womentowomen – Page 6 – Marcelle Pick Site

Dry Eyes and Hormone Imbalance

womentowomen on January 2, 2014

by Marcelle Pick, OB/GYN NP

They say that your eyes are said to be the window to your soul and if you look deep within you can see the person’s genuineness and truth! But what happens when your eyes aren’t seeing clearly they are irritated, dry, red, and itchy? If you have symptoms of dry eyes, you might have something else going on in your body that needs attention.

Most people think of hot flashes, moodiness, vaginal dryness, and night sweats when they think of menopause. Research has found, however, that dry eyes affect 60 percent of menopausal women. There are other imbalances at work that might also affect the eye and they often become more evident when your hormones begin to fluctuate.

If you experience dry, itchy and irritated eyes, you may have tried to treat your dry eyes with eye drops to reduce the irritation. But many times this is like putting a band-aid on an abscess. We are not looking at the real issue. At Women to Women we have had tremendous success treating this problem by looking upstream for the actual causes, antecedents or triggers. So let’s discuss the symptoms of dry eyes and how you can learn methods to restore a healthy balance to your eyes and your body again.

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Dry eye symptoms

Temporary mild symptoms of tired, itchy, or red eyes that abate with sleep, a change in environment, or taking your contact lenses out can be chalked up to obvious culprits. But worsening or persistent symptoms should be taken seriously. They include:

itchiness
a scratchy or gritty feeling
tears running down the cheeks
increasingly tired eyes during the day
irritation from smoke, wind, or air movement
stringy mucus
sensitivity to light
blurriness
problems wearing contact lenses

There are some symptoms (red, itchy, tired) that are mild and are relieved with rest, environmental change, or by removing your glasses or contacts. If the symptoms persist or get worse, please see your doctor. Serious symptoms include the following:

blurriness
extra sensitivity to light
irritation from smoke, wind, or air movement
itchiness
problems with wearing contact lenses
a scratchy or gritty feeling
stringy mucus in your eye
tears that spill out of your eyes and running down your cheeks
increasingly tired eyes during the day

It is recommended that if you have dry eye that you begin to seek treatment for your dry eyes, so that you can avoid harsh damage like scaring your cornea, which in turn can cause ulcers. You are also at a higher risk of an eye infection, because the fluids in your eye can’t carry the debris away and protect your eye. Furthermore, you might also notice changes in your vision and feel constant pain in your eyes.

Causes of dry eyes

There are two reasons that dry eyes develop: (1) not enough oil production by the meibomian glands (in the inner eyelids) or (2) excessive evaporation of the tears. Usually people are affected with low oil and high evaporation. If you have certain autoimmune diseases, such as diabetes, arthritis, lupus, and Sjögren’s syndrome, you are more prone to develop dry eye.

If you have ongoing symptoms of dry eye, please call your doctor to schedule an evaluation.

Below are some common reasons that may contribute to your dry eyes:

Reading or computer work (you may not blink enough to redistribute eye fluid)
Living and/or working in dry environments
Contact lenses that absorb eye fluids
LASIK eye surgery, which cuts nerves and reduces blinking
Allergy drugs, diuretics, beta-blockers, birth control pills, or other drugs
Diets poor in essential fatty acids or anti-inflammatory foods
Certain health conditions, such as diabetes, arthritis, lupus, and Sjögren’s syndrome, which also causes dryness in the mouth.
Eyes that have excessive droopiness

As a functional medical practitioner, I believe it is important to dig deeper and try to identify the cause of the dry eyes. If we take a closer look we know that hormones are quite important for production of tears and lubrication of the eyes.

Dry eyes and hormonal changes

The way in which particular hormones affect your eyes depends on your individual genes and diet and lifestyle. Since we know that hormones are important to your eye health and studies have associated androgen (testosterone) and estrogen receptors on the cornea and on the meibomian gland. What this means is that there is a connection between your tears and your sex hormones.

Before menopause it is known that the greater your testosterone, the fewer tears you produce and the greater your estrogen, the greater your tears. During menopause, this reverses, the greater your testosterone, the greater your tears and the greater your estrogen, the fewer your tears. We have much more to learn about how hormones play a role in the lubrication of your eyes, but we are understanding that dry eyes can result from a deficiency in estrogen, progesterone, or testosterone.

If your eyes are dry for a long period of time then you will experience inflammation. The immune response releases inflammatory substances that make your eyes become red, itchy, and swollen. Dry eye symptoms go along with other menopausal signs of “drying,” such as sore joints and dry vaginal tissues. One way to help remedy your dry eyes is to restore a natural balance among estrogen, progesterone, and testosterone. For a better view of dry eye, let’s look to the East.

An alternative approach to dry eyes

The eyes are crucial diagnostic tools in many Eastern healing traditions. Practitioners will look deeply at a patient’s eyes to obtain better insight about the health concerns. In Traditional Chinese Medicine (TCM), the eyes are thought to be where your purest energy flows. When your life is balanced and you are healthy, your eyes radiate clarity that is visible to the practitioner. When your life is not balanced, your eyes show it, because the liver (organ of detoxification) rules the eye in TCM.

Symptoms of dry eye might be a warning sign that your body is not detoxifying properly and thus inflammation occurs. The inflammation connection is supported many conventional eye doctors who encourage their patients to add omega-3 supplements or fish oil to their dry eye treatment. A recent study showed that a diet rich in omega-3 fatty acids reduced the risk of dry eye by 20 percent compared to women with low levels of omega–3.

In addition, there are other benefits when you increase your intake of omega-3 fatty acids (with supplements; eating fish, such as mackerel, tuna, or wild salmon; or eating some nuts and seeds). They naturally moderate inflammation. They also assist in tear stimulation and secretion and help to increase oils in the secretion. In addition they are thought to moderate extra production of estrogen. These all help provide natural lubrication instead of temporary “artificial” relief, such as over the counter eye drops.

Eye drops and artificial tears

As mentioned at the beginning of this article, most people use eye drops or “artificial tears” to help relieve symptoms of dry eye. The good news is that the drops can help make you more comfortable temporarily. The not-so-good news is that it’s only a temporary relief, and your symptoms will probably reoccur.

If you choose to use eye drops then please educate yourself on what is out there because eye drops can vary quite a bit. You will want to make sure that you are not using something that has preservatives that might further irritate your eyes. And remember that the drops that “get the red out” are not for dry eyes. To find permanent relief, you need to look deeper and not depend on the eye drops.

Functional dry eye relief

I’ve helped women find permanent relief from their dry eye symptoms by building up their healthy nutrition and restoring their hormonal balance. You are unique and might have to try a few combinations to find what works best for you. I believe that supplemental essential fatty acids and a nutritious diet will help with dry eyes. So let’s start here with some methods for you to try:

Nutrition. Eat three healthy and sensible meals and snacks every day. The meals should always include whole foods. Take a daily multivitamin, essential fatty acids, with EPA and DHA, plus vitamin E, which helps omega-3 do its work. Look for the right balance of omega-3, omega-6, and omega-9—it is all about balance. Read the label to determine if it’s free of lead, mercury, PCBs, and other contaminants.

Balance your hormones. Endocrine support can help your body produce natural levels of estrogen, progesterone, and testosterone. Try eating more whole grains, less sugar, and fewer processed foods. This will help to control insulin levels and keep inflammation under control.

Check your medications. If you are on prescription drugs, talk to your healthcare provider to see if anything might be causing your dry eyes. There could be alternate medications.

Avoid pollution and irritants. Smoke aggravates dry eyes. Avoid rubbing your eyes because that can disturb the tear film, remove tears, and transfer irritants to your eye. If you wear makeup it is suggested that you purchase hypoallergenic make-up.

Hydrate and humidify. If you are dehydrated, the fluid in your eyes can be depleted, so drink lots of water and herbal teas. Another thing you can try is a humidifier. Clean it with soap so you don’t add more irritants to the air.

Blink! Try to blink every five seconds, especially when staring at your computer screen or kindle or Ipad.

Special care with contact lenses. Contact lenses can soak up the fluid in your eye and they also collect proteins on the surface, which further irritates the eyes. Keep lenses clean, and try not to wear them all the time. If you need to use eye drops, check the label, as not all drops are made to be used with contacts.

Get more sleep! Enjoy the goodness of regular sleep! This will give you’re your eyes the rest they need and will also help reduce the stress that contributes to imbalance in your hormones. Your body repairs its cells and detoxifies while you sleep, which in turn also helps decrease inflammation.

Paying attention to your third eye

You have a “third eye” and it’s your intuition. This could be the best tool for you to find a way to keep your eyes healthy. Dry eye is a common symptom during menopause. Many women experience this symptom and many get relief. Be patient while you are improving, and speak with your doctor if your symptoms get worse. Eyesight is an important part of daily lives and we tend to take it for granted. Make positive changes for your healthy lifestyle that will benefit you and your eyes.

The Effects Of Adrenal Imbalance – Stress Does Count

womentowomen on January 2, 2014

by Marcelle Pick, OB/GYN NP

One of my patients recently said to me “I’m so tired of being tired!” and “I’m so tired of talking about being tired!” and “I’m tired of saying I wish I had the energy to…” Then through teary eyes she asked “What’s wrong with me?”. This patient is like so many I’ve seen recently – women do so much today – have more responsibilities than ever before – most are busy from the time they get up until the time they go to bed with little, if any, time built in for self-care. No wonder women feel tired! By the time many seek help, they just want to feel better – some are not even interested in getting to the root cause.

All of my patients breathe in a sigh of relief when I assure than that as long as other major health issues are ruled out, we can absolutely have them feeling vibrant and full of energy.

I usually recommend a series of simple tests for patients who come to me with these symptoms. These tests evaluate cortisol and DHEA levels as well as stress markets. At Women to Women we find that the results are astonishingly consistent – less that 25% have cortisol levels which indicate healthy adrenal function, while more than 75% show impaired adrenal function – there are women who are wake up feeling tired and without any increase in energy throughout the day, there are women who wake up with very high energy levels (sometimes even before the sun rises) but who can’t stay awake after 3pm and then there are those who can’t seem to wake up in the morning, but are wide awake at 2am. This wide spectrum of adrenal function is a pattern I’ve seen for many years with women – its known as adrenal dysfunction.

Adrenal dysfunction tells us that the adrenal glands are either under producing or overproducing stress hormones. The effects can be baffling and concerning for women – a feeling of weakness, overwhelming fatigue, immune system weakness, moodiness or depression, insulin resistance, muscle and bone less, hormone imbalance, hair loss, autoimmune disorders, and many other health concerns.

Our adrenal glands help us to have a healthy – sometimes lifesaving – stress response, which wasn’t designed to last very long.

These two walnut shaped glands are located on top of our kidneys where they act as small centers of hormone production. The very innermost section of each gland produces adrenaline and noradrenaline. The adrenal cortex, the layers outside the center, produces the hormones DHEA, cortisol and our sex hormones – estrogen, progesterone and testosterone.

Our adrenal gland’s primary purpose is to give us the energy we need when facing a threatening situation – the ‘flight or fight’ response is often used as an example. When this happens, our adrenals immediately increase production of adrenaline and cortisol. This causes our heart rates to increase, our metabolism and digestion to slow down, and our senses to sharpen. We need all of these systems supported during times of intense, immediate stress – and these amazing glands respond to every kind of stress – emotional, psychological, physical, environmental, even infectious! When we have chronic, unrelenting stress, our adrenals don’t give up on us! They keep producing what we need – and the domino effect in our body begins. Fatigue, weight gain, moodiness, hormone imbalance, thyroid imbalance and irritability may follow.

Our adrenals were designed to override other body functions – and they were designed to push and pump stress hormones non-stop!

To understand how adrenal imbalance develops, it is helpful to consider the original, evolutionary function of the adrenal glands. The adrenals are walnut-sized glands located on top of each kidney, where they serve as important manufacturing centers for many of the body’s hormones. The innermost section of each gland produces adrenaline (which you may know as epinephrine), and noradrenaline (also called norepinephrine). The layers outside the center, called the adrenal cortex, produce several other hormones, including cortisol, as well as DHEA, and the sex hormones estrogen, progesterone, and testosterone.

Along with several other key responsibilities, your adrenal glands’ primary purpose is to help you survive in the face of a threat, rallying all your body’s resources into “fight or flight” mode by increasing production of adrenaline and cortisol. Healthy adrenals instantaneously increase your heart rate and blood pressure, release your energy stores for immediate use, shut down digestion and other secondary functions, and sharpen your senses. But since they are programmed to respond to every kind of stress — physical, emotional, perceived, psychological, environmental, infectious, or any combination of these — a woman under chronic stress can strain her adrenal glands. Stress comes not only from a dramatic life event, but lack of sleep, financial worries, chronic dieting, infection, digestive issues, reliance on stimulants such as alcohol or caffeine, unresolved emotional issues and other worries or concerns. When the adrenals are chronically overextended, she can end up with issues like thyroid imbalance, weight gain, insomnia and severe fatigue.

Let’s emphasize two points about this healthy stress response. First, it takes priority over all other metabolic functions. Second, it wasn’t designed to last very long. It is important to remember that the hormone cortisol converts fats and proteins into energy – just what we need during those stressful times! But prolonged high levels of cortisol are actually damaging to your body. Digestion, metabolism and mental clarity are impaired, normal cell regeneration and healing slow down, healthy muscle and tissue are compromised, healthy endocrine function and immune function are compromised, and hormone production is impacted.

The cumulative effect of high cortisol levels can take a toll on even the healthiest of bodies. We’ve talked about fatigue, weight gain and sleep issues – but there are other symptoms, too. Adrenal imbalance may also be a factor in depression, fibromyalgia, arthritis, hypo-thyroidism, hair loss and acne.

I’ve helped patients thousands of patients regain healthy adrenal function. There are four easy steps to start with – things you can do every day – addressing the root causes of your adrenal imbalance.

Before you get started, it is important to rule out the possibility of any serious underlying medical condition – have a full medical exam to rule out this concern.

To start healing your adrenals, eat regularly and choose your foods wisely! Make every bite count – choose nutrient rich foods, ones which haven’t been processed and do not contain sugar. Blood sugar spikes and drops create stress for your body. I encourage my patients to eliminate gluten from their diets as well. Eat five to six times a day and include protein, a complex carb and high quality fat every time you eat. A healing body needs good nourishment!

Build in time to get more rest! Now’s a good time to commit to getting seven to nine hours sleep a night. Practice good sleep hygiene – create an environment that welcomes a good nights’ sleep. Turn off all electronics an hour before bed – allow your mind to slowly unwind and your body will follow!

Think about what causes your stress and think about ways to put some stress reduction measure in place. For some, this may mean taking on less…for some others it may mean setting aside time each day to problem solve. Some women find that exercising helps – the hormones which are released during exercise help many women feel better, but some of my patients report that the focused time during exercise gives them the time and uninterrupted attention to think about potential solutions to their stressors!

I urge you to consider talking a high quality multi-vitamin to close any gaps in your nutritional needs. Its more difficult that that ever before to get all the nutrients our bodies need from our daily diets. A body healing needs support – a multi-vitamin rich in vitamins and minerals combined with an omega-3 fatty acid supplement – also known as fish oil – are great building blocks to start with.

In most cases women report feeling better in a few weeks and return to feeling ‘like themselves’ in just a few months. In some instances, women may require more support such as low dose compounded DHEA or other herbs. I urge you to work with a practitioner if you feel you may need more support – some of the more advanced treatments can have adverse interaction if not used properly.

Our bodies have an amazing ability to heal when given the right support! Regaining your energy, your clarity and your vitality is a must!

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Emotional Eating

womentowomen on January 2, 2014

by Marcelle Pick, OB/GYN NP

In all my years as a health provider for women, I think I can count on one hand the number of women for whom emotions played absolutely no part in their relationship with food. Our emotions and how we eat (and when and what) are so intertwined that I think it is virtually impossible for a woman to get healthy — and, eventually, to lose weight — without first addressing her emotional attachment to food.

Each day I hear all kinds of stories about women’s emotional relationship to food. For many of my patients, these memories, particularly the early ones, are fond ones: the ice cream truck on a hot summer day, traditional holiday meals celebrated with family. These stories underscore how food can be used to make us feel comforted, connected and loved. In many families food is the only currency of love, a legacy many women unwittingly pass on to their own daughters and sons.

Or just as often, the opposite may occur. Mealtimes may have been excruciating exercises in power or parental control. How many children sit down to a meal only to hear, “I have a bone to pick with you?” How many are forced to sit at the table until they eat everything on their plate? Who wouldn’t eventually lose their appetite after being fed a regular diet of criticism and shame every evening?

As women move into their adolescence, stories often morph into tales of deprivation and triumph over food, the perceived enemy. One of my patients describes how she and her friends ate one meal a day all through their senior year in high school, squeezing each other’s hands in support, so they could fit into tiny little prom dresses in June. Another remembers coming home and lambasting herself if she ate more than half a yogurt container for lunch. Often adolescence for girls is the entry into what may become a lifetime of self-loathing, all for wanting and needing to do something that is a vital necessity — eat!

Our society has few rituals in place to make teen-aged girls feel comfortable with their emerging curves and hormonal surges. As a result, a girl’s burgeoning body, her promise of fertility and womanhood, can feel threatening—more so to herself and her parents than anyone else. And if a woman never finds a way to feel comfortable with her grown-up shape, either through romantic love or emotional work, this discomfort parlays into an ongoing struggle with food and self-esteem.

Eating disorders aren’t the exclusive domain of young women. In their book, Runaway Eating, Cynthia Bulik and Nadine Taylor help clarify why huge numbers of women in their 40’s and early 50’s now find themselves coping with midlife stress through unhealthful eating patterns, including binge eating, yo-yo dieting, calorie restriction and compulsive exercise. While a woman at this age may not consider herself anorexic because she eats regularly, her obsession with maintaining control (and not just of her food intake) can be just as destructive. Emotional attachment to ritualized denial — of food, of pleasure, of money, of rest, of sex — is anorexia in another guise. It is an effort to erase a part of yourself or your life that weakens your sense of control.

And women aren’t the only ones doing the erasing. Just look at what has happened to dress sizes in the past 40 years — for those of you who still sew, you know your pattern is really a “12” even though designers are sewing size “6” labels into your clothes these days. And what’s with size “0,” “00” and “000” anyway? Do women need to fully disappear to be truly attractive?

At least 80% of the patients I see have some form of emotional issues with food — and what I’ve learned over the years is that most of them grew up in dysfunctional families. If you see yourself among the ranks of these women, it may reassure you that you don’t have to suffer alone — you are part of a wide continuum, at either end of which lie extreme over-eaters and under-eaters — and just by reading this article you are taking another step toward healing.

So now that you know that age has nothing to do with an emotional attachment to food, let me assure you that it has nothing to do with your level of education or socioeconomic bracket, either. What does vary among emotional eaters is how an individual has learned to respond to stress. Some women become hyper-responsible or obsessive-compulsive, and use food as a form of control over themselves or others. Others are sensate types and cope by taking it all in, learning to soothe and stuff their feelings with food. In every case, though, what we’re talking about is preoccupying yourself with food to prevent yourself from feeling unwanted feelings — including but not limited to the big ones: pain, despair, and shame.

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The Gluten Spectrum – From Sensitivities to Celiac Disease

womentowomen on January 2, 2014

by Marcelle Pick, OB/GYN NP

There is tremendous confusion around the term gluten sensitivities vs. actual celiac disease, and generally, conventional medicine continues to ignore the diagnosis of gluten sensitivity. In the standard community, the advice given to patients with celiac disease is to be strictly gluten-free for life, while those with a sensitivity may just cut back and reintroduce it again later, and having it in smaller amounts is also considered acceptable. From my perspective and that of many of my functional medicine colleagues, the line between the two is not so distinct. Imagine that celiac lies on one end of the spectrum and gluten sensitivity falls at the other end and of course there are many degrees in between. And even a mild sensitivity to gluten, it is now understood, may (depending on the circumstances), develop into something more significant such as full-blown celiac symptoms.

Celiac disease is most often associated with significant anatomical changes within the lining of the gut, specifically the small intestines. A wide range of symptoms can be present before a diagnosis and there is always presence of certain antibodies in the blood, particularly antiendomysial, and anti–tissue transglutaminase antibodies. For many years the gold standard to obtain a positive diagnosis was to obtain an intestinal biopsy. The more damage and irritation to the gut, the more likely the antibodies would be elevated. But what has become more apparent is that not everyone with gluten sensitivity had dramatic changes, and of more interest is that modern medicine has still not done a very good job of testing and accurately diagnosing this condition.

Recent studies have reported that about 46% of celiac patients are actually misdiagnosed, and many of them, especially those with “classic” GI symptoms, 59% are told they have some form of Irritable Bowel Syndrome, or IBS. The best part of all of this is that more sensitive tests have been and are being developed. In the works is a saliva test which you can do at home to check for antibodies associated with gluten sensitivity. As always, knowing early on that you are reacting to gluten can go a long way to prevent damage to your intestine, from constant exposure to repeated gluten, as well as negative effects elsewhere in the body.

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Gluten-associated Disorders

Autoimmune disorders are ten times more likely in celiac patients than in the general population.

Here are some common ones:

Type 1 (autoimmune) diabetes
Thyroid disease
Addison’s disease
Cardiomyopathy
Sjögren’s syndrome
Autoimmune liver disease
Osteoporosis
Rheumatoid arthritis
Hair loss

Although until recently there was no understanding of the term gluten sensitivity, it is now more frequently identified and accepted today because of its prevalence. There is even an insurance code for the diagnosis.

Up to 30 percent of the population carries a genetic predisposition to gluten sensitivity and celiac disease. This causes an inflammatory/autoimmune response in your gut when you are exposed to gluten. Gluten is an antigenic protein found in many grains that are part of the wheat family and includes other grains such as rye and barley.

Laboratory and Diagnostic Testing for Celiac Disease

Three-month trial of gluten elimination
Celiac panel
Anti-deaminated gliadin IgG and IgA
Anti-gliadin IgG and IgA
IgA anti-endomysium antibody
IgA and IgG anti-transglutaminase ELISA (tTG)
Total IgA (IgA deficiencies ten times more common in CD)
HLA DQ2, DQ8 typing
Intestinal biopsy

Anxiety And Worry In Women – Causes, Symptoms And Natural Relief

womentowomen on January 2, 2014

by Marcelle Pick, OB/GYN NP

Many women operate in an ever-present state of low anxiety or worry, also called generalized anxiety that may blossom into episodes of full-blown panic attacks, phobia or anxiety disorders during times of psychological stress or biological change — like menopause.

A majority of my patients with chronic anxiety are so accustomed to living with it – often since childhood — that they don’t even mention it until I ask or until they begin perimenopause and their anxiety symptoms worsen.

Anxiety and worry are knots of both emotions and physiology feelings. Most psychologists look at anxiety as purely emotional: the outward sign of repressed negative feelings and inner conflict. But over 30 years of scientific research into severe anxiety disorders and panic attacks has established that all anxiety has a real, physiological cause that is just as important to treat — especially for relief of anxiety related to hormonal imbalance.

This is good news. It means that anxiety symptoms that were once dismissed as character flaws (think of the terms “worry wart”, “head case” and “control freak”) are not feelings you just have to live with or medicate when they get too severe for you to function. There’s a lot more to the story — and a lot that you can do to get that monkey of anxiety off your back.

What is anxiety?

Everyone experiences anxiety or feels panicky from time to time: the shaky knees and thudding heart, the shortness of breath, and the mind going a million miles per minute. Part of what keeps us alive is our ability to feel fear. In fact, we are made with a kind of built-in alarm system that brings the full weight of our mental and physical prowess to bear in the face of danger — the “fight or flight” response.

The limbic system, the parts of the brain responsible for orchestrating our emotions, including the fight or flight response, relies on a complicated interplay between neurotransmitters and hormones to fuel the body and mind to deal with a perceived enemy.

What’s not natural is to feel afraid and upset most of the time without any tangible cause. Like our immune response, our fight or flight response is meant to click into action in the face of danger and then rest. But in our day and age, too many of us never get to relax: our minds are perpetually on high alert with the accompanying physical response.

It’s no exaggeration to say there is an epidemic of anxiety. Over 19 million American adults and millions of children have anxiety disorders ranging from mild to severe. And the statistics only count the people reporting their anxiety symptoms to doctors. I know from my practice that there are many more on the mild to moderate scale who feel reluctant or even ashamed to admit their anxiety.

Our culture tells us that feelings of fear, vulnerability, and even shyness are signs of weakness — which makes anxiety the fault of the victim. Women are taught from childhood to “grin and bear it.” The people who accuse us of medicalizing anxiety are not being helpful. The truth is that telling women to suffer through anxiety is just as terrible as telling them that drugs are the only remedy for anxiety and panic attacks. Neither is correct.

Let’s start by looking at the major types and symptoms of anxiety and then examine the real roots of anxiety. That’s where we’ll find solutions.

Severe anxiety disorders

Severe panic and anxiety disorders like obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social phobias, and stress disorders affect only a small minority of anxiety sufferers.

Severe anxiety disorders are highly treatable but require medical diagnosis. If you think you may be experiencing any of these disorders, contact your healthcare practitioner right away. Different approaches that include drugs and cognitive-behavioral therapies (such as exposure therapy) are proving to be very successful.

One hot topic of study is the connection between anxiety disorders and genetics, because anxiety disorders clearly run in families. At Women to Women, we think genes are a factor in some anxiety disorders, but generally not the most important factor. More often than not, anxious women grew up in anxious households. Anxiety is usually a learned behavior that can be unlearned — even when it’s severe. We’ll return to this topic after we explore generalized anxiety disorder, which affects many more women than the severe anxiety disorders.

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Adrenal Imbalance And Insomnia

womentowomen on January 2, 2014

by Marcelle Pick, OB/GYN NP

Our internal clocks can be disrupted by ongoing stress of almost any kind – and women today have ongoing stress of all kinds.

In times of chronic unrelenting stress, women can experience adrenal dysfunction and eventually become cortisol dominant. High cortisol can actually change our normal sleep cycling and reduce the amount of restorative (REM) sleep you experience.

One of the first things to do is to look at what is really causing stress in your life – is it a family member? Too much to do in a day? Chronic dieting? Your job? Sometimes writing things down help bring them into your awareness and then you can start to problem solve.

The good news is the that once you have identified this type of insomnia pattern, there are steps you can take to restore your normal rhythm! Remember that insomnia is a symptom of what else is going on in your life.

Eat well! I recommend that women eat three meals and two snacks per day. This helps keep blood sugar levels stable – putting less of a burden on your body. Consider reducing or eliminating sugar, caffeine and alcohol from your diet.

Exercise mindfully. If you don’t exercise, consider starting a regime so that your body feels physically tired. Pick something you enjoy – walking, dancing, biking, yoga – anything that feels good to you!

Consider adrenal testing. Talk with a qualified healthcare professional.

Try herbs and nutrients that support sleep naturally. Taking a magnesium and calcium supplement before bed can be very helpful for some women. Chamomile, valerian and passion flower have been used for a long time to support sleep.

Establish a bedtime routine. Try going to bed and waking up at the same time every day – and remember that we need seven to nine hours sleep a night. Turn off all electronics at least one hour before bed.

While insomnia can be frustrating for many women, there are ways to regain your sleep – try some of our easy steps. You may be surprised at the difference just a change or two makes!

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Hypothyroid Symptoms

womentowomen on January 2, 2014

by Marcelle Pick, OB/GYN NP

Hypothyroidism is the medical term for a sluggish thyroid. It can lead to a wide range of hypothyroidism symptoms:

Severe fatigue, loss of energy
Weight gain, difficulty losing weight
Depression and depressed mood
Joint and muscle pain, headaches
Dry skin, brittle nails
Brittle hair, itchy scalp, hair loss
Irregular periods, PMS symptoms
Breast milk formation
Calcium metabolism difficulties
Difficulty tolerating cold and lower body temperature
Constipation
Sleeping more than average
Diminished sex drive
Puffiness in face and extremities
Hoarseness
Bruising/clotting problems
Elevated levels of LDL (the “bad” cholesterol) and heightened risk of heart disease
Allergies that suddenly appear or get worse
Persistent cold sores, boils, or breakouts
Tingling sensation in wrists and hands that mimics carpal tunnel syndrome
Memory loss, fuzzy thinking, difficulty following conversation or train of thought
Slowness or slurring of speech

Subclinical hypothyroidism may present itself with mild versions of these hypothyroid symptoms, or often just fatigue or depression. Hypothyroidism often occurs along with insulin resistance, and these two conditions share some similar symptoms.

In some cases, hypothyroidism leads to a goiter, an enlargement of the thyroid sufficient to be externally visible. The gland enlarges to try to compensate for its sluggish production. Goiters can also result from an overactive thyroid, called hyperthyroidism. In this case, the gland enlarges in response to attacks by antibodies, which are triggered by the thyroid’s overproduction.

It’s important to note that without treatment or relief of the underlying causes of hypothyroidism, the symptoms will generally worsen over time, eventually resulting in permanent damage.

In the most extreme cases, such as Hashimoto’s disease, the body forms antibodies to its own thyroid gland, creating permanently low thyroid function.

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

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How Can You Feel Good With Early Menopause

womentowomen on January 1, 2014

by Marcelle Pick, OB/GYN NP

Menopause is a time of life that many women dread. They hear horror stories about it’s symptoms, including weight gain, insomnia, mood swings, and vaginal dryness, all that can be quite bothersome. This is especially true for women experiencing early menopause. If you are between 40 and 45 and are beginning this life shift much sooner than you expected, you may be upset and concerned, and rightfully so.

But while menopause does create many challenges for women, there are also many remedies. When we pay attention to our symptoms, we have taken the first step in correcting them.

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Signs of early menopause

In early menopause estrogen levels can rapidly decline causing symptoms to appear suddenly, feel severe, and last longer. Here are some telltale signs you are in early menopause.

You are between the ages of 40-45
You experienced an absence of periods for a full 12 months.
You may be suffering from common symptoms including hot flashes, headaches, weight gain, depression, insomnia, mood swings, fuzzy thinking or fatigue.

For most women in early menopause, addressing the hormonal imbalance is the first step to finding relief from physical and even emotional symptoms.

Understanding the difference in types of menopause

There are many terms to describe the different stages of the menopause cycle, which makes it confusing for women who just want to understand why they are not feeling like themselves. These phases are all physiologically different, but the symptoms can feel similar.

Perimenopause is a transition easily confused with menopause that can last for several years. This phase presents similar symptoms to menopause that gradually increase, including fatigue, irritability, mood swings, and weight gain. The difference is that women in perimenopause continue to have periods, although they may be irregular. When you do not have a period for 12 months, you have entered menopause.

Early menopause occurs in women between the ages of 40 and 45, and occurs naturally, in other words, is not medically or surgically initiated.

Premature ovarian failure (POF) occurs when the ovaries slow or stop production of mature eggs and reproductive hormones before age 40. Between 5 and 10 percent of women diagnosed with POF actually go on become pregnant without any medical intervention.

Surgical menopause is a result of a hysterectomy, oophorectomy (removal of ovaries,) and other pelvic surgeries. Ablations, procedures to remove the lining of the uterus, can mimic menopause by stopping menstrual periods.

Medical menopause may occur after medical treatments such as chemotherapy, radiation therapy, and during the course of various drug regimens. A common one is tamoxifen, used primarily to prevent the reoccurrence of breast cancer.

No matter what stage or type of menopause you may be experiencing, any abrupt change in your symptoms necessitates a visit to your health care provider. This is especially true if you think you are in early menopause or premature ovarian failure.

Possible cause of early menopause

When many of my patients learn they are in premature menopause they ask, “why me?” Symptoms often catch them by surprise, and they worry about what may have caused it, or what it means for their future. We don’t have all the answers about what causes early menopause, but we do know there are some definitive factors.

Genes: Women with a family history of premature menopause are 60 percent more likely to experience it themselves.

Also, events that occur in utero while a female’s ovaries are developing may result in a smaller number of egg-producing cells, which can then shorten a woman’s reproductive lifespan.

Environment: Toxins in our environment may be contributing to reproductive changes found in both women and men, although scientists have yet to uncover the exact causes.

Lifestyle: These factors are associated with early menopause

Poor nutrition and poverty.
Smoking increases your risk of early menopause by 30 percent.
Alcohol may contribute to entering the phases of menopause at an earlier age, although not necessarily as “early menopause”.
Medical treatments such as chemotherapy and radiation can initiate menopause earlier than usual.

Studies show that oral contraceptives however, may actually reduce your risk for early menopause.

Relief for the symptoms of early menopause

Our estrogen, progesterone, and testosterone levels are constantly shifting throughout our life, and that’s normal. But as we age, the fluctuations and ratios between these hormones can become more extreme. When the body cannot regulate these shifts in hormone levels, women can experience common symptoms of menopause, including night sweats, hot flashes, food cravings, and fatigue.

But by approaching these symptoms naturally, balance can be restored, and both the frequency and severity of symptoms will improve. Here’s how.

Nutrients provided by both a diet consisting of healthy, whole foods, along with nutritional supplements can help restore balance at the cellular level.

Herbal remedies can help balance the fluctuations in hormone levels. A functional medicine provider can work with you to determine exactly what herbs you need to help your specific imbalances.

Lifestyle changes including removing environmental toxins, getting proper sleep, and reducing chronic stress can help reduce the symptoms associated with early menopause.

All of these changes can effectively and proactively help you reduce your risk for diseases as well, especially of the heart and bones.

Health concerns with early menopause

Our sex hormones (estrogen, progesterone, and testosterone,) are beneficial in the years leading up to menopause, by offering protection against cardiovascular disease and osteoporosis. To continue protecting against these health issues, talk with your healthcare practitioner about your risks, and consider adding the following steps to your daily routine.

Support your bones by adding more Vitamin D. This inexpensive supplement can help bones stay strong and resilient.

Tend to your heart. Studies show that women who go through menopause before age 46 are twice as likely to suffer from coronary artery disease or have a stroke. Proper nutrition, maintaining a healthy weight, and not smoking are the top three ways to help protect our hearts. But there are other ways to lower our risk for heart-related health conditions.

High quality omega-3 supplements can nourish our cardiovascular system.

Hormone replacement therapy (HRT) may also be appropriate to address any long term health risks associated with early menopause.

Many women choose natural methods to support their bodies as they go through the stages of menopause, and beyond. If you work with a health practitioner and are committed to making appropriate long term adjustments, you can transition through menopause with relative ease, and keep it from impacting your overall health.

Emotional impact of early menopause

Menopause is certainly a milestone for most women. But the impact of early menopause can be quite dramatic. It can cause a shift in a younger woman’s sense of identity, making her feel powerless, and older than her age. Some women even feel they have lost their womanhood (a common feeling among many women going through menopause.)

The reality for women going through early menopause who chose to wait to become pregnant can be very painful. The path to motherhood is not always what we plan, but that does not mean we will never be mothers. I encourage my patients who are experiencing early menopause to seek additional emotional support if needed, to help work through some of the emotions associated with its arrival.

Menopause can be a time of reflection and insight. It does not prompt you to let go of the past, only to honor it and to shift the way you think about your life. When you have natural supports in place to relieve the physical symptoms of menopause, your emotional health will not suffer. In fact, you may actually welcome this change wholeheartedly, embracing the next phase of life.

Type 3 Diabetes

womentowomen on January 1, 2014

by Marcelle Pick, OB/GYN NP

We have all heard about diabetes and how prevalent it is becoming in our country, especially Type 2. This condition, although commonly called “adult-onset diabetes”, actually affects people of all ages, and is connected to a diet high in sugar, lack of exercise, and even some environmental factors. But just recently, researchers have revealed another type of diabetes similar to Type 2 that is linked to Alzheimer’s disease. Scientists are now saying Alzheimer’s and dementia may actually be a form of diabetes, known as Type 3 diabetes. This is a huge discovery!

Nearly every day in my practice I come across patients who are on their way to developing insulin resistance, a pre-cursor to diabetes. Because the symptoms may be minimal at first, many people do not even know they have it. We are proactive when it comes to checking blood sugar levels, and we always encourage our patients to eat nutritiously, exercise, and curb chronic stress. But now we have evidence that these factors are more important than ever in preventing a number of diseases, including the recently identified Type 3 diabetes. The good news is, we can virtually stop this disease before it even starts. Let’s take a look at the bigger picture.

What is Type 3 diabetes?

Diabetes occurs when the pancreas is unable to make adequate amounts of insulin, a hormone released to help cells absorb glucose (also known as blood sugar), providing us with energy. Diabetes is divided into categories, and each characterized by its own set of circumstances.

Type 1 diabetes usually develops in children or young adults and cannot be corrected with diet or a change in lifestyle. Type 1 is genetically predetermined, and requires daily insulin injections to balance glucose levels.

Type 2 diabetes happens when the cells cannot identify or absorb the insulin put out by the pancreas, and usually occurs with obesity, and/or a strong family history of diabetes. The good news is that in its earlier stages, Type 2 is easier to manage with diet and lifestyle modifications.

With Type 3 diabetes, the researchers at Brown Medical School and Rhode Island Hospital discovered that insulin is not only released from the pancreas, but also the brain. This opens a whole new perspective on both diabetes and Alzheimer’s – the progressive degenerative disorder causing loss of memory, intellectual capacity and even personality changes.

Type 3 diabetes is an extension of Type 1 and Type 2, and follows a similar pathophysiology as Type 2, but in the brain. Insulin is needed to help the neurons in the brain absorb glucose for healthy functioning, and if the cells in the brain become insulin-resistant, it can lead to Alzheimer’s.

This form of dementia worsens over time, eventually impeding daily functioning. Early diagnosis is critical to try to slow down the disease and help maintain quality of life. For many years, an Alzheimer’s diagnosis has been linked to genetics and lifestyle, diet, diabetes, high blood pressure, and high cholesterol. The groundbreaking study at Brown not only shows us this common thread, but teaches us that we can actually change the way our brain cells respond by controlling our diets. This is amazing news!

Ways to help prevent Type 3 diabetes

Since the link between diet and diabetes – and now Alzheimer’s – has been established, let’s think about our lifestyle. We live in a country of “super-sized”, easily accessible, processed foods, providing quick energy. High on refined sugar, but low on nutrition, these foods, including processed meats, fast food, donuts, sugary colas, and candy, can actually inhibit cell functioning, leading down a pathway to disease.

Some healthier choices include fresh fruits, green, leafy vegetables, whole grains, high-fiber breads and cereals, fish, nuts, and legumes. A healthy diet lowers our risk of diseases, boosts our immune system, and even helps delay the aging process, not to mention we feel better when we eat right.

In addition to good nutrition, exercise also plays an important role in keeping our cells, and therefore our body, functioning properly. The key here is to do something you enjoy, so you do it consistently. The benefits of exercise are numerous. Not only does it improve our resistance to disease, it helps reduce inflammation associated with disease, sharpen our minds, and keeps all of the systems in our body flowing smoothly.

Reducing our exposure to environmental toxins is also helpful in preventing Type 3 diabetes. We know that cigarette smoke, air and industrial pollutants, and artificial chemicals can pose hazards to our health. Although the studies are fairly new, researchers are also investigating electropollution, or frequent exposure to the energy emitted from electronic devices, as a contributor to this form of diabetes. Since we are almost constantly exposed to technology, how do we combat electropollution? Fresh air. A brisk walk outside has been shown to reduce blood sugar.

At Women to Women, we work with our patients each and every day on the importance of lifestyle balance. We know that obesity, lack of exercise, chronic stress, and not enough sleep can cause a number of health issues, such as heart disease, diabetes, metabolic syndromes, risk of stroke, and impaired brain function. We can now add Alzheimer’s to our list of nutrition-modulated, potentially preventable diseases.

I’m excited to learn about this study, as its results may change the course of a disease that impacts not just those who have it, but families, caregivers, and medical providers. When we can control so many of the factors that lead to diseases like Type 3 diabetes, we can become empowered. Imagine being able to not only improve your health span, but do it with a sharp mind and renewed energy.

What Is C Reactive Protein (CRP and hs-CRP)?

womentowomen on January 1, 2014

by Marcelle Pick, OB/GYN NP

Inflammation is a quickly becoming recognized in conventional medicine as a key component of serious health problems, including heart disease, diabetes, and osteoporosis. Inflammation is the body’s response to infection. Acute inflammation occurs almost immediately after trauma — from a cut or break, to a heart attack. Chronic inflammation is an ongoing process by which tissue breaks down and is repaired over and over, causing scarring or even tissue destruction. Chronic inflammation is common with autoimmune disorders, when the immune system attacks itself.

Detecting inflammation can be tricky, but a marker called C-reactive protein (CRP), is released into the bloodstream by the liver when inflammation is present, and can be revealed in blood tests. Although doctors and scientists are still uncertain about the specifics around when the test should be done or who should have it, most clinicians use CRP tests to monitor acute inflammation or disorders specifically linked to inflammation, such as inflammatory bowel disease or arthritis.

Cardiovascular risk and CRP

Many things can contribute to low-grade inflammation, including stress levels, nutrition, and environmental exposures. The problem occurs when these ongoing factors create inflammation in the body that potentially leads to serious conditions such as cancer and heart disease.

In 2003, the American Heart Association and Centers for Disease Control and Prevention (AHA/CDC) published their recommendations on the clinical use of CRP testing. They established levels of cardiovascular risk by assigning CRP values as follows:

Low risk: less than 1.0 mg/L
Average risk: 1.0-3.0 mg/L
High risk: above 3.0 mg/L

But the AHA/CDC also said that these values are only useful as an independent marker for risk of cardiovascular disease and should not be used as a screening tool or to track treatment. It is my experience as a functional medicine practitioner that CRP is a very important marker, especially for preventative intervention. When I have a patient whose CRP is over 1 mg/L, I recommend lifestyle changes to help manage and reduce inflammation. I also recommend an hs-CRP test, or high-sensitivity CRP. This test in my opinion is critical to help determine more accurate CRP levels.

A recent worldwide study revealed that people with high levels of hs-CRP benefit from the use of a common statin drug that can help reduce the risk of heart attack or stroke. My hope is that this study will encourage all practitioners to test for hs-CRP, but instead of simply writing a prescription for a statin, actually investigate and address the underlying causes of inflammation.

If CRP or hs-CRP is elevated, there are many things that we can do to help temper inflammation and the risk of inflammation-related disease before beginning a lifelong course of prescription medication. The first place I check is the digestive system, the seat of a healthy immune system. Simple changes in diet can improve digestion and change CRP levels for the better. There are also anti-inflammatory spices that can be used in cooking, such as turmeric, ginger, and other Indian spices that may help reduce CRP.

Although this is a fairly new path in conventional medicine, inflammation has always been considered a high priority in my practice. For more information about inflammation and natural approaches for reducing it, see my many articles in our Inflammation section.