H is for hormones!

Hormones are the main messengers of the body. They tell the body what to do, how to do it and when. It could be a message that boosts up your energy so you can meet that deadline at work, one that tells your body to release an egg, or one that gets you in the mood for love.  Hormones link one system to another and permit parts of the body to communicate with one another. One hormone greatly impacts another and hormones are in delicate balance.  Once you get to the root cause and fix hormone related problems, health can be dramatically improved.

In this post we’ll go through each hormone, their roles, signs of deficiency or excess and a few treatment options!

Hormones related

Hormones are intricately related.

Cortisol

Our first hormone, cortisol, comes from the adrenal glands and is essential for many metabolic and immune functions. It’s the hormone our body uses to deal with stress and can be chronically elevated due to physical, psychological, chemical or environmental stress.   One of the first things I do with every patient is assess their cortisol.  Are you someone whose tired in the morning and has a tough time getting going? Do you get wired at night if you stay up past 10pm? Are you emotionally unstable if you don’t keep your blood sugar controlled with regular meals? Having a tough time losing weight? Suffer from insomnia? These are all signs that your cortisol is out of wack. Naturopathic doctors assess your cortisol two ways and both are important.

Wired and tired

Firstly, we collect urine for 24 hrs to assess total cortisol and its metabolites in your urine.  This tells us if your cortisol is way to high or too low.

Second, we assess the pattern of cortisol through-out the day.  Patients take a salivary sample of cortisol 4 times a day. Saliva is actually a very useful indicator of health since it contains free and therefore active hormones, as compared to hormones in the blood which are bound to receptors.

Normal depicted in green

Normal depicted in green

Cortisol is suppose to be higher in the morning when you wake and then decrease to its lowest concentration at night.

Signs of elevated cortisol

  • Food allergies, environmental sensitivities, muscle and skin breakdown, PMS, diabetes, obesity, mood disorders, chronic fatigue, infertility, bone loss, high estrogen, low progesterone, low growth hormone, aging due to lower levels of the anti-aging hormone DHEA, high blood pressure and poor memory.

If you think you may be a candidate for adrenal testing, take the test below.

http://www.diagnostechs.com/Pages/StressEvaluationTest.aspx

What can you do?:

  • Yoga/meditation/stress reduction
  • B vitamins, vitamin C
  • Rhodiola, ginseng, ashwaghanda to build you up
  • Magnesium and/or phosphatidyl serine to bring you back down at night.

DHEA

DHEA increases muscle, improves immune function, is associated with anti-aging and is the precursor to all other hormones, especially testosterone and estrogen. DHEA levels peak in our early twenties,  and then, unfortunately decrease from then on.  High levels of cortisol greatly deplete DHEA.

Symptoms of DHEA deficiency

  • Fatigue, loss of stamina, low sex drive, memory decline, muscle weakness/wasting, loss of bone mass and sleep problems to name a few.

What can you do?:

  • DHEA is a fantastic hormone, but currently its illegal for canadians to prescribe. It’s readily available in the states as an over the counter prescription.
  • Try increasing levels naturally with magnesium, Relora and Puncture Vine (Tribulus)

Thyroid hormone

Thyroid function and adrenal function go hand in hand. Cortisol greatly impacts how the thyroid functions and  is one of the main causes of hypothyroidism. The thyroid sits in the throat and releases active thyroid hormones (T4 which converts to T3) in response to TSH with help from its percursors tyrosine, selenium and iodine.  The thyroid controls metabolism, energy, bone turnover and heat regulation among many other things.  Up to 90% of your thyroid hormone is bound in the blood and only a small amount circulates as free physiological T4 and T3.  It’s important to measure these active free hormone levels, in saliva or in the blood.  Ask for a free T3 and T4 if your doctor suspects you have hyper or hypothyroid issues, don’t settle for a TSH only.

You may be suffering from an under-active thyroid if you have:

  • A goiter, or swollen thyroid, anemia, a metal taste, anxiety, fatigue, constipation, cracking/dry skin, depression, edema, hair loss, palpitations, low body temperature, cold extremities, a slow pulse and weight gain.
The thyroid affects weight gain and loss.

The thyroid affects weight gain and loss.

What can you do?:

  • Avoid goitrogens, which deplete iodine: turnips, cabbage, mustard, soy, peanuts, pine nuts, millet
  • Doctors often prescribe Synthroid which contains T4. Some people will benefit form T4, but most will not be able to convert T4 to T3 and will continue to suffer with symptoms.
  • I prefer dessicated thyroid hormone which contains bioidentical T4 and T3.
  • Thyroid precursors: Selenium, Iodine , zinc, B-vitamins and Tyrosine
  • Animal glandulars (Whole thyroid gland from another animal)
  • Bladder wrack (Fucus versiuclosus)

Estrogens

Estrogens, cortisol and thyroid hormone greatly affect one another.  Elevated cortisol, leads to high estrogen and when estrogen is high, hypothyroidism commonly occurs. There are three main forms of estrogen in the body: Estrone (E1), Estradiol (E2) and Estriol (E3). Each has different degrees of interaction with estrogen receptors making them relatively strong or weak estrogens.  Estrone is formed in the liver from precursor hormones such as androgens, DHEA and progesterone. Estrone remains high after menopause since it isn’t synthesized in the ovaries, is a strong estrogen and is often called “bad” estrogen since one of its metabolites is associated with increased rates of cancer.  Estradiol is produced by the ovaries from cholesterol, its main role is to build the uterine lining during the second half of the menstrual cycle.  It is also a relatively strong estrogen. Finally, estriol is a weaker estrogen, is secreted in high amounts during pregnancy to protect the fetus from estradiol and does not cause abnormal cell growth in the breasts and uterus and thus is not linked with cancer risk. Estrogen becomes deficient during menopause when the ovaries are no longer capable of producing estrogen. There is however some estrogen left from adrenal production, and fat storage

Signs of estrogen deficiency include:

  • Brain fog, painful intercourse, urinary tract infections, vaginal dryness, night sweats and thinning of the vaginal wall.

What can you do?:

  • Many herbs are helpful in menopausal symptoms that are due to low estrogen: Black cohosh, Chaste berry, Red clover, Sage and Alfafa.
  • Supplementing estrogen is very popular after menopause, however its imperative that the RIGHT estrogen is given in a safe form. I recommend topical estrogen only and insist patients are on supplements which help prevent estrogen conversion into cancer causing metabolites.
  • Furthermore I assess liver function in these patients prior to beginning supplement and carefully monitor serum levels of estradiol once supplementation has begun.
  • I like Biest, a combination of estriol (80%) and estradiol (20%) applied topically.

chaste

Too much estrogen can cause several issues in both women and men. For starters its associated with cancer risk, can generate endometriosis, fibroids, obesity, hypothyroid, lumpy breasts, heavy periods and more. One of the main culprits associated with high estrogen are something called xenoestrogens.  These are estrogen mimickers that wreak havoc on your entire endocrine system.

Common sources include:

  1. pesticides
  2. beef
  3. dairy
  4. cosmetics (especially parabens)
  5. plastic
  6. cleaning chemicals
  7. fabric softeners
  8. farmed fish
  9. hair dye

You may have high estrogen if you experience:

  • Acne, anemia, depression, endometriosis, fatigue, fluid retention, irritability, PMS, weight gain, irregular/long or short periods.

What can you do?:

  • Avoid xenoestrogens
  • Consume brassica rich foods like broccoli or foods that are rich in DIM or indole 3-carbonate (I3C).
  • Supplement with calcium d glucarate.

Progesterone

There are receptors for progesterone in the brain, skin, thyroid, blood vessels, breasts, bone and more. Although its main roles are to shed the uterine lining during menses and maintain the placenta during pregnancy, the relative levels of progesterone in the body compared to estrogen is extremely important for good health. Progesterone deficiencies are very common.  This is because progesterone is used to synthesize cortisol.  Given our stressful lifestyles many of us are using progesterone to make cortisol.

Symptoms of low progesterone include:  

  • Anxiety, insomnia, abdominal fat, depression, a poor ability to deal with stress, headaches and miscarriages.

What can you do?:

  • Protect your progesterone with Dong Quai and Turmeric
  • Detoxify and clear estrogen with I3C, DIM, calcium-d glucarate and liver support.
  • Another great option is either oral or topical bioidentical progesterone. I like prometrium.

natural-micronised-progesterone-100mg-200mg-400mg-softgel-250x250

Testosterone

Important for both males and females, testosterone builds muscle, affects skin health/tone, bone health, heart function and sex drive.

Low levels of testosterone have been linked with:

  • Depression, obesity, osteoporosis, low libido, skin aging and heart disease.

What can you do?:

  • Avoid  pesticides, plastics and xenoestrogens
  • Chill out! When the body needs more cortisol less testosterone is made from their common precursor (cholesterol). When this happens it is known as pregnenolone steal.
  • Increase zinc and fiber
  • Inhibit testosterone conversion to estrogen with aromatase inhibitors like resveratrol, chamomile, passionflower and red clover.
  • Enhance testosterone with Tribulus terrestis, Maca root and Damiana (Turnera diffusa)

Final thoughts

I recommend all patients have a complete hormone work-up if they aren’t experiencing optimal health.  A salivary panel can assess estrogen, testosterone, DHEA, progesterone and cortisol.  Once the results are in, dietary, supplement, botanical and pharmaceutical recommendations will be tailored to you to give you back your life and your health.

Biodentical replacement (BHRT) and balancing hormonal health are an important part of a naturopathic practice.

We are living a lot longer these days and quality of life needs to be addressed.  I think the best way to ensure we are living both longer and happier lives is to address endocrine health.

Bet these guys are on DHEA and have cortisol under control!

Bet these guys are on DHEA and have cortisol under control!

Advertisements

E is for exercise.

Exercise is regarded by many as the magic pill. It’s effect on health, mood, disease and well-being are incomparable to any other therapy.

Simply moving your body can improve memory, concentration, energy, circulation, pain, depression, insomnia, libido, stamina and can rock your body. Any of these benefits sound good to you?

E is for exercise.

Several studies exist in support of exercise for health to name a few; exercise has been shown to be of benefit in:

  1. Cardiovascular disease
  2. Brain health
    • Exercise promotes production of the neuro-protective BDNF (brain derived neurotrophic factor) which is associated with a decreased risk of dementia and Alzheimer’s
    • In clinical studies, exercise has been shown to improve: Memory, cognitive function, reactive time and alertness.
    • If Grandma stops her daily walk and swim, a noticeable change in her mental alertness and cognitive function will occur-you’re no different.
  3. Immune system health
  4. Cancer prevention and treatment
  5. Prevention of diabetes
  6. Depression
  7. Bone health and osteoporosis prevention
  8. Lifespan

Here is what I think is THE most awesome and simplest fitness formula:

  1. Stress – provide a physical stress to your body that is just beyond what you are capable of doing.
  2. Rest – allow your body to positively adapt.
  3. Repeat – be consistent

Simple eh? Swear on my Manolo Blahniks folks, this is it!  Everything else you’ve read regarding exercise is classified into one of these three categories (with a lot of finer details within each).

#1 – Stress

Human are extremely adaptive, this process is initiated by a stressor.  Cavemen, our bare backed, fur wearing, meat hunting friends; avoided being eaten by larger prey by developing a way to be faster (so they could run away), stronger (to climb trees) and smarter (to avoid crossing paths with these predators in the future).  The key to their adaptation and ultimately, their survival was STRESS.  Stress is required for a species to adapt. Natural selection is really just that. We select the traits that allow us to survive a stress, whether it be a new climate, a new diet or a fast angry predator.

#1 (a) Progressive stress-what was sufficient yesterday isnt enough today.

An ancient tale describes one Milo of Croton who lifted and carried a newborn calf on his shoulders every day and continued to pick up and carry the same calf as it grew into maturity: Forcing his body to become stronger.  The story ends with Milo walking into the Olympic stadium carrying a full grown bull over his head, which of course kinda made him the man- as far antiquity went anyway

Milo’s fable represents the principal of progressive overload. A gradual increase in volume, frequency, intensity or time is required to produce a positive adaptation! Positive adaptations like less fat stores and increased muscle tone.  

To attain exercise therapy results you must do one of the following:

  1. Increase volume (weight/distance)
  2. Increase intensity 
  3. Increase frequency (number of reps or sprints) 
  4. Increase time (longer run or length of cardio)

The body will only spend what energy is absolutely necessary to get a job done. Say today you decide its zero to hero day and you’re gonna leave your sofa cruising, vampire diaries watching habbits behind (Good for you).  Say you do really well and end up running 5 km and it takes a very respectable 30 minutes. During that run your body likely burnt about 1000 calories. Assuming you actually run again (lets be honest lots of us make it to one work out and give up again) if you continue to run 5km but in the same 30 minutes every time, your body will start to adapt to this workout and ultimately burn less and less calories (since it is now more efficient at said 5km run).  What used to burn 1000 calories now burns 600 lets say by run number 10.

HOWEVER, if you increase the volume of your run, like running 6km, or the intensity of your run (run the same 5km but in 20 min), or the duration/time of your run (running the intensity you ran for the first 5km but for 35 minutes instead of 30);  you will continue to improve and get better.

This is THE most prevalent problem for your average gym goer.  You know that dude in the weight room who’s been doing the same weight routine with the same amount of weight for like every day and yet can’t figure out why his body isn’t changing? He doesn’t understand the concept of progressive loading, but now you DO!

Ask yourself: Did I do better this time then last? If so then YAY you’re on the right track.

__________________________________________________________________________________________

#2 REST

Sleepy kitty

If you have too much stress/yang and not enough rest/yin you will beat yourself up and tear your body down, although this seems beneficial in the short term, more calories burnt => more fat breakdown => more success, but in the long term it does the very opposite. We DO NOT make improvements to our body during our workouts but rather between them – during the rest period. You are not breaking down fat and increasing your metabolism during your kettle bell swings, but the alterations in your metabolism and the micro- repairs done to your damaged tissues while you are RESTING alters the physiology of your entire body and results in more lean body mass & less fat.

The physical stress you place on your body with a workout gets the ball rolling; but in order to get more fit, more toned and better cardiovascular health-your body has to react to the stress and positively adapt so that it is better prepared to meet the demands of this stress when it comes across it again.

Rest is key to progressive stress. Rest is why we can progressively lift heavier weights or run longer distances once we have conditioned our body to do so.  What determines whether your hard work will pay off is the relative duration of the stress you place on your body to the rest and nourishment it then receives.

You can gather then, that shorter, intense workouts are great because they provide a quick stress followed by rest (Consider 10  50m sprints, 45 kettle bell swings or 4 sets of 4 deadlifts).

Long duration workouts put the body under distress, rather then adaptive stress. This increase in cortisol (from stress) and prolonged physical trauma ironically generates an INCREASE in fat storage and even a breakdown in lean muscle tissue.

Similarly to prolonged work outs, work outs that are too frequent, prevent the body from adequately recovering as well.  If you workout on Monday for example then perform another workout on Tuesday you are interrupting your body’s natural repair process which you will instinctively perceive as a distress.  Follow your workouts up with periods of relaxation.  Food and sleep are two of the best ways to make the most out of recovery time between workouts.

My recipe for rest:

  1. Get 8 hours of sleep each night
  2. Have a post workout drink with carbs and protein to start the recovery process as soon as possible.
  3. Take an adaptogen like ginseng to help your body cope.
  4. Take on less responsibilities by saying “No” to things that aren’t important to you
  5. Meditate

__________________________________________________________________________________________

#3 – Repeat

You now know how to adpatively stress your body, and you know how crucial allowing it to rest is to weight loss, building muscle and getting success, but the third and perhaps most difficult part to THE best and simplest work-out formula is Consistency.  

Consistency can be tough.  We live in a world where we can get anything we want almost immediately –  we somehow think this should carry over to building muscle or losing weight.  Unfortunately, it is very difficult to lose the 50+lbs you have steadily gained over the course of 2-3 years in 8 weeks.

For example: Farmers take the time to nurture their crops and don’t not frantically run around planting seeds and watering them like crazy two weeks before the date they need to harvest.   However, in gyms everywhere, maybe even this very second you could go watch someone who hasnt exercised all year but who now can be seen training like a crazed animal during the two weeks that lead up to their trip down south.

Health and fitness is a lifestyle choice ladies and gentlemen.  A quick fix will not give you long-term results and quite frankly is very hard on your endocrine system, your metabolism and your health.

But, long term, consistent exercise is guaranteed to improve your well-being, your health and your entire life.