Burnout busting luteal phase malted milk

I grew up in the 90s and 2000s. And yes, I am enjoying the y2k resurgence immensely, but these two decades were also rife with diet culture - and that extended to drinks. I survived off diet coke and low fat (but high sugar) diet instant Horlicks and hot chocolates.

My periods reflected the state of my low cal, low fat and high sugar approach to eating. They were about 1-2 days long, light pink or brown, and practically non-existent. I had horrific mood swings that left me incredibly low and in a dangerous place mentally, and I had a lot of high androgen symptoms like back and chest acne and black hair growth on my belly button.

In short, I wasn’t eating enough to make sufficient oestrogen levels, resulting in lighter and barely there periods because my uterine lining wasn’t thickening up, as it would with healthy levels.

Additionally, it’s likely I wasn’t ovulating due to the low oestrogen levels, or if I was, the quality of my developing follicles was poor due to lack of nutrients, so I was either not making any progesterone at all or the amount I was making was low.

Progesterone is only produced once ovulation occurs, because it is made from a temporary gland called the corpus luteum, which is formed from the follicle sac that our egg developed in. If we don’t ovulate, the egg doesn’t leave the follicle sac, and the sac cannot turn into the corpus luteum and make progesterone. If that isn’t the problem, we can still struggle to produce healthy progesterone levels if we don’t have those key nutrients to make it - zinc, B6, magnesium, healthy fats and more.

And then there were my testosterone levels and androgen levels. We need these guys in small-ish doses to ovulate and to feel good, but too much and it causes a lot of hormonal problems like sporadic ovulation, but also acne (esp. face, chest, back), female pattern hair loss, irregular menstrual cycles and wiry black hair growth on places like the nipples, belly button and chin (hirsutism). Androgen/testosterone levels can increase with high sugar intake, as this drives up insulin levels, which in turn, tells the ovaries to make more testosterone.

So, my ‘healthy’ diet malts drinks weren’t loving my body, yet sometimes I get nostalgic for those hot drinks which I found so cosy and comforting as a teen. The problem is, it’s super hard to find any malted hot drink that is gluten, dairy and sugar free (or low sugar) - not to mention, good for you and your hormones.

This recipe is all those things: gluten and dairy free, contains naturally occurring sugar only and yet is low glycemic so won’t spike blood sugar, is rich in hormone supportive nutrients and is also energising and helps our body to cope with stress.

It’s kind of like a cosy super drink for the crazy festive season ahead of us. If you’re feeling burnt out and you’ve got signs of hormonal imbalances (PMS, mood swings, irregular periods, heavy periods, etc), then this is for you.

P.S. Before we begin, you’ll note that this recipe contains maca. If you’re wondering whether maca is safe for endo, scroll to “Important Notes”.

This recipe is…

A source of period and hormone supportive nutrients such as magnesium, zinc, iron, calcium, potassium, vitamin E and B vitamins like B6 from the maca, carob and almond butter (and cacao, if included).

Calcium and magnesium are both shown to aid with preventing PMS and period pain, whilst potassium can help ease water retention (which many experience in the luteal phase).

Low levels of calcium has been repeatedly associated with increased PMS symptoms and research has shown that treatment with calcium supplements can reduce the syndrome and even period pain (because low levels of calcium can cause more contractions).

Magnesium helps reduce PMS symptoms, supports healthy oestrogen metabolism (clearance) and is a treatment for period pain, because it lowers prostaglandins, the suckers that drive up menstrual pain.

Low levels of zinc have been demonstrated in the research on endometriosis and may be involved in the immune dysfunction that allows endo to grow. Zinc has also been shown to help with period pain and PMS.

Low levels of iron are extremely common full stop, but even more so in people with heavy menstrual bleeding. Iron plays a major role in preventing fatigue, and yet many of the clients who I work with, come to me with significantly low levels due to having SIBO, avoiding red meat, heavy periods or other reasons. Supporting healthy iron absorption and intake is a key part of beating endo fatigue.

B6 is a wonder nutrient for hormones, a bit like magnesium and zinc, it does it all. It’s involved in progesterone production and oestrogen metabolism (by supporting phase I and II of liver pathways), has been shown to reduce PMS, supports healthy energy production and also helps to clear histamine from our body (which can worsen PMS and period pain) by keeping DAO levels healthy, an enzyme in the gut that helps us break down histamines from food.

Vitamin E is an antioxidant which can help us fight oxidative stress (a contributor to endo), it’s also been shown to reduce pain, pain duration and blood loss in people with primary dysmenorrhea.

Note that because of the serving sizes, the amount of these vitamins and minerals are low, but help to contribute to your overall daily intake. The maca does contain vitamin C as well, but because vit C is heat sensitive, it’s less likely to be a significant source in this recipe.

This recipe is gluten and dairy free for those with sensitivities, helping to lower inflammation and endo belly reactions.

Most malted drinks are made from malted milk powder and gluten based grains like barley, and are laden with added sugar. Some people with endo have trouble digesting milk - fermented dairy or certain types of milk like A2 milk are often better tolerated, but typically it’s hard to find a malted milk powder that isn’t made with regular cow’s milk. Additionally, for some of us, we may find regular ingestion of milk to influence our hormones (it’s nuanced, so you can learn about it here) or worsen hormonal problems like acne, so I wanted to avoid dairy milk in this recipe to avoid these issues, but you can always swap to dairy based milk if it works for you.

Typically, the malt in malted drinks comes from the gluten based grains, which for some with endo, need to be avoided for several reasons. People with endo do have a higher risk of coeliac disease, there is also some data showing that the removal of gluten can improve endo symptoms, and additionally, regular ingestion of gluten can contribute to leaky gut by increasing zonulin. These tiny holes in the intestinal lining allows gram negative bacteria and their toxins, lipopolysaccharides to escape into the body and the pelvic area, where they can further endo development. Whilst not everyone benefits from removing gluten entirely, being more mindful of intake may be helpful, so I’ve cut it from this recipe so more of us can enjoy it.

This recipe is adaptogenic to help your body deal with stress and burn out (which is definitely going to help you get through the festive season).

Maca is an adaptogen herb, which means it helps our bodies to adapt to physical and emotional stressors. Maca does this by acting on the hypothalamic pituitary adrenal axis (HPA axis) to promote a more normalised stress response. The HPA axis is a system between our brain and adrenal glands that controls our stress response and our cortisol and adrenaline output. Maca prevents the overstimulation of the HPA axis, which stops cortisol levels from getting excessively high, but because maca supports the HPA axis to function optimally, if you’re struggling with low levels (a problem in the endo community) it can raise them to levels that help you to deal with stress and also, to energise your day (cortisol is your waking hormone, not just your stress hormone).

Maca can also aid with stress by replenishing nutrients that get depleted during stressful periods and are essential for energy production, like magnesium. In fact, it’s been shown to reduce fatigue levels and improve energy.

This recipe can aid hormonal imbalances thanks to the maca root powder.

Maca is a herb originating from Peru which as I just covered, helps the body cope with stress. The effects of maca on the HPA axis have a positive downstream effect on your sex hormones, because when stress goes up, your sex hormones pay the price. This is because of the hypothalamic pituitary ovarian axis (HPO) - basically, your stress response is one of the most important functions in your body. It keeps us alive by alerting us to danger and driving energy to the organs and muscles we need to fight or run. But this stress response is also connected to your ovaries by the HPO. Essentially, your sex hormones become just ‘nice to have’ in a stressful situation, they’re not essential, and so your body drives resources away from the ovaries in order to conserve energy, nutrients, etc. for surviving. Additionally, your body very sensibly believes that stress is not a safe time to conceive, so it lowers your sex hormone output and ovarian function. Finally, cortisol can actually block the effects of progesterone, because it locks into progesterone receptors.

Maca improves hormonal balance by supporting the HPA and HPO axes, and as a result, maca has demonstrated improvements in sex hormones in studies on humans and animals. What’s great about maca is that it isn’t a phytoestrogen so it’s not mimicking the affects of oestrogen, instead, it’s helping your body to work optimally and therefore to make the right amount of hormones for you, whatever your particular struggles or imbalances are.

There are other ways maca can help our hormones too - it’s rich in minerals and nutrients required for healthy ovarian function and hormone production (as discussed above).

Finally, various studies have shown maca particularly shines in perimenopause and menopause (although researchers believe it can support sex hormones at all stages of our menstrual life). It’s demonstrated improvements in hot flashes, night sweats, mood, libido, sleep problems, cognitive function and energy.

This recipe has a low glycemic load (3) and a low-moderate glycemic index (40-50), and contains only naturally occurring sugar*.  This means that this comforting hot drink will have a minimal to moderate impact on blood sugar, with no spike that we can get from typical sugary hot drinks (Horlicks contains 19g sugar per serve).

The glycemic index and glycemic load can help give us an idea of how much a meal/food will affect blood sugar levels. The higher the rating, the more a food will raise blood sugar. Despite being sweet and high in naturally occurring sugar, carob, thanks to its fibre and polyphenol content, has a low glycemic index and has even been shown to have a lower GI than multiple types of sweeteners (and has also been shown to have better nutritional benefits too)! To learn more about the many benefits of carob and how it affects blood sugar, check out this recipe where I break down all the info. *Estimates generated by AI.

Keeping blood sugar levels stable helps to prevent oxidative stress, which leads to more inflammation in the body and that may trigger further pain and symptoms.

Additionally, constant blood sugar swings can take their toll on hormones, leading to issues like elevated androgens (think testosterone), which can affect ovulation and cycle length. Blood sugar swings may also cause oestrogen excess or dominance and low progesterone if ovulation is interrupted or stopped entirely.

This recipe is polyphenol rich thanks to the carob, cacao (if using) and even the maca, which has significant levels of polyphenols like flavonoids. Polyphenols are types of antioxidants found in certain plant foods that not only have a profound effect on reducing inflammation levels and improving overall health, but they are also a favourite food for our gut microbiome.

Because people with endo tend to have microbiome dysbiosis, with lower levels of some beneficial bacteria and higher levels of pathogenic (bad) bacteria, feeding our gut bugs is essential to reestablishing balance.

But this isn’t where the magic of polyphenols end. Polyphenols actually can help inhibit the growth of pathogenic bacteria through various mechanisms, and olive oil, carob and cacao have all exhibited antimicrobial effects against the pathogens we see that are elevated in endo, such as e.coli. No - a chocolate mug cake won’t wipe these guys out completely, but it’s the food that you eat which can dramatically help you modulate your gut bacteria.

Important notes to help you tailor this toast recipe to your own body and needs (and tastebuds!)

Maca can be stimulating

Maca can help raise energy levels and is stimulating, so if you find that you feel a bit too weird and stimulated after drinking this, reduce your dose by half and then slowly build up over time to see where your tolerance threshold lies.

FODMAPS and bloating

This recipe isn’t low FODMAP due to the carob syrup. FOMDAPs are fermentable carbohydrates which can cause bloating and gut issues in people with SIBO, IBS and FODMAP sensitivities. Carob powder is low FODMAP at 6g, but carob syrup hasn’t been measured and probably is a bit higher in FODMAPS because it’s concentrated. However, I do only use a small amount in this, and the rest of the ingredients are low FODMAP (maca is low FODMAP at 2g), so I would hope that this is tolerated.

Having said that, everyone is different, so if you find carob to be bloating, reduce the serving size by half. It’ll be less sweet and a little less malted in flavour, but hopefully still good! If you want to remove entirely, you could use monk fruit to sweeten it, which is my preferred sweetener for sugar free hot drinks due to its beneficial affects or you could use maple syrup, but I would reduce the amount from 10g to 5g as maple syrup has more of an affect on blood sugar than carob does. The carob syrup does lend some of the malty flavour (the rest comes from the maca and almond butter) so do expect for some slight taste changes.

Is maca safe for endo?

Maca is not a phytoestrogen, it contains no plant compounds that mimic oestrogen, so if you’re sensitive to those and find they worsen your endo symptoms, that’s not an issue with maca (although in theory, phytoestrogens can be helpful, but it’s very individual).

As discussed above, maca’s supports our endocrine system to work optimally, which means that the body can make normal and sufficient amounts of sex hormones. It shouldn’t cause oestrogen to skyrocket because it’s not directly increasing our sex hormones, just helping our body to work properly to make normal levels. However, everyone is different, and so if you feel like you are more oestrogenic from maca - sore boobs, water retention, more PMS, more cramping, heavier bleeding, etc., then it may not be right for you, or you may need a lower dose.

Having said that, a cozy drink here and there with some maca in it shouldn’t really have that much of an impact, but if you’re drinking it daily, that’s when you may want to observe how you feel on it.

Can this spike my blood sugar?

As explained above, in theory - no, because of the low glycemic load and beneficial effects of the carob. However, it is still a syrup, which makes this sugar easier to digest and so we always have to be mindful of our personal responses, especially as blood sugar reactions are very individual. If you want to reduce the amount of sugar/carob, you can do so and sweeten the drink with monk fruit.

Where can I find carob?

Carob can generally be found online or in Turkish, Greek or Cypriot delis and food stores.

Maple syrup

If you want to swap to maple syrup, you can do so, but I would halve the amount to 5g as maple syrup is more of a blood sugar spiker than carob. Swapping to maple syrup will also lose some of the beneficial properties of this drink (see above) and some of the malty flavour.

Almond alternatives

If you’re allergic to nuts, you can use sun butter, but it may affect the taste slightly as the almonds add to some of that malty taste.

Further resources

If you’re struggling with your gut health, you might find my courses and one to one coaching helpful. You can find out more here. I’ve also got endless podcast episodes on gut health and blood sugar.

To understand more about the low FODMAP diet, start here.

Method:

Combine the carob, maca and almond butter into your favourite mug and mix until a smooth paste forms. Stir in a small amount of your milk until smooth and lump free, then add the remaining milk.

Heat gently on the stove or in the microwave, until it reaches your desired temperature. Maca is better absorbed when cooked, so whilst you could add it afterwards, you’ll get the best benefits from heating it with the milk.

If you’re adding cacao, add this once the drink is hot and whisk well. The antioxidants in cacao are most potent when the cacao is raw/unheated so best not heated with the other ingredients.

If your almond butter is not completely smooth and has left little bits in your drink, you can quickly blitz in a blender, otherwise, serve!