical Injury Recovery During Perimenopause

9:04 Hormones and Their Role with Inflammation

11:16 Catching the Signs of Immune Dysregulation

15:38 The Gut Microbiome and Introduction of New Sensitivities

22:04 Mid-Episode Break

22:34 Exploring the Importance of the HPA Axis

27:47 Understanding Free Cortisol

33:12 Hormone Dysregulation and Its Effect on Stress and Sleep

39:31 Chronic Stress and Our Immune System

42:15 Recognizing Patterns with the DUTCH Test

About our speaker

Allison Smith, ND completed her education at the National University of Natural Medicine in Portland, Oregon. She has worked in private practice focusing on primary care, women’s health, and dermatologic laser therapy. Over the last 10 years, she has consulted with providers on thousands of cases in the context of hormone testing and brought awareness of testing to providers in clinical practice through consulting, webinars, case presentations, and articles. She now leads an esteemed lineup of clinical educators at Precision Analytical, home of the DUTCH Test. 

Show Notes

Check out our DUTCH Education Hub for more resources on perimenopause, menopause, stress, and inflammation!

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