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10 Tips to Treat PMS Naturally

PMS (premenstrual syndrome) sucks.  That’s not medical jargon, that’s just the way it is.  Once a month, up to three-quarters of women experience physical or emotional discomfort or pain which can last up to 14 days (two weeks!!).  Over 150 symptoms of PMS have been identified but the most common symptoms are:

Naturopathic treatment of PMS
There are over 150 symptoms associated with PMS
  • Decreased energy
  • Irritability, nervousness, anxiety and anger
  • Food cravings
  • Depression
  • Headache
  • Altered sex drive
  • Breast pain
  • Muscle aches and low back pain
  • Bloating
  • Diarrhea and/ or constipation
  • Swelling of the hands and feet
  • Trouble concentrating
  • Difficulty sleeping

What causes PMS?

Honestly, we don’t exactly know what causes PMS.   It’s most likely a combination of imbalances in our hormones, neurotransmitters and environment that leads to symptoms of PMS.

Balancing these diverse systems gives most women relief from their PMS symptoms.  It sometimes takes time to determine which treatment is right for you.  An experienced Naturopathic Doctor will be able to tailor an individualized plan to give you the best chance for success.

10 Tips to Treat PMS Naturally

1. Exercise

Exercise is important for your overall health, but it can also decrease symptoms of PMS.  Studies have shown again and again that women who engage in regular exercise have fewer PMS symptoms than women who do not.  And the exercise doesn’t need to be intense – it just needs to happen regularly (at least 3 times per week throughout the month).

Exercise is thought to reduce PMS symptoms by reducing estrogen levels, improving glucose tolerance and raising endorphin levels.  Aerobic exercise (swimming, cycling, running, etc), yoga or tai chi are all beneficial.

2.    Cut out sugar

Women who experience PMS have been reported to eat whopping 275% more refined sugar than women who do not get PMS symptoms.  Refined sugars deplete our magnesium levels, increase sodium and water retention and create imbalances in our insulin levels.  All of these processes have been linked to the development of PMS symptoms.

Eliminating refined sugar and limiting simple carbohydrates in favour of high fiber complex carbohydrates lowers blood levels of estrogen, improves magnesium levels and can significantly improve symptoms of PMS.   So cut out the cookies, cakes, bagels and breads in favour of oatmeal, popcorn, quinoa, brown rice and other fiber rich foods.

 3.    Eliminate caffeine

Caffeine consumption is associated with more and worse PMS symptoms.  Caffeine is linked especially to breast tenderness,anxiety, irritability and difficulty sleeping during PMS.  The impact is even worse when combined with sugar (pay attention all you Frappuccino drinkers!).  Eliminating caffeine, or limiting it during the premenstrual phase can improve PMS symptoms for a lot of women.

4.    Take a probiotic

Probiotics are not just for digestive health!  Having good bacteria in our intestines has wide ranging benefits for our health.  Healthy bacteria can decrease symptoms of PMS by increasing beta-glucuronidase enzyme activity and promoting estrogen excretion.

The best way to establish a healthy bacteria flora in your intestinal tract is to take a probiotic supplement.  Try for one with both Lactobacillus acidophilus and Bifidobacterium bifidum.  Taken with food, probiotics are extremely safe and have no negative side effects (you can experience bloating if you take too much – 1 to 10 billion is usually a safe amount).

 5.    Take a calcium and magnesium supplement

1k-7649 spinachThere is a direct relationship between calcium and estrogen.  Estrogen is involved in the absorption, metabolism and utilization of calcium in our bodies.  Clinical trials have found that both mood and physical symptoms of PMS are improved with daily calcium supplementation

Magnesium deficiency is a major concern and is seen in a majority of women with PMS.  Magnesium deficiency causes fatigue, irritability, mental confusion, menstrual cramps, insomnia, muscle aches and pains and heart beat irregularities.

Dietary sources of calcium include dark green leafy vegetables, dairy (cheese, yogurt, milk), tofu, and almonds.  Dietary sources of magnesium are similar and include green leafy vegetables, tofu, legumes, nuts, seeds and whole grains.  Calcium and magnesium supplements should be taken in the evening, away from iron supplements and thyroid medications.

6.    Take B vitamins

B vitamins are involved in hundreds of different processes in our bodies.  The liver uses various B vitamins to detoxify estrogen and allow our bodies to eliminate it.

Additionally, pyridoxine (vitamin B6) can ease symptoms of PMS by increasing production of the neurotransmitters serotonin and dopamine.  Low levels of these neurotransmitters have been suggested as a cause of many PMS symptoms including low energy, irritability and mood swings.

As if that wasn’t enough, B6 is also involved in transfer of magnesium into cells – without B6 magnesium wouldn’t be able to enter cells.  This is another reason why B vitamins, and especially B6 are so important in the relief of PMS symptoms.

7.    Dong Quai

Dong Quai (Angelica sinensis) is a traditional Chinese herb with thousands of years of use for imbalances in the female reproductive system.  It has been used for menopause, painful menstruation, no menstruation and as a uterine tonic.  Dong quai has phytoestrogenic properties and is best used for women who experience PMS symptoms in addition to painful menstruation.

 Dong quai is usually used from ovulation (day 14) until menstruation begins.  If you are also experiencing painful periods, continue it until your period stops.

 8.    Chaste tree

While best known as a treatment for menopause, chaste tree (Vitex agnus castus) is probably the single most important herb in the treatment of PMS.

The effects of chaste tree appear to be due to the impact it has on the hypothalamus and pituitary – the starting point for hormone production in the body.  As a result, chaste tree is able to normalize the secretion of many hormones, for instance, reducing prolactin levels and normalizing the estrogen to progesterone ratio.

Chaste tree is best taken daily throughout the menstrual cycle.  Studies have found it to be useful for almost all symptoms associated with PMS including irritability, mood swings, anger, anxiety, headache, and breast tenderness.

9.    Licorice

Licorice (Glycyrrhiza glabra) is an amazing herb!  It has been used in both Western and Eastern herbal medicine for thousands of years for a wide variety of ailments.  It also has impressive modern scientific research to back up its historical uses.

 Licorice is useful in the treatment of premenstrual syndrome because it lowers estrogen levels while simultaneously raising progesterone levels.  Licorice also blocks the hormone aldosterone, decreasing water retention.

 Licorice is usually taken from ovulation (day 14) until your period starts.  It should not be used if you have a history of kidney disease or high blood pressure.  You should be under the care of a Naturopathic Doctor while taking licorice.

10. See a Naturopathic Doctor

This is probably the best thing you can do to help manage your PMS symptoms.  Naturopathic Doctors are experts in correcting the underlying imbalances that lead to PMS symptoms.  Your unique set of symptoms will give an experienced ND a lot of information that can be used to individualize a treatment plan just for you.  NDs also can order comprehensive hormone panels that will identify imbalances in prolactin, estrogen, progesterone or testosterone that may be contributing to your symptoms.  You can find a licensed Naturopathic Doctor in your area by visiting the national association websites – CAND in Canada and AANP in the United States.

Disclaimer

The advice provided in this article is for informational purposes only.  It is meant to augment and not replace consultation with a licensed health care provider.  Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

Photo credits:

Creative Commons License Mislav Marohnić via Compfight

Creative Commons License Ed Yourdon via Compfight

Tim Hamilton via Compfight

Diagnosing PCOS

Diagnosing PCOS

Polycystic ovarian syndrome is one of the most common conditions that I treat in my naturopathic practice. It affects 1 out of every 10 women and can manifest in many different ways – hair loss, facial hair growth, acne, difficulty losing weight, irregular menstrual periods or infertility. Because of the many different symptoms of PCOS, an accurate diagnosis is important.

The Rotterdam Criteria

The diagnosis of PCOS is currently made according to the Rotterdam Criteria, a 2003 consensus reached by the Society for Human Reproduction and Embryology (ESHRE) and the American Society for Reproductive Medicine (ASRM).

Diagnosis of PCOS requires that a woman meets two of three criteria:

  1. Infrequent or no ovulation (resulting in irregular or absent menstrual periods)
  2. Signs and symptoms or laboratory tests that show high androgen (male hormone) levels – these include acne, hair loss, facial hair growth, darkening of the skin at skin folds
  3. Cysts on the ovaries on ultrasound

For a diagnosis of PCOS it is also important to rule out other causes of these symptoms, such as a pituitary, thyroid or adrenal disease.

Clinical Evaluation

taking-notesThe first step in diagnosis of PCOS is a thorough evaluation with your medical or naturopathic doctor. Your doctor will ask a lot of questions. Be sure to share if you experience any of the following:

  1. Irregular periods – menstrual cycles that are longer than 35 days, infrequent periods or no periods at all can all be associated with anovulation and PCOS.  (Keep in mind: 1 in 5 women with PCOS still have regular periods, so having a regular period does not rule out PCOS)
  1. Acne – facial, chest, or back acne can be a sign of elevated androgens
  2. Hirsutism – abnormal growth of coarse hair in a male pattern (lip, chin, torso)
  3. Hair loss – elevated androgens is a major cause of head hair loss in women
  4. Oily hair or skin
  5. lump-sugar-549096_640Sugar cravings – a sign of insulin imbalance, one of the major hormonal imbalances in PCOS. Other symptoms include dizziness, lightheadedness or irritability (or “hangry”) if a meal is missed.
  6. Recurrent yeast infections – a sign of elevated blood sugar levels. Other symptoms include excess thirst and frequent urination.
  7. Overweight or difficulty losing weight – often a cause, and consequence, of the hormone imbalances in PCOS
  8. Darkening of the skin – especially at the back of the neck or in the skin folds at the underarms, under the breasts and between the thighs. This darkened skin is called acanthosis nigricans and is associated with elevated testosterone.
  9. Infertility – difficulty getting pregnant is often the driving factor for a diagnosis for PCOS
  10. Family history of PCOS or diabetes

 Laboratory Testing

Laboratory testing is the second criteria for a PCOS diagnosis. Many different lab tests can be used to confirm a suspected PCOS diagnosis, and these tests may highlight the underlying hormonal imbalances that cause PCOS. If you are taking the birth control pill to suppress your PCOS symptoms these tests will not provide accurate information.

Luteinizing hormone (LH) – high – produced by the pituitary gland to stimulate ovulation, levels are often elevated because ovulation is not occurring

Follicle stimulating hormone (FSH) – normal or low – typically assessed in relation to LH levels, some women with have a higher than normal LH:FSH ratio (greater than 1:1)

PCOS laboratory testingSerum testosterone (free and total testosterone) – high – 80% of women with PCOS have elevated levels of androgens. DHT levels may also be elevated

Progesterone – low – during the second half (luteal phase) of the menstrual cycle progesterone levels will be low due to the lack of ovulation

Estradiol – normal – typically in PCOS estrogen levels are normal or slightly elevated

Sex hormone binding globulin (SHBG ) – low – if tested, levels may be low

Fasting blood glucose – high – women with abnormal blood sugar levels typically have higher body weight, have higher androgen levels and are more insulin resistance

HbA1C – high – a long term (3 month) measure of blood sugar stability

Anti-Mullerian hormone (AMH) – high – levels of AMH are often elevated in PCOS due to the lack of regular ovulation

DHEAS – high – half of women with PCOS will have elevated adrenal production of DHEAS

Prolactin – normal – elevated prolactin can cause symptoms similar to PCOS; if your prolactin levels are high a pituitary tumour must be ruled out.

Thyroid stimulating hormone – normal – should be measured to rule out other causes of menstrual irregularities

Cortisol – normal – should be measured to rule out Cushing’s syndrome

Additionally, a pelvic or transvaginal ultrasound may reveal multiple 2-6mm follicular (simple) cysts on the ovaries. Ovarian volume or area may also be increased.

Moving Beyond Diagnosis

PCOS DietAn appropriate diagnosis of PCOS is important for women seeking optimal hormone balance. But the diagnosis is only the beginning. Your naturopathic doctor can be your partner as you move beyond diagnosis towards understanding and hormone balance. Read the other articles in the PCOS Series by Dr. Lisa Watson: Understanding PCOS, The PCOS Diet (also available as an infographic), PCOS and Infertility, PCOS in Adolescence, PCOS and Pregnancy, Hormonal Balance in PCOS and Naturopathic Medicine for PCOS.

Dr. Watson is currently accepting new patients at both her Toronto clinics. Contact her for a complimentary meet and greet appointment, or book your initial consultation today. The best time to start balancing your hormones is now.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

Pin this article for later: https://www.pinterest.com/pin/207165651589076259/

PCOS Diet: Infographic

In celebration of PCOS Awareness month this September, I have prepared this infographic on the PCOS diet.  Polycystic ovarian syndrome impacts 1 in 10 women and is the most common cause of anovulatory infertility.

It is also a condition that responds incredibly well to dietary and lifestyle changes.  Take charge of your health, and your hormones and start following the PCOS diet today.

If you need more support on your journey to hormone balance, book a free 15 minute consultation or initial consultation with me.  You can have balanced, healthy hormones!

pcos-diet-infographic_drlisawatsonnd

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

Wheat Woes: Celiac disease, wheat allergy and gluten sensitivity

Many people are beginning to recognize the personal benefits of a gluten-free diet. For some individuals the simple avoidance of gluten (a protein in wheat, barley and rye) can improve or completely resolve symptoms of diarrhea, constipation, gas and bloating.

So what is the problem with gluten? Why are so many people benefiting from avoiding this specific protein? The answer is not that simple. In fact, there are three distinct medical diagnoses that may apply to people who improve on a gluten free diet.

Celiac Disease

Bread slicedCeliac disease is an autoimmune disease impacting about 1 in 100 people. In this condition the body is stimulated to produce auto-antibodies against the lining of the small intestine. These auto-antibodies are only produced in the presence of gluten in the diet. Celiac disease incidence has increased 5-fold in the past 40 years – a trend that is seen with a number of autoimmune conditions. Having celiac disease increases the risk for the development of other autoimmune conditions in your lifetime. The only treatment for celiac disease is lifelong avoidance of gluten.

Wheat Allergy

Wheat allergy results when the body produces an allergic reaction to gluten or another component of wheat. The allergic sequence is similar to other allergies, with the release of histamine from mast cells and basophils, triggered by immunoglobulin E (IgE) cross-linking. Symptoms of wheat allergy include redness, swelling, hives and other allergy-type symptoms. Wheat allergy is the rarest of the wheat-associated diagnoses with only 1 in 500 people being impacted.

Gluten Sensitivity

By far the most common diagnosis associated with wheat is gluten sensitivity. It is estimated to impact 1 in 10 people and is 6x more prevalent than celiac disease. The symptoms of gluten sensitivity include:

  • Abdominal pain (68%)Gluten Free Logo
  • Eczema or rash (40%)
  • Headache (35%)
  • Foggy mind (34%)
  • Diarrhea (33%)
  • Depression (20%)
  • Anemia (20%)
  • Numbness in legs, arms or fingers (20%)
  • Joint pain (11%)

Diagnosis of gluten sensitivity is typically a diagnosis of exclusion. If you test negative for celiac disease (auto-immune antibodies), negative for wheat allergy (IgE immunoglobulins) but still improve on a gluten free diet then you will likely receive a diagnosis of gluten sensitivity.

Food sensitivity testing, such as the IgG food sensitivity panel, can help to confirm a diagnosis of gluten sensitivity. It can also identify other food sensitivities which may be occurring simultaneously, such as a dairy, egg or nut sensitivity.

If you suspect you may be gluten sensitive, cut it out of your diet for at least three weeks and watch your symptoms for improvement. Or contact your Naturopathic Doctor to discuss comprehensive testing for celiac disease, wheat allergy and gluten sensitivity. Take charge of your health, and let go of your wheat woes!

Select references

Sapone A, Lammers KM, Casolaro V, et al. Divergence of gut permeability and mucosal immune gene expression in two gluten-associated conditions: celiac disease and gluten sensitivity. BMC Med. 2011;9:e23

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

 

Hashimoto’s and Gluten

Gluten. It seems like everyone is talking about it. Books are lining shelves declaring the evils of this grain-based protein most of us have been eating for years. The grocery stores are full of “gluten-free” labels and gluten free bakeries are popping up in cities all across the country.

Gluten Free LogoWhy are we suddenly so aware of this protein? And what does it mean for people who have Hashimoto’s? Let me take you through some of the basics.

What is Gluten?

Gluten is a protein found in several different grains – wheat, barley, rye, spelt, kamut and triticale. It is a combination of two different proteins, gliadin and glutenin. Not all grains contain gluten and a gluten-free diet can still provide the essential nutrients found in these grains.

Autoimmunity

Hashimoto’s thyroiditis is an autoimmune condition where the immune system attacks and destroys the thyroid gland. It is, in essence, an immune condition with the thyroid being the unfortunate victim.

Autoimmune conditions are thought to develop when there are a combination of different factors. The three most commonly suggested factors are:

  • Genetic predisposition
  • A triggering event – this can be a nutrient deficiency, acute illness, chronic infection, dysbiosis, excess stress, food sensitivities or impaired detoxification
  • Increased intestinal hyperpermeability or “leaky gut”

The increased intestinal hyperpermeability, or “leaky gut” is where gluten becomes a major issue.

Leaky Gut

Keep outThe cells that line our digestive tract are joined at tight junctions – these close connections allow only the smallest particles of digested food to present to our immune system. Certain foods, like gluten, are more difficult for our enzymes to completely digest. These partially digested proteins, called peptides, can cause inflammation at the lining of the digestive tract, leading to damage of the tight junctions. When these tight junctions are compromised they become more permeable, or leaky, allowing larger molecules (peptides) to present to our immune system.

Once the immune system has been exposed to these large peptide molecules it may begin to produce antibodies against the peptides – an attempt to protect us from this foreign molecule.

The issue of autoimmunity, especially Hashimoto’s thyroiditis, occurs when the immune antibodies begin to circulate through our body, searching for the sequence of amino acids that make up the gluten peptide. The surface of the thyroid gland is made up of fats and proteins – and unfortunately the amino acid sequence of proteins on the surface of the thyroid is the same as the gliadin peptide in gluten. This results in the immune system destroying the thyroid gland, mistaking it for the component of gluten that triggered the response in the digestive tract.

Gluten and Food Sensitivities

wheat is a common food allergenIn my practice I recommend that all people diagnosed with Hashimoto’s thyroiditis eliminate gluten from their diet. However, leaky gut can be caused by, or lead to many other food sensitivities which can also have the same devastating effect on the thyroid gland, and other tissues in the body.

Every person with an autoimmune condition, including Hashimoto’s should seriously consider having an IgG based food sensitivity panel done to identify their own sensitivities. Understanding the action of your immune system in your body is imperative to decreasing the overactivity of the immune system and preventing further damage to your body.

For more information on Naturopathic Medicine and Hashimoto’s Thyroiditis, please read the other articles on this website written by Dr. Lisa Watson, ND: Understanding Hashimoto’s, Hashimoto’s and Fertility, Naturopathic Treatments for Hashimoto’s. If you are ready to start on your path to healing your Hashimoto’s you can book an appointment with Dr. Lisa by following the links here.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

Select references

Carrocio A, D’Alcam A, Cavataio F, et al. Gastroenterology. High Proportions of People With Nonceliac Wheat Sensitivity Have Autoimmune Disease or Antinuclear Antibodies.2015 Sep;149(3):596-603.e1.

Fasano A, Shea-Donohue T. Mechanisms of Disease: the role of intestinal barrier function in the pathogenesis of gastrointestinal autoimmune diseases. Nature Clinical Practices. 2005 Sep:2(9):416-422.

 

Understanding Hashimoto’s Thyroiditis

Hypothyroidism is a common condition impacting women, with women between 5-8 times more likely to develop this condition than men. The most common cause of hypothyroidism in Canada and the US is Hashimoto’s thyroiditis.

What is Hashimoto’s Thyroiditis

Hashimoto’s thyroiditis is an autoimmune condition in which the body’s own immune cells attack and destroy the thyroid gland resulting in decreased thyroid function (hypothyroidism). Hashimoto’s most often impacts young and middle aged women (20’s to 50’s) and can lead to permanent damage of the thyroid gland and lifelong hypothyroidism.

Symptoms of Hashimoto’s Thyroiditis

Hashimoto’s thyroiditis in it’s early stages is often silent with few to no symptoms. Some people experience a sense of fatigue or not feeling their best, but often do not seek medical care for these common symptoms.Winter hat

The symptoms of Hashimoto’s are indistinguishable from other forms of hypothyroidism:

  • Weight gain
  • Fatigue
  • Swelling
  • Muscle weakness
  • Constipation
  • Cold intolerance
  • Dry skin
  • Dry or brittle hair
  • Hair loss
  • Firm or nodular thyroid gland on palpation

Diagnosing Hashimoto’s Thyroiditis

All hypothyroidism is diagnosed using a thyroid stimulating hormone (TSH) level. TSH is produced in the pituitary gland and tells the thyroid gland to make thyroid hormones. If the TSH is too high, that means the thyroid is not working effectively and a diagnosis of hypothyroidism can be made.

In Hashimoto’s thyroiditis anti-thyroid antibodies (antithyroid peroxidase, antithyroglobulin) are commonly present. However they are rarely tested, despite the majority of hypothyroid cases being autoimmune in origin.

In my Naturopathic practice I always test for anti-thyroid antibodies to confirm Hashimoto’s and to monitor treatment.

Hashimoto’s and Autoimmunity

An autoimmune condition is any condition where the body’s immune system begins to attack the body’s own tissues rather than the viruses and bacteria it is designed to fight. Hashimoto’s thyroiditis occurs when the immune system attacks the thyroid gland. It is not in essence a thyroid condition, but an immune condition where the thyroid is the unfortunate victim.

Once a person develops one form of autoimmune condition they are more likely to develop others. The incidence of Hashimoto’s is higher in people with pre-existing autoimmune conditions such as celiac disease, rheumatoid arthritis, psoriasis, vitiligo and lupus.

Conventional Treatment of Hashimoto’s

Thyroid medicationConventional treatment of Hashimoto’s thyroiditis does not differ significantly from treatment of other forms of hypothyroidism. The main treatment is L-thyroxine (T4) taken daily in the morning. This T4 is then converted in the body to the active thyroid hormone, T3.

There are controversies regarding this treatment for Hashimoto’s thyroiditis. Studies have shown that combined use of T4 and T3 results in better relief of hypothyroid symptoms than T4 alone. This is accomplished by using a dessicated thyroid extract, prescribed to you by your Medical Doctor, endocrinologist or Naturopathic Doctor.

Another controversy in the treatment of Hashimoto’s is the lack of treatment targeted at the immune system. The use of L-thyroxine does not prevent or treat the inflammation and autoimmune destruction of the thyroid nor does it lower anti-thyroid antibodies.

Naturopathic Treatment of Hashimoto’s Thyroiditis

An experienced Naturopathic Doctor can be an amazing ally in the treatment of Hashimoto’s. Your ND can personalize a protocol that will address the root cause of your Hashimoto’s – an overactive immune system.

In Ontario your ND may be able to prescribe dessicated thyroid, provided they have obtained additional education and a license to prescribe.

Nutritional supplements, such as selenomethionine, may also be used to decrease autoimmune thyroid antibodies. Dietary support such as gluten avoidance, immunoglobulin food sensitivity testing, celiac testing, detoxification support, gut healing protocols and more can also be used to support the immune system and decrease over-reactivity.
More information on the Naturopathic treatment of Hashimoto’s Thyroiditis can be found in the following articles: Hashimoto’s and Gluten, Naturopathic Treatment of Hashimoto’s Thyroiditis, Hashimoto’s and Fertility.  You can also book an appointment with Dr. Lisa Watson, ND and get started on healing your Hashimoto’s now.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

 

 

 

Healing Your Hormones: Progesterone Deficiency

Women’s health is both the focus of my naturopathic practice and a passion in my life. There is no topic I am more excited to talk about, read about and learn about. And within women’s health there is no more important topic than hormone balancing. Because hormones are the main factor that differentiates men from women across the lifespan.

In this series I will take you through the basics of some common hormone imbalances that occur in women – progesterone deficiency, estrogen deficiency, estrogen excess, low thyroid hormone, excess thyroid hormone and testosterone excess.

So whether you are just interested in learning more about hormones, or hoping to identify some of your own signs and symptoms in this series, read on and get ready to learn how to heal your hormones.

What is Progesterone?

The reproductive system in women has two main hormones – estrogen and progesterone. Progesterone is our “pro-gestation hormone” – it is produced in the ovaries after ovulation to prepare the uterus for pregnancy. It is also produced in small amounts in the adrenal glands and in large amounts by the placenta during pregnancy.

What Does Progesterone Do?

Hormone sleepProgesterone prepares the body for pregnancy by stimulating the production of proteins that prepare the uterine lining for implantation. Progesterone also regulates our menstrual cycle – if a pregnancy does not occur, progesterone levels drop off and a menstrual period will result.

Progesterone is much more than just a pregnancy support hormone. Receptors for this hormone are found in the brain, breasts, blood vessels, and bones, in addition to the receptors in the reproductive organs. Progesterone is the natural balancing agent for estrogen – preventing estrogen from producing too many growth-stimulating effects on our tissues.

Progesterone also has significant anti-anxiety and relaxing effects on the body. It helps our mind and body cope with stress and can promote healthy sleep.

Changes in Progesterone Hormone Balance

Production of progesterone peaks in our mid-reproductive years – around 25 years of age. After that age we see steady declines in progesterone production until perimenopause and menopause when production drops off almost entirely.

Women who do not experience regular periods, or women who are not ovulating typically have low levels of progesterone as well.

Symptoms of Progesterone Deficiency

Low levels of progesterone can lead to a vast number of symptoms. Many of the symptoms are not taken seriously by doctors or may be attributed to other causes (especially anxiety, depression, insomnia and PMS). But for a large number of women the real cause of symptoms is an imbalance in progesterone levels.

 Escalator hormone balanceSymptoms of Progesterone Deficiency

  • Premenstrual mood changes
  • Painful or lumpy breasts
  • Insomnia
  • Premenstrual headaches
  • Anxiety
  • Infertility
  • Recurrent miscarriage
  • Unexplained weight gain

The Progesterone Hormone Web

No hormone functions in isolation. Each hormone in our body interacts with other hormones for optimal balance. Progesterone interacts with a number of important hormones, a few of which are noted here:

Estrogen

Progesterone is the natural balancer to estrogen. When progesterone levels are deficient, we can see symptoms of estrogen dominance. These include the symptoms listed above but also:

  • heavy periods
  • fluid retention
  • foggy thinking
  • decreased sex drive

Cortisol

Progesterone is the direct precursor to the production of cortisol, our stress/survival hormone. If progesterone levels are low, our ability to cope with stress diminishes and we may develop anxiety, depression, insomnia or feel overwhelmed.

Thyroid Hormone

Thyroid hormones stimulate the production and release of progesterone from ovarian cells. Thyroid hormone also influences the formation of progesterone receptors on cells throughout the body. If your thyroid function is low (hypothyroidism) you may also be experiencing low progesterone levels.

Hormone Healing for Progesterone Deficiency

Yoga natureLaboratory testing is necessary for all women seeking treatment for progesterone deficiency. It is imperative to understand the balance in the different hormones before starting any type of hormone treatment.

A lifestyle approach to improving progesterone levels is the foundation for all other treatments. Decreasing stress levels, encouraging a healthy diet that provides adequate protein and healthy fats, and engaging in regular exercise are all important to balancing progesterone levels.

There are a vast number of nutrients, and plant-based botanical medicines that can influence the production of progesterone. Some women also choose bioidentical progesterone cream, which can be prescribed by Naturopathic Doctors in Ontario who have prescribing rights.

Vitamin B6

Necessary for appropriate ovulation and subsequent progesterone production. If you are deficient, you will likely also be deficient in progesterone. Excellent food sources include tuna, salmon, turkey, chicken, sweet potato, sunflower seeds and dark leafy greens.

Magnesium

Magnesium is necessary for detoxification of hormones, especially estrogen. If you are deficient in magnesium you may have higher circulating levels of estrogen, resulting in a relative progesterone deficiency. Food sources of magnesium include pumpkin seeds, leafy greens, soy beans, sunflower seeds, and beans.

Chaste berry (Vitex agnus-castus)

Chaste berry (or chaste tree) has been found to increase progesterone levels during the second half of the menstrual cycle. It can also help to balance other hormones such as prolactin. Your Naturopath can help you decide if chaste berry is right for you

Bioidentical progesterone cream

Bioidentical hormone replacement therapy (BHRT) uses hormones that are identical to those in your body to balance your hormones and relief symptoms of hormone imbalance. Bioidentical progesterone is made from wild yams or soybean and is typically applied in cream form during the second half of the menstrual cycle.

Transdermal progesterone results in effective absorption of progesterone and movement of progesterone to the target tissues – brain, uterus, breast and blood vessels – to decrease symptoms. It is typically used twice per day and dosages vary – your Naturopath will work with you and a compounding pharmacy to establish your proper balance of hormones.

Hormone imbalance is not in your head – it is in every cell in your body. If you think your hormones are out of balance, talk to an experienced and qualified Naturopathic Doctor to help you find your optimal balance.

Natural Treatments for Thin Endometrial Lining

The uterus is made up of three layers: an outer protective layer, a muscular layer, and an inner lining (endometrium) which develops each month to support and nourish a fertilized egg. If a woman does not conceive, this lining is lost during the menstrual period.

Endometrial thickness is an important factor in improving pregnancy outcomes. An ideal thickness is between 9-10 mm at ovulation. If your endometrial lining is thin it may not allow for optimal implantation and successful pregnancy.

A thin endometrial lining can be identified on ultrasound done at or near ovulation, or can be suspected in women who have very light menstrual periods.

Women with long term use of birth control pills (10 years or longer) are more likely to experience thin endometrial lining. Use of the fertility drug Clomid (Clomiphene citrate) is also associated with thin endometrial lining, especially when used for multiple cycles in a row.

Below are some suggestions for ways to naturally increase the thickness of your endometrial lining and improve your chances for a healthy pregnancy.

Red Raspberry Leaf Tea

An herbal medicine with a very long history of use, red raspberry leaf (Rubus idaeus) is a uterine tonic that may help to optimize development of the uterine lining. It is also a rich source of nutrients to support a healthy endometrium, including iron and vitamin C. Drink three cups of the tea per day from the first day of your period until ovulation.

Black Cohosh

Another herbal medicine, black cohosh (Actaea racemosa) is a rich source of phytoestrogens that can provide further estrogen stimulation to the uterus and support a thick endometrial lining. Studies have been done combining black cohosh with clomid and found improved endometrial thickness and more successful pregnancy rates. Dosage ranges from 80-120mg per day from the first day of your period until cycle day 12. Best taken under the supervision of a naturopathic doctor who can monitor liver function for optimal safety.

Red Clover

Red clover (Trifolium pratense) is another isoflavone rich phytoestrogen, similar to black cohosh. It is used to increase blood flow to the uterus and support estrogen balance in the body. It is used daily from cycle day 1 to 12 at a dose of 40-80mg of standardized isoflavones.

Bioidentical Estrogen

red poppyEstrogen is necessary for the development of a healthy endometrium. If estrogen levels are low (which occurs as we get older) then the lining of the uterus will not develop optimally before ovulation. A blood or saliva test for estradiol can identify low estrogen levels and a bioidentical estrogen cream can be used safely to increase estrogen levels in the first half of the cycle, prior to ovulation. Your Naturopathic Doctor can prescribe bioidentical estrogen at a dose that is individualized to your needs.

Iron

Iron deficiency is the most common nutrient deficiency in women. Necessary for the health of red blood cells, low levels of iron may lead to an inadequate development of the uterine lining. If you are a vegan or vegetarian or have a history of having a thin uterine lining, ask your Naturopath or Medical Doctor to test your iron (ferritin) and hemoglobin levels.

Exercise

Inadequate blood flow to the uterus can be a significant cause of a thin uterine lining. This can be caused by a sedentary lifestyle, chronic stress or uterine fibroids. Exercise and acupuncture are two of the most effective ways of improving blood flow to the uterus. Swimming, walking, jogging, dancing, yoga or hula hooping are all excellent ways of getting the blood flowing to the uterus. Try engaging in some form of physical activity every day, especially in the two weeks leading up to ovulation.

red tulipsVitamin E and L-Arginine

Researchers have found that the use of these two nutrients can increase the blood flow to the uterus through the uterine radial artery. Published in the journal Fertility and Sterility in 2010, it was found that vitamin E increased blood flow in 72% of patients and increased the endometrial thickness in over half of patients. L-Arginine increased blood flow in 89% of patients and increased endometrial thickness in two-thirds of patients. Dosage of vitamin E in the study was 600mg per day and the dosage of L-arginine was 6g per day.

Acupuncture

Acupuncture is one of my favourite ways of addressing the issue of a thin endometrial lining. Acupuncture has many benefits for women’s hormonal health. It decreases stress, supports hormone balance, and regulates and increases blood flow to the reproductive organs. Clinical studies have demonstrated an improvement in the thickness of the endometrial lining with regular acupuncture treatments. Points that are often considered include: CV4, CV6, LI10, KI3, SP6, SP10 and ST36. Moxibustion, a warming technique, can also be used in combination with the acupuncture.

Working with a Naturopathic Doctor can help you to develop an individualized plan that will improve your chances of a healthy pregnancy. Additionally, if you difficulty conceiving be sure to have your thyroid thoroughly assessed because low thyroid function is also associated with failure of implantation.   Be sure to work with a Naturopathic Doctor who is experienced in supporting fertility and can help you achieve your goals, naturally.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

Select references:

Takasaki A, Tamura H, et al. Endometrial growth and uterine blood flow: a pilot study for improving endometrial thickness in the patients with a thin endometrium. Fertil Steril. 2010;93(6):1851-8.

Yu W, Horn B, et al. A pilot study evaluating the combination of acupuncture with sildenafil on endometrial thickness. Fertil Steril. 2007;87(3):S23

Natural Approaches to Heartburn

The number of patients in my practice with heartburn is staggering. And what is even more staggering to me is how many people think it is normal! Just because it is common does not mean that it is normal!

What is Heartburn?

Heartburn, also known as reflux or gastroesophageal reflux disease (GERD) is a burning sensation in the esophagus that may be associated with:

  • Sour, acidic taste in the mouth
  • Pain behind the breastbone or between the shoulder blades
  • Unexplained cough

A New Perspective on Heartburn

In conventional medicine, heartburn is the consequence of excess stomach acid and acid suppressing medications (proton pump inhibitors or calcium carbonate) to reduce symptoms. However, functional doctors and naturopathic doctors believe that low stomach acid may be a more likely cause of heartburn.

Stomach acid is necessary to for proper digestion. If acid production is decreased the stomach will not empty properly and the contents (partially digested food and stomach acid) can reflux up into the esophagus and cause heartburn.

Stomach acid production naturally declines as we age. Stress, unhealthy diet (high in refined grains, sugars and processed foods) and use of medications are all common causes of low stomach acid.

Treating Low Stomach Acid

Water There are a number of natural ways to improve your production of stomach acid. Your Naturopathic Doctor can help you to understand which options are best for you.

  1. Become a “chewitarian” – the longer the food spends in your mouth, the more signals your brain and enyzmes in your saliva will send to your stomach to produce stomach acid. So slow down, chew carefully and savour each bite.
  2. Limit beverages at mealtimes – water and other fluids can dilute stomach acid, requiring our body to produce more. Take only small sips of water during meals and save the majority of your water for between meals.
  3. Apple cider vinegar – can help low stomach acid by providing a source of acid, allowing your stomach to have an optimal pH even if you aren’t making enough stomach acid on your own. Doses vary, start low with 1 tsp and see if it helps you.
  4. Betaine hydrochloric acid – a powerful treatment for heartburn and low stomach acid, betaine HCl provides you with a safe source of stomach acid. This will help optimize your stomach acid levels and promote total digestion of food, leading to a healthy stomach emptying time and decreased symptoms. Your ND will give you guidelines on safe supplementation.
  5. Deglycyrrhizinated licorice (DGL) – an excellent support for heartburn, DGL improves symptoms of heartburn by healing the esophagus and tonifying the lower esophageal sphincter – the opening at the top of the stomach. Try chewing one capsule when you experience heartburn to decrease symptoms while you work to optimize your stomach acid levels.

The Importance of Treating Heartburn

Heartburn may be miserable, and uncomfortable and for many that is reason enough to try to clear the symptoms. But getting to the underlying cause of the heartburn is important because optimal digestion of our food is the only way we will get all of the nutrients we need for our bodies to function.

If you are producing inadequate stomach acid, or taking acid-suppressing medications, you may experience difficulty breaking down protein, an increase in food sensitivities, deficiencies in nutrients, and increased inflammation. The consequences of poor nutrient absorption can not be underestimated!

So speak with your Naturopath today to find ways to optimize your health and overcome your heartburn symptoms, once and for all!

Disclaimer

The advice provided in this article is for informational purposes only.  It is meant to augment and not replace consultation with a licensed health care provider.  Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

 

Botanical Medicines to Avoid in Epilepsy

This past weekend I presented at the Toronto Epilepsy annual conference.  I was happy to be invited to speak on the topic of Integrative and Naturopathic Medicine in the Management of Seizures.

One of the things I was most interested to share with this audience was the fact that while nearly half of people with epilepsy use some form of complementary or alternative treatments, up to 75% of those people don’t discuss the use with their medical doctor or neurologist.

This situation has to change.  Natural treatments may be effective, but they are not always safe.  Especially for people who take medications, like anticonvulsants, that may be altered by the use of natural products.

Botanical Medicines and Anti-Convulsants

There are three primary ways that botanical (plant based) medicines can negatively impact a seizure disorder

  1. Decrease the seizure threshold – making a person more likely to experience a seizure
  2. Has pro-convulsant effects – this plant has been found to cause convulsions or seizures
  3. Interfere with the absorption or metabolism of anticonvulsants – changing the way the drugs act in the body and potentially decreasing their effectiveness

Not all botanical medicines have these effects.  Most botanical medicines can be used safely in people with seizures.  It is important to know which ones can, and can not be used. And this is the role of the Naturopathic Doctor in integrative care.  We are experts in safe prescribing of botanical medicines and can see if your medication will interact with a herbal medicine in a negative way.

Botanical Medicines to Avoid

This list is a general list of botanicals that have been found to have potential negative effects on epilepsy.  This list is not exhaustive, new research is being done all the time.  You should not take any of these plant medicines without a consultation with your Naturopathic Doctor.  And be sure to discuss the use with your medical doctor and neurologist.

Botanical Medicines that May Decrease the Seizure Threshold

  • Goldenseal (Hydrastis Canadensis)
    Goldenseal (Hydrastis Canadensis)

    Borage (Borago officinalis)

  • Damiana (Turnera diffusa)
  • Evening primrose oil (Oenothera biennis)
  • Ginkgo (Ginkgo biloba)
  • Ginseng (Panax ginseng)
  • Goldenseal (Hydrastis Canadensis)
  • Green tea (Camellia sinensis)
  • Guarana (Paullinia cupana)
  • Wormwood (Artemesia absinthium)
  • Yohimbe (Pausinystalia yohimbe)

Botanical Medicines that Have Pro-Convulsant Effects

  • St. John's Wort (Hypericum perforatum)
    St. John’s Wort (Hypericum perforatum)

    Bearberry (Arctostaphylus uva ursi)

  • Clove (Syzygium aromaticum)
  • Coffee (Coffea spp.)
  • Ephedra/ Ma Huang (Ephedra sinica)
  • Ergot (Claviceps spp.)
  • Eucalyptus (Myrtacea spp.)
  • Juniper (Juniperus communis)
  • Kava (Piper methysticum)
  • Monkshood (Aconite napellus)
  • Oleander (Nerium oleander)
  • Pennyroyal (Mentha pelugium)
  • Sage (Salvia officinalis)
  • St. John’s Wort (Hypericum perforatum)
  • Thuja (Thuja occidentalis)
  • Yohimbe (Pausinystalia yohimbe)

Botanical Medicines that Interfere with Anti-Convulsants

  • Echinacea (Echinacea spp.)
    Echinacea (Echinacea spp.)

    Garlic (Allium sativum)

  • Echinacea (Echinacea spp.)
  • Pycnogenol (Pinus pinaster)
  • Milk thistle (Silybum marianum)
  • American hellebore (Veratrum viride)
  • Mugwort (Artemisia vulgaris)
  • Pipsissewa (Chimaphila umbellata)

Botanical medicines can be safely used by people with epilepsy.  Be informed, be safe and consult your Naturopathic Doctor for optimal results!

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.