Archive for hormones
The holy grail of weight loss research is finding a pill that enables people to lose weight with theoretically less action than what people are willing to take. We have all heard the mantra that increased activity and reduced food consumption is the way to lose weight. Anyone who has ever needed to lose weight understands this equation. The difficult part has always been developing and sticking to a plan that works.
Many medications developed for weight loss have been effective, but usually at a tradeoff that presents serious problems for some other system in our body. Remember Phen-Fen? That was highly effective in causing weight loss, but was found to cause serious heart and lung problems. So it looks like for now, we are back to the equation of eat less move more for weight loss.
Researchers have known for years about the different hormones associated with eating and food metabolism. What has been an eye opener is how these hormones interact and effect our appetite and sense of fullness. Most studies have been performed on men, but there has been a recent study performed on a small group of women noting the affect of exercise on appetite and hunger.
Appetite and hunger are complicated and involve signals from many parts of your body, as well as our emotions. There is one hormone that stimulates hunger, called ghrelin. What ghrelin does in response to exercise has been inconsistently documented in studies, however a this recent study suggests it is variable for women, depending on what exercise you engage in. This study found that this appetite hormone spiked during running exercise in the test subjects, but not in the walking test subjects. Additionally, the hormones associated with feeling full also were raised following the running exercise group but not the walking exercise group.
The combined result surprisingly showed that appetite and food intake was reduced following exercise for the runners, but not for the walkers. The walkers were noted to eat more following their exercise, more calories than what they burned for their activity.
What does this mean for us?
- To lose weight, you must pair your exercising with a diet that is restricted in calories to some degree.
- The more vigorously you exercise may also positively impact your appetite and resulting calorie intake.
- There may be some difficulty with weight loss using walking alone as your exercise.
- Interval training may be more effective, with short bursts of intense exercise added at intervals with your walking.
- As of yet, there are no pills or short cuts to the process of weight loss.
Find a schedule or program that works for you, that you enjoy; and stick to it. There are many ways you can enjoy exercise.
- Zumba and dancing and dance aerobics are fun ways to move and may appeal to you who do not like gyms. Many classes are offered through gyms as well as churches and facilities not requiring a membership.
- Walking or jogging/running with a club or friend(s) may appeal to the social side of you. Some local athletic stores sponsor walking and running clubs that are loosely structured but can help get you moving.
- Many gyms have classes that can appeal to you such as spinning, pilates, as well as different movement regimens.
- For those of you that want to start off in the privacy of home, exercise CD’s or home equipment can be a good and often affordable option.
Keep in mind the more vigorous your exercise, the more you will engage natural hormones to help you with healthy food metabolism and appetite control. Adding healthy food choices in your kitchen and getting rid of unhealthy choices can then help you replenish with less calories. This is a key to weight loss, and unlike pills, can be continued for a lifetime!
Venous thromboembolic disease is a serious and potentially life threatening condition. Both men and women are at risk for this, however hormone therapy often used in menopause increases this risk. Blood clots in the leg veins, known as Deep Venous Thrombosis or DVT, are the most common manifestation of thromboembolic disease.
Predisposing factors include:
- A hypercoagulable state in which the normal clotting mechanisms and the inhibitors which prevent uncontrolled clotting are inhibited
- Venous stasis where this is decreased blood circulation
- Damage to the blood vessel wall which can include chemical, physical and immune related injuries
It is generally agreed that the above three conditions are required for a DVT to occur. These conditions can be present in several different forms. Coagulation is mediated by several proteins which are produced in response to damage to the wall of the blood vessel. The platelets which travel there to repair the injury also help to produce coagulation proteins. There are several inherited conditions which can alter the response of these proteins, resulting in impaired coagulation.
There are also inhibitory substances that are responsible for dissolving a clot after it is created. These inhibitors act to neutralize the coagulation pathway when appropriate. A deficiency in these proteins can allow the coagulation system to be hyperactive.
Elevated levels of estrogens as seen in pregnancy, as well as use of HRT and oral contraceptives can create a hypercoagulable state through increased production of some coagulation proteins.
When other precipitating events or conditions exist in the setting of increased estrogen, you are at risk for a DVT.
Venous stasis can be caused by:
- Prolonged bed rest such as a hospitalization
- Prolonged air travel of over 4 hours without opportunity to walk
- Heart failure
Damage to blood vessel wall can include:
- A medical procedure which involves placing a catheter in the groin blood vessel
- Cancer and cancer treatment drugs
- Fractures of legs or pelvis
- Recent surgery of hip, knee or female reproductive organs
- Cigarette smoking
Other factors which could place you at risk for a DVT include age over 60, obesity, and being of blood Type A.
Signs and symptoms of a DVT includes an acutely swollen and painful leg without prior cause or reason for this. Pain in the calf with movement or flexion of your foot upwards can also be a sign of a blood clot, especially when combined with the above precipitating factors.
It is important to seek medical care as soon as possible if you believe you have a blood clot as several dangerous events can occur with these blood clots. The most serious problem could be a piece of the clot breaking loose and travelling to your lungs. This causes inability for that section of lung to work correctly and can ultimately cause destruction of this segment of lung. This event, pulmonary embolus, can be life threatening.
It is important to realize that anyone with several of the risk factors and the situation of immobility can be at risk for dangerous blood clots, however being older an being on hormone therapy increases this risk. It is important to take measures to prevent these clots such as use of support hose if involved with prolonged immobility, drink plenty of water, and work on improving fitness.
Have you had an experience with phlebitis? Do you have something to add or a feeling you want to express to me? If you do, then many others reading this will also. Please, tell me what is on your mind in the comments section. I look forward to having a conversation with you.
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Fatigue is one of the most common problems that women voice as they are moving through the menopausal transition. We have discussed in previous posts the causes of fatigue in peri and post menopausal women. The reasons can be numerous and multifaceted.
The commonly thought of causes include sleep disturbance from hot flashes, restless leg syndrome and obstructive sleep apnea.
Women can become anemic from irregular and heavy menses in peri-menopause, this can certainly cause fatigue.
Often times women on are medication to treat disorders and diseases, and these medications can cause fatigue.
Thyroid disorders can cause fatigue, as the thyroid hormones are responsible for setting our metabolic rate (the rate at which our bodily functions work).
Lastly, depression and anxiety can cause fatigue mostly through the chemicals in our brain not being in enough supply or in the correct proportion.
Let’s talk about hormones and how they can affect fatigue. The steroid hormones are hormones produced for an action, production is stimulated by the brain, and they are meant for immediate use by the body. The hormones I will discuss are produced in both the ovaries and the adrenal glands. The hormones that are primarily responsible for the change in how you feel during menopause are:
- thyroid hormone T3 and T4
Cholesterol is the precursor for all of these hormones with the exception of thyroid hormones. Cholesterol is broken down into basically 2 parent compounds which then go through changes to become the above list with the exception of thyroid hormones.
One parent compound, pregnenolole eventually becomes
- cortisol and
The other parent compound becomes Adrostenedione which eventually becomes
Why is this important for me to know?
Because knowledge is power. Once you understand what might be going on, you can decide to make changes to help relieve yourself of some of the symptoms you are experiencing.
Pre-menopausal, the production of these important hormones takes place in 2 places, your ovaries and your adrenal glands. Estrogen and progesterone in the ovaries and also in the adrenal glands, the rest are produced by the adrenals.
The adrenals are small organs which sit atop the kidneys. When the ovaries stop working, the production of progesterone starts a slow steady decline. The estrogen level falls rapidly but can also rise as the ovaries sputter along.
Many symptoms of bloating, fatigue and mood disturbance can be linked to not enough progesterone early in peri-menopause. While hot flashes, brain fog and fatigue can be linked to fluctuating and then low levels of estrogen. Prior to menopause, healthy estrogen levels help the action of cortisol which also helps to prevent cortisol excess. When estrogen falls, it leaves the cortisol unopposed and therefor in excess.
Why is excess cortisol bad?
Excess amounts of cortisol for prolonged periods of time can cause the following ill effects:
- weaken the immune system
- slow healing and normal cell repair
- impair digestion
- break down healthy muscle and bone
- interfere with the normal function of other hormones
- interfere with sleep
- increase appetite
Cortisol is a very important hormone when it is needed for immediate action or a stress response. Today’s stressful lifestyles can cause prolonged increase levels of cortisol and as a result, the above list of problems can occur.
So what can a person do to decrease the effects of hormonal changes and stress?
There is, of course, medication to treat the different symptoms. This you can discuss with your medical provider, it may mean you could be taking several different pills for all these different symptoms. What your medical provider may not have time to talk about are the lifestyle changes that can help all of this. (If you would like to talk to me about lifestyle changes, send me an email via out contact form. Click on the word contact on the black navigation bar at the top of this page.)
The following are all suggestions sited by the experts on how to change your lifestyle to help facilitate relief:
- decrease your stress response through measures such as yoga, meditation, prayer, anger management counseling, therapeutic massage
- exercise-this helps lower cortisol, lowers blood pressure, helps with stress, helps the cardiovascular system and your muscles remain healthy
- sleep-studies have shown people who get less than 4-5 hours of sleep are 72% more likely to be obese. This is due to hormones also
- a diet low in sugars and refined carbohydrates can lower the entire cascade of hormones which help to create obesity and elevated cortisol levels.
- a diet high in fresh vegetables and fruits, preferably produced locally so nutrients have not degraded, provides you with healthy anti-oxidants and other substances which the cells of our bodies utilize for healthy functions.
All this discussion of hormones and cortisol may seem mysterious and I will try to shed some light on the intricate interplay of these hormones in a future post. It is important to understand that you can change much of what is happening during menopause that is undesirable through your lifestyle.
It takes work and change and many people do not want to do this. The rewards of making changes and gaining some element of control over what is happening to your body can be very empowering. Every patient I have seen that successfully makes these changes have been immensely satisfied by the changes they have made. So ask yourself, what is stopping you from making the changes you know you should make?
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questions, tell me about your experiences, relate an epiphany you had or a way you have improved your energy. If you don’t want to do that, then share this with your friends on Facebook, Twitter or email by using one of the icons below.
Fatigue is a problem which plagues all age groups, but becomes especially troublesome as we age. We want to blame many things for our fatigue, and we may be right much of the time.
Causes of fatigue as shared with me in the Family Practice clinic where I work include:
- not getting enough sleep
- working too many hours
- depression or anxiety
- unknown causes
To the above reasons, many of us can say yes, I have those problems. Many of us can devise a plan, or at least an idea of a plan, to help reduce or lessen these pr0blems.
We all know…
- if we go to bed earlier
- draw boundaries on work obligations and stick to them
- get a little exercise
- stretch some
- have some fun or at least spend time daily doing what we like
We will feel better and not be so tired.
After all, most of us feel just fine when we are on vacation!
What about that grinding fatigue that hits even though you are doing everything right. There is a name for this fatigue, crashing fatigue. Its name says it all! This is the fatigue that hits you all of a sudden, makes you feel that if you do not go lay down now, you will drop where you stand. That fatigue that makes you feel you cannot go on at that moment.
Fatigue causes and treatment?
The medical providers that recognize Crashing Fatigue do not exactly know the causes for it. It is not even recognized by many mainstream medical providers. For anyone who feels it… Crashing Fatigue Exists. The cause is most likely related to the complicated interplay of hormones which run the body, and that are changing now that you are going through menopause. This is often the basis for what is termed Adrenal Fatigue, another condition not recognized by mainstream medical providers. There has been little research regarding the possibilities for these conditions, and until something is proven by the medical establishment it is often not recognized as a valid illness.
This doesn’t change the fact that for many of us, something very different is going on with our bodies. This difference is often not met or explained by standard medical testing and treatment. This is the basis for the alternative branch of medicine which investigates problems through testing in unconventional routes, such as saliva testing. Use of specialized, compounded creams and pills are formulated to match your specific hormonal imbalance to improve symptoms. This practice has helped many women feel much better with their symptoms of menopause. The potential problem arises due to the relatively unregulated nature of this testing, medication manufacturing and prescribing. This form of treatment is being hotly debated between mainstream providers and alternative providers. I suspect that it is an issue which will be resolved in some fashion over the next decade.
Just as the causes for fatigue can be numerous, so are some of the treatments. There is no one pill which can correct this, although many women have obtained relief through hormone replacement. It is vital that you take care of yourself, just as you take care of loved ones! Eat nourishing, healthy meals containing foods packed with nutrients. Get plenty of rest, and I mean relaxation as well as sleep. Elevated cortisol levels from stress can cause fatigue as well as a host of other problems. And get some exercise! Even when you are tired, exercise can increase your energy.
I will talk about the different hormonal changes happening during menopause in future posts, I would love to hear from readers about their experience with fatigue, compounded hormone preparations and any experience with Integrative/Functional Medicine. Please write in the comments section and tell us your stories!
What are Bioidentical Hormones?
They would be hormone replacements that are used to supplement the hormones of humans who have a shortage in the production of their own hormones. A hormone is chemical substance, produced by an organ in your body, secreted directly into your blood and intended to have an effect on another organ or group of tissues. Examples would be Insulin, Human Growth Factor, Estrogen, Progesterone and Testosterone.
When I was trained in medicine (I think I might have met Hippocrates) there were only two forms of insulin – Regular and NPH. They were manufactured from the pancreas of either pigs or cows. It helped, but also caused big problems. Then came bioidentical Insulin – made by putting the human gene into bacteria. It is just like the insulin you produce in your pancreas – Human Insulin.
Now everyone – specialty medical clinics, celebrities and others are touting the benefits of bioidentical estrogen, progesterone and testosterone. Specialty Pharmacies – called compounding pharmacies – are creating creams and lotions of various strengths to be rubbed on the skin for absorption into the blood.
The selling point is that these are “bioidentical”. Progesterone, or the most common type of progesterone, has been made from the urine of pregnant horses for many years. This type was shown to accelerate heart disease in women. Thus the proliferation of compounding pharmacies and conflicting claims made by so many individuals.
We have an imperfect system
The system of drug regulation and enforcement is quite imperfect. It is influenced by politics, moneyed interests and the ineptitude of bureaucrats. The regulatory agency is understaffed and sometimes under trained. The underlying principles are good and basically the system works. It has flaws but generally it works. The pharmacies doing the compounding are regulated by the states. The system there is even more flawed and less staffed. Unless there are flagrant violations of state law, the over site is minimal. Thus you are dependent upon the integrity and training of the person or persons involved. Unfortunately, the practice of medicine involves more and more impersonal interactions. The less personal the interaction, the more room there is for abuse. The motive becomes strictly money.
What do the experts say?
I read a publication called The Medical Letter.
It is an independent nonprofit organization that provides health care professionals with unbiased drug prescribing recommendations.
In volume 52, Issue 1339 the authors review the Manufacturing Standards, Dosages, Adverse Effects and Drug Interactions of Bioidentical Hormones from compounding pharmacies. They conclude:
There is no acceptable evidence that “bioidentical” hormones are safe or effective. Patients should be discouraged from taking them.
I put a lot of stock into what they say. I think this is a good general statement. The idea in medicine is to care for people well and do them no harm. The organization doing this has to make money. In the tiny organization in which I work, we have to make several thousand dollars each day we open our doors just to pay expenses on the building, staff salaries, licenses, computer technologies, medical record software, phones, electric, water, etc,etc,etc…
What is the proof that what a Clinician does is effective and improves your health?
I believe the problem enters in when you purchase your product through the clinic. When the clinic is using tests that are not standard in medicine (saliva tests for hormone levels is still quite crude) and their mission is to keep you “young” and not to prevent disease or treat serious problems, you are likely to not get the highest level of care. What you do get at some hefty expense is a spa experience and medical treatment that is intended to make you feel good about how you look. Ultimately is is all about money. Those treatments and the clinics that do them are doing things that are legal but are for people with the money to afford them. People full of fear of getting old, not looking good and not feeling good.
Let the Buyer Beware. Know in your mind what claim they made that caused you to go there. What are you wanting? Why do you have to go there to get it? Why isn’t the largest medical organization in your state providing this same treatment?
What do you think? Is this just “sour grapes” to all the people in medicine not doing it? Are these clinics and pharmacies the “saviors” of our health? Leave a comment with your opinion. If you like this, use the tabs to make it for others on your favorite site like Twitter or Facebook.