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PMS or PMDD?

Premenstrual syndrome (PMS) is a many-headed beast – with over 150 different symptoms attributed to PMS, many women find the week before their period to be a challenging time.

But what about those women who are completely destroyed by their PMS? Who suffer with severe mood changes, insomnia and fatigue? For those women, they may be suffering from PMDD – premenstrual dysphoric disorder.

A Diagnosis of PMDD

PMDD is classified as a depressive disorder. It is not the same as clinical depression as it occurs with a very specific timing – during the second half of the menstrual cycle, after ovulation, and it resolves within a few days of starting your period.

PMDD causes a lot of distress and significantly impacts a woman’s ability to function and to maintain her quality of life. Between 2-6% of women experience PMDD, but many of them don’t seek treatment and instead suffer each month with severe symptoms.

PMDD is different from PMS in the severity of symptoms and the consequences of the mood changes.   The diagnosis is made by using symptom tracking reports and needs to meet the following criteria:

Treatment of PMDD

The conventional approach to treating PMDD results in most women being given one of two options: the birth control pill, or an antidepressant. While these treatments may be effective for some women, many more women are seeking a more natural, empowered approach to managing their PMDD.

Natural Approaches to PMDD

In my article on Ten Natural Treatments for PMS I discuss the lifestyle and diet for managing PMS. I suggest all women with PMDD also follow those recommendations. But for PMDD I tend to take a more aggressive approach – the symptoms are often severe enough to warrant a very targeted and bold plan.

Vitamin B6

Used in both PMS and PMDD, vitamin B6 is necessary for the production of cortisol, progesterone and serotonin – all hormones involved in PMS and PMDD. Taking high (orthomolecular) doses of vitamin B6 can be helpful at reducing symptoms of PMS and PMDD. Vitamin B6 is usually taken all month long, but higher doses can be used in the second half of the cycle if needed.

Calcium

Calcium has been found in studies to reduce a wide variety of symptoms associated with PMS. While I don’t find it to be useful on its own, in a robust protocol calcium can play a role in reducing both the mood and physical symptoms of PMS and PMDD.

L-tryptophan and 5-HTP

Two supplements that can increase the production of serotonin in the body, L-tryptophan and 5-HTP, show a lot of promise in the treatment of PMDD. Supporting the serotonin system in women has been one of the most effective means of treating PMDD. L-tryptophan and 5-HTP are the direct precursors of serotonin and can significantly reduce mood symptoms of PMDD. These supplements are not taken together, and should not be combined with other antidepressants. Use under the guidance of a knowledgeable and experienced Naturopathic Doctor.

St. John’s Wort

One of the most commonly used botanical medicines, St. John’s Wort is an excellent treatment for women with PMDD. Acting on the serotonin system in the body, St. John’s Wort can reduce depressive symptoms of PMDD and improve mood. It can be taken all month long, or just during the second half of the menstrual cycle.

Chaste Berry

Chaste berry (chaste tree, Vitex agnus-castus), which I also discussed in the PMS article, has been found to be effective for PMDD. Chaste berry can reduce anger, irritability, anxiety, mood swings, and physical symptoms associated with PMS and PMDD. My experience is that it can be moderately effective for PMDD, but often additional treatments are needed to help women feel considerably better.

IV Micronutrient Therapy

One treatment that I have found to drastically improve PMS and PMDD symptoms in women is IV micronutrient therapy (IVMT). IVMT allows us to administer doses of vitamins (like B6, calcium and magnesium) at higher doses than you would be able to take orally. IV therapy also provides an abundance of nutrients necessary for detoxification of hormones – and reducing the hormone burden in the body can greatly improve symptoms of PMDD. Not every woman is a candidate for IVMT, but talk to your Naturopath to find out if you are.

Bio-Identical Progesterone

While we don’t know exactly what causes PMS and PMDD, one suspect in this mystery is an imbalance of estrogen and progesterone – often called estrogen dominance. When progesterone levels are unstable, or low, and estrogen levels are high, PMS and PMDD depression and mood swings can result. For some women, especially those in their 40s, bio-identical progesterone can be a lifesaver. Your ND will give you a questionnaire to identify a possible progesterone imbalance, and may also recommend hormone testing.

Empowering Your Journey

If you are interested in learning more about how to manage your PMDD, I suggest working with a qualified Naturopathic Doctor who can guide you on this journey.  PMDD is too severe, and too complex to try and piece together a treatment on your own.  Working with an ND who can guide and support you on this journey may be the best decision you make for your health and your sanity.

Select Resources

Comprehensive Gynecology, Seventh Edition. Ed. Lobo R, Gershenson D, Lentz G. 2017; 37, 815-828.

Ferri’s Clinical Advisor. Premenstrual Dysphoric Disorder. Ed. Ferri FF. 2019

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.

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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 (seriously.  14 days.)  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.  Researchers, clinicians, and people all over the internet debate this constantly.  We do know that it’s most likely a combination of imbalances in our hormones, neurotransmitters, lifestyle factors and our environment that leads to symptoms of PMS.

Balancing these diverse systems gives most women relief from their PMS symptoms. But it can take some time to determine what will work for you!  Don’t try to do this alone – an experienced naturopath or functional medicine doctor can guide you and give you the best chance for bidding farewell to your PMS.

Below you will find my TOP TEN natural treatments for PMS.  Start here.  Empower yourself with knowledge.  Then find the support you need.

10 Tips to Treat PMS Naturally

1. Exercise

Come on.  We know exercise is important, but did you know it can decrease your PMS symptoms?  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 can reducing estrogen levels, improve blood sugar levels and raise your feel-good endorphins!  And really, any exercise will do.  So run, dance, swim, cycle, hula hoop, yoga or pilates – it doesn’t matter.  Just do it!

2.    Cut the sugar

Women who experience PMS have been reported to eat whopping 275% more refined sugar than women who do not get PMS symptoms.  DAMN.

Refined sugars zap our magnesium levels, increase salt and water retention and create imbalances in our insulin levels.  All of these concerns have been linked to PMS symptoms.

Eliminating refined sugar and limiting simple carbohydrates (grains, pasta, baked goods) in favour of high fiber complex carbohydrates (fruits and vegetables, whole grains) lowers 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

I hate to be the bearer of bad news, but 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!  Those little buggers living in our intestines are working hard 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 healthy bacteria levels in your gut 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.    Consider Cal-Mag

1k-7649 spinachEstrogen and calcium are BFFs in our bodies.  Estrogen is involved in the absorption, metabolism and utilization of calcium in our bodies (this is why we are more prone to osteoporosis as we age – we’re learning so much today!)  And studies have found that both mood and physical symptoms of PMS are improved with daily calcium supplementation

Magnesium deficiency is a serious concern and most women with PMS are deficient in magnesium!  I’m going to say that again – MOST women with PMS are deficient in magnesium.   Magnesium deficiency causes fatigue, irritability, mental confusion, menstrual cramps, insomnia, muscle aches or 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.  Take to your ND about a Cal-Mag supplement, and take it in the evening away from other medications and supplements.

6.    Bring the B vitamins

It is hard to keep track of the hundreds of different things B vitamins do!  One of the most important is the detoxification of hormones through our liver.  If you don’t have enough B vitamins, your body is going to be dealing with those hormones a lot longer than you want to be.

Vitamin B6 is also a superstar when it comes to treating PMS.  Necessary for the production of two neurotransmitters – serotonin and dopamine (read all about them in my article on hormones for happiness!), vitamin B6 can seriously ease symptoms of PMS such as 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 women’s hormones.  It has been used for menopause, painful menstruation, no menstruation and as a uterine tonic.  Dong quai has phytoestrogenic properties and I recommend it 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

The SINGLE most important herb in the treatment of PMS, chaste tree (Vitex agnus castus) has been a life-changer for many women in my practice.

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 production 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 – one of the most powerful we use.  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

Obviously I think this is 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 cortisol, 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.  And of course, you can contact me if you’d like us to work together.

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.

The Empowered Woman’s Guide to HSV

Oh herpes. No one wants you. But with 2/3 of people under age 50 having some form of herpes, a lot of women are dealing with this unwanted guest in their lady garden. And herpes isn’t going anywhere – once you have the herpes virus, you always have the herpes virus. Herpes is one of the types of virus that is able to remain in a hidden state in our bodies (called “latent” infection) and pop out when we least want it to.

Types of Herpes

There are two types of herpes simplex virus – HSV-1 and HSV-2. HSV-1 is the virus associated with most cold sores. HSV-2 is the one associated with genital herpes. However their location doesn’t really matter – you can have HSV-1 on your genitals, and while relatively rare, you can also have HSV-2 around your mouth.

How to Get Herpes

Now no one wants to get herpes, but honestly it is hard to avoid. HSV-1 and -2 are transmitted by physical contact, kissing or sexual intimacy. As one of the most common sexually transmitted infections, exposure rates are very high. To avoid exposure to HSV use condoms or dental dams when having sexual contact, and avoid direct contact during known outbreaks in a partner.

While HSV-2 is commonly transmitted sexually, it can infect the mouth as well through oral sex. Most cases of HSV-1 are contracted during childhood, but can also occur sexually. HSV-1 and -2 can both also be passed along to infants during childbirth.

Symptoms of HSV

Many people recognize the symptoms of cold sores – a watery blister near the lip (or sometimes the nose) or in the mucous membranes of the mouth. As the blister heals it forms a characteristic scab.

But herpes can also be completely silent – many people have HSV infections and never know it. This contributes to the high rates of exposure to HSV – it can be passed on even if no active blisters or sores are present.

Symptoms of an outbreak can also cause some symptoms such as tingling, burning or flu-like symptoms before the blisters appear. It is important to avoid direct contact with a partner during these times (use a condom or dental dam).

The first contact with the virus will cause the primary outbreak – usually with symptoms showing up between 2-21 days after contact. Typically this outbreak is more severe and can last longer than subsequent outbreaks.

Triggering Future Outbreaks

Any number of different triggers can lead to the resurgence of the herpes virus. Things that compromise your immune function – like lack of sleep, stress, poor diet and alcohol consumption are common triggers. Other triggers may be sun exposure, excessive heat, skin irritation or other local infections.

Diagnosing HSV

The best test is a simple swab, done in your doctor’s office soon after the onset of the blisters. It can take up to a week for results to come back, so treatment is often started if the symptoms and appearance are consistent with a herpes infection.

There are blood tests available as well that can be used if HSV is suspected.

An Empowered Approach to Treating HSV

My first step in treating HSV in women is to offer assurance. You are practically a unicorn if you have never had HSV – most people in Canada do have it (and remember, once you’ve had it you always have it). It is a virus like any other and we need to let go of some of the negative connotations around contracting HSV.

Second, there are antiviral medications available that can help to lessen the severity of an outbreak and lower the chances of passing HSV to a partner. While I don’t advocate for on going use of these medications, they can be used judiciously in women who are looking for short term support.

Of course, as a naturopathic doctor, my focus is on empowering women to make choices for their health based on knowledge and informed by science. So I like to emphasize what we, as women, can do to help control HSV and prevent outbreaks.

St. John’s Wort – most commonly known as a treatment for depression, Hypericum perforatum (St. John’s Wort) also has powerful antiviral properties that are effective against herpes viruses. Typically taken at higher doses for 1-2 weeks, then decreasing to a lower or maintenance dose.

Lysine – one of the more well-known treatments for HSV, lysine is an amino acid that helps to stabilize the virus and prevent reactivation. It is most often taken daily to prevent outbreaks. Many doctors also suggest consuming more lysine in the diet, and avoiding arginine – this balance supports the immune system in it’s work. Below you’ll find a list of foods high in lysine (enjoy lots of these!) and foods high in arginine (limit these).

Lemon Balm – topical lemon balm is stellar at soothing and supporting the healing of cold sores and genital herpes. It is applied directly to the lesions once or twice per day during an outbreak.

Coriolus Mushrooms – mushrooms pack one hell of a punch when it comes to optimizing our immune system. Coriolus mushrooms in particular have been found to optimize immune function and support the immune system in it’s battle against viruses. I suggest taking mushrooms regularly to support your immune function.

Empowered Steps

If you are struggling with recurrent HSV outbreaks, or this is your first outbreak, I hope that you feel more knowledgeable after reading this article. As always, I suggest that you work with a qualified Naturopathic Doctor to put together a plan that approaches all aspects of your health, and the health of your lady garden. If you’d like to work with me, I am happily taking new patients in my women’s health focused practice in Toronto. You can book 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.

The PATH To Treating Bacterial Vaginosis

BV, or Bacterial Vaginosis is the most common vaginal infection in women worldwide. With few symptoms, aside from an unpleasant odour, many women are experiencing recurrent BV infections without receiving appropriate treatment.

But no more. Today I will take you on the PATH to treating BV, so that you don’t have to struggle with BV any longer.

Understanding BV

Bacterial vaginosis occurs when the healthy bacteria balance in the vagina is disrupted. With trillions of bacteria colonizing the vaginal tract, when those populations are out of balance the delicate pH of the vagina changes and symptoms can occur.

Unlike yeast infections, bacterial vaginosis typically has fewer symptoms. Not usually associated with pain, itching, irritation or pain with intercourse, bacterial vaginosis has just two main symptoms:

  • a thin whitish discharge
  • a foul “fishy” odour

These symptoms are often worse after a menstrual period or exposure to semen in the vagina – these can alter the pH balance and support the growth of less-than-desirable bacteria in the lady garden.

The most common bacteria involved in BV is Gardnerella vaginalis, but some other bacteria have been implicated as well – including Mycoplasma hominis, Ureaplasma urealyticum and Prevotella bivia…along with many others.

The metabolic activity of these bacteria causes the discharge and the characteristic odour of BV.

While BV may have few symptoms on its own, it can lead to urinary tract infections (UTIs), pelvic inflammatory disease, infertility, candida infections and an increased risk for sexually transmitted infections (STIs).

Diagnosing BV

BV is pretty straightforward to diagnose – and most women can tell you without a doubt if they are experiencing it. To diagnose BV your doctor will use what is called the Amsel Criteria. This can easily be done in office.

The PATH To BV Treatment

Understanding that BV is caused by an imbalance in healthy bacteria is the most important step in treating BV. When I am treating BV, I encourage all women to follow the PATH – four essential steps in treating BV so that it doesn’t keep coming back.

            PROMOTE Healthy Vaginal Flora

The bacteria that live in our lady garden are essential for maintaining a healthy vaginal environment. Their health often depends on our behaviours – so we need to do what we can to support them.

A diet high in sugar can promote the growth of undesirable bacteria. As can a diet low in fiber from plant foods. A lack of fermented foods in the diet can lead to low populations of healthy bacteria as well.

The most important thing we can do to promote healthy vaginal flora is to take a probiotic supplement. Both oral and vaginal probiotics (suppositories and creams) can support and promote a healthy balance of bacteria levels in the vaginal tract. Selecting appropriate strains is important – make sure that any probiotic you choose has adequate amounts of Lactobacillus – at least 10-12 billion per day for at least 6 months is what is recommended.

            AVOID Triggers of Vaginal Infection

Just as we need to promote healthy bacteria levels, we also have to avoid those things that promote infection.

Bacteria imbalances are more common in women using the birth control pill – both due to the high doses of estrogen and the less frequent condom use in women on the pill. Antibiotic use will also alter bacteria balance and increase the incidence of BV.

Douching and wearing non-cotton based underwear will also increase the risk for BV and should be avoided, especially during active treatment for BV.

            TREAT Overgrowth of Bacteria and Normalize pH

The normal pH of the lady garden is somewhere between 3.8-4.5 – a nice acidic environment.   The pH is maintained in this range by the healthy bacteria – mostly Lactobacillus that colonize the vaginal tract. In BV the pH is elevated above 4.5 – sometimes as high as 7.0! Restoring the healthy pH is essential for resolving the symptoms of BV and preventing recurrence.

The best way to normalize the pH is with the use of boric acid suppositories. Having a similar pH to the healthy vaginal tract, boric acid can restore the pH and, when combined with healthy bacteria supplementation, treat BV very effectively.

Your ND will help you to understand the protocol for use of boric acid suppositories and you can have a local compounding pharmacist make the capsules just for you.

HEAL Inflamed or Irritated Tissues

For the majority of women bacterial vaginosis is not associated with significant irritation or inflammation. If you have redness or swelling of your vulva, discuss with your Naturopath whether you may also have a candida (yeast) infection.

For women using the boric acid suppositories to restore healthy pH balance, there is a small chance of irritation. If this occurs a topical vitamin E gel is highly effective for decreasing irritation and healing the tissues.

Taking the PATH

Now that you have a roadmap to treating BV, I hope you will always consider the PATH when you are managing your BV. This approach has helped countless women in my practice overcome their bacterial vaginosis, and I hope it will help you too. If you’d like to work together and allow me to be a guide on your PATH, don’t hesitate to book an appointment today!

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 Resources

Cribby S, Taylor M, Reid G. Vaginal Microbiota and the Use of Probiotics. Interdiscip Perspect Infect Dis. 2008 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2662373/

 

PCOS & Berberine

While your medical doctor may not have heard of it, the functional and naturopathic medicine community is raving about berberine for polycystic ovarian syndrome (PCOS). And if you haven’t heard about it – you are about to go to school on WHY berberine may be exactly the treatment you have been looking for.

What is Berberine?

Berberine is a compound (technically a quaternary ammonium salt – damn! science!) found in several plants – most notably barberry, Oregon grape and goldenseal.  It has been used as a medicine in Traditional Chinese Medicine for over 5000 years.

Berberine Improves Insulin Responsiveness

One of the key findings in many women with PCOS is a poor response to insulin. When the cells (including those of the ovaries) stop responding to insulin, energy goes down, weight gain goes up and many of the hormone imbalances associated with PCOS show up.

One of the most common prescription treatments for PCOS is metformin, a drug that improves insulin response. But studies have found that berberine is able to do this too – and maybe even a bit better than metformin!

Berberine stimulates cells to take up glucose, so blood sugar and insulin levels drop. This can result in ovulation for women with PCOS. One study also found that the women taking berberine lost more weight than the women on metformin. Win-win!

Berberine Lowers Testosterone

The elevated testosterone associated with PCOS is the one hormone imbalance most women want addressed quickly. Elevated testosterone leads to the acne, head hair loss, chin and upper lip hair growth that women despise. Studies have demonstrated that berberine can lower testosterone levels and speed the resolution of these symptoms.

Berberine Benefits Your Gut

Berberine is not just great for your ovaries, but it’s great for your gut too. Berberine has been used for generations to treat symptoms of gas, bloating, constipation and diarrhea. Now we understand that it does this by helping increase the production of short chain fatty acids and supporting the healthy bacteria (probiotics) in our guts. Healthy bacteria help us to eliminate estrogen – minimizing the potential for estrogen dominace – another common hormone imbalance in PCOS.

Berberine Loves Your Liver

Your liver is essential in hormone balance. Berberine has been found in studies to increase the production of sex hormone binding globulin (that’s a mouthful…) or SHBG that binds to testosterone and makes it unavailable for use in your body.

Berberine has also been found to lower liver enzymes in non-alcoholic fatty liver disease, a condition that is commonly found in women who are overweight and have PCOS.

Berberine Benefits Fertility

Whether you are trying to get pregnant or just balance your hormones, it is reassuring to know that berberine can improve ovulation and pregnancy rates in women with PCOS. In women with PCOS undergoing IVF procedures, those who took berberine (no matter whether they were normal weight or overweight) had higher pregnancy rates than women using metformin or a placebo.

Berberine Boosts Weight and Fat Loss

Not every woman with PCOS is overweight (I talk about that more in the PCOS Types article), but if you are even mildly overweight berberine can help you to shed some unwanted fat.

Berberine has been found in multiple studies to support weight loss and to help target fat loss from the midsection of the body. Berberine helps to lower the production of our hunger hormone, leptin – a hormone that stimulates our appetite. Women with PCOS and women who are overweight often have abnormal levels of leptin.

Building on Berberine

Berberine is an excellent option for many women with PCOS. It can be the cornerstone for PCOS treatment and help you to achieve your dreams of hormone harmony.

Discuss with your Naturopathic Doctor if berberine is the best bet for you.  It may be used in combination with other natural treatment options, diet and lifestyle changes to improve your health and hormones, naturally.

Select Resources

Toronto Naturopath, Dr. Lisa Watson discusses the use of berberine for PCOS - polycystic ovarian syndromeAn Y, Sun Z, Zhang Y, Liu B, Guan Y, Lu M. The use of berberine for women with polycystic ovary syndrome undergoing IVF treatment. Clin Endocrinol (Oxf). 2014 Mar;80(3):425-31

Wei W, Zhao H, Wang A, Sui M, Liang K, Deng H, Ma Y, Zhang Y, Zhang H, Guan Y. A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndrome. Eur J Endocrinol. 2012 Jan;166(1):99-105.

Wu X, Yao J, et al. Berberine improves insulin resistance in granulosa cells in similar way to metformin. Fertility and sterility.2006; supplement S459-S460.

Yang J et al. Berberine improves insulin sensitivity by inhibiting fat store and adjusting adipokines profile in human preadipocytes and metabolic syndrome patients. Evid Based Complement Alternat Med. 2012

Zhao L et al. Berberine improves glucogenesis and lipid metabolism in nonalcoholic fatty liver disease. BMC Endocr Disord. 2017 Feb 28;17(1):13.

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.

Natural Treatment of PCOS

PCOS is the most common hormone imbalance impacting women and teenage girls. Polycystic ovarian syndrome, meaning “multiple ovarian cysts” can start soon after puberty and can persist for years. For some women it starts later – but for all women and teenage girls, it can be an incredibly frustrating, and sometimes painful condition.

WTF is PCOS?

Ovarian cysts occur when ovulation doesn’t occur as it is supposed to. In every cycle each ovary stimulates a number of follicles to develop, one of which will release an egg at ovulation. In PCOS the follicles are stimulated to grow (totally normal), but they do not respond to the hormonal cue to release an egg at ovulation. Instead they continue to grow and form cysts within the ovary.

There are many reasons why you may not respond appropriately to the hormones and instead form ovarian cysts – you can learn more about the types of PCOS in this article.

How Do I Know If I Have PCOS?

I talk about the diagnosis of PCOS in this article, but these are the most common symptoms that may suggest a diagnosis of PCOS:

  • Irregular or absent periods
  • Infertility
  • Hair growth on the upper lip or chin
  • Hair loss from the head
  • Acne – especially on the body or on the “beard distribution” of the face
  • Weight gain or excess weight around the abdomen

If you have a family member with PCOS, you are more likely to develop it. So talk to your mom, sister, aunts and grandmothers to see if you have a family history.

If you suspect you may have PCOS, then discuss it with your MD or ND and get an appropriate diagnosis.

What Causes PCOS?

PCOS is the result of failed ovulations – so the cause can be anything that disrupts healthy ovulation. Hormone imbalances stemming from the pituitary gland, the thyroid, the adrenal glands or pancreas can all cause PCOS. Insulin resistance – when your cells no longer respond to the hormone insulin – is probably the most common hormone imbalance that leads to PCOS.

How is PCOS Treated?

In conventional care, PCOS is most often treated with the birth control pill. Other choices, like spironolactone or metformin, are also suggested if acne or insulin resistance are present. However, many women are successfully choosing a more empowered approach to treating their PCOS through diet, exercise and some health supporting supplements.

Diet and Lifestyle

While not every woman with PCOS is overweight, if you are, losing weight is an important goal. Losing as little as 5% of your body weight can reverse insulin resistance, promote ovulation and decrease testosterone (less acne and chin/lip hair!)

I go into great detail on the basics of the PCOS Diet in this article – also available as a fun infographic! Check it out for all the information you need.

Vitamins and Minerals

Many different supplements can be used for managing PCOS. These are best selected by working with your ND – knowing what your hormone imbalance is will allow you to choose those supplements most likely to work for you. Here are a few of the most helpful options:

Vitamin B6 – can help balance prolactin levels, a hormone often elevated in PCOS.

Chromium – essential for proper blood sugar regulation. Taking chromium (also known as insulin tolerance factor) increases the uptake of glucose into cells, decreasing insulin resistance.

Vitamin D – essential for healthy ovulation. Every Canadian is deficient during the winter months, and supplementation is often needed to correct that deficiency.

Herbal Medicines

Plant medicines can be incredibly powerful medicines, especially when it comes to supporting hormone balance. It depends on your type of PCOS what herbal medicines may be recommended.

Saw palmetto (Serenoa repens) – an incredibly effective hormone balancer, saw palmetto decreases the conversion of testosterone to its more powerful form, dihydrotestosterone (DHT). This makes saw palmetto an excellent choice in the treatment of acne, hair loss, and facial hair growth.

Chaste tree (Vitex agnus-castus) – one of the best known herbal medicines for PCOS, chaste tree lowers prolactin levels and raises progesterone levels. It can also restore regular ovulation, the main issue in PCOS!

Other Natural Supplements

A few honourable mentions are necessary in any discussion of PCOS – treatments that have excellent research and deserve to be considered in any woman seeking a more empowered approach to her PCOS.

Inositol – a B-like vitamin, inositol has many benefits for PCOS – it decreases insulin resistance, decreases testosterone levels and helps to promote regular ovulation. It is a super-star for PCOS treatment.

Berberine – compared in studies to metformin, berberine has powerful actions on blood sugar regulation and insulin resistance. It can reduce testosterone, and androgens. Women taking berberine also achieved greater weight loss in some studies.

Next Steps

Knowing that there are a great many different options for the treatment of PCOS, some women can feel overwhelmed by information. This is one of the many benefits of working with a Naturopathic Doctor. Your ND can help you understand your individual hormone imbalance and guide you to the treatments that will be most effective for you.

Remember, any hormone imbalance will take time to resolve. Start taking the steps now to achieve your healthy hormone balance.

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.

 

Natural Treatments for Pain-Free Periods

Natural treatment options for period cramps

Ok ladies. In the last article we talked about why your periods can be painful – conditions l

ike endometriosis, fibroids or pelvic inflammatory disease, and lifestyle factors. We also talked my top ten lifestyle tips for pain-free periods. (If you haven’t read that article, pop over and read it now, then come on back and join me here. I’ll wait.)

In this article we’re going to go deeper into the science on period pain and discuss ten of most promising natural treatments for managing period cramps and painful periods.

But remember, these won’t work if you don’t have a healthy foundation in place, so start with the lifestyle changes, and then work with your Naturopathic Doctor to layer in some of these treatments to help you achieve your pain-free period!

Nutrients for Menstrual Cramps

B1 – Thiamine

Ah, thiamine, vitamin B1 – named so because it was the first B vitamin discovered! I’ve got a weak spot for B vitamins (and all vitamins really) because they are literally how our bodies get sh*t done! Thiamine is needed for your body to make energy from food – especially the grains that it is abundant in.

The mechanism by which this B vitamin can help period cramping stems from it’s action on the central nervous system and neuromuscular system – all coming down to it being effective for reducing spasmodic uterine pain (i.e. cramping). One study (link: https://www.ncbi.nlm.nih.gov/pubmed/8935744) found that taking vitamin B1 daily for 3 months completely alleviated period pain in 87% of study participants – damn! Worth a shot I think!

B6 – Pyridoxine

Vitamin B6 has fast become one of my favourite B vitamins (sorry B12!) due to it’s profound actions on female hormone balance. In addition to supporting energy production (just like all the B vitamins), vitamin B6 is needed to make progesterone, serotonin, norepinephrine and melatonin.

When used with its BFF, magnesium, vitamin B6 may be helpful in decreasing period cramps. When used for 10 days prior to the period, women have reported less painful periods (and less premenstrual acne!) when using a combination of B6 and magnesium. While it may not be enough on its own, it can be an important part of a treatment plan for period cramps.

Magnesium

Magnesium, known primarily for its ability to relax muscle (making it incredibly useful for blood pressure, muscle cramps and asthma), is unfortunately one of the most common nutrient deficiencies in North America. Found mostly in unprocessed foods (like leafy greens, nuts and seeds), magnesium deficiency can cause:

  • fatigue
  • irritability
  • weakness
  • muscle spasms
  • menstrual cramps
  • poor nail growth (I get asked about this issue all the time!)
  • insomnia
  • sugar cravings
  • anxiety

It has been suggested that the majority of women with PMS have a deficiency of magnesium – unfortunately magnesium is not easily tested for in laboratory tests, so deficiency often goes undiagnosed.

But the benefits of magnesium are not going unnoticed! A Cochrane study found that using magnesium for period cramps was effective for pain relief and resulted in women using less pain medication during their periods. Win! Magnesium: 1, period pain: 0.

Omega 3s

The last of our nutrients for period cramps, are our omega 3 fatty acids. These amazing compounds decrease inflammation (by altering prostaglandin production – remember this from the last article?) and taking relatively high doses (around 2 grams per day) has been found to reduce pain scores in women with period pain. And with all the side effects of omega 3s (healthy skin, less inflammation, improved mood, better heart health), it sure won’t hurt to give these a try.

Botanicals for Menstrual Cramps

While nutrients help our body to function optimally (that’s what they do!), botanicals, or plant medicines, act more like medications – changing or encouraging our bodies to function in specific ways. Most often I have my patients on a combination of nutrients (Woot! Optimal health!) and plant medicines to get the best outcomes.

Valerian

Best known for it’s sleep supporting actions, valerian (Valerian officinalis) can be very supportive for managing painful periods. With the ability to bind to GABA receptors in our brain (the same ones Valium uses), valerian can reduce pain, anxiety and insomnia. It has also been found to reduce spasmodic contractions – those same ones that lead to all the pain of period cramps. Valerian doesn’t need to be taken all month – just during your period to manage the discomfort and misery of painful periods.

Crampbark

Well doesn’t the name just say it all?? Crampbark (Viburnum opulus) has been used for generations for period cramps. Acting as a uterine relaxer and antispasmodic, crampbark is your best friend if your period cramps are accompanied by low back pain or pain that radiates into your thighs.   Taken in a similar manner as ibuprofen, one capsule of crampbark every 3-4 hours can help to reduce cramping and pain.

Ginger

I hate to play favourites (no, that’s not true. I totally love my favourites), but ginger is the BOMB when it comes to managing period pain.

With antispasmodic effects as well as the ability to inhibit the production of inflammatory and spasmodic prostaglandins (again with the prostaglandins!), ginger is a powerhouse of period pain management.

There have been studies comparing ginger with ibuprofen and found no difference in the effectiveness of the two treatments for period pain – in fact, more women in the ginger group were completely pain free than in the ibuprofen group. BOOM!

Ginger is most effective starting a few days before your period, and continuing through the first days when cramping is most likely to occur.

Black Cohosh

One of the best researched botanical medicines in the world, black cohosh’s claim to fame is in managing symptoms of menopause. But that’s not all it is good for.

Black cohosh (Actaea racemosa) is another uterine relaxer that can be useful for period cramping. It’s best for women who also have significant water retention (think swollen ankles, bloating and tender breasts), irritability during PMS, and delayed or irregular menstrual periods.

Other Natural Supplements

A few other natural medicines can help you achieve your dream of a pain-free period. And I certainly couldn’t leave them out! These two treatments are best used under supervision or advisement of your Naturopathic Doctor – so have a talk with them about whether to include these in your plan for a Pain-Free Period!

Melatonin

Melatonin for period crampsMelatonin is most commonly thought of as our sleep hormone, produced by the pineal gland in our brain to support sleep-wake cycles. But it does so much more than that!

Melatonin levels are lower during the second half of our menstrual cycle (during our luteal phase), and this is thought to be a factor in the development of period pain.

When melatonin levels are high, it can decrease the contractile force of the uterus – decreasing painful cramps. As well melatonin is known to have analgesic properties – decreasing pain. Melatonin also inhibits the production of those pesky prostaglandins that lead to most period pain.

Safe for most women, melatonin should be used for a few days prior to the onset of the period and for the first few days of the period. Taken before bed, you’ll likely get some stellar sleep as well!

BHRT Progesterone

For women whose period pain does not improve, no matter how many things they try, bioidentical progesterone can be a game changer.

Progesterone is the hormone that dominates the second half of the menstrual cycle, and a drop in the level of progesterone leads to an increase in inflammatory arachidonic acid and prostaglandins from the uterus. Welcome to Pain City.

If we can lessen the severity of this drop, or delay it, then often we can reduce the pain and intensity of uterus contractions that come from a hard drop in progesterone.

Best indicated for women in their 30s and 40s, bioidentical progesterone should be prescribed by a knowledgeable practitioner. Used for somewhere between 3-12 days before the onset of the period, progesterone may be exactly what some women need.

Onwards in your Pain-Free Period Journey!

Ladies, you don’t have to suffer. There are SO many things you can do to manage your periods so that they do not negatively impact your life. If you want to learn more, browse through some of the other articles on this website, or book an appointment to get your periods back on track!

Is my IBS actually SIBO?

Gas, bloating, abdominal pain, diarrhea, constipation – present to your medical doctor with any of these symptoms and you’ll likely get a diagnosis of IBS – irritable bowel syndrome. But what if it’s more than that? What if rather than having a cranky digestive tract you actually have a bacterial imbalance in your small intestines? What if you have SIBO?

What is SIBO?

SIBO stands for small intestine bacterial overgrowth, a condition where abnormally large numbers of bacteria (both the good and bad kind) are present in the small intestine. SIBO is a very common cause of IBS-like symptoms – studies have shown SIBO to be involved in between 50-84% of IBS cases. More importantly, when treated for SIBO, a 75% reduction in IBS symptoms has been found. For people who have been suffering for years (or decades!) with IBS symptoms, a proper diagnosis of SIBO can be life-changing.

Symptoms

While most people who experience digestive issues are given a diagnosis of IBS, the symptoms of SIBO are so similar that I recommend every patient who has been told they have IBS be tested for SIBO. Symptoms of IBS include:

  • Gas and bloating (often causing visible distention of the abdomen)
  • Flatulence (farting) and belching (burping)
  • Abdominal pain, cramping or general discomfort
  • Constipation or diarrhea (or both!)
  • Heartburn
  • Nausea
  • Nutrient deficiencies (due to malabsorption – vitamin D, B12, K)

The bacterial overgrowth in SIBO can cause significant gas and bloating – if you are experiencing severe gas or bloating, SIBO testing should be considered. With healthy normal bacteria levels, a single ounce of milk will cause about 50cc of gas to be created. With SIBO, that same amount of milk will cause up to 5000cc of gas to be created! And that gas has to go somewhere – filling the intestines and causing pain, or being released as gas and burping.

Many conditions may also be associated with SIBO, with the additional symptoms of those conditions being present. Some of those conditions include:

  • Hypothyroidism
  • Gallstones
  • Crohn’s disease and inflammatory bowel disease
  • Lactose intolerance
  • Diverticulitis/ diverticulosis
  • Fibromyalgia
  • Chronic pancreatitis
  • Lactose intolerance
  • Celiac disease
  • Restless leg syndrome
  • Rosacea
  • Diabetes

What Causes SIBO?

In our bodies we support a population of around 300 trillion bacteria. Living mostly on our skin and in our large intestine, these bacteria are powerful supporters of healthy human function. Producing vitamins like vitamin K and B12, producing neurotransmitters like serotonin, and regulating the function of our immune system – these bacteria are essential for optimal health.

SIBO occurs when the bacteria that should be in our large intestine migrate upwards into our small intestine. There they produce gases and disrupt nutrient absorption, leading the symptoms often attributed to IBS.

There are some specific triggers that can lead to this movement of bacteria into the small intestine. Some of those triggers include:

  • A stomach flu or food poisoning
  • Low stomach acid (or use of antacids)
  • Prior bowel surgery
  • Use of antibiotics (especially multiple courses)
  • Moderate or high alcohol consumption (greater than one drink per day for women or two drinks per day for men)
  • Use of birth control pills

One of the organisms involved in SIBO, Methanobrevivacter smithii has been linked to obesity in humans

Clues to SIBO

There are some clues that your IBS may in fact be SIBO. If you answer “yes” to any of these questions, you should invest in SIBO testing now.

  1. Did your digestive symptoms start, or become worse, after a bout of the stomach flu?
  2. Have you experienced short term improvement in your symptoms after taking an antibiotic?
  3. Do your symptoms get worse when taking a probiotic or prebiotic supplement?
  4. Does eating a high fiber diet worsen constipation or IBS symptoms?
  5. Do you have celiac disease that has not sufficiently improved following a gluten-free diet?
  6. Have you been diagnosed with an iron deficiency, despite having an iron rich diet?
  7. Do you have IBS symptoms and take antacids more than once per month (including Tums, Rolaids, Nexxium or Prilosec)?
  8. Do you experience gas that has a strong “rotten-egg” odour?

Diagnosis

The overgrowth of bacteria seen in SIBO can be identified through a breath test. The bacteria produce high amounts of hydrogen, hydrogen sulfide, or methane gas. These gases are not produced by human cells, but only through the action of bacteria on carbohydrates in our intestines.

The most common (and effective) test for SIBO is a combined hydrogen/methane breath test. This test is readily available from your Naturopathic Doctor. This is the only test for SIBO – stool tests will not help to diagnose SIBO.

Next steps

If you suspect you may have SIBO, you should see your Naturopath for appropriate testing. Once a diagnosis has been made you can embark on a treatment plan that may finally resolve your symptoms and get you back on the path to optimal health.

The treatment of SIBO is multifaceted and individualized for each person. Some of the key areas we focus on are supporting small intestine motility, optimizing digestive acids and enzymes, healing the lining of the digestive tract, eradicating biofilm and promoting healthy bacterial balance in the large intestine. Addressing the lifestyle and diet for long term prevention of recurrence is also important. Discontinuing medications, like antacids and proton pump inhibitors that encourage SIBO must also be considered.

You don’t have to continue to suffer. Digestive health is essential for optimal health. Get yourself tested, and get on the path to wellness today.

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.

Hormone Harmony in PMS

Welcome to the first installment of the “Hormone Harmony” series. In this series I’ll be exploring some of the most common states of female hormone imbalance, how your hormones can explain your symptoms, and some simple hormone hacks to help bring your body back into a state of hormone harmony.

Premenstrual Syndrome (PMS)

While a definition of PMS may not be necessary if you are reading this (it’s likely you’ve had first hand experience), I will try to give one that encompasses exactly what PMS is.

PMS is a recurrent set of physical and/or behavioural symptoms that occurs 7-14 days before a period and negatively impacts some aspect of a woman’s life

There have been over 150 (seriously!) symptoms of PMS identified. Some of the most common include:

  • Low energy
  • Mood changes – anger, crying, irritability, anxiety, depression, bitchiness
  • Food cravings
  • Headache
  • Low sex drive
  • Breast tenderness
  • Digestive upset – constipation, bloating, diarrhea, gas
  • Difficulty sleeping

Unfortunately we don’t really know what causes some women to experience PMS more than other women. But hormone imbalances are a common proposed cause, and in my practice I see balancing hormones as the most important means of decreasing symptoms of PMS.

Hormone Imbalances in PMS

The relationship between estrogen and progesterone is one of the most important hormone balances in a woman’s body. Imbalance in estrogen and progesterone levels is thought to be the primary cause of PMS.

Estrogen is produced throughout the month by the ovaries, adrenal glands and fat cells. It main action is growth – growth of breast tissue in puberty, and growth of the endometrial lining in the uterus during menstrual cycles.

Progesterone is produced during the second half of the menstrual cycle – after ovulation – by the ovaries.  Progesterone helps to balance the effects of estrogen and prepare the uterus for a possible pregnancy.

A too high estrogen level, or a too low progesterone level is thought to be the most likely cause of PMS symptoms in most women. This state, commonly called “estrogen dominance” is the most common hormone imbalance in women between the ages of 15 and 50. Estrogen dominance is becoming more common in North America due to increasing exposure to xenoestrogens (chemicals in our environment that mimic estrogen), high rates of obesity, decreased ability of our livers to detoxify and overwhelming amounts of stress.

The important thing to remember with PMS and hormone balance is that it is the relationship and balance of estrogen and progesterone that leads to symptoms. You may have normal levels of estrogen, but if your progesterone is low you will still experience symptoms. Progesterone levels are low in women who do not ovulate, and in those with significant stress (your body will convert progesterone into cortisol, leaving you deficient in much-needed progesterone).

Hormone Hacks for PMS

If you are a woman experiencing PMS, taking charge of your hormones and getting them into balance can make a huge difference in your quality of life. Below are some simple Hormone Hacks to get you started.

  1. Follow the PMS diet

There have been some significant findings in the diets of women who suffer from significant PMS. Compared to women who do not have PMS they eat 275% more sugar, 79% more dairy and 62% more refined carbohydrates. Avoiding these foods – and instead choosing fruits, vegetables, whole grains and healthy proteins – can diminish PMS symptoms significantly and promote healthy hormone balance.

  1. Cut the caffeine

No one wants to hear it, but drinking caffeine-containing beverages increases the severity of PMS. And those effects are worsened if you add sugar to your tea or coffee. So cut back, or cut it out all together if you want to decrease your PMS.

  1. Exercise

Women who exercise regularly have less PMS. Multiple studies have found this to be true, and the more frequently you exercise the better the boost. Exercise is known to decrease estrogen levels – so get out there and get moving.

  1. Get your nutrients in

Deficiencies in many nutrients have been found in women with PMS. Some notable ones include magnesium, vitamin B6, and zinc. All of these nutrients can be found in nuts and seeds – also known to be excellent sources of vegan protein.

  1. Get tested

Understanding your hormone imbalances can be incredibly valuable to managing symptoms like PMS. Testing your hormone levels will give you a clear understanding of what is happening in your body during a specific phase of your menstrual period. For PMS we test hormone levels (estrogen, progesterone and prolactin) about 7 days before your expected period.

  1. Herbal hormone balancers

There are some phenomenal hormone balancers in the world of herbal medicine. Vitex agnus-castus (also known as chaste berry) can improve progesterone levels, helping to balance estrogen dominance. Phytoestrogens, like those found in black cohosh, soy and flaxseeds, can also help to normalize estrogen levels by decreasing the action of our body’s own estrogen in favour of the milder estrogen signal from plant estrogens.

  1. Bioidentical progesterone

When all else fails in hormone balancing for PMS, your naturopathic doctor can prescribe low dose bioidentical progesterone in a cream that you can apply during the final weeks of your menstrual cycle. This will be helpful if your progesterone levels are low, or if your estrogen levels are high. Be sure your ND is qualified to prescribe bioidentical hormones, as additional training is required.

Don’t suffer with hormone imbalances like PMS.  You can achieve hormone harmony, and working with a Naturopathic Doctor can get you there.  Book an appointment, or a meet and greet now to find your personal balance.

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.           

Natural Treatments for Tinnitus

Tinnitus impacts nearly 400 000 Canadians and can severely impact the quality of life. Tinnitus is defined as the perception of sound without an external source. It may be described as a hissing, ringing, or whooshing noise.   Many individuals diagnosed with tinnitus are told that the condition is chronic, will never improve, and they will just have to learn to live with it.

While Naturopathic Medicine can not guarantee a successful treatment of tinnitus, there may be hope in some of the integrative treatments available.

Cause of Tinnitus

The exact underlying cause of tinnitus is not known. It can be associated with noise trauma (explosions, loud noises), physical trauma, post-inflammation, anxiety and other conditions. In many cases an underlying cause is not identified.

The symptoms of tinnitus may be processed by different parts of the brain than typical auditory pathways. The amygdala and limbic system – parts of the brain responsible for memory and emotions – seem to play a significant role in tinnitus.

Diagnosis of Tinnitus

Diagnosis of tinnitus is generally clinical – the presence of a reported noise with no external source. An audiologist assessment should also be performed. A contrast MRI is also a useful tool and can identify possible underlying causes of tinnitus. Blood work for autoimmune antibodies, vitamin B12, inflammatory markers (ESR), cholesterol levels, blood sugar levels, thyroid-stimulating hormone and comprehensive hormone testing can also provide useful information in identifying metabolic, hormonal, or autoimmune cases of tinnitus. Questionnaires can also be valuable in tracking progress with integrative treatment options.

Conventional Treatment Options

There are several different treatment options offered by qualified audiologists. Many involve sound therapy, masking, hearing aids or tinnitus retraining devices. A referral to an experienced audiologist is necessary for these treatments.

Correcting underlying causes of tinnitus will be helpful in a patient-by-patient basis. If the tinnitus is caused by a hormonal imbalance, such as thyroid disease, correcting the thyroid dysfunction can lead to resolution of symptoms. Antidepressants (impacting serotonin and/or dopamine) and GABA-enhancing medications have also been used in some individuals with success.

Naturopathic Treatment Options

While no guarantee of success exists in the treatment of tinnitus, the lack of conventional treatment options leads many people to seek out natural and integrative therapies. The majority of these options are safe and may provide some degree of relief to people suffering with tinnitus. Working with a knowledgeable Naturopathic Doctor is advised as these treatments may have side effects or interactions with other medications.

Ginkgo biloba

One of the most commonly sold botanical medicines worldwide, ginkgo is used to increase blood flow to the head and treat symptoms of Alzheimer’s disease, dementia and vascular tinnitus. ginkgo has antioxidant, neuroprotective and platelet-inhibiting effects. Studies suggest that ginkgo may have a positive impact on patients with tinnitus, by increasing blood flow to the ear and may be especially useful in the elderly. The use of ginkgo may be limited by its interactions with medications, especially blood thinners, aspirin and seizure medications.

Zinc

Zinc is an essential mineral with significant actions in the central nervous system, including the hearing pathway, as well as in hormone production, enzyme function, and synthesis of DNA and RNA. Studies have suggested that zinc deficiency impacts between 2-69% of individuals with tinnitus. Giving zinc to individuals with tinnitus is a low risk intervention, and measuring serum zinc levels may identify those in greatest need for supplementation.

Melatonin

Melatonin, a hormone produced by the pineal gland during the night, regulates sleep/ wake cycles and acts as an antioxidant. Some studies have found that supplementing melatonin may improve tinnitus, especially in individuals with sleep disturbances. Melatonin may also help in individuals with stress by balancing cortisol production, another hormone often involved in tinnitus.

Vitamin B12

An important nutrient, and common deficiency, there have been studies showing a relationship between vitamin B12 deficiency and abnormal function of the hearing pathway. For every individual experiencing tinnitus, vitamin B12 levels should be assessed and optimal levels should be achieved through dietary and supplemental means.

Garlic

The flavourful garlic bulb is useful for many cardiovascular conditions. It has cholesterol-lowering effects, lowers blood pressure and can decrease blood clot formation. It may be useful for tinnitus by improving blood flow to the inner ear. There are no current studies on the use of garlic for tinnitus, but the possible benefits are evident.

Pycnogenol

Preliminary research suggests that the antioxidant, pycnogenol (pine bark extract) can decrease symptoms of tinnitus after one month of use. It is suspected that it’s influence on inflammation and the cardiovascular system may lead to improvements in tinnitus.

Hormone Modulation

Hormonal imbalances have been identified in many individuals experiencing tinnitus, with imbalance in the hypothalamus-pituitary-adrenal (HPA) axis being most common. This HPA axis is involved in the stress response, with abnormal cortisol production being a common feature. One study found that individuals with tinnitus had a blunted cortisol response after stressful events. Identifying and correcting underlying hormonal imbalance can improve tinnitus in some people, especially those with stress.

Acupuncture

Several studies have demonstrated improvement in tinnitus symptoms with acupuncture treatment. Improvements with acupuncture have not been found in all studies, and improvements may be short lived (average of 100 hours in one study). Acupuncture is a very safe treatment, with limited side effects and no interactions with medications. Administered by a qualified naturopathic doctor or acupuncturist, it may be a valuable option for the treatment of tinnitus.

Taking an integrative approach, managing stress and balancing your hormones may help to improve the symptoms of tinnitus, and also improve the quality of life of people suffering with tinnitus. To learn more, speak to a qualified Naturopathic Doctor.

References:

The sound of stress: blunted cortisol reactivity to psychosocial stress in tinnitus sufferers. Hébert S, Lupien SJ. Neurosci. Lett. – January 10, 2007; 411 (2); 138-42

Diagnostic value and clinical significance of stress hormones in patients with tinnitus. Kim DK, Chung DY, Bae SC, Park KH, Yeo SW, Park SN. Eur Arch Otorhinolaryngol – November 1, 2014; 271 (11); 2915-21

Hormones and the auditory system: A review of physiology and pathophysiology Neuroscience, 2008-06-02, Volume 153, Issue 4, Pages 881-900, Copyright © 2008

Complementary and Integrative Treatments for tinnitus Gregory S. Smith MD, Massi Romanelli-Gobbi BM, Elizabeth Gray-Karagrigoriou Au.D and Gregory J. Artz MD  Otolaryngologic Clinics of North America, The, 2013-06-01, Volume 46, Issue 3, Pages 389-408

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.