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Love and Happiness: Hormone Hacks for a Happy Life

Hormones are chemical messengers that influence essential aspects of our health and wellbeing. The emotions of love and happiness are included as essential components of our lives. Three key compounds are involved in love and happiness – oxytocin, dopamine and serotonin. Today I’ll discuss the action of each and give some Hormone Hacks to help you boost your love and happiness in your day-to-day life.

Oxytocin

Oxytocin is a hormone and neurotransmitter that is often called the love hormone or the cuddle hormone. It is produced during times of bonding – during labour, breastfeeding and intimate contact with loved ones.

The release of oxytocin increases empathy and sensitivity to the emotions of others. It increases trust, caring for others and positive social interactions. It can make you feel more extroverted, and may even encourage you to lie for the benefit of a group!

Oxytocin also influences other hormones, leading to decreased stress hormone production and strong anti-anxiety effects.

Levels of oxytocin are high during the first six months of a romantic or significant relationship, but we can carry on that oxytocin high by focusing on these Hormone Hacks.

Touch and warmth – massage has been found to increase oxytocin, as has cuddling, holding hands, kissing or petting an animal

Give and receive hugs – some experts suggest both your immune system and oxytocin levels will benefit from 12 hugs per day

Eye contact – positive eye contact can increase oxytocin significantly, especially during intimate conversations and physical contact

Positive smells – smells associated with positive memories can increase oxytocin

Practice gratitude – focusing on the blessings in our lives can improve our mood, well being, and oxytocin levels. Simple steps like keeping a gratitude journal or sharing gratitude at the dinner table can go a long way towards improving happiness

Participate in something great – volunteer work, social movements, and any activity that benefits society and the greater good can boost oxytocin and social connectivity

Orgasm – the most direct line to increased oxytocin, it is produced by both men and women at orgasm. The boost is especially pronounced in loving relationships

Interesting fact: oxytocin is being studied for its potential benefits for autism and increasing empathy and social interaction. It may also be useful for tinnitus, but only preliminary studies have been done.

Dopamine

Dopamine is a feel-good neurotransmitter and hormone that is produced during new and novel experiences. It is a reward based neurotransmitter that increases desire, focus and attention, short term memory, boldness and delight in small details. It can also lead to a lower need for food or sleep and increase risk taking.

It is also a hormone associated with addiction. Dopamine feels good, so we repeat behaviours that encourage dopamine production, even if they have damaging effects on our lives.

Knowing this aspect of dopamine we can focus on building habits that are positive to our overall wellbeing.

Below are some Hormone Hacks to increase the beneficial effects of dopamine.

Try something new – engaging in a new activity will boost dopamine. Traveling to new places, visiting art galleries and trying new and novel activities

Eat something spicy – eating seemingly dangerous foods – spicy, hot, icy, fermented – will all trick your body into a dopamine boost

Take a healthy risk – riding rollercoasters, watching scary movies or playing video games, basically any mildly thrilling activity will increase dopamine

Achieve a goal – even small goals like finishing a book, finishing a chore, winning a game against friends can give you a dopamine edge

Meditation and visualizationmeditation has been found in studies to increase dopamine. And if you aren’t feeling adventurous enough for a rollercoaster, just visualizing the activity can trigger a dopamine release – just as if you were actually doing it!

Serotonin

Another feel-good neurotransmitter, serotonin is essential to a balanced, happy mood. It is also necessary for will power, to create long term plans and delay gratification. Serotonin makes us feel like anything is possible.

Serotonin is made both in the brain and in the digestive tract (80-90%). Not only does serotonin impact mood and memory, but also appetite (especially carbohydrate cravings), nausea and bowel function.

Low levels of serotonin are found in impulsivity and depression – but we don’t know if the low serotonin is a cause or effect of depression.

Increasing serotonin is often done through medications (some legal, others not), but there are many natural ways to increase serotonin.

Sunshine – outdoor light, or light boxes (available at some Toronto area libraries, or for personal home use) stimulate serotonin production and vitamin D synthesis, an essential nutrient for serotonin action

Exercise – in addition to making us feel good, exercise improves the function of serotonin in the brain

Massage – another kudos to massage therapy – massage can increase serotonin levels by 28% and decrease the stress hormone cortisol by up to 30%

Eat your greens – vitamin B6 (pyridoxine), found in leafy greens, cauliflower, fish and lean poultry, is an essential nutrient for the production of serotonin. Low levels can lead to low serotonin

Eat legumes – legumes, particularly chickpeas, are high in tryptophan – the amino acid necessary for serotonin production. Other foods high in tryptophan include nuts, seeds, tofu, turkey, lentils, eggs and dairy

Remember happy events – surrounding yourself with positive memories – photos and mementos of happy moments, special occasions, and loved ones, can give you a serotonin surge every time you see them and remember happy times

Hormones really are essential components to our health and happiness. Use these Hormone Hacks to help increase the love and happiness in your life. Got a tip I didn’t include? Please leave it in the comments below.

And if you’re interested in achieving your personal Hormone Harmony, book an appointment 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.

Are Menstrual Clots Normal?

One of the “joys” of womanhood, our monthly menstrual flow, can sometimes come with some surprises. One of those occurrences for many women is menstrual blood clots. Most women want to know if this is normal – and why it is happening.

Your Period

During your monthly cycle the lining of your uterus (endometrium) grows thick and increases the blood supply to support a potential pregnancy. When a pregnancy does not occur the drop in hormones (especially progesterone) leads to a release of the innermost lining of the uterus and we experience a period. In an average period women lose 30-40ml (6-8 tsp) of blood, with women experiencing heavy periods losing more than 60ml (12 tsp).

Blood Clots During Your Period

In a typical menstrual flow, the blood is not clotted due to the release of anticoagulants. The contraction of the uterus also stops further bleeding from the remaining blood supply to the uterus, and helps to expel the menstrual blood. After 3 to 4 days of bleeding, most of the inner lining of the endometrium (the “stratum functionalis”) has been released and blood loss slows considerably.

Blood clots are often a consequence of heavy menstrual flow. When the blood loss is too much, or too fast, the anticoagulants produced are not adequate to breakdown the lining of the uterus and prevent further clotting. Most women who experience clotting do so on the heaviest days of their menstrual period.

Possible Underlying Causes of Menstrual Blood Clots

  1. Miscarriage

Sometimes clots are actually a very early stage miscarriage. These clots may be found along with small gray clumps of tissue. If you experience other signs or symptoms of pregnancy along with clots, you may consider having your beta HCG levels tested to determine if it was, indeed, an early miscarriage.

  1. Uterine Fibroids (Leiomyomas)

Uterine fibroids are benign (non-cancerous) growths that occur in the muscular layer of the uterus. Some women with fibroids experience no symptoms at all, but for many women with fibroids they experience heavy periods (and blood clots) as a result. Fibroids are more likely to occur as we get older, especially after having children. Fibroids are also more common in women of African descent, those who are overweight and those with a family history of fibroids.

  1. Adenomyosis

Adenomyosis occurs when the endometrium breaks through into the muscular layer of the uterus (the myometrium). This can cause cramping, bloating, heavier menstrual periods and the presence of blood clots. Adenomyosis is also more common with age, in women who have had children, and in those who have had uterine surgery (such as a Caesarean section).

  1. Iron deficiency

In one of the great injustices in women’s health one major consequence of heavy periods, iron deficiency, can also lead to heavy periods. If you are experiencing heavy periods it is vitally important to test your hemoglobin, hematocrit and ferritin (iron) levels and build up your iron levels if needed.

  1. Hormonal imbalances

Imbalances between the two main female hormones, estrogen and progesterone, can lead to increased thickening of the uterine lining, resulting in heavy menstrual periods and blood clots. Imbalances in these hormones can occur at any stage of the reproductive life span, but are most common during adolescence and through the 40s and perimenopausal years.

  1. Thyroid imbalances

The thyroid is a small, butterfly shaped gland in your neck that controls your metabolic rate and has significant impacts on your hormonal health. An underactive thyroid can cause many symptoms – fatigue, difficulty losing weight, hair loss, and heavy periods. And with these heavy periods may come menstrual blood clots.

Recommended Testing for Menstrual Clots

If you regularly experience blood clots during your period, having some laboratory and imaging studies done is a good idea. It can help you understand why you are experiencing blood clots and your Naturopathic or Medical Doctor can work with you to determine an appropriate treatment plan.

Complete blood cell count – including hemoglobin and hematocrit to look for healthy red blood cells

Ferritin – to assess for iron deficiency anemia

TSH and complete thyroid panel – to assess health of the thyroid

Female hormone panel – to compare levels of estrogen and progesterone, along with other reproductive hormones, to ensure balance

Transvaginal or pelvic ultrasound – to identify uterine fibroids or other abnormalities of the uterus and uterine lining

MRI – a further visual assessment of the uterus if ultrasound is not adequate

If you are experiencing heavy periods and menstrual clotting, speaking to your Medical or Naturopathic Doctor can help you understand why you are experiencing these symptoms and develop a treatment that is as unique to your body and your period.

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.

References:

Young, B. Wheater’s Functional Histology, 6th Edition, 2014.

Melmed, S. Williams Textbook of Endocrinology, 2016.

 

Understanding Spotting Between Periods

“Why am I spotting?” is a common question that comes up in my naturopathic practice, impacting up to 1 in 3 women at some point in their reproductive lifespan. Spotting is most common in women during adolescence and during the transition to menopause, but can occur at any point in a woman’s life. While most women are told spotting is not significant, speaking to your doctor is suggested to determine the underlying cause.

What is Spotting

Spotting, also called intermenstrual bleeding, or even more technically “metrorrhagia” occurs when there is bleeding from the uterus at irregular intervals, most often between expected menstrual periods.

Causes of Spotting

  1. Ovulation

Ovulation is the most common cause of spotting in women. Around ovulation estrogen levels drop off slightly as an egg is released from the ovary. This drop in estrogen can lead to bleeding that is most often significantly lighter than a period and lasts for a shorter time. The blood may also be a different colour – brownish or pink. This ovulatory spotting is considered to be normal, but you should discuss with your health care provider to ensure nothing else is causing this symptom.

  1. Birth control pill

Birth control pills, and other forms of hormonal contraception (IUDs, patches, injections and implants), commonly cause spotting (called “breakthrough bleeding”) during the first few months of use. Most common in the first three months, for some women it doesn’t improve – if this happens a higher dose birth control or different method of contraception may be needed. Breakthrough bleeding is also common if you don’t take your pills as directed (missing a day or not taking at the same time each day). Women who smoke and take birth control pills are more likely to experience breakthrough bleeding (and should consider other forms of contraception due to the increased risk of blood clots.)

Other medications have also been found to be associated with intermenstrual bleeding, including anticoagulants (warfarin, heparin), antipsychotics, corticosteroids, and selective serotonin reuptake inhibitors (SSRIs.)

  1. Polycystic ovarian syndrome

One of the hallmarks of PCOS is irregular periods. In PCOS women do not ovulate, which leads to a lack of progesterone production and unopposed estrogen causes continued growth of the uterine lining. The lining will continue to thicken until it outgrows its blood supply and degenerates. Different sections of the lining may outgrow their blood supply at different times, causing spotting.

This lack of ovulation can also have similar results in adolescent girls who do not yet have a mature reproductive hormone cascade, resulting in spotting.

  1. Local infections

Infections of the vagina, cervix and endometrial lining can all cause spotting between periods. The infection is most often secondary to a sexually transmitted infection, but can also occur with pelvic inflammatory disease. Inflammation of the cervix (cervicitis) or uterine lining (endometritis) can also cause bleeding after sexual intercourse.

  1. Uterine or Cervical Polyps

Polyps are soft growths that can occur on the inside surface of the uterus or on the surface of the cervix. These growths are benign but may cause irregular bleeding, especially after intercourse.

  1. Perimenopause

The changes in hormone balance that occur in the years prior to menopause can lead to irregular periods and spotting between periods. With the transition to menopause comes a decrease in egg quality, resulting in less progesterone production and shorter menstrual cycles. The decline in successful ovulation can also lead to longer cycles. And both of these states of hormonal imbalance can lead to spotting.

  1. Thyroid hormone imbalances

The healthy function of the thyroid directly influences the healthy function of the reproductive organs. Under functioning of the thyroid (hypothyroidism) has been known to cause menstrual spotting, and correcting the underlying imbalance typically resolves the symptom.

  1. Pregnancy

Spotting in pregnancy can be an alarming symptom, but for many women it is totally normal. Some women experience spotting associated with implantation that can be very similar to a menstrual period. If you do experience spotting in pregnancy, see a doctor immediately to ensure optimal safety for both mom and baby, and to rule out an ectopic pregnancy which can be life-threatening if not treated.

  1. Uncommon causes

Less common causes for intermenstrual spotting include foreign bodies in the vagina (most often toilet paper or tampons) and certain types of reproductive cancers, including cervical, ovarian, endometrial and vulvar cancers. Clotting disorders can also worsen spotting and should be considered in teen girls with heavy periods or frequent spotting.

Testing for Spotting

While most spotting between menstrual cycles is benign and normal, it is important to try to identify an underlying cause, and correct it if possible. Achieving hormone harmony is possible, and can be done with the support of your Naturopathic Doctor.

Discuss this checklist with your Medical or Naturopathic Doctor to help you achieve your personal hormone balance.

Menstrual spotting checklist

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 Testing

The importance of hormones for human health can’t be understated. The over 50 hormones in the human body act as chemical messengers that control most major bodily functions – from hunger, stress, mood and emotions to reproduction.

The body maintains an intricate balance of hormones, a state called homeostasis. When this delicate balance is challenged a wide variety of symptoms can occur – insomnia, fatigue, depression, anxiety, weight gain, acne, premenstrual syndrome, endometriosis, PCOS, diabetes, menstrual irregularities, and many, many more.

When identifying an unbalanced hormonal state, hormone testing can provide valuable information that will allow you to take steps to restore your optimal hormone balance, resolve symptoms, and restore optimal health.

Hormone Testing

Three important factors need to be considered when seeking testing for hormone balance.

            Timing of Testing

Time of day and time of month are important factors in getting valuable information from hormone testing. For most hormones, testing should be done first thing in the morning. An exception to this rule is cortisol, which is often tested at multiple points over the course of the day.

Time of month, or more accurately, time of the menstrual cycle, is also an important consideration for women. Generally hormones should be tested about one week before an expected period, when levels are at their peak.

Testing Sample Type

There are three main ways to test for hormone levels – blood (serum), saliva or urine. Each has it’s benefits and can be used, depending on the information needed.

Blood – a simple blood draw can give a great deal of information about thyroid hormones, insulin and blood sugar levels, vitamin D, prolactin, FSH and LH. It’s a quick process with well established reference ranges. However, it’s not considered the best test for steroid hormones like estrogen and progesterone, as levels in the blood stream do not accurately reflect free hormone levels available for action in the body.

Saliva – a home saliva test kit will provide excellent information about the free hormone levels of many steroid hormones: cortisol, estrogen, progesterone, DHEAS and testosterone. This test is often considered the most accurate reflection of hormone balance in the body. The drawbacks to salivary testing are the less well established reference ranges and the lack of testing for hormone detoxification pathways.

Urine – a newer testing type for hormone balance, the dried urine test for comprehensive hormones (DUTCH), gives a good overview of the steroid hormones estrogen, cortisol, progesterone, testosterone, DHEAS as well as the metabolites produced when our body breaks down these hormones.

            Balance Over Absolute Values

The last important consideration for hormone testing is that the results of your hormone test should be interpreted by a practitioner with a great deal of expertise in hormone testing and hormone balancing. When looking at a hormone test the most important information is the balance between the different hormones, rather than the absolute values of each individual hormone. A low normal progesterone with a high normal estrogen results in the same symptoms as a normal estrogen and a very low (or abnormal) progesterone.

Hormones are responsible for a vast variety of functions in our bodies, and their imbalance is an important (and common!) cause of symptoms. If you suspect you may have a hormonal imbalance, book an appointment with your Naturopathic Doctor today to discuss your options.

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 Options for PUPPPS

 

PUPPPS may sound like a cute acronym, but ask any pregnant woman who has experienced it and you will soon realize this condition is anything but cute.

PUPPPS stands for pruritic urticarial papules and plaques of pregnancy.  This translates to “itchy, allergy-like rash during pregnancy”.  PUPPPS is a hive-like rash that occurs in around 1 in 200 women during pregnancy.  The rash is itchy and most commonly starts on the abdomen and may spread to the legs, feet, arms, chest and neck but usually does not occur on the face.

We don’t know why some women develop PUPPPS during pregnancy but it most often begins in stretch marks and is more common in women with significant skin stretching. Women with large fundal measurements and those who are carrying large babies or twins and triplets are at greater risk.

Interestingly there is a higher rate of PUPPPS in women carrying boys. Statistics have shown that bw-pregnant-window70% of women with PUPPPS deliver boys. Researchers think this may be due to male DNA interacting with the mother’s body, leading to irritation.

The good news is that PUPPPS, aside from causing itching and irritation, has no long term negative effects on either the mother or the baby and tends to resolve on its own within a week of delivery.

Most treatments for PUPPPS involve hydrating the skin and keeping the mother comfortable.  Certain antihistamines may also be tried.  From a Naturopathic perspective, we focus on decreasing the allergic response of the immune system, supporting the detoxification properties of the liver, decreasing inflammation and helping to clear and possible underlying causes.

6 Natural Treatment Options for PUPPPS

  1. Increase vegetable consumption and vegetable juice consumption

To optimize liver function by supplying healthy antioxidants and cholagogues (plant based compounds that support optimal liver function). Ideal vegetables are dark green leafy vegetables, beets, carrots, broccoli, cauliflower, bok choy, brussels sprouts, kale and kohlrabi

Also increase consumption of canned tomatoes for the lycopene content, an excellent antioxidant and member of the beta carotene family – but be sure to choose organic canned tomatoes to decrease exposure to BPA. Glass containers are even better.

  1. High quality omega 3 rich oils

TomatoesOmega 3 fatty acids, such as those found in flax seeds, chia seeds, salmon and fish oil supplements help to improve the fluidity of skin membranes, decreasing the potential for stretch marks. Omega 3 fatty acids are also anti-inflammatory and can help to decrease the production of inflammatory mediators, decreasing redness and itching in skin rashes.

Consume omega-3 rich foods such as ground flax seeds and chia seeds daily. Consume omega 3 rich fish (those that are safe in pregnancy include salmon, tilapia, cod and Pollock) at least two to three times per week. An omega 3 rich fish oil supplement may also be recommended by your Naturopathic Doctor.

  1. Moisturize the skin with a soothing moisturizer

    Coconut oil is a safe choice for pregnancy and is highly moisturizing. Chickweed ointment is another stellar choice as chickweed is a natural antihistamine and can greatly reduce itching sensations.

  1. Dandelion Root (Taraxacum officinalis)

    allergy_dandelion medicineAnother highly effective treatment for PUPPPS. Dandelion acts as a hepatic and cholagogue – it enhances the function of the liver and gallbladder, clearing inflammation and congestion through that system. It is highly indicated for chronic skin eruptions, especially those that are hot, red or itchy.

    Dandelion is available as a tea (which will have diuretic effects) or as a capsule. For PUPPPS I usually recommend starting with a tea and introducing a supplement if needed.

  1. Milk thistle (Silybum marianum)

    Mike thistle is a liver supportive treatment that can be used to enhance the actions of dandelion root or on it’s own. It is effective in increasing the secretion and flow of bile from the liver and gall bladder. Milk thistle also promotes milk secretion and is encouraged for breast-feeding mothers.

  1. Avoid food sensitivities

    There is some research suggesting a correlation between food sensitivity (especially dairy) and PUPPPS. Consider food sensitivity testing or elimination diets to address symptoms.

PUPPPS can be a difficult condition to life with, and with the support of naturopathic medicine you may not need to!  Gentle and safe natural treatments are available.  Speak with your Naturopathic Doctor today to put together a plan.

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.

Naturopathic Acupuncture

As a Naturopathic Doctor, I have received extensive training in Traditional Chinese Medicine (TCM) and acupuncture. TCM is a system of medicine that has been used to prevent, diagnose and treat disease for over 5000 years. It is based on the Eastern philosophy of “Qi” (life energy). Traditional Chinese Medicine seeks to balance the flow of Qi in the body in order to maintain health, treat illness and relieve pain.

Acupuncture is the use of very fine, sterile acupuncture needles inserted into specific points (acupoints) in the body to manipulate and control the flow of Qi. Acupuncture has been proven to be beneficial in the treatment of many conditions including joint pain, chronic back pain, digestive difficulties, menstrual irregularities, depression, insomnia, migraine and many others.

In my practice I use TCM and acupuncture for a variety of conditions, most notably fertility enhancement, IUI and IVF cycle support, female and male hormone balancing, menstrual irregularities, endometriosis, labour induction, menopause symptoms (hot flashes, night sweats), anxiety, depression, insomnia, headaches and digestive complaints (diarrhea, constipation, heartburn). Acupuncture is safe and effective for all adults, including pregnant women. Acupuncture provided by Dr. Lisa is covered by most extended insurance plans under Naturopathic Medicine.

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.

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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.

 

 

 

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