Hormones & Thyroid

Are You Soul Tired?

Image Courtesy of http://lillieduncan.com/

Image Courtesy of http://lillieduncan.com/

Are You Truly Resting? 


Most of us measure our amount of rest or need for rest in hours of sleep. Although sleep is critical for recovery and repair from each day's challenges, true rest is far beyond just merely time spent in slumber.  The Scripture talks often about rest outside of the context of sleep. This type of rest or "sabbath" is something most of us long for in our souls but don't really know how to experience. 

Many who are driven in life and desire to help others and excel in whatever they do can easily fall into a very dangerous rut. This rut is characterized by often feeling guilty if we aren't doing something productive. In Wayne Muller's book, "Sabbath," he says, " While many of us are terribly weary, we have come to associate tremendous guilt and shame with taking time to rest. Sabbath gives us permission; it commands us to stop." 

In another fantastic book called Emotionally Healthy Spirituality, Peter Scazzero describes it this way: "We listen to sermons and read books about slowing down and creating margin our lives. We read about the need to rest and recharge our batteries. Our workplaces offer seminars on increased productivity through replenishing ourselves. But we can't stop. And if we aren't busy, we feel guilty that we waste time and are not productive....It's like being addicted-- only it is not to drugs or alcohol but to tasks, to work, to doing. Any sense of rhythm in our daily, weekly, and yearly lives has been swallowed up in the blizzard of our lives." 

So what? What's the danger of living without resting? I think most of us know this but don't want to face it. We miss life. We miss the beauty that's right in front of us. We live with short fuses and almost anything can cause us to get irritable, anxious, depressed, and angry. We do violence to our own lives and bodies and do violence to everyone that comes in contact with our disoriented life. We have no space in our lives for people to be human. 

If this hits home with you, don't beat yourself up. We are already good at that and it only makes matters worse. Show yourself compassion. Dig into this. The 2 books mentioned above can literally save your life, restore your relationships, and return the joy back into your life, even when storms are all around. They can remind you that God sees you in your struggle and He loves you. He has given us several ropes to find our way back home. Grab hold and join me on this exciting, restful journey. 

~ Jake

Beautycounter: Safer Beauty & Personal Care Products

At Stewarding Life Wellness, we are passionate about living a healthy, balanced, and toxic-free lifestyle. We strive to eat healthy food that supports our health, we use safe cleaning products in our home, exercise, sleep well and meditate often. However, one thing that is easily overlooked in the pursuit of health are the cosmetics and personal care products we use daily such as lotions, soaps, deodorant, and make up.

Americans spend over 62 billion dollars every year on personal care products, and many of these are filled with toxic chemicals. Thousands of these chemicals are used without adequate testing or research done to identify the effects they have on us. The FDA does not require testing to approve chemicals used on humans, nor do they have the power to recall a product that could be dangerous. The European Union has banned nearly 1400 toxic chemicals from their cosmetic products. America has only banned or restricted 30.

Why are avoiding toxic chemicals so vitally important for our health?

It is easy to assume that, since we are only using these products on our hair or skin, that it isn’t affecting our health like food or supplements do. But did you know that your skin is the largest organ in the body, and that it absorbs these toxic chemicals in less than 26 seconds directly into the blood stream? Some of these chemicals have dangerous impacts on our body. Research has shown that toxins in our personal care products can contribute to cancer, infertility, hormone disruption, autoimmune diseases, rashes, and many other medical conditions.

We have found lots of healthy options that just don't work effectively - especially cosmetics! In our search for safe products, we were introduced to Beautycounter and have been very impressed. Beautycounter has extremely rigid third party testing, a "Never List" of over 1500 ingredients they never use, and the strictest heavy metal standards in the industry. Not only do we love the quality of their products, we also are impressed with their mission as a company. Below is a short video discussing their mission to provide safe products for their consumers:

One of my favorite things about these products is that they are high performing, and I have the comfort of knowing they are safe. My daughter has a lot of fun “dressing up like Mommy,” and I love being able to let her play with my make up with out being concerned about heavy metals or dangerous chemicals.

Some of my favorite products for our family are:

 

Charcoal bar
 

Charcoal helps to extract toxins from the skin and leaves it feeling smooth and clean. It is great for men, women, and teenagers!


Balancing Face Mask

I feel like I have been to a spa after using this. It leaves my skin feeling amazingly clean and rejuvenated. I have also used it on rashes and other skin irritants, and it helps tremendously in healing. This is fantastic for men and women!


Tinted foundation

This tinted foundation is amazing! I have never been a fan of liquid foundations because of how heavy and sticky they feel, but this one feels light and covers well. For a thicker coverage, you can also use this concealer pen


Baby products

 Children today are exposed to far more environmental toxins than we were as children. I am committed to minimizing the number of toxic chemicals that my children are exposed to at home during our daily routines. I have tried many baby products, but these are the best I have used! I use these products on my children every single day, and I use the baby oil on my own face every night before bed - it's that awesome!


It is so important to be mindful of the things we are putting IN our bodies, but also equally important to consider what we are putting ON our bodies. We believe in the importance of removing toxins from our lives, and would love to help you find the best products that will continue to support your best life. 

If you have any questions, please feel free to email our nutritionist, Stephanie. Stephanie@stewardinglifewellness.com.

Safe Cosmetics + A Giveaway

At Stewarding Life Wellness we are passionate about living a healthy, balanced, and toxic free lifestyle. We strive to eat healthy food that supports our health, use safe cleaning products in our home, exercise, sleep well and meditate often. However, one thing that is easily overlooked in our pursuit of health are the cosmetics and personal care products we use daily such as lotions, soaps, deodorant, and make up.

Americans spend billions of dollars every year on personal care products and most of these are filled with toxic chemicals. Thousands of  these chemicals are used without adequate testing or research done to see the effects they have on us. Even the FDA does not require testing to approve chemicals used on humans or even has the power to recall a product that could be dangerous. The European Union has banned nearly 1400 toxic chemicals from their cosmetic products. America has only banned or restricted 11.

Why are avoiding toxic chemicals so vitally important for our health?

It is easy to assume that since we are only using these products in our hair or on our skin that it isn’t affecting our health like food or supplements do. However, our skin is our largest organ and absorbs these toxic chemicals readily on a daily basis, having dangerous and negative impacts on our body. Research has shown that these toxins in our personal care products can contribute to cancer, infertility, hormone disruption, autoimmune diseases, rashes, and many other medical conditions.

As we are switching to safe, toxic free products, we have tried a lot of healthy options that just don’t work effectively- especially cosmetics. Several people mentioned Beautycounter to us and that it is a great company that makes safe cosmetics and is extremely rigid in all their testings. We were intrigued and began trying their products and learning more about their mission as a company. Below is a short video discussing their mission to provide safe products for their consumers:

 

We have been extremely impressed and use them on a daily basis. As a company, they have banned over 1500 chemicals from ever being used in their products and are rigid in their testing to not include toxic chemicals or heavy metals to give us the safest and most effective products they can. 

Some of my favorite products for our family are:

 

Charcoal bar

Charcoal helps to extract toxins from the skin and leaves it feeling smooth and cleaner than any other products I have used! It is great for men, women, and teenagers!


Charcoal mask

I feel like I have been to a spa after using this. It leaves my skin feeling amazingly clean and rejuvenated. I have also used it on rashes and other skin irritants and found that it has helped tremendously in healing it. 


Tinted foundation

This tinted foundation is amazing! I have never been a big fan of liquid foundations because of how heavy and sticky it feels, but this one feels light and covers well. For a thicker coverage you can also use this tinted moisturizer underneath. 


Mascara

 I feel like good mascara is one of the hardest clean cosmetic products to find. I was wary of this products but love it! I like the brush and that the mascara doesn't clump on my lashes and gives some volume. After using it for a month, many have found that their eyelashes are actually thicker and longer, too!


Baby products

Children are exposed to far more environmental toxins than we were as children and I was adamant that I didn't want our children being exposed to hundreds of toxic chemicals in our daily routines at home. I have tried many products but these are the best I have used! I use these products on my children every single day and confession- I use the baby oil on my face every night before bed- it is that awesome! 


It is so important to be mindful of the things we are putting in our bodies, but also equally important to consider what we are putting on our skin and hair and what we are providing for our family to use on a daily basis. We believe in the importance of removing toxins from our lives and would love to help educate you on finding the best products that will continue to allow you to steward your life to the best of your ability. We would also love to answer any questions you have or even help you try a few samples at the office.

October Specials

* Also, this month (October, 2016) we wanted to offer a special gift if you spend $50 (before tax) we will also include a peppermint lip conditioner with your order.

* If you spend $125 or more (before tax) we will send you a complimentary charcoal bar.

 

Giveaway

This week we are going to have a giveaway for one of our favorite products: the charcoal mask! You can enter to win until Thursday, October 27th. The winner will be announced on Friday, October 28th so be sure to check back on our blog!

And the winner is...

Debra Floyd!

Thank you for all who participated! 

Is Low Dose Naltrexone a Magic Pill? - Alternative Holistic Medicine Keller TX

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There is a lot of buzz in the Functional Medicine world around all of the potential benefits of Low Dose Naltrexone (LDN) for everything from Fibromyalgia to some types of cancers. Is this the magic pill we’ve all hoped for that will right all of our wrongs and heal all of our illnesses. Of course the answer is no and of course there is only One who has ultimately healed all of our wounds but LDN still offers some exciting potential benefits for many patient populations

What is LDN and how does it work?

Low Dose Naltrexone (LDN) is a simply a low dose of a medication called Naltrexone has been around for a long time. It is an opioid antagonist (or blocker) that has been used for opioid and alcohol addiction. However, it has been discovered over the past decade or so that the immune system is intricately connected with our own internal opioid system or endogenous opioid system. The normal dose of Naltrexone is 50 mg when used for its normal opioid blocking effects but when used at a very low dose of 1.5-4.5 mg just before bed, something mysterious and somewhat magical appears to occur within the body. This low dose gives temporary blockage of the opioid receptors in the body that is believed to cause an up-regulation of many of the vital elements of the immune system by upregulating the body’s endorphins.

Therefore the theory continues that many disease processes that involve a malfunctioning immune system such as autoimmune disease, neurodegenerative diseases, and cancers are partially a downstream effect of having a deficiency in endorphins. So claims have thus come this that some have seen an upregulation in numerous aspects  of health and healing including helping get autoimmune diseases into remission and stimulating natural apoptotic properties within the body to fight cancers from within. Case studies continue to come out claiming benefits in many different disease processes and some clinical trials are potentially starting to confirm these reports.

Current Research and Clinical Indications for LDN

While it is important to have good research to support using a pharmaceutical or nutraceutical, I also like to see a lot of anecdotal evidence. When both are present and the risk of using the intervention is low, I am excited. So where is the current clinical research on LDN? Unfortunately it may never have any large studies done because it is a generic medication that no one can make a fortune on. Therefore no big pharmaceutical company would spend millions to do good research. But there have been a few small studies come out that showed potential benefit in pain management, Fibromyalgia, Multiple Sclerosis and Crohn’s Disease. Here are some of the studies:

LDN and for Induction of Remission in Crohn’s Disease - this is a Cochrane review of several small Randomized Controlled Trials that could be found. The author’s conclusions are skeptical but a look through the trials that were discussed is very interesting and promising as a potential addition to a full lifestyle and dietary overhaul.

LDN for Improving Quality of Life In Multiple Sclerosis Patients - shows safety of LDN for MS but no proven efficacy

Pilot Trial of LDN and Quality of Life for Multiple Sclerosis Patients- again shows safety and points to significant improvement in quality of life markers published in the Annals of Neurology. The authors conclude that more in depth studies are needed which is seconded by this author.

LDN and Complex Regional Pain Syndrome (CRPS) - two case studies revealing significant improvements in some long-standing cases! This one is cool to read and see the pictures of how severe these cases were.

LDN and Fibromyalgia and Chronic Pain - These are both good reads addressing the possible mechanisms that people with fibromyalgia and other poorly understand chronic pain syndromes are getting relief from LDN with little to no side effect profile.

Izabella Wentz, known as the Thyroid Pharmacist, has written a lot of information online and in her books regarding LDN and autoimmune thyroiditis (aka Hashimoto’s Disease).  She says,

“Low Dose Naltrexone (LDN) balances the immune system by increasing the amount of T-regulatory cytokines and modulating TGF-B, leading to a reduction of Th-17, the promoter of autoimmunity. This means that it turns off the cells that cause autoimmunity!”

She also makes sure to say that LDN is not a cure but a potentially great immune modulator to prevent further damage to the thyroid while looking for the root cause.

My Clinical Experience With LDN

My experience with LDN has been primarily limited to Hashimoto’s patients.  The vast majority have had a positive response on the medication and only a few out of the hundred or so said it affected their sleep and they could not get use to it. Not only did most subjectively feel better but lab parameters in the form of auto-antibodies also improved revealing a decreased autoimmune attack and therefore less destruction of the thyroid gland by the immune system.

Precautions with LDN

Common pitfalls with LDN include improper compounding, incorrect dosing, and falsely relying on LDN as a magic pill. If LDN is compounded incorrectly with the incorrect fillers or extended release instead of immediate release then the medication will likely be worthless and and a waste of money. You will want a practitioner who is LDN savvy and knows which local or mail order pharmacists know how to compound LDN correctly. See this link for some further information regarding correct compounding of LDN.

Dosing is also tricky and there are currently no guidelines that fit everyone. Typically 4.5mg before bed is a safe dose but with those taking medications that could quickly become too potent if an autoimmune disease process goes into remission, it could be dangerous. So especially with Hashimoto’s Disease, starting at 1.5-2.5 mg is a safer place to start and then slowly titrate up to 4.5mg.

Lastly, if LDN is expected to fix everything and someone expects to see tons of improvement in symptoms and labs, they are set up for failure. While supporting the immune system with LDN may be beneficial it will not fix the underlying causes of most disease processes. For example, with autoimmune diseases in general there will always be a ton of gut work to kill pathogens (if needed), remove candida overgrowth and heal intestinal permeability (leaky gut). This is all secondary to testing and supporting the HPA (hypothalamic pituitary adrenal) axis which is intricately involved with the immune system and gut health.

Final Thoughts

LDN has a lot of potential for most anything that involves a malfunctioning immune system. I’ve seen its clinical utility in autoimmune disease but clinical studies and other clinicians have seen benefits in treating cancers, neurodegenerative disorders, and other inflammatory conditions. While LDN is promising it needs to be kept in the proper perspective and place. It will never replace looking deeper for the underlying causes of immune system malfunctions and other disease processes with an in depth Functional Medicine approach to your health. If you don’t have a Functional Medicine provider, please let us help you. 

 

As of fellow steward of God’s grace,

Jake Duncan PA-C
Functional Medicine Provider
Stewarding Life Wellness
info@stewardinglifewellness.com

 

A STEP-BY-STEP APPROACH TO HASHIMOTO'S THYROIDITIS

Hashimoto's Disease is one the most common causes of thyroid problems, particularly hypothyroid. However it is also one of the most commonly missed and mistreated causes as well. Hashimoto's is diagnosed most commonly by lab testing that reveals elevated antibodies on a lab test. It can also be diagnosed with an ultrasound or biopsy report.  There is no definitive way to completely rule out Hashimoto's because it would entail biopsy of 100% of the thyroid. When Hashimoto's Disease is found it is a lock for an autoimmune process in which the immune system has triggered the thyroid as a foreign invader and is trying to destroy it. This point is critical because it is NOT inherently A THYROID PROBLEM. Let me repeat this foundation point: Hashimoto's Disease is not primarily a thyroid problem. It is an immune system malfunction.

Possible Symptoms of Hashimoto's Thyroiditis:
✓ Weight gain or weight loss (because thyroid hormone output can fluctuate early on)
✓ fatigue
✓ brain fog
✓ hair loss
✓ dry skin
✓ thinning of outer 3rd of eyebrows
✓ palpitations
✓ tremors

Not A Thyroid Problem

Let me explain further. Conventional training has taught me and other practitioners that we treat Hashimoto's disease no different from any basic hypothyroid condition; we replace thyroid hormone.  However in Hashimoto's the thyroid is really just the innocent bystander who got falsely accused of a crime he didn't commit. The immune system is the real culprit who is misguided and killing the thyroid. If that critical component is not at the core of your thinking, treatment and further investigation then you are treating as superficial as you can get. The sad reality is that most people don't even get a diagnosis for years because it is not even looked for when symptoms are present. 

So What Do I Do? 

If you have been diagnosed with hypothyroidism and never had your antibodies checked, the first step is get them checked and make sure you get an ultrasound.  The antibodies you need to request are TPO (thyroid peroxidase) and TGB or TAA (Thyroglobulin Antibodies). If you request these from your medical provider they should be happy to run them for you. If not, look for someone who will. You are paying them. They work for you. The ultrasound is a screen to look for something really abnormal that needs further investigation like a biopsy. Thyroid cancer is relatively common and needs to be looked for or you won't find it. 

Educate Yourself

Secondly, educate yourself! Don't blindly assume others will do what's best for you. Everyone is different and you won't even know the right questions to ask your practitioner if you haven't done some reading. You will have to wade through some things online but you will find some good info if you look.  Stop the Thyroid Madness and Facebook groups like Hashimoto's 411 are popping up often helping people get educated. One of the first areas you will want to educate yourself on is the link between the immune system and the digestive system. In other words, your diet matters significantly! With any autoimmune disease the most important place to start the healing process is through using food as medicine.  Don't tune out here. Seventy to eighty percent of your immune system lines your digestive tract. If there is an unhealthy barrier system due to lack of sleep, processed foods, gluten, stress, or over-training then every time you eat you may possibly be damaging and over-working your immune system. Read about "leaky gut" or increased "intestinal permeability" and work toward an autoimmune paleo diet (AIP). 

Find an Advocate

Self education is foundational but does not negate the need of finding a health care practitioner who can take you deeper.  The reason why is because you will need to investigate deeper as to how to heal and balance your overly reactive immune system. If you don't, there is a risk of additional autoimmune diseases presenting in your future. Supporting gut healing, hormonal balance and inflammation in the body can not only improve your symptoms but it can also prevent future disease processes that are dependent on these broken systems.   Functional Medicine's philosophy is built on finding the underlying cause rather than just treating symptoms. If you can find a Functional Medicine practitioner near you, you will gain one of the best teammates you can hire.  Functional lab testing is essential to rule out digestive pathogens (i.e. bacterial infections, parasites, candida, overgrowth of opportunistic infections), hormonal imbalances (i.e. Hypothalamic Pituitary Adrenal dysfunction, estrogen dominance), or detoxification issues affecting your mitochondrial health and neurotransmitter production. These tests are typically around $500 total out of pocket but can provide a huge direction when it comes to focus on healing the body. 

Medications Versus Supplements

If you catch Hashimoto's early, there is a chance you can avoid needing thyroid replacement medications. However, it is not the worst thing in the world if you do need thyroid support. There are two main options for prescription support: synthetic medications (synthroid/levothyroxine, cytomel/liothyronine) or natural dessicated medications (Armour, Nature-throid, Westhroid). Most people do better on the natural dessicated glandulars but this is when you need a practitioner who is thoughtful and will work with you until you find the right medication for you. Once a new medicine is started you will want to recheck your labs in 4-6 weeks to see how you are responding and keep your practitioner abreast on how you feel. Very few general practitioners are thoughtful in this area but I was blessed to learn under a very thoughtful DO and he taught me a lot in this area about listening to patients and being a constant learner. Thank you Dr. Simonak! 

So if you have discovered Hashimoto's early and are not terribly symptomatic (weight gain, fatigue, brain fog, dry skin, hair loss...) then you should go hard after the root cause and see if you can facilitate healing with supplement protocols.  This should be lab based. Blindly supplementing can at times be dangerous and make things worse. But again, do not feel bad if you need a medication. Thyroid medications are not terribly expensive and for the most part are safe to be on long term. If you are a young female looking to get pregnant it is vital that your thyroid levels are optimal and this sometimes requires frequent lab checks and tapering of medications. 

Final Thoughts

While you are working with your thoughtful PCP or Functional Medicine Provider to heal the root cause of your Hashimoto's Disease, you may also want to consider looking into Low Dose Naltrexone (LDN). There are not many medications that I am excited about but this is one. The risk to benefit ratio is amazing and can help balance the immune system while the body is healing. It may not be needed long term but may prove very helpful at reducing your antibody count and need for increasing medication dosages. 

Educate + Teamwork = Healing

Here is the winning equation again. Get serious about self-educating. Let me know if you want additional reading material and I can recommend several books and websites. Next start looking for your teammate/health detective who can help you look deeper. And get to work! Don't sit on the sidelines and wait for someone else to take care of you and don't even rely on a medication or supplement protocol. Your choices each day to eat a clean nutrient dense diet, think positively, go to bed early, and exercise will be the most potent prescriptions you can fulfill! 

For Further reading, check out this very thorough article from Verywell.com on thyroid disorders.  

Functional Fertility - Part 2

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How Methylation, Homocysteine and Nutrients Affect Your Fertility

Please read Part 1 of this blog as well if you or someone you know if having fertility issues. In summary of Part 1 - Optimal hormone production and timing is critical to have assessed and corrected as a foundation to any fertility treatment.  In today's blog we will dive into another important aspect: Methylation and Nutrient Levels. Methylation is a term that describes a process that is constantly occurring millions of times per minute throughout your body when a methyl group is added in the place of a hydrogen atom.  Adding a methyl group could then in turn lead to numerous outcomes but the big picture is that it is constantly making, maintaining and repairing your DNA. If this is not happening optimally for the reasons we will discuss shortly, risks of almost every modern disease process go up significantly.  Epigenetic signaling could potentially trigger mutations in genetic codes, autoimmune diseases, cancer cell proliferation secondary to altered ability to keep oxidative stress minimized and so on.  When it comes to fertility, nutritional status and particular nutrients are vital to not only conceiving but optimal maternal and fetal health. 

MTHFR, Homocysteine, and Folic Acid

MTHFR is a hot topic. I won't rewrite my former blog but please have this gene checked by your PCP.  Even if you have only one mutation request a follow up fasting serum homocysteine level. A mutation in the MTHFR gene can significantly affect methylation and homocysteine can build up in the blood. Elevated homocysteine has been proven to increase the risk of a cardiovascular event which is an inflammatory process. Any chronic inflammatory process is not good for you or your potential baby and could compromise a healthy pregnancy. Direct links have been found between elevated homocysteine and miscarriages.  Dysfunction in this area is also commonly behind low thyroid function (hypothyroidism) which is also linked to difficulty maintaining a healthy pregnancy. 

This same methylation pathway significantly affects folate and B12 metabolism.  If these pathways are malfunctioning because of mutations and/or toxic burden then inactive forms of folate (i.e. folic acid) could potentially prove harmful and no amount of inactive B12 (cyanocobalamin) will improve a B12 deficiency. 

As you can see above, nutrients like B12 and folate are critical in healthy conception and healthy babies. Folate deficiencies have been implicated in neural tube defects for decades but just in recent years has genetic testing proved that a significant portion of the population will have an even more significant problem with folate metabolism with MTHFR gene mutations. If you or someone in your family has one or two gene mutations then please find a medical provider who is well versed in this area and will watch your fasting serum homocysteine levels closely (optimal is thought to be <7 at this time) and will recommend a solid prenatal vitamin pack that contains active B12 and folate and optimal EPA/DHA (omega 3s). Here is the one I recommend from Orthomolecular below. Contact me if you need access to order it through our website. 

Does the Male Partner's Health Matter In Fertility? 

Of course! More than most of us even realize! Women usually take all the blame on themselves when conception becomes difficult but very commonly it is not their fault at all. If males are not healthy internally then their sperm will not be either and this means that they will not have the count, motility or structure in order to even reach the female's egg or penetrate it.  Poor diets high in processed grains and a lack of phytonutrient dense vegetables promote weak sperm. Add on top of that high stress, lack of sleep, and lack of exercise and you have a recipe for infertility from the male's side. Take a look at this nutrient wheel for Male Fertility.  

Men, take the lead on this one and get your self checked out by a local functional medicine provider who can look at your nutrient levels and talk with you about any lifestyle modifications that will improve your overall health and your fertility. Get on a good multi-vitamin daily and help your wife with making healthy food choices. Let me know if you want to stop wasting money on over-the-counter one-a-day vitamins and I can point you to some solid options that will actually benefit your body. Here is my current favorite foundational multivitamin pack for men. You can get it shipped to you from our online Orthomolecular store if you are interested. Email me for details. 

Testing recommendations for any fertility case

  • MTHFR - this can be drawn by your PCP
  • Fasting Homocysteine Level - Always get this if you have had any trouble with miscarriages or if you have a MTHFR gene mutation
  • Organic Acid Testing - This will give you a very good glimpse at nutrient needs and let you know if your MTHFR gene mutation is significantly affecting your methylation status. This test is used by most Functional Medicine providers because it gives so much information into your health. 
  • Routine Labs plus thorough thyroid panel - to screen for anemia, liver, kidney, electrolyte or thyroid imbalances. 
    • Thyroid labs (minimal) - TSH, Free T3, Free T4, Rev T3, Anti-thyroglobulin antibodies and Thyroid Peroxidase Antibodies (TPO)
  • Month long salivary hormone panel - See part 1 of this blog
  • Adrenal Stress Profile - Source of many hormonal imbalances and fertility problems
  • GI Pathogen Testing - BioHealth and Diagnostic Solutions offer great stool testing
    • The health of your gut is vital and must be part of any long term health support
Overview of all the info you get back from an Organic Acids Test (OAT). It really is an amazing test.&nbsp;

Overview of all the info you get back from an Organic Acids Test (OAT). It really is an amazing test. 

 

Links for Further Self Study

Please email us with any questions or comments. This is in no way a comprehensive blog on the topic but tries to cover big things that are easily overlooked. Let us know if there is another aspect to this that you would like us to blog on. 

Functional Fertility - Part 1

Is It a Timing or Production Issue?

So many things can disrupt a female’s hormonal cycle and therefore ovulation that it is amazing any pregnancies occur. I contribute that fully to the grace of God. Stress and oral contraceptives are among the biggest offenders. Women are all too quickly put on birth control pills when there are having any unwanted or uncomfortable cycling issues and these pills almost always wreak havoc on the natural timing and production of hormones that every woman should have. This disruption in timing and production can make conceiving a massive challenge. However, the good news is that it is pretty easy to find these abnormalities and correct them with a functional medicine approach and the right testing.  

A Delicate Situation

This is obviously a delicate and difficult topic for those experiencing difficulty conceiving and there are many factors that can play into the process besides just timing and production of hormones. We will save most of those for a future blog but I wanted to start with optimizing female hormonal cycles first because it is one of the most common causes of fertility issues. Other factors that play in are nutritional status of the male and female.  Sperm motility and quantity is completely dependent on how well they are nourished. The female's eggs (fertilized or not) are protected by certain nutrients in the diet and possibly supplements as needed. A diet high in fast food and soda will leave the body nutritionally deficient and an obvious disadvantage to conceiving. Again we will leave that for a future blog. Even considering some genetic or anatomical disadvantages, optimizing the hormone timing and production will improve the possibility of conception significantly.

How Stress Affects Your Female Hormones

Stress in any form will put the body into the stress response. The stress response was created by God to aid in our survival in stressful situations like famine or escaping the attack of a wild animal. Therefore the stress response is actually a survival response. What happens when the body is trying to survive? Another evidence of a brilliant designer is seen here. If you were trying to survive in a situation where food is sparse and you are having to move your family hundreds of miles to a place where hopefully the situation is better, the last thing you need to be focusing on is reproducing right!? Your body will divert its attention away from making sex hormones like testosterone, estrogen, progesterone and DHEA to make survival hormones like cortisol and adrenaline. Your body will also down regulate your metabolism so you don’t burn calories as fast to conserve and help you survive! Evolutionary chance or brilliant Design? Cover your eyes if you don’t want to see the obvious.

The big point is that any chronic stress will deplete the body over time of its sex hormones and cause hormonal imbalances leading oftentimes to an estrogen-dominant state. Take a look at the chart below. Progesterone is used to synthesize cortisol and therefore will drop fastest during chronic stress. DHEA pathway will also get less attention thereby dropping the testosterone and estrogen levels but not as far as progesterone. This will lead to all sex hormones typically being low but in a relative estrogen dominance. This can definitely be confusing and needs more than a paragraph but in summary,  estrogen dominance is not good. Though it is somewhat over-simplified you can do more reading on this topic by researching "Pregnenolone Steal." It will lead to PMS symptoms, abnormal cycles and bleeding, difficulty conceiving, and increased risk for estrogen driven cancers like uterine, breast and prostate (for the men reading this). 

 

Is PMS normal?

PMS has almost become a household term and an expected time of the month where men stop speaking for several days and children hide in their closets until the storm passes. This is NOT NORMAL. Let me repeat myself...This is NOT NORMAL. Hormonal fluctuations during a female cycle should be smooth and the main noticeable symptom should really only be increased libido around the fertile time of each month. If Dr. Jekyll and Mr. Hyde exist inside of you, please seek out  a functional medicine provider and get your hormones balanced. You really want to see what your entire cycle looks like so find someone who does full month long salivary hormone panels.  

Healthy Cycles = Healthy Fertility

The two main problems within a female cycle that will make conception nearly impossible are a TIMING issue or PRODUCTION issue. By timing, I mean that ovulation is not occurring around day 14 like it should. If you are ovulating on day 3 instead of day 14 then you have almost no time to build up an endometrial lining to house a fertilized egg (aka: a baby!). If you are ovulating too late then your body didn’t have time to have a good progesterone spike and sustain the endometrial lining. Here is an example of poor timing. 

 

As you can see with the two spikes of progesterone that should follow a estrogen rise signifying ovulation, this patient almost looks like she may be ovulating twice - both at the wrong times! Look at a picture below of what a normal cycle should look like. After the hypothalamus and pituitary cause a spike of Luteinizing Hormone ovulation occurs. This delicate cycle can be easily disrupted with years of poorly managed stress and birth control use. The good news is that it is always wanted to get back into balance again and sometimes it does not take as long as you might think.

 

Another common abnormality seen on the month long panel is an insufficient amount of progesterone spike after ovulation occurs. This is unfortunately a common and easily corrected cause of recurrent miscarriages. If you have had one or more miscarriages please visit us or someone who can look at a month long salivary hormone panel on you. Also ask your PCP to run a genetic test called MTHFR and get a fasting serum homocysteine level to make sure there is not a gene mutation that needs significant nutritional support and likely a switch in prenatal vitamins. A urine organic acids test would also benefit you to further look at methylation status and possible nutrient needs. This will be discussed further in Part 2 of Functional Fertility.

Healthy Adrenals = Healthy Hormones

While stress definitely disrupts the female hormone cycle, it is simultaneously disrupting the Adrenal Hormone production. This is critical to grasp because if you try to fix the hormonal cycle without addressing the broken HPA axis (Hypothalamic-Adrenal Axis) then you will spin your wheels. When the stress response is brought under control and adrenal hormone production is supported and balanced, the body’s natural production of sex hormones can be restored! Hence the importance of stress physiology. Please read through some of the other blogs on adrenal health and try to make it to one of our monthly Group Visits on Restoring Balance: Stress Hormones and Your Health. Click HERE to get more info.

One Big Piece of the Puzzle

Though hormonal timing and production issues are not always the root cause of fertility issues, they are one of the most common and a great place to start. Nutrition of both spouses is also critical and will be the topic of the next fertility blog so stay tuned. It is also important to not ever place our complete trust in anything other than God. Sometimes we will never find an answer to the “why” behind our trials but remind yourself of this: God is always working things out for His glory and the good of His people. Do your part and take action. Steward your body well. Eat clean. Give your body adequate rest. Don’t try to play God by worrying about everything. But in the end, no matter what comes your way, trust in the Sovereign Creator and Sustainer of life, Jesus. He is worthy to be praised even if we never receive another blessing from His hand. Here is a good time for a book recommendation. Trusting God: Even When Life Hurts by the late Jerry Bridges is one of the best reads for your soul if you are struggling with recurrent pregnancy loss or any other trial.

 

 

 

 

 

 

PCOS: A Functional Medicine Approach

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PCOS is an abbreviation for Polycystic Ovarian Syndrome. This name is a little misleading because it entails a constellation of symptoms. Cysts on the ovaries are only one of many components to this complex syndrome. It is also misleading because it creates a label that feels like it can’t be changed and can lead to a hopeless feeling once the diagnosis has been given. This is similar to how diabetics get labeled and then often times succumb to the false notion that this is their lot and medical therapy is the only hope to try to keep the disease process at bay. Though medical diagnoses are needed and can be helpful, they can also often be very paralyzing and prevent people from finding ways to heal their body and prevent progression without always needing to rely solely on medications.

PCOS is an area where functional medicine shines. The conventional approach to PCOS relies on a medication or two in an attempt to try to manage the symptoms of blood sugar instability, elevated testosterone and DHEA levels and often increased acne and facial hair.  When the approach is solely medical, it is easy to miss the opportunity to get deeper and address things at the root cause instead of putting on band-aids that only cover things up.  If you or someone you know suffers from the side effects of PCOS and has not had much improvement with medications alone, please read on and pass this on to others.

PCOS tends to have several commonalities across the board. There tends to be several digestive issues going on. Though women may not be plagued with severe digestive symptoms, often there are multiple underlying food intolerances.  Gluten is often the worst and most common one. Grains of any kind also tend to cause a worsening of the inflammation that is going on in the GI tract. Therefore removing all grains for a period of time often provides significant healing opportunities. Much work can be done on the gut without even the need for lab testing and medical therapies. However, often it can be very helpful to get a few tests done to see what additional therapies would be beneficial and speed up the healing process. The majority of female hormones are made by the ovaries and therefore cysts in the ovaries could obviously cause a hormonal mess. The secondary place female hormones are made is in the adrenal glands which also manages our stress hormones. PCOS can lead to loads of stress, affecting adrenal function and further disrupting female hormone balance. Testing the adrenals and also getting a month long saliva test of estrogen and progesterone levels will show just how imbalanced the hormones are and likely show several areas where bio-identical progesterone at specific times during the month could show huge improvements in symptoms, including fertility!

As mentioned earlier, the GI tract has a huge potential for improving or perpetuating symptoms. Therefore testing this body system would also be very wise and could reveal a number of problems including dysbiosis (bacterial imbalance), pathogens (bugs) or bacterial overgrowth. The last body system to consider supporting is the body’s detox pathways. The main test for this is a urine Organic Acids Test. It not only shows detox issues but also nutrient needs, methylation concerns, neurotransmitter markers and mitochondrial energy markers. Amazing test but I’d probably do that one last if not in the budget up front.  Let me summarize the recommendations below:
 

PCOS Action List

  • Clean up diet - Remove grains (including gluten), dairy, soy, and sugar
  • Highly consider doing a Whole30 (see whole30.com) as a jump-start
  • If not significantly improving with dietary changes alone:
    • Meet with a functional nutritionist
    • Get functional lab testing done with your functional medicine practitioner
      • Adrenal Stress Profile
      • Month long female hormone panel
      • GI Pathogen Screen

I hope this short blog proves helpful for you or someone you love. If we can be of any service to you please send us a message and schedule an appointment to start looking deeper into how to support your body’s healing processes.

 

Are You a Skeptic?

If you are much like me, you grew up with the mentality that you can trust conventional medicine. Doctors are trained well and have your best interest at heart and you never really thought twice about whether a medicine prescribed to you was good for your health or not. Some on the other hand are natural skeptics about everything and especially anything to do with their health.

I’m not in any way opposed to western medicine. Nor do I think that the majority of physicians have any malintent.  Actually quite the opposite. I praise God for conventional medicine practitioners. Our son, Elias, recently was hospitalized at Cooks Children’s Hospital in downtown Fort Worth due to a rare liver disorder that we are still investigating weeks out.  His emergency care was outstanding and likely life-saving. His specialists have been equally amazing. Surgeons and ER docs save lives daily and internal medicine practitioners are solving medical mysteries daily. However, I am also a natural skeptic.

Skepticism can be healthy or harmful. If it paralyzes you and you never move forward in any direction then it will harm you. If it leads you to think and research and seek out answers then this it is a virtue. My skepticism ran high during PA school when I got to the pharmacology courses. Thankfully, my professor was also kind of a natural skeptic too and always pointed out how the clinical trials were done and how easily results could be skewed and really taught us to read these trials with a very scrutinizing mind. He showed us drug companies could run numerous trials that showed their medications to be more harmful than helpful and only publish the one(s) that showed their drug as efficacious and safe.

Now this is not to say that all medications are bad just because the system is broken at best. Medications can be lifesaving. Antibiotics save lives but can also cause significant health issues if used inappropriately. Without insulin, type I diabetics would still only survive a few years after diagnosed when now they can live virtually normal lives! With any medical decision the big question is: Does the benefit outweigh the risk? If a medical intervention is low risk but is very likely to benefit you then it’s a no brainer. The water gets very muddy quickly however when the risk and benefit ratio is very tight. Moderate risk of harm and moderate risk of benefiting you.  This is the time to put your skepticism glasses on and ask the right questions and research yourself. Being a healthy skeptic will go a long way when it comes to your health.

What is killing most Americans? The way most Americans will leave this life will not be due to some freak accident. It will be due to cardiovascular disease and cancers. No medicine can change a person’s lifestyle or prevent cancers from forming. Our body was designed to function well when treated well and will break down when abused. This does not mean that all disease and cancer was from bad life decisions but it does mean that our lifestyle choices matter. And they matter a lot. Any athlete knows if they over-train and don’t rest optimally, they will get hurt. This is a simple concept that is so lost when we think about our diet, sleep, and stress management. Poor diet? High chronic stress? Sleeping 4 hrs/night? Your immune system WILL be compromised and you will have a high risk of getting very sick. Of course genetics play a large role in our health but epigenetics (aka lifestyle choices) are much more powerful to how these genes will be expressed. If you don’t believe this go online and read the hundreds of thousands of people who have put autoimmune diseases into remission with dietary changes alone. There are some cultures who don’t even have cases of heart disease and it kills over half a million Americans a year!  

All this to say, be a healthy skeptic! Find a Primary Care Physician who is lifestyle-medicine  minded and uses medication judiciously. I’ve been blessed to work for two amazing DOs in Fort Worth who think this way. Do your research and ask around. And if you are making good lifestyle choices but still struggling with weight, fatigue, hormone imbalances, mood issues, or digestive complaints despite a full negative workup, seek out a Functional Medicine Practitioner who is trained to help you search out the root cause of your symptoms.  You have to be your own biggest health advocate. You can’t rely on your doctor who sees you once or twice a year to just prescribe you medications to help your symptoms. If you don’t know what functional medicine is, stay tuned…

Jake