womentowomen – Page 8 – Marcelle Pick Site

Aging With Grace, Naturally

womentowomen on January 1, 2014

by Marcelle Pick, OB/GYN NP

Aging is an interesting process, taking on many different aspects as each layer of our lives builds upon the next, physically, emotionally, and spiritually. Aging is just a part of life – naturally – we are born as babies and grow old. But how we age, how we adapt and adjust to the changes, and what we make of it, is all a personal experience.

Caring for women in a women’s health clinic has given me a wonderful opportunity to see and explore the aging process. Both my patients and my own family members have one thing in common: the desire to age gracefully, but also feel strong both mentally and physically. Desire to look younger is a given, but so is feeling younger — having vibrant energy, a sharp memory, and a strong, healthy body.

Without access to a real fountain of youth, we have to rely on both practical and evolving methods to help us through the aging process, along with plenty of wisdom and courage. We can increase our life and health span naturally, if we pay attention and gently nurture ourselves along the way. But where do we start?

We’re as old as we feel

We live in a culture obsessed by youth, and the first thing we can do is stop believing everything we hear about our age. The messages associated with growing older are everywhere, and it is up to us to sort out what really applies, and more importantly–what doesn’t. Aging does not automatically equal a decline in health, or looks for that matter. Active lifestyles and glowing health are actually brought about by the power of positive thinking.

As we age we face different challenges with physical functioning, social activities, employment, and other lifestyle changes. Maintaining a healthy attitude is as important as caring for our bodies. Staying connected to family and friends, exercising our brain as well as our body, managing stress, eating a healthy diet, and most importantly, engaging in activities we enjoy each day, all contribute to positive thinking.

Also, how we feel affects how we look. Body image is connected to how we feel physically, as well as how we think about ourselves. When we feel healthy, strong, and able, it shows, regardless of our age.

Understanding the biology behind aging

There is a time in a woman’s life when she discovers, almost as if by surprise, that she is not as young as she used to be. When that occurs varies for each woman, and the reasons are as unique as she is. Biological aging is a complex process involving cells at a molecular level. All living things are made up of cells that undergo a life cycle. The balance between a cell’s ability to renew, and knowing when to die, drives the aging process.

Our cells are programmed by DNA to manage all of the systems in our body. Research shows that a cell’s life cycle depends on a special region of DNA located at the end of our chromosomes called a telomere. Telomeres actually protect the genetic information stored within the chromosomes. Elizabeth Blackburn, a leading molecular biologist, describes the telomere like the plastic cap at the ends of shoelaces. The longer the telomere, the more frequently it can divide and remain youthful. But with each division the telomeres shrink, lose capacity to repair and regenerate themselves, and eventually disappear. During this process, cells can become deficient and defective, and even destroyed. That is when biological aging reveals itself in the body.

We don’t yet know if telomere length is determined inside our genetic blueprint, or is a function of age, or lifestyle and environment, but research shows it may be all of these factors. The leading hypothesis describes damaged telomeres with an inability to repair themselves, combined with oxidative stress (burdens placed on the cells by toxins and other agents,) along with inflammation, can make our cells simply fizzle out.

A study in 2008 actually linked shorter telomeres to cardiovascular disease and hypertension, and scientists are exploring telomere length as a marker for aging. Another study is underway looking at an enzyme called telomerase, an active and present force within cells which may help chromosomes replenish the DNA sequence that is lost each time the cell divides. Normally telomerase slows down over time, but in certain instances, such as invasive cancers, it actually becomes more active, and enables cancer cells to thrive. Healthy aging depends on the right amount of this enzyme to do its job.

When we are young, our long telomeres help enrich and protect our systems. For example, our heart and blood vessels are resilient, our immune cells fight off infection, our bones mineralize and stay strong, our hair follicles produce healthy hair, and our skin is elastic and supple. But as we age, our telomeres change form, and so does our body.

Biological aging can also be influenced by other things, including environmental and molecular free radicals – entities that are highly reactive and can cause damage inside of cells; maladaptive biochemical reactions; spontaneous errors in genetic coding; and nutritional issues. Some of these things are within our control, others are not.

Can we slow down or stop the aging process?

We can’t stop aging, but the good news is we can slow it down and can increase our health span. Numerous studies link simple lifestyle changes with longer telomere length, which is an exciting prospect! A 2009 study published in the American Journal of Clinical Nutrition, reported that women ages 35-74 who take a daily multivitamin had telomeres that were approximately 5.1 percent longer than those who did not take multivitamins.

Another study of women ages 18-79 found that higher vitamin D levels were associated with longer telomere length. Increasing vitamin D levels simply by sensible skin exposure to the sun, or taking vitamin D supplements, may help regulate oxidative stress and inflammation in the body.

Another micronutrient recently linked to aging is vitamin K, which may help off-set our risk for diseases of aging, osteoporosis, and arteriosclerosis. This is an interesting concept. Known as the “triage theory”, a cell uses nutrients to function, and in order of importance. When a particular nutrient is in short supply, its functions may end up at the bottom of the cell’s “to do list”. The cell uses its most important nutrients first, and when some nutrient levels remain in short supply, thus restricting their use, changes may occur, increasing our risk for disease.

There are upwards of 40 essential vitamins, minerals, proteins and fatty acids that actually “talk” to our genes. The nutrients in food make a difference, and the Mediterranean diet is testament to that. This diet which, according to reports, can effectively lower mortality, includes low consumption of meat and meat products, moderate consumption of alcohol -specifically red wine, and high consumption of fruits, vegetables, legumes, nuts, and olive oil. We are learning more and more about how nutrition plays a key role in the messages our cells receive about activating – or blocking – disease in our bodies.

The more positive information that our cells receive from our choices in nutrition and lifestyle, the better our cells respond, and the less likely we will incur disease that we may be predisposed to in our DNA. Many of my patients are worried that they will develop a particular disease because it runs in their family. But more and more we are understanding how to stop these disease pathways before they start.

Hormones, resveratrol, and calorie restriction

There has been much in the media about celebrities using bioidentical hormones to prevent aging, such as the human growth hormone, and the reports have been positive. But there is controversy around this method, because we don’t really know the long term effects of using any type of hormone – synthetic or bioidentical – as a way to stay young.

Resveratrol is a potent antioxidant compound found in plants, especially the seeds and skin of red grapes (and hence red wine). In 2003, scientists discovered that resveratrol could extend the lifespan of fruit flies and yeast. They are now considering the effects of it in mice, which will lead to clues about how it may act in humans. There is still a lot of work to be done around this particular methodology, but the thought is that resveratrol may reduce the risk for diseases of aging, not necessarily stop the aging process. Some of the positive effects include protecting cardiovascular health, inhibiting cancerous cells, protecting against neurological disorders, and promoting healthy metabolism.

Calorie restriction is another mechanism long debated as a way to reduce the risk of disease and lengthen longevity. It is not clear how caloric-restriction really works, or how people can commit to this regimen successfully, and in fact, it could even backfire. Blackburn discovered in her research that women who yo-yo diet, or go on and off diet plans as opposed to making long term lifestyle choices, have shorter, no longer telomeres. The psychological stress of yo-yo dieting alone places stress on the body.

Recent research on both soy and resveratrol shows similar results to calorie restriction, without severe side effects, like feeling hungry.

What we can do right now

While science is working to uncover some of the ways we can increase our healthy lifespan, numerous studies link simple lifestyle changes to longevity. Eating a nutritiously-balanced diet, absorbing plenty of the right micronutrients, adding a quality multivitamin, reducing chronic stress, and getting plenty of sleep, can actually help telomere length. These non-medical, nonsurgical approaches are not only manageable, but prove successful.

These are just some of the things we have been telling our patients for years. A natural approach to health is always appropriate, and will certainly enhance rather than detract from our wellbeing. Here are a few ways to feel stronger, healthier, and beautiful as we age:

Eat a balanced diet rich in antioxidants and low in refined carbohydrates, unhealthy fats, and processed foods.
Feed your cells the nutrient-rich information found in fruits, vegetables, nuts, legumes, healthy oils, and unrefined grains. The messages your cells receive from a cupcake are very different from those of a plate of greens drizzled with olive oil and lime juice.
Take a top-quality multivitamin, an omega-3 supplement, and consider extra vitamin D.
Preserve the length of your telomeres and the ability of your cells to divide by providing antioxidant-rich vitamins and the anti-inflammatory effects of omega-3s. Finding a quality multivitamin and omega-3 supplement not only can do wonders for your energy now, but will pay off in the future.
Exercise in a way that replenishes rather than drains you.

The benefits of exercise to aging have been well documented. The key is to find something you look forward to rather than something you avoid or even dread. It only takes a tiny spark of motivation to get started, and a tiny spark to keep going, so exercising becomes a habit you will find you can’t live without!

Explore ways to decrease chronic stress

There’s no doubt that chronic stress is one of the biggest health problems we face today. It contributes to inflammation and increases everyday “wear and tear” on our bodies. Make an honest effort to set aside time each day to lower your stress levels. You might try meditation, yoga, massage, or simply eliminating some unnecessary responsibility on your to-do list.

While the biology behind the aging process is complicated, the steps we can take each day to age gracefully are simple. Understanding how our body’s age is helpful, but if we maintain a lifestyle that supports healthy cell functioning, we won’t have to worry about what our cells are doing, we can just enjoy vibrant health at any age.

Weight Loss and Adrenal Stress

womentowomen on January 1, 2014

by Marcelle Pick, OB/GYN NP

We go through periods of time in our lives when the demands are greater and the stress load is heavier. Regardless of the reasons – illness, relationship difficulties, work struggles, caring for an aging parent or ailing child – there can be a physical impact. We may turn to food for comfort, or we may not nourish ourselves adequately. During times of stress there are actual physiological changes that happen in our bodies, one of which is weight gain. It may not happen overnight, but if we do not pay attention to our body’s needs, over time we may notice we are putting on the pounds.

Our adrenal glands govern our stress response, by secreting hormones relative to our stress levels. They actually help control many hormonal cycles and functions in our body. When the adrenal glands are overworked, the body prepares for disaster, by storing fat and calories. We crave foods, we lose precious energy, and we gain weight. So how can we keep the heavier stress load from equaling heavier bodies?

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How stress becomes physical

For millions of years, humans were forced to protect themselves from environmental factors. From the earliest days of dinosaurs and cavemen, nature has proven its ability to put fear in human beings. Life and death circumstances have evolved around the ability to understand danger, and seek protection and survival. If you were being chased by a predator, your adrenal glands initiated a “fight or flight” response, releasing adrenaline and cortisol into the body. These hormones provided extra physical energy and strength from stored carbohydrates and fats.

While most of our stressors are not the same a our earliest ancestors, the body’s natural course of evolution has maintained this original fight-or-flight stress response. But whether we are being physically threatened or not, with any increased stress our body looks to its stored fuel, and then replenishes it when used. Also, with increased levels of cortisol, our body also does not respond as well to leptin, the hormone that makes us feel full, so we eat more.

Modern-day stress may be more psychological than physiological, but it is also more constant. Many of us face chronic stress as a way of life, which means we have consistently elevated levels of cortisol. Now the body thinks it continually needs extra fuel, and typically stores that as fat around the abdomen, or as it’s commonly referred to, the old “spare tire.”

Belly fat: a common sign of adrenal fatigue

Adrenal imbalance causes a number of issues, including an expanded waistline. The science behind it is quite interesting. Normally when we feel begin to feel hungry, our blood sugar drops and the brain sends a message to the adrenal glands to release cortisol. Cortisol activates glucose, fats, and amino acids to keep our body fueled with energy until we eat. Cortisol maintains blood sugar levels, and insulin helps our cells absorb glucose. When we have longterm stress, both insulin and cortisol remain elevated in the blood, and the extra glucose is stored as fat–mostly in the abdomen.

Here’s where it gets interesting. Scientists have discovered that fat cells actually have special receptors for the stress hormone cortisol, and there are more of these receptors in our abdominal fat cells than anywhere else in our bodies! In addition, scientists have shown that belly fat is actually an active tissue, acting as an endocrine organ that responds to the stress response by actually welcoming more fat to be deposited! This is an ongoing cycle until we take steps to correct this adrenal imbalance. How do we do that?

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Adrenal Dysfunction

womentowomen on January 1, 2014

by Marcelle Pick, OB/GYN NP

So many women come to see me suffering from overwhelming fatigue, sleep disruptions, fuzzy thinking, and irritability, inability to cope with stress, recurrent infections and low libido. Many women have seen healthcare practitioner after healthcare practitioner only to be told that there’s nothing that can be done to make them feel better. Many health care practitioners don’t acknowledge adrenal dysfunction.

Adrenal fatigue is recognized in many parts of the world, here in the US there has been much skepticism in the conventional medical world. Man physicians seem to want to point to other health issues such as hypothyroidism, depression and fibromyalgia which can cause similar symptoms to adrenal dysfunction.

Testing that conventional doctors use look only at the very extremes of adrenal imbalance. These two extremes – Cushing’s syndrome in which the body produces excessive levels of cortisol, and Addison’s disease which occurs when cortisol production is deficient- both require immediate medical intervention.

Unfortunately, many times if you your test results don’t fall within the specific test limits, its likely that you’ll be told your adrenal function is normal – even if you are very close. Sadly, sometimes credence isn’t given to the way a patient feels which can be a strong indicator of what is really going on.

In my practice, I find that saliva tests for adrenal function are more accurate. Women who come to me with symptoms of adrenal imbalance are tested to evaluate cortisol and DHEA levels and other metabolic tests to insure that there are no other health concerns present.

Out of the thousands of patients seen at Women to Women in the course of a year, less than 25% have cortisol levels which are consistent with healthy adrenal function. A resounding 75% plus have impaired function.

Tired of waking every morning tired? Or feeling the need for a nap by mid day? Its time to take back your life! Women to Women has the solution for you! Take our easy quiz to determine which product will best help you with your individual systems — and order today! Let this be one of the last days that you feel tired instead of energized!

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Insulin Resistance In Women

womentowomen on December 31, 2013

by Marcelle Pick, OB/GYN NP

Insulin resistance is so pervasive today that we evaluate nearly every woman who visits our clinic to determine her level of risk. Most are taken aback when they learn they either already have the condition or are well on their way to developing it. Experts estimate that 25% of all Americans suffer from insulin resistance. We believe the percentage is much higher among perimenopausal women.

The health effects of insulin resistance — also called Syndrome X — are dramatic. Besides leading directly to diabetes, it’s been implicated in heart disease, breast cancer, Alzheimer’s, polycystic ovarian syndrome (PCOS) and many more diseases. It also often accompanies, and contributes to, related problems of hormonal imbalance such as adrenal fatigue.

Because insulin is one of the “major” hormones, it’s also impossible for your body to balance its “minor” hormones (estrogen, progesterone and testosterone among them) until your insulin metabolism is balanced first. To put it simply, if you have hot flashes and you are insulin resistant, it’s going to be nearly impossible to cure the hot flashes without first healing the insulin resistance.

The good news is that you can heal insulin resistance. This has been a primary focus of our practice at Women to Women for over a decade, and our approach has been quite successful. Let’s explore our methods and how they might help you.

Why all the concern about insulin resistance?

Over 80 million Americans suffer from insulin resistance, and it appears to sit at the center of a web of related health problems. Women who are insulin resistant are at much greater risk of obesity, diabetes, hypertension (high blood pressure), heart disease, high cholesterol, breast cancer and polycystic ovarian syndrome (PCOS). There is some evidence that insulin resistance may contribute to endometrial cancer. It’s also been implicated in Alzheimer’s disease.

Insulin resistance often accompanies the most common complaints we hear at Women to Women — fatigue and weight gain. As women approach menopause, they become increasingly intolerant of carbohydrates and find it easier to gain weight, especially around their waists. Afternoon blahs, sugar crashes and carbohydrate cravings may all be early symptoms of insulin sensitivity.

Insulin sensitivity – the way it should work

All of the food we eat – fats, proteins and carbohydrates — is broken down during digestion into proteins, micronutrients and glucose. The body uses the proteins and nutrients in cellular metabolism, immune function, and cell replacement. The body uses glucose as its basic fuel, which is carried by the bloodstream to individual cells.

Our demand for fuel varies from moment to moment, but the brain needs our blood sugar level to remain stable. So getting the cells the energy they need without changing that level is a critical function — and that’s the role that insulin plays. Insulin signals the cells to absorb glucose from the bloodstream. The body monitors what we’ve digested, blood sugar levels, and cell demands, and releases insulin in just the right amounts. That’s why a healthy body is described as “insulin sensitive”.

How insulin resistance develops

Our metabolism evolved eons ago, when our diet included fewer and more complex carbohydrates. Today most calories in an average diet come in the form of carbohydrates, and most of those are simple carbohydrates — sugars that quickly enter the bloodstream. The body has to release high levels of insulin to keep the level of glucose in the bloodstream from spiraling out of control. But in time the cells quit responding to this signal. At this point the body is “insulin resistant”.

One immediate consequence is that the body is forced to release even more insulin. Letting blood sugar get too high is simply not acceptable. But the body wasn’t designed for these prolonged high levels of insulin, which disrupt cellular metabolism and spread inflammation. Diabetes occurs when the body fails to keep blood glucose under control. But as we have noted, that is only the most obvious of the diseases caused by insulin resistance. There are many negative health effects before full-blown diabetes.

Insulin resistance and menopause

Of special concern to women is how insulin resistance disrupts fat metabolism. When the cells won’t absorb the extra glucose, the liver has to convert it into fat. Fat cells are loaded with glucose receptors, so this is a vicious cycle. Ironically, while the insulin-resistant woman is gaining weight, her cells are actually “starved” for glucose, so she feels exhausted and tends to eat carbohydrate-heavy foods in search of energy.

These extra fat cells are also little estrogen factories. That contributes to the estrogen dominance that causes so many symptoms during the early stages of perimenopause.

Symptoms relating to insulin resistance usually predate the onset of menopause, but most women do not complain of them until then. Women’s health can deteriorate rapidly during menopause with the decrease of estrogen stores in the body. Digestive issues that were once a hassle become an affliction when the body’s natural defenses against inflammation (estrogen being one) are depleted.

In addition, women approaching menopause are particularly prone to insulin resistance due to metabolic changes related to fluctuations in adrenal and thyroid secretions. In fact, the decrease of certain hormones, like estradiol, may trigger a sensitivity to insulin in patients that had never experienced it before. Certain blood pressure medications can mask symptoms without treating the problem. Frequently, women unwittingly exacerbate their condition by fighting weight gain with low-fat, high-carbohydrate diets.

How do I know if I’m insulin resistant?

The unfortunate truth is that anyone can become insulin resistant even if they are thin. We are all at risk in our in our society where we have access to a lot of refined carbohydrates (white bread, sugar, bagels, pasta, potatoes, Coke/Pepsi, processed foods with added fructose, etc.). In fact, most of us are likely to be somewhat sensitive to insulin. It is just a matter of degree. The more processed and refined food that we eat, the more insulin we require to metabolize it. The more insulin in our blood, the less responsive our cells become. As we age, this continual exposure wears out our tolerance for refined carbohydrates and reduces our sensitivity to insulin.

If you suffer from high cholesterol, high triglycerides, and hypertension, you should get checked for insulin resistance, regardless of your weight or age. If you have high blood pressure, it is likely that you are also suffering from insulin resistance. High blood pressure medication will not cure insulin resistance.

The greatest risk factors for Syndrome X

You are at the highest risk for developing this condition if you have a family history of Type 2 Diabetes or if you have suffered from gestational diabetes, hypertension, or are seriously overweight.

Apple-shaped women, or those who tend to gain most of their weight around their abdomen, show less tolerance for insulin. To assess your risk, measure yourself around the smallest part of your waist (don’t hold your stomach in!) and the biggest part of your hips. Divide the waist measurement by the hip measurement. A ratio bigger than 0.8 for women (or 1.0 for men) indicates that your abdomen is obese and you are at risk for developing insulin resistance.

Women with dyslipidemia, especially those with low HDL levels and high triglycerides, may also be resistant. I tend to look at the ratio of HDL to triglycerides. If I can divide the triglyceride count by the HDL count and get a three or more, I immediately suspect insulin resistance. A skin change called acanthosis nigricans, which is warty-like darkened patches of skin at the neck and armpits, indicates insulin resistance in over 90% of the women who experience it. The good news is that insulin and glucose levels are very easily influenced by changes in lifestyle, exercise, and diet. If you are diagnosed with insulin resistance, there is a lot you can do to reverse its course.

Bringing insulin into check

At Women to Women, we understand that insulin resistance may be an underlying factor in a range of health problems. Before designing a patient’s plan, we always take into consideration this possibility. Our goal at Women to Women is to enable all our patients to feel energetic, lively, attractive, passionate, and excited for years to come, as opposed to feeling lethargic, irritable, and hormonally imbalanced. Thankfully, we have discovered that a lot that can be done to decrease a patient’s insulin sensitivity and bring their hormones back into natural balance.

When we evaluate a patient for insulin resistance, we recommend a blood test for glucose and insulin levels after fasting for 12 hours and then again two hours after a meal (preferably a high-carbohydrate meal). On the fasting tests, we hope to see glucose levels of no more than 75-80 and insulin of less than 14; higher levels indicate a risk of insulin resistance. Increased triglycerides make me suspicious too. We also take into account the patient’s lifestyle, diet and exercise patterns, and stress factors. All of this can be changed with diet and lifestyle modifications.

Talk to your primary care provider about being tested if you feel you are at risk. Many younger practitioners are familiar with the concept of insulin resistance, as it is now being taught in medical school. Unfortunately old-school physicians may still be unaware of its importance.

Healthy habits

If a patient presents with insulin sensitivity, I recommend a reevaluation in their diet and exercise habits. I encourage all of my patients to shop the outside aisles of the supermarket, and to studiously avoid the inner rows of processed food, sugar cereals, high-sodium snacks and soda.

A diet that consists primarily of lean meats and dairy; high-fiber grains, vegetables and legumes; leafy greens; and fruit will substantially aid the body’s ability to balance insulin levels. If a patient is already insulin resistant, I recommend a meal plan consisting of breakfast, lunch, dinner, and two snacks. Each meal should have 15 grams of carbohydrates in the form of vegetables and fruits (and prohibiting “white” food such as bread, pasta, and sugar) and some lean protein. Each snack should contain only 7 grams of similar carbohydrates. Healthy fats, or those rich in essential fatty acids (EFAs), are also important. EFAs can be found in avocados, cold-water fish like salmon and tuna, flax seed, and eggs.

I also recommend a pharmaceutical-grade nutrient plan which can help decrease carbohydrate and sugar cravings, but also helps normalize the hormonal function in menopausal and perimenopausal patients.

Regular exercise of 30 minutes or more per day, 3-5 times a week is also beneficial for regulating metabolic function and hormonal balance. Decreasing stress, thereby lessening strain on the adrenal glands will result in better overall health and contribute to keeping the body’s insulin levels in check. Stopping smoking, moderating alcohol intake and proper sleeping habits will help to alleviate chemical blood surges, which in turn will promote a thriving, well-balanced body.

Hopefully the picture that’s emerging is that your body’s hormonal balance is like a symphony. Insulin is one of the loudest and most important instruments. When its metabolism goes wrong, it throws off everything else. We’ve seen over and over that women with menopause symptoms must reverse their insulin resistance in order to find relief. The good news is that it can be done, and our job is to help you understand what needs to be done and then you can do just that.

Is Stress Affecting Your Memory?

womentowomen on December 31, 2013

by Marcelle Pick, OB/GYN NP

I talk with almost every patient about stress. Most of our patients report having moderate to high stress levels. Some are surprised when our discussions lead to the conclusion that they are actually experiencing chronic stress. When this happens, our adrenal glands secrete cortisol too frequently.

The symptoms associated with memory and cognition makes many women fearful. Many women breathe a sigh of relief when I share with them that the most common cause for changes in brain function is stress.

Chronic stress from trauma, your job, a difficult relationship – or any situation which causes you stress – can have effect on your brain. These are:

Disruption in the production of neurotransmitters. Neurotransmitters help regulate cognitive function and our moods.
Changes at a cellular level in the hippocampus – this is the part of the brain that controls memory and learning.
Decreased ability to clean up inflammation and free radicals which can lead to accelerated brain aging.

It’s evident that decreasing your stress will affect your memory and cognition in a positive way. We know that women today are dealing with more stress than ever before – more responsibilities, higher expectations, less time and managing a constant flow of information. We all have different ways to cope with and manage stress. You may want to consider making a list or keeping a journal of the situations that cause you the most stress. Once you’ve written things down, it may be easier to think about solutions.

Eating regularly will keep your blood sugar stable which keeps your brain functioning efficiently. Eating three meals and two snacks per day will keep your brain fueled for learning, paying attention and remembering! Be sure to include lean protein, carbohydrates and good quality fats every time you eat.

Sleep is critical for good brain function. Most adults need seven to nine hours sleep per night. There are wonderful herbs to help you fall asleep and stay asleep. Passionflower, valerian root and chamomile can all be helpful.

Exercise mindfully. While the benefits of exercise cannot be debated for overall health, if exercise is causing stress, you may want to rethink how, where and why you are exercising. Try to find a form of exercise you enjoy, and ones which fit into your lifestyle – both time and location might be important.

When your body is under stress, there may be a gap in its nutritional demands and the nutrients you take in through your diet. Please consider taking a high quality multivitamin and omega-3 supplement (Women to Women has specially formulated products to offer). Even without the additional demands stress places on our bodies, it can be difficult to take in the nutrients we need. A body – and brain – under stress needs more.

Take time several times a day to breathe – deeply and mindfully. Deep breathing in through your nose can engage your parasympathetic nervous system which may help keep your brain calm.

You may want to consider herbal support to help decrease the impact of stress on your brain and body. Siberian ginseng, astragulus root, cordyceps, and rhodiola are all good choices.

Addressing stress on every level will help restore the balance you need.

For more information on this topic, read our article, “Am I Losing My Mind? What You Can Do About Fuzzy Thinking.”

Digestion And Dysbiosis

womentowomen on December 31, 2013

by Marcelle Pick, OB-GYN, NP

The major function of the digestive system is to break down food and provide a means by which the nutrients can be absorbed in the body. Nutrients that are liberated by this process allow the body to grow, heal and function on a day-to-day basis.

Unfortunately it is very common for this process to be disrupted (known as dysbiosis). A wide range of factors can influence how well the digestive system function — including dietary habits, medications, and emotional wellness — and most people are affected by at least one of these factors. In fact, an estimated two-thirds of women suffer from gastrointestinal problems, which often lead to malabsorption.

What makes this so important is that much of your health is riding on your body’s ability to absorb nutrients. Healing the GI tract and ensuring that the digestive system is functioning properly is a necessary first step to reaping the benefits of good nutrition.

So let’s take a look at how a healthy digestive system works, and how this delicate process can be disrupted. This is the first step towards improving your digestive health.

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The healthy digestive system

Digestion begins in the mouth, where the teeth break up food and mix it with saliva. Salivary enzymes initiate the breakdown of food into usable forms, particularly the initial digestion of fat and starch.

The stomach mechanically churns food, breaks up and emulsifies fat, and exposes the molecules to multiple enzymes such as hydrochloric acid and pancreatic juices.

The resulting semi-digested slurry is passed from the stomach to the small intestine, whose membranous surface could cover a football field if stretched flat. The small intestine is filled with billions of bacteria (some three and a half pounds — equal in size and functional importance to a major organ) some friendly, some not. Friendly bacteria promote good health and protect the body from the unfriendly bacteria.

Needless to say, a number of factors may go awry. Because the intestinal tract plays a key part in nutrient absorption, any problem there can affect the function of the entire body and our overall health.

Dysbiosis

When the intestines contain the balance of good and bad bacteria that is optimal for good health, they are described as being in a state of symbiosis. Alternatively, dysbiosis (a contraction of the term “dys-symbiosis ”) occurs when this balance is upset. Dysbiosis can result from a deficiency of good bacteria or an overgrowth of harmful organisms. In either case, organisms that are not usually predominant in the intestines, such as unfriendly bacteria, yeast (candida) and protozoa, actually induce disease by altering nutrition patterns in the body.

Dr. Leo Galland and a number of others believe, as I do, that optimal health requires that the intestinal flora maintain a healthy balance between allowing the more than 400 organisms that usually reside there and preventing the overgrowth of any particular one.

Signs and symptoms of dysbiosis, malabsorption and other GI problems

When the digestive system is out of balance, the following symptoms may occur:

Bloating, belching, burning, flatulence after meals
A sense of fullness after eating
Indigestion, diarrhea, constipation
Systemic reactions after eating
Nausea or diarrhea after taking supplements
Rectal itching
Weak or cracked finger nails
Dilated capillaries in the cheeks and nose in the non-alcoholic
Post-adolescent acne or other skin irritations such as rosacea
Iron deficiency
Chronic intestinal infections, parasites, yeast, unfriendly bacteria
Undigested food in the stool
Greasy stools
Skin that’s easily bruised
Fatigue
Amenorrhea (absence of menstruation)
Chronic vaginitis (vaginal irritation)

Some authors have speculated that other symptoms, such as impotence, loss of libido, infertility, muscle atrophy, cramps and joint pain, are also linked to malabsorption. A fair amount of research supports this connection.

What are the major causes of intestinal dysbiosis?

The delicate balance that makes up the ecology of the intestines can be disrupted fairly easily. Here are some of the most common factors that contribute to dysbiosis.

Stress
Diets that are quite poor or imbalanced and lacking nutritional supplementation; imbalanced diets may be extreme in carbohydrates, fat, or animal products
Food allergies or sensitivities (these may in turn be a byproduct of dysbiosis)
Frequent antibiotic or drug therapy
An immune system that is suppressed; this can occur for a number of reasons, including emotional stress
Intestinal infections
Parasite infestation
Inflammation

It’s important to emphasize that if our intestinal tract were balanced, infestation would rarely occur — even if we were exposed to parasites — as the immune system would work naturally to keep the parasite population under control and in balance. However, eating spoiled or heavily infested food will make even a healthy system sick.

Like your hormones, the flora in your digestive system are easily prone to upset and disruption by external sources. This is where stress, self-criticism, and anxiety come into play by changing the pH level (the acid/alkaline balance) in your intestines. The intestinal tract is noticeably one of the first areas of the body to react to fear or personal stress (think of the nausea and/or loose-bowel feeling that can accompany stage fright). In a balanced system, once the stress is reduced, the pH straightens out and symptoms may disappear. In a weakened system, such as occurs under unrelenting stress, the intestines stay irritated and contribute to chronic discomfort.

Why are women more prone than men to GI distress?

In the United States and other Western cultures, women are two to three times more likely to seek out medical help for digestive disorders than men. There is still a lot of research to be done on this topic, but preliminary data suggest that ovarian hormones (estrogen and progesterone) influence digestion.

Most of us are familiar with the bloated feeling that may occur around our period. Some of this feeling may be attributed to how slowly our stomach and intestines empty during the last two weeks of the cycle compared to the first two weeks. Research points to the fact that transit time slows significantly during the last two weeks of a woman’s monthly cycle (the luteal phase) with a marked rise in digestive complaints right before a period starts. Post menopausal women often see a similar delay. Based on this information, it appears that a decline in ovarian hormones is strongly linked to a rise in symptoms of GI distress.

Next steps

Healing your digestive system is one of the simplest ways to see big improvements in your health — and there are many steps you can take on your own to get started.

Can Your Thyroid Be Affected By Stress?

womentowomen on December 31, 2013

by Marcelle Pick, OB/GYN NP

The brain controls both the adrenal and thyroid glands
How stress affects your thyroid gland
Tips for improving thyroid and adrenal health

As a female practitioner of functional medicine, I began to notice patterns among my patients linking stress to various physical disorders. Although this is a recognized occurrence in medicine now, it was not often explored in earlier medical training. I knew about it, but it became quite clear years ago in my clinical practice, especially in my patients with thyroid dysfunction. There is a very strong connection between a woman’s stress response and her thyroid function — we just haven’t always considered it.

We all know chronic stress has a negative impact on our bodies, we just don’t always know how to fix it. Long term stress leads to elevated stress hormones produced by the adrenal glands, and our bodies respond with inflammation, disorders, and disease. So how do we change our lives to reduce this pattern, or more importantly, stop the cycle?

Over the years I have learned how to help women improve their thyroid function by reducing stress without drugs or other medical interventions. It’s exciting to know that we can help ourselves naturally, and utilize effective tools to balance our hormones. First, let’s look at the physical components and how our adrenal and thyroid glands impact one another.

Adrenal and thyroid functioning

Simply put, hormones are released to carry messages to and from different parts of the body. Different glands produce different hormones. The thyroid produces specific hormones to direct cells to produce proteins and to burn energy. The adrenal glands produce hormones to help regulate stress and how we respond to it. Both of these glands work to protect our endocrine system, or our larger hormone-producing mechanism. The adrenal and thyroid glands work together responding to our body’s continually-changing conditions, and relaying information between the brain and the body.

The way these glands are signaled to release their hormones begins in the hypothalamus, an area of the brain that sends hormonal messages to the pituitary gland. This gland sends messages to the adrenal and thyroid glands, which then produce specific hormones, and send that feedback to the brain. This is referred to as a negative-feedback loop called the hypothalamic–pituitary–thyroid–adrenal axis (HPTA).

For the thyroid to function optimally, it needs the right amount of stress hormone, or cortisol. Because the hormones interact along their respective loops, when an imbalance occurs along the HPTA axis, it will result in either overactive, or under active glands. The trouble is there is a range in which this functioning is measured in lab tests, so even if your thyroid is not functioning normally, it may still appear within the “normal limits.” So what exactly does this mean?

Thyroid symptoms and stress

When any kind of stress cues the brain, it releases corticotrophin-releasing hormone (CRH) which tells the pituitary gland to signal the adrenal glands to make cortisol. But both CRH and cortisol can suppress the thyroid-stimulating hormone (TSH), as well as impact the conversion of the T4 thyroid hormone into T3. Every, single cell in the body uses T3, so a decrease in that can cause an array of symptoms, from weight gain, fatigue, hair loss, and poor concentration, to cold intolerance, depression, and infertility.

Most medical literature correlates stress-induced thyroid dysfunction to overactive thyroids, noted frequently in hyperthyroidism, and a condition called Graves’ disease. This condition is marked by an autoimmune response causing the thyroid to make too much thyroid hormone, especially after a sudden, stressful change in life circumstances. It’s not uncommon to lose weight for a short period after experiencing major events like divorce or a death in the family due to too much thyroid hormone. But excessive stress can also lead to another condition called hypothyroidism, when the thyroid slows down its hormone production. Either condition can create problems.

With chronic stress, either process can actually go on for years in your body, unnoticed, before you start to have symptoms reflecting the imbalance. Sometimes it’s called subclinical hypothyroidism, when lab results appear within the normal range, but patients are still experiencing symptoms. The good news is that we can change our stress-response, and regulate the loops along the HPTA axis.

How to break the stress-thyroid connection

Nourish yourself. Eat three well-balanced and two healthy snacks each day that include high-quality protein. Breakfast is especially important to help regulate blood sugar and hormone production. Reducing sugar and caffeine intake is important to help combat stress. Also, enjoying meals in a relaxed setting and eating slowly can help digestion and metabolization of important nutrients.

Add vitamins and supplements. There are many important elements to healthy thyroid functioning. Iodine, Selenium, zinc, copper, iron, and vitamins A, B, C, and E all play crucial roles in the production and maintenance of thyroid hormones. High-quality multi-vitamin and mineral supplements can help support the necessary balance.

Get enough sleep. Sleep is an amazing way to restore and rejuvenate our bodies and our minds. When we have the right amount of sleep, our bodies will regulate and reset our neuroendocrine system to help promote hormonal balance, and also help us face the next day’s challenges. Especially important is adequate downtime before bed, so that our adrenal glands slow down the stress response and rest as well.

Relax. There are many ways to counter daily stress and help our bodies and minds relax. Options include deep breathing exercises, yoga, meditation, walking, or simple exercise. Too much exercise can actually stimulate our adrenal glands as opposed to relaxing them, so moderation is key. Be sure you find a few methods you enjoy, so that you can commit to a daily relaxation regime.

Think about therapy. Making emotional changes can be very difficult. Sometimes we are so entrenched in certain negative patterns that we not only cannot get out of them ourselves, but also may not even recognize it. Exploring both positive and negative patterns in our lives can help us break the stress responses that over time can lead to physical distress and disorders. With training in both functional medicine and psychology, I always try to help women connect the dots between their health and their emotions, and recommend ways to do it. Many of my patients have success with both the Emotional Freedom Technique and the Hoffman Quadrinity Process as avenues to healing.

Our lives are busy and stressful, and we can’t just remove stress from our lives. But we can try to support ourselves both physically and emotionally not just during stressful times, but on a daily basis. When we nurture and care for ourselves, we can manage the waves of stress with more ease. If you think you have a thyroid imbalance, or have a family history of thyroid dysfunction, remember you and your health practitioner can work with these natural methods to help repair the problem. Even with small steps, you can make big strides towards a very healthy outcome.

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Caffeine Withdrawal – Doing It With Ease

womentowomen on December 30, 2013

by Marcelle Pick, OB/GYN NP

For many women, it may be easier to detox from caffeine a little at a time. Many times I will recommend a tapering method for my patients. It looks like this: first have a regular cup of coffee, then for your second serving, have a cup that’s half-regular and half-decaffeinated coffee. Any ratio will work – the withdrawal process will be easier on your body if you are methodical.

If you’ve never attempted to cut back on your caffeine consumption, you may not be aware of withdrawal symptoms. They can include fatigue, inability to focus, irritability, depression, sluggishness, daytime drowsiness and the most common of all headaches. Most who suffer from a ‘caffeine headache’ will report a throbbing, pressure filled headache.

If you drink caffeine throughout the day, you may want to consider limiting caffeine to the morning hours. Morning intake is less likely to interfere with your normal cortisol pattern – and therefore less likely to interfere with sleep.

A great tip for cutting down on caffeine is to drink a big glass of water or a cup of herbal tea, before you take in any caffeine. Eat your breakfast as soon as possible, – be sure to include adequate protein. If you still want your usual caffeinated drink have it! If a second cup is needed, start your taper.

Some people may notice a change in bowel function during this caffeine transition period. Dietary fiber encourages bowel function, which sometimes slows down during caffeine withdrawal. Fiber promotes good bacterial balance in the digestive tract.

Your liver is responsible for breaking caffeine down for elimination from your body. I recommend my patients support their liver with nutritional supplement to help it through this detox process.

The supplements I recommend are:

Vitamin C (which supports adrenal function and helps with withdrawal symptoms)
Milk Thistle
Tracel Minerals
Magnesium
Calcium
Potassium
Zinc
Amino Acids
N-acetyl cysteine
B Vitamins

You can also help support your liver by eliminating toxins or allergens from your diet. Be sure to eat enough protein. Follow an alkaline diet – this is helpful because it provides antioxidants which help with detoxification.

May of my patients who are considering removing caffeine from their diet, express concerns that they might ‘lose their edge” or not be able to ‘stay alert’ throughout the day. If you are having these same concerns, please remember that our bodies and minds are not designed to be ‘on’ 24 hours a day, 7 days a week. Our bodies need rest to rebuild and re-energize.

Set Point Weight – Fact Or Fiction?

womentowomen on December 30, 2013

by Marcelle Pick, OB/GYN NP

We all know that our hair color, eye color, freckles and personality traits and more are inherited from our parents. Could this be true about our weight? Scientists long believed that set point – which is our body to fat ratio within a 10-15 pound weight range – was inherited. It’s also important to remember that our bodies like stability – so our metabolisms may speed up or slow down as we move to the outer limits of our set point weight.

Over the past twenty years, new studies are showing that set point isn’t entirely unchanging and predestined. In 2010, German scientists published an article stating “Searching for the genetic background of excess weight gain in a world of abundance is misleading since the possible biological control is widely overshadowed by the effect of the environment.” And here’s the good news – environment includes our eating habits and lifestyle choices.

Nutrigenomics is a new and emerging field of research that investigates the effects nutrients has on our genes in both disease and health scenarios. Finally! There’s research which is showing how our food intake affects us! Your food choice not only talks to your jeans…but your GENES. The information our genes receive from our food can be a powerful influence on them to respond in ways that promote good health and potentially prevent disease.

Our genes receive messages from our nutritional choices and also our pattern of emotions. Creating a food plan full of nutrient rich foods from all food groups is a good first step. Limiting processed foods, sugar and gluten which are known inflammatory creating substances and eating regularly to keep blood sugar stable all send good messages.

Dr. Candace Pert, author of The Molecules of Emotion, talks about the sources of negative emotions to reduce the flow of negative messages being sent to our genes and cells. Trauma from our past can be a source of daily sadness and anger. With awareness, these messages can be changed. I’ve seen women have remarkable changes when they are.

Influencing your set point doesn’t happen all at once. Insuring that your nutritional needs are met, your emotional health is recognized, your stress levels are addressed as well as maintaining healthy stress levels will all help create the balance needed.

Read more in-depth about this topic in our article, “Reprogram Your Genes And Cells For Healthy Weight.”

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Five Women’s Health Myths

womentowomen on December 30, 2013

by Marcelle Pick, OB/GYN NP

These days we are so inundated with media messages – fat is good, fat is bad – eat more, more – exercise more, exercise less – eat grapefruit – eat all you want! No wonder women everywhere are confused!

In order to make good health choices, we need good information – not the flood of information that comes in piecemeal to use over the internet, on a magazine cover or in an infomercial.

Below I’ve chosen the top five myths I hear from my patients –

1. Women don’t need multivitamins if they eat well

Ideally we would get all the nutrients we need from the foods we choose – but unfortunately that just isn’t the case in today’s world. Current farming practices and packaging methods offer deplete nutrients from our foods. When you couple that with the choices some women have to make given location, convenience, knowledge base and finance, it’s no wonder that women aren’t able to take in the nutrients we need. What’s more, our bodies are constantly being inundated with toxins and free radicals – in ways in which we are sometimes unaware or helpless to control. Additional support is needed to help our bodies detoxify heavier and heavier toxic burdens. The better you can support your body’s nutritional needs, the better chance you have of keeping your body in balance!

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2. As you age, sex drive decreases

Its very true that as women approach menopause, all three of the major sex hormones – progesterone, estrogen and testosterone may shift out of balance. Testosterone is the hormone primarily related to libido – so if you are experiencing those hormonal shifts your sex drive may be impacted. The great news is that there are simple and easy ways to bring your hormones back into balance and regain your sex drive!

In talking with my patients, I’ve discovered that many women experience physical problems related to sex such a vaginal dryness or pain. These, too can be addressed with a health care practitioner. The more difficult issues to address are those around our emotions about sex. Some women may feel unattractive due to mood swings or hot flashes, others may feel distanced from their partners and for some, sex has grown to feel like more of a an obligation than a time of sharing and pleasure.

The issue of sex drive can be a complicated one – for women, sex is much more than a physical connection – it’s more of an emotional connection. It’s well known that a woman’s sexual desire is connected to her own sensuality.

There are several factors which can affect sex drive – the great news is not of these situations is permanent! Sexual desire can be rekindled – it may take some time and some investigation – but the end results can be so rewarding.

3. All women gain weight during menopause – and few every lose it.

It’s not uncommon for women to gain weight during the perimenopausal years – but this weight certainly doesn’t have to be a permanent weight gain – pounds which you will never be able to shed.

It’s important to remember that our bodies are biologically programmed to protect fertility. In the perimenopausal years as the ovaries decrease estrogen production, the body works to store more fat – fat cells can provide another source of estrogen. As ovarian function winds down, our adrenal glands start to produce small amounts of estrogen and other sex hormones. If our adrenals are compromised by chronic stress, more cortisol than we need may be produced affecting our delicate hormonal balance even more. It’s important to remember that our hormones are all interconnected –and explains why weight gain can be caused by imbalances in estrogen, progesterone, testosterone, insulin, cortisol, DHEA and hGH. All of these hormones work in symphony to regulate metabolism and weight.

4. To lose weight you should eat a low fat, low calorie diet.

Weight, and weight loss in particular, is a common, ongoing concern for many women. For some women, calorie reduction may definitely be the answer for weight loss, but in my years of experience, I’ve found it’s not what we eat, it’s how we metabolize our food.

Our bodies have evolved to metabolize food slowly, conserving fat to protect us against periods of starvation. In modern times, it would be unusual for women to suffer long bouts of starvation – but when we cut calories, our bodies are conditioned to slow our metabolism which makes it more difficult to lose weight.

I help women everyday understand how complex our bodies really are – that undiscovered unbalances can also affect metabolism. The most common imbalances are:

Insulin resistance
Thyroid imbalance
Toxic overload
Adrenal imbalances
Food sensitivities

All of these imbalances affect the way we metabolize food and store fat. Almost all the women I see as patients realize the best results when they take the time to investigate the underlying cause of weight gain.

Our bodies are designed to eat! Most of the women I see are not overeaters! They have underlying imbalances which need to be addressed.

5. Your body requires more sleep as you age.

Our sleep does seem to change as we age – but we don’t require less of it! Women need 7 to 9 hours of sleep per night – sleep is critical to help rebuild and restore. While we may not sleep as deeply or uninterrupted as we did in our 20’s and 30’s…our body’s need for sleep doesn’t change.

Many of my patients report disrupted sleep patterns. Cortisol can be a primary factor in keeping you awake when you want to fall asleep or waking you before you’d like! Evaluating and managing your stress levels are so important to your sleep cycle!

I encourage my patients to practice good sleep hygiene. Good sleep hygiene practices include:

Keep your room dark. Light blocking shades are helpful. Cover alarm clocks or electronics with LED lights.
Exercise early in the day.
Turn off all electronics one hour before bed.
Keep reading material light – disturbing books can affect your sleep!
Eat your last meal of the day several hours before bed.
Insure you bedroom is a comfortable temperature.

There’s certainly a lot of information coming to use about our health – I urge you to listen to your inner self. Listen to what feels right to you – investigate if you are interested – or disregard messages which don’t resonate with you. Use your inner wisdom to decide what is good for you.