womentowomen – Page 26 – Marcelle Pick Site

Osteoporosis And Inflammation

womentowomen on October 28, 2013

by Marcelle Pick, OB/GYN NP

An emerging area of study is the relationship between bone loss and blood acidity. It has been known for a while that vegetarians and women eating a low-protein diet have a lower rate of bone loss.

New studies are showing that high levels of the pro-inflammatory blood acid called homocysteine double the risk of osteoporosis-related fractures. Homocysteine is an amino acid that is a natural byproduct of digesting protein. It has been linked to other inflammatory conditions like heart attack, stroke, and Alzheimer’s disease.

A recent report published last year in the New England Journal of Medicine asserted the idea that elevated homocysteine levels inhibit new bone formation by interrupting the cross-linking of collagen fibers in bone tissue. It’s also possible that the body tries to stabilize a lower pH (more acidic) blood serum by releasing more bone calcium. Homocysteine levels can also be stabilized by taking a vitamin supplement with folate, B12 and B6.

Other foods that cause blood acidity are refined carbohydrates and simple sugars.

So, if we know that all this and more go into the proper balance of bone formation and resorption—and one function can’t thrive without the other—why is mainstream medicine so skewed to one side?

Osteoporosis, Calcium, Magnesium, Vitamin D And Other Minerals

womentowomen on October 28, 2013

by Marcelle Pick, OB/GYN NP

Calcium is one of the most important minerals in the body, not only for bones which store up to 99% but other physiological functions, including nerve transmission, blood clotting, muscle growth and contraction, heart function, hormone function, and metabolism.

Whenever your body needs calcium, it calls upon the bone tissue to release some of its stores into your blood. Your bones comply by upping the rate of resorption (osteoclasts skim off old bone into the blood stream). Whatever doesn’t get used gets excreted through the kidneys—this is why doctors test your urine for calcium as one marker of bone loss. Excessive calcium can cause other difficulties, like kidney stones, gallstones and hypercalcemia.

If your body can’t metabolize calcium properly from your diet because of deficiencies elsewhere it won’t matter how much calcium you eat, your body will take it from your bones. This triggers more osteoblast activity, but bone needs the same nutrients to form—so over time the whole system weakens and affects other body functions.

Even though we have an ample supply of calcium in our diets through dairy products, leafy green vegetables, and seaweed products, many women lack the other minerals necessary for the proper absorption of calcium. A mineral deficiency is usually seen first in non-vital areas like your teeth, hair, and nails.

Vitamin D is crucial to the proper metabolism of calcium, in conjunction with stomach acids and vitamin C. One reason older women have a hard time absorbing calcium is that they lack the digestive acids necessary to break down the mineral.

Magnesium is another mineral that must be present for you to utilize calcium. Magnesium increases calcium absorption form the blood into the bone. Dairy products contain little magnesium and alcohol depletes it. Too much calcium blocks the absorption of magnesium, leading to a deficiency characterized by hair loss, muscle cramps, irritability, trembling, and disorientation.

Trace minerals like boron, selenium, copper, silicon, manganese, and zinc are also important in supporting the healthy balance that makes bone. For an in-depth explanation of all this and more, I encourage you to read Annemarie Colbin’s wonderful book, Food and Our Bones.

Calcium metabolism is dependent on a range of other factors, but I’ll cover only two other substances here: calcitonin and parathyroid hormone—both secreted by the thyroid gland. The former is excreted to stabilize high levels of calcium; the latter is triggered by low levels of calcium, usually characterized by high levels of phosphorous in the blood. Phosphorous is as important to bone strength as calcium, in the right amount. Soda and red meat—two staples of the American diet—are chock full of phosphorous.

Osteoporosis, Menopause And HRT Therapy

womentowomen on October 28, 2013

by Marcelle Pick, OB/GYN NP

The brief acceleration of bone loss (also called resorption) that every woman experiences during menopause indicate that a dip in estrogen levels promotes bone resorption—and research has borne this out. It’s one reason many doctors prescribe Hormone Replacement Therapy (HRT). Furthermore, evidence shows that low doses of estrogen does slow bone loss, inhibiting osteoclast activity, but plateaus at about seven years post-menopause. What’s more, progesterone seems to be just as beneficial for bone formation, encouraging osteoblast activity.

However, once HRT is discontinued, bone loss accelerates to reach its age-appropriate rate. Most of these studies are rarely carried out for longer than a few years, at which point bone loss may have stabilized itself. So HRT may hold the train at the station, but it will eventually depart. And there’s no indication that HRT therapy has any long-term effect on fracture risk in women over 75—when most fractures occur.

Remember that bone function is a two-way street; if resorption is delayed, then so is formation—so no bone is lost, but no new bone is made. What effect does this have on bone strength (an answer the makers of Fosamax have yet to discover). No studies have been done to examine what the long-term side effects on bone are following HRT therapy.

Evista (raloxifene) is a selective estrogen receptor modulator similar to tamoxifen. It is often prescribed to women with osteoporosis. Developers claim it reduces fractures without the risks of HRT. Side effects include increased hot flashes, leg cramps, flu-like symptoms, blood clots and peripheral edema, among others.

What’s appears to be more important is to promote your bodies natural hormonal balance throughout adulthood so that bone growth stays consistent or only slightly slower than bone loss. This can be difficult during perimenopause, when progesterone levels fluctuate, or if you’ve had your ovaries removed at an early age.

For more information, read our many informative articles in our Bone Health and Bioidenticals and HRT sections.

Fractures

womentowomen on October 28, 2013

by Marcelle Pick, OB/GYN NP

Breaking a bone is scary, there’s no doubt. And when it is a major bone, like your pelvis, hip, or spine it can be debilitating. But the numbers surrounding the prevelance of wrist, hip, and spine fractures and osteoporosis just don’t match up with what we know.

Most fractures occur as the result of falling. Wrist fractures occur most often from women bracing themselves as they fall and have less to do with fragile bones than the conditions of the fall. As response time declines with age, women are less able to throw their arms up in time and end up falling on their hips.

Statisticians will tell us that more than one third of people over 65 will fall at least once. About half of them will have a fracture (15%). If you have established osteoporosis, the risk of life-impeding fracture is elevated because once an osteoporitic bone is broken it is very difficult to mend.

Hip Fractures

Hip fractures are particularly frightening because they have the most impact on a woman’s quality of life. After age 75, 30% of people with hip fractures don’t recover enough to fully engage in their usual lives. By 90, one third of all women may experience a hip fracture.

But these figures are misleading when it comes to osteoporosis because at least half of all hip fractures after age 80 can be attributed to a fall caused by other factors—not a bone spontaneously breaking. And in most cases where bone fragility was a factor there were other co-factors.

The statistic you need to heed is that over 85% of women turning 50 years old today with a life expectancy of 80 will not have a hip fracture, regardless of their bone density. Perhaps by then we’ll all feel comfortable wearing aerodynamic hip pads under our clothes—a simple device proven to prevent broken hip bones.

Spine fractures

Losing height and getting a hump are two images of osteoporosis seared into our brain by the media—but the truth behind spine fractures is less daunting. Most vertebral fractures are due to compression and are symptom-free.

Spinal compression occurs when the cushioning tissue between each vertebrae deteriorates over time—it has nothing to do with osteoporosis unless you have been diagnosed with spinal osteoporosis. Losing height for the vast majority of women is just part of gravity’s pull.

Spinal deformity caused by hairline fractures in the vertebrae can cause curvature of the spine and back pain: the dreaded “dowager’s hump.” The chance of developing this condition is exceedingly rare in women under 80.

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Are Stress And Adrenal Imbalance Keeping You From Weight Loss?

womentowomen on October 28, 2013

by Marcelle Pick, OB/GYN NP

How stress can make us gain weight
Number one for your adrenal health: Eat!
Pacing yourself to promote healing

Too often, women and their healthcare practitioners think weight loss is all about cutting calories and exercising more. But I have several patients who’ve tried these avenues with no success. The majority of women I see at my practice are genuinely trying to do everything “right” for their health. They exercise regularly, eat well, take their supplements, and so on. But many are frustrated with their weight gain and haven’t lost a pound. They’re literally desperate when they come to me — and trust me, I know how they feel, because I’ve been there!

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Could adrenal fatigue be causing your weight problem?

Do you feel bone tired during the day, only to perk up at night?
Do you tend to nod off at the movies, at meetings, or while reading during the daytime?
Do you love to snack in the evening and frequently stay up late into the night?
Do you feel hungry, confused, or shaky when under pressure during the day?
Do you habitually rely on caffeine and high-carb snacks to boost your flagging energy?
Have you noticed a “spare tire” growing larger and larger around your waist each year?
Are you eating modestly and exercising, but still not losing weight?

If you answered to yes to two or more of the above, adrenal fatigue could lie at the core of your weight gain.

These patients are always surprised when I ask them about the stress in their lives, and they want to know, What does stress have to do with weight gain?

With years of chronic stress the adrenal glands — which govern our stress response, help balance a woman’s blood sugar, and regulate many other of our body’s processes — can become imbalanced, leading to cortisol dominance or deficiency, insulin resistance, and unwanted weight gain. When this happens, it doesn’t matter how many calories you cut from your diet. The body is in crisis mode and is preparing for a famine. To do this, it clings to every calorie and packs it away in case the need arises.

Many women with adrenal imbalance feel like exhaustion is just their natural state of being. Some depend on caffeine and high-carb snacks to get through the day. Others can barely get out of bed. Our adrenal glands are fundamental to our health, and when they are out of balance, the body prepares for disaster the best way it knows how — by storing calories. Genetically, some of us are more predisposed to this than others. But the good news is that if we heal the adrenals, stubborn pounds often fall away without too much effort, and our energy returns.

Take a closer look at your adrenal glands and find out about solutions for healing yours — and finally getting rid of that stubborn weight. Read more with our articles on adrenal health.

Hypothyroidism, Thyroid Issues and Weight Gain

womentowomen on October 28, 2013

by Marcelle Pick, OB/GYN NP

Over the years, I’ve treated a number of women with unusual weight gain or difficulty losing weight. They often ask me, “Is it my thyroid?”.

The answer for many of these women is yes, but the connection isn’t simple. Thyroid function is intimately connected with your metabolism — thyroid hormones basically regulate calorie consumption. But a healthy thyroid also depends on the proper functioning of other body mechanisms, including your neurotransmitters, your reproductive hormones and your adrenal glands.

The thyroid and weight gain

Because patients with an underactive thyroid tend to have a very low basal metabolic rate, one of the most noticeable symptoms of hypothyroidism is weight gain and difficulty losing extra weight. (Sometimes an overactive thyroid can mimic an underactive thyroid by causing weight gain, although this is less common). A minority of women with hypothyroidism don’t gain weight. The difference arises from their individual biochemistry, the quality of the calories they consume, and how they use those calories.

Often the “metabolic burn” continues to fall as calories are reduced when dieting. That’s why some women with low thyroid can have weight gain even when they severely restrict calories. In order to fix your metabolism, you have to understand your entire health picture, not just your thyroid.

The thyroid in women

More women than men suffer from hypothyroidism, and many more women than men with thyroid issues have problems with weight gain. Most thyroid problems occur within the gland itself and often don’t reveal themselves until a broader pattern of hormonal imbalance develops. That’s why thyroid issues, menopause and weight gain often appear together.

Why do women experience low thyroid and weight gain with such frequency? The reasons are manifold, but primarily:

Women spend much of their lives dieting, usually in a yo-yo cycle of feasting and then fasting. This undermines your metabolism and decreases your metabolic rate, a compounding factor for the thyroid, especially during perimenopause.
Women tend to internalize stress, which affects their adrenal, brain, and thyroid function, resulting in increased cravings for sweets and simple carbs to provide instant energy and feel good hormones.
Women experience monthly hormonal fluctuations that affect their biochemistry.

What you can do about hypothyroidism and weight gain

The first thing to do if you are experiencing stubborn weight gain is to talk to your practitioner. She or he may ask for a thyroid test or measure TSH (thyroid stimulating hormone). I have found in my practice that many women who test within the “normal” range of traditional medical standards still need thyroid support. Their TSH may be only slightly elevated, but enough so that it influences their metabolism and causes weight gain.

For these women, supplemental nutrients such as selenium and a regular meal plan that balances a proper ratio of protein to carbohydrates increases their metabolic functioning and they begin to lose weight. In some cases, a low-dose thyroid replacement hormone is also needed.

There is a lot of controversy in the endocrinology world regarding hypothyroidism treatment. There are those that believe that patients who test within the normal range but have very low basal metabolic rates and very low basal temperatures need thyroid supplementation. There are others that argue that only patients with significant abnormalities should be supported with thyroid hormones.

At Women to Women we look at the individual needs of each patient and treat her accordingly — sometimes using medication, sometimes not. Weight gain is not sufficient evidence to conclude that someone has a thyroid abnormality, but it is one part of the picture we try to bring into focus. Efforts to lose weight without addressing related thyroid issues are doomed to fail. The greatest success is found through a holistic, natural approach that considers thyroid function as an integral part of your overall hormonal balance.

For more information on this topic, read our many informative articles in the Thyroid Health section of our Health Library.

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Bladder Control And Menopause

womentowomen on October 28, 2013

by Marcelle Pick, OB/GYN NP

As if the hot flashes and mood swings weren’t enough, many of us going through menopause start to experience more episodes of urinary incontinence. A decrease in estrogen initiates a thinning and weakening of the pelvic muscles and connective tissue — our house just starts to sag a little.

The relationship between bladder control and hormonal balance becomes increasingly important as we get older and transition through menopause. Some of us have been keeping an eye on the bathroom all along the way, but what about those women who never had an awkward leaky moment until their 40’s or 50’s?

We’re now seeing more ads for pharmaceuticals directed at female incontinence (somebody finally noticed!) but as usual, they only address the most obvious symptoms and do nothing to treat the underlying loss of muscle tone. Most of the drugs available act on the muscle spasms related to overactive bladder but do nothing for stress incontinence and can cause other bothersome side effects.

As with any drug or synthetic hormone, you need to weigh the long-term risks against the potential benefits before taking a pill that could do serious long-term damage to your health. Of course, we recommend you try the most natural steps first, and resort to drugs only if necessary to get symptom relief.

After menopause, women are more prone to bladder infection, chronic urinary tract infection (UTI) or cystitis. As the urethral muscle loses strength and elasticity due to loss of estrogen, pockets of bacteria can flourish. Taking an antibiotic — nowadays there’s a one-day massive dose — is usually adequate, but in some cases inflammation takes hold and damages the lining of the bladder.

This condition, called interstitial cystitis (IC), is a growing concern in women’s health that warrants an entire article of its own. It’s an inflammatory condition that manifests with all the symptoms of a urinary tract infection even when no bacteria are present. It would not surprise me to find in the future that estrogen imbalance is somehow implicated in the escalating rates of interstitial cystitis that I’m seeing.

The emotional connection to the bladder

In Chinese medicine, the bladder is related to issues of anger and control — there’s ancient wisdom at work when we say we’re “pissed off”.

In yoga, the root lock — or mula bunda in Sanskrit — is located at the base of the perineum. It is one of the three major body locks that control our inner life force, or kundalini. (Note that this inner life force is considered to be female!). It is closely related to the earth and the force that connects all living things. Lifting the mula bunda creates stability and energy within the body (as you do with a Kegel exercise — discussed below), channels our life force up through the chakras and imbues our bodies with a sense of weightlessness.

Incontinence can sometimes be a physical manifestation of some deep-seated fear or worry that weighs us down. It’s often related to anxiety or anger about losing control. Occasionally, sporadic episodes of incontinence will occur during a particularly stressful — or “out-of-control” — phase of your life. Pay attention to your feelings and see if you notice any patterns.

Testing For Adrenal Fatigue

womentowomen on October 28, 2013

by Marcelle Pick, OB/GYN NP

Conventional medicine is truly amazing at treating serious disease-state conditions, but when it comes to chronic health issues it does not have such a great track record. Unfortunately its focus on drugs also tends to suppress early-stage symptoms rather than treat their underlying causes. This is where functional medicine come is so well, we look at what is going on upstream that is creating the problems that are present.

By only looking at symptoms and getting a diagnosis this can have the effect of delaying treatment until a disease state has developed. This is true in the case of adrenal dysfunciton cortisol testing. In the conventional standard of care, any cortisol level within a very broad range is considered normal, and anything outside that range indicates disease. Serious disease I might add.

In our practice, we measure cortisol levels at several points in the day to track the adrenals’ day–night pattern (called the “diurnal rhythm”) using a panel of simple saliva tests. We expect to see cortisol higher in the morning to help you get going, and lower as the day progresses to night, when it is at its lowest to support restful sleep.

In the early stages of adrenal dysfunction, cortisol levels are too high during the day and continue rising in the evening. This is called the “Race Horse” in my book, Is it Me or My Adrenals. In the middle stages, cortisol may rise and fall unevenly as the body struggles to balance itself despite the use of caffeine, carbs and other factors, but levels are not normal and are typically too high at night. This cause increased issues with regards to sleep, which greatly increases exhaustion. In advanced stages, when the adrenals are exhausted from overwork, cortisol will never reach normal levels, I call that my “Flatliner”.

Conventional medicine will detect only the extremes of these conditions, when damage to the adrenals has already occurred (Cushing’s disease and Addison’s disease). Within those extremes, you can feel miserable and still be told your cortisol levels are normal. But by responding to early-stage symptoms of adrenal fatigue, we can reverse the developing dysfunction.

Should you get an adrenal test?

In general, if you feel happy and well, have steady energy and emotions, sleep soundly seven to nine hours a night, wake up feeling rested, recover well from stress, and maintain a healthy weight without dieting, then your adrenals are probably doing well.

On the other hand, if your energy ebbs and flows during the day, you feel emotionally stretched much of the time, you sleep poorly most nights, you can’t lose excess weight even while dieting, you use caffeine or carbohydrates as “pick-me-ups” — these are all signals indicating adrenal dysfunction.

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Natural Adrenal Support — How To Restore Healthy Adrenal Function

womentowomen on October 28, 2013

by Marcelle Pick, OB/GYN NP

The first step is to have a full physical exam to rule out disease or other factors. In our experience, women with mild to moderate cases of adrenal dysfunction can see such life changing improvement through the following steps:

Dietary changes to improve your nutrition and reduce carbohydrates and stimulants. Adding pharmaceutical grade nutritional supplements, and including essential fatty acids from fish oil.
Stress reduction, including exercise and taking more time for yourself. It’s helpful to make a list of your stressors, especially those that are constant.
Get more rest. Your body needs time to heal.

Women with more severe symptoms, or those that I call “Flatliners” in my book Is it Me or My Adrenals? have reached complete adrenal dysfunction, and usually need greater intervention and time to heal. At our practice we use the steps outlined above with the added natural support of phosphorylated serines, adaptogenic herbs, sometimes low-dose compounded DHEA, and occasionally deglycyrrhizinated licorice if the person does not have high blood pressure. We personalize the therapy to each woman’s symptoms and test results. We urge you not to self-prescribe these substances, as they can have adverse health effects.

It’s important to remember the role of emotional factors. Stress, pain from past hurts, self-destructive habits such as alcohol, overeating, overwork, and unresolved relationship problems — your past and present emotional responses may serve as an ever-present stressor. Learning to Deal with these problems head on is much more beneficial than trying to overcompensate for the stresses they create.

In all but the most extreme cases, we expect to see dramatic improvement within about four months. For mild to moderate adrenal fatigue the turnaround can be much faster. Remember it took you a long time to get here, it may take a while to see results.

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The Destructive Effect Of High Cortisol Levels

womentowomen on October 27, 2013

by Marcelle Pick, OB-GYN NP

What is cortisol? In it’s normal function, cortisol helps us meet life’s challenges by converting proteins into energy, releasing glycogen and counteracting inflammation. For a short time, that’s okay. But at sustained high levels, cortisol gradually tears your body down. Cortisol is one essential we can’t live without. But too much of a good thing is not healthy.

Sustained high cortisol levels destroy healthy muscle and bone, slow down healing and normal cell regeneration, co-opt biochemicals needed to make other vital hormones, impair digestion, metabolism and mental function, interfere with healthy endocrine function; and weaken your immune system.

Adrenal fatigue may be a factor in many related conditions, including fibromyalgia, hypothyroidism, chronic fatigue syndrome, arthritis, premature menopause and others. It may also produce a host of other unpleasant symptoms, from acne to hair loss. The really good news is that is easily treatable.

For more information, read our numerous articles about Adrenal Health in our Health Library.

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