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Test -
Don't Guess
For the
past 5 years over 300 medical studies have used saliva as a way to measure free
hormone levels. The free hormone level is the key here. Ninety to 99% of
hormones are bound to proteins, making them unavailable for accurate testing in
the blood. For years women have been asking to have their hormones tested, and
we will provide that testing. Normally we use a combination of blood and
saliva testing, we can assess your female hormones and thyroid hormones to
determine if there is an imbalance present. To use an analogy from Dr Eldred
B. Taylor's book, Are Your Hormones Making You Sick, "A woman has a
hundred pieces of her favorite chocolate candy in a bag and decides to eat two
pieces of candy. She unwraps two pieces of candy and enjoys it. If she is
driving a car, she may decide to unwrap a few pieces and leave them in the bag
to make them easily accessible. There are a hundred pieces of candy in a bag but
only two to three pieces are unwrapped and accessible. Measuring estrogen and
progesterone in the blood reveals how much hormone is in the blood but not how
much is accessible to the tissue. Blood measurements reflect the total hormone
(candy) present but not how much hormone (candy) is free or unwrapped and
accessible. The saliva is an excellent medium to measure the amount of free
hormone available to the breast, uterus, brain or other tissues that are
sensitive to these hormones. This method of testing was discovered in 1959 and
is now widely available and many insurance companies cover the cost. However,
this form of testing is still new to most doctors".
Saliva
testing can accurately measure your free and available hormone levels,
eliminating the guessing from your treatment. If we discover a deficiency or
imbalance we can monitor your hormone levels after starting bio-identical
hormone treatment, which allows us to individualize your hormone therapy.
If you are experiencing symptoms, you will want to test at least two hormones,
estradiol and progesterone. If you would like a more comprehensive picture, we
can perform a five panel test measuring estradiol, progesterone, testosterone,
DHEAS and morning cortisol.
Saliva
testing is easy to do in the comfort of your own home. We will provide you with
a test kit in our office, and you collect the specimen at your home, and mail
your specimen to ZRT labs in the pre-paid envelope. It's that easy! We will
receive your results about one week later, and we will meet withl you to discuss your results
and your treatment options.
Estrogen,
Progesterone, Testosterone
These three
female are mainly secreted by the ovaries, and have pivotal functions in
fertility, menstrual cycles, and basic female well being. In general, estrogen
levels drop off around age 51, but progesterone and testosterone decline as
early as the thirties, or even twenties for some women. The estrogen and
progesterone levels need to be properly balanced to each other, like a see saw,
for women to feel their best. When the progesterone levels fall in the thirties,
then there is a functional excess of estrogen. The levels of estrogen may be in
the normal range, but without progesterone for balance, women can have multiple
symptoms of progesterone deficiency, or estrogen dominance. (The see saw is not
equal). With testing and treatment, this situation is usually easily
resolved, and women are spared multiple symptoms during these peri-menopause
years.
Make sure
to take our hormone quizzes to help you identify
your symptoms.
Thyroid
Another
hormone shared by both men and women is the thyroid hormone. The thyroid is a
small gland, shaped like a butterfly, located in the lower part of your neck.
The function of a gland is to secrete hormones. The main hormones released by
the thyroid are triiodothyronine, abbreviated as T3, and thyroxine, abbreviated
as T4. These thyroid hormones deliver energy to cells of the body. When the
thyroid gland is underactive, improperly formed at birth, surgically
removed all or in part, or becomes incapable of producing enough thyroid
hormone, a person is said to be hypothyroid (too little=hypothyroid). A
hypothyroid patient will have a high level of TSH, thyroid stimulating hormone,
as it is attempting to stimulate the thyroid gland, but it is not responding.
This lack of response makes the body make more TSH, hence the rising TSH when
the gland is NOT working. One of the most common causes of
hypothyroidism is the autoimmune disease called Hashimoto's disease, in which
antibodies gradually target the thyroid and destroy its ability to produce
thyroid hormone.
Symptoms of hypothyroidism usually go along with a slowdown in metabolism, and
can include fatigue, weight gain, constipation, dry skin, depression, hair
loss, irregular periods, sleep disturbance, infertility, hoarse voice, light
sensitivity... among others.
When the
thyroid gland becomes overactive and produces too much thyroid hormone, a
person is said to be hyperthyroid (too much=hyperthyroid). The most common cause of hyperthyroidism is
the autoimmune condition known as Graves'
disease, where antibodies target the gland and cause it to speed up hormone
production.
Symptoms of
hyperthyroidism usually go along with a speed up in metabolism, and can include
rapid heartbeat, weight loss, diarrhea, moist skin, and anxiety/nervousness...
among others.
To test
your thyroid, we can perform simple blood tests to measure your TSH (thyroid
stimulating hormone), Free T3, Free T4 and thyroid antibodies to evaluate for
Hashimoto's hypothyroid. The TSH level is evaluating the stimulation to the
thyroid gland. If they thyroid gland does not respond to the stimulating hormone
(TSH), the body responds by making more TSH, if the thyroid still does not wake
up, still more TSH is made, therefore HIGH TSH levels mean LOW
functioning thyroid (hypothyroid). The current TSH range used by most labs is .5
to 5.5, although most people do not feel good unless their TSH levels are around
1-2.
Looking at
the whole picture - TSH, Free T3, Free T4, thyroid antibodies, cortisol,
hormone levels, plus your symptoms, will help us determine if you need thyroid
replacement.
Some
patients can have functional hypothyroid, meaning the blood tests appear to show
normal function of the thyroid, but the patients have all the classic symptoms
of hypothyroid. Sometimes, adding the vitamins that are crucial for thyroid
function, such as iron, iodine, selenium, zinc, copper, manganese, vitamin C and
B vitamins, will help the thyroid function better. And sometimes these patients
will respond to low dose thyroid hormone replacement.
Good
supplements that can help your thyroid perform are iodine, iron, selenium, zinc,
copper, manganese, vitamin C and
B vitamins. It is important to know your cortisol function when determining if
you have suffered hypothyroidism for a long time and not been treated. The
cortisol response becomes tired over time, trying to compensate for a poor
functioning thyroid, and even when your thyroid condition is treated, if you
adrenals are still tired, you may not feel better. (Read above Stress section
for more information on adrenals and cortisol)
Replacing
thyroid hormone is relatively easy and inexpensive. It can just take time to
find out which dose of thyroid hormone will alleviate your symptoms. We can
replace thyroid hormone by giving you synthetic T4, in such preparations as
Synthroid or Levoxyl, or by using Armour thyroid, which has a ratio of T4 and T3
in it. In the body, T4 must be converted to T3, and some patients lack this
conversion response, therefore some patients respond better to a combination of
T4/T3 than T4 alone. No matter which combination of medications we use, when
using thyroid hormone we "start low and go slow" in order to decrease
side effects form adjusting your medications too quickly. It just takes time for
your thyroid to respond to our newly added medications.
Make sure
you take our hormone quizzes to help identify
your symptoms.
Diet
and Lifestyle
The
presence of estrogen and progesterone in proper ratio creates balance in the
body. Modifying diet and lifestyle choices can control many of the risk factors
for hormone imbalance. A diet high in fiber and low in fat is shown to decrease
PMS symptoms and pain associated with your period. Exercise decreases weight,
stress, and insulin levels, all which affect your hormone balance. Supplements
can assist in relieving symptoms and restore depleted vitamins and minerals.
Adequate sleep will assist in all aspects of your well being.
Limit your
exposure to toxins. Buy organic meat, dairy and produce. If you can't buy
organic produce, buy a bottle of veggie/fruit wash and try to remove as many
pesticides from your foods as you can. Limit your use of the microwave, but if
you use the microwave, cook your food in glass. Store foods in glass or ceramic
and not plastic, avoid use of plastic wrap. Drink your water from stainless
steel containers, not plastic bottles.
Weight
and Nutrition
Women make
200 subconscious food decisions in one single day! It is not surprising that a
majority of women feel they need to lose weight. We have always known there were
health implications associated with being overweight, but what about our
hormones? Overweight women have a large amount of available estrogen due to it's
storage in body fat. They are more likely to have irregular bleeding because
they have more available estrogen than progesterone. They also have an increased
risk of breast cancer, and uterine cancer, two cancers that are very sensitive
to estrogen. Approximately 50% of the American population is 20% over their
ideal body weight. Therefore it is likely that a majority of women have increased
free estrogen instead of decreased levels of free estrogen. Most of these
women are given estrogen replacement therapy in menopause or perimenopause, but
if tested using saliva testing, would show high levels of free estrogen, and low
levels of progesterone. Most of these women don't need estrogen at all!!! They
may benefit from a little progesterone if the tests indicated, and progesterone
supplementation may be all that is needed to bring balance to the
hormones. Once in hormonal balance, women are more able to lose weight and
feel better.
Make the
commitment to lose weight, your health and future depends on it.
Read the Eat Clean Diet
book. It is awesome at explaining nutrition and helping with weight loss. (www.eatcleandiet.com).
Author Tosca Reno states weight loss is an 80-10-10 split. 80% nutrition, 10%
exercise, and 10% genetics. So, how are you eating? We have been struggling with
how to each patients nutrition, and we have found it. This book teaches you
everything you need to know on how to change your nutrition habits, from
shopping, cooking and ordering out healthy, delicious meals that will help you
feel great and lose weight.
Check out
Dr. Oz's website, www.realage.com.
They
have volumes of information concerning total health, from obesity to high blood
pressure to weight loss. Their book, You on a Diet, and You the Owner's Manual
are must read's too.
Check out
Dr. C.W. Randoph's website www.hormonewell.com.
He has two good books, "From Hormone Hell to Hormone Well", and
"From Belly Fat to Belly Flat". They are must read's for women. He
touches on hormones, diet, stress reduction, and vitamins.
Check out www.lowglycemicdiet.com
to make good choices about your foods. Choosing foods with a low glycemic index
will allow you to store less fat, and lose weight instead of gaining. Also,
rethink your food pyramid. Check out www.oldwayspt.org
and look at the Mediterranean food pyramid.
Remember
that weight loss begins at the grocery store! All the books above have tips on
how to be a better shopper. Only have the foods at home that you should eat. The
whole family will benefit if you are a better shopper.
Stress
One test we
recommend is a cortisol level. This can be measured just one time, in the
morning, with your hormone levels, or up to 4 times in that one collection day
to give us an accurate picture of your cortisol pattern. Cortisol is produced by
your adrenal glands, small glands situated on the top of your kidneys. Your
adrenal glands are involved in energy production, fluid and electrolyte balance,
fat storage, sex hormone production. DHEAs is made almost exclusively in the
adrenals, and after menopause are the major sources of estrogen and
progesterone. When you are under stress, whether emotional, physical or medical,
cortisol production rises, which affects every major process in your body -
energy production, fluid and electrolyte balance, fat storage and sex hormone
production. Over time, if the stress doesn't go away, your adrenals get tired
and eventually will get in crisis mode. This means weight gain (especially
abdominal fat), diabetes, insulin resistance, hormone imbalance symptoms, high
cholesterol, high blood pressure...Wow, stress never looked so serious.
You have to make some changes when you are under stress. Stop refined
carbohydrates or high glycemic foods, stop caffeine, stop eating excess
calories, start exercising, start taking supplements, and commit to performing
stress management techniques. First begin by eating real food, not packaged
food. Fresh is best, but frozen is the next alternative, with canned being the
last choice. We recommend going organic, especially with dairy and meat and
certain fruits and vegetables. Adopt a Mediterranean diet, (www.oldwayspt.org),
with nutritious foods, lots of vegetables, fruit, fish, beans, olive oil, with
low glycemic foods. Eat in moderation, avoid overeating and take time for your
meals. The Italians have it right here! Eat protein at every meal and snack,
eliminate caffeine, white flour foods, and artificial sweeteners. Reduce white
sugar but eliminate high fructose corn syrup or any -ose ingredient. Exercise
30-40 minutes a day, varying your exercise between aerobic (walking, light
jogging, sports), anaerobic (weight lifting) and flexibility (yoga and pilates).
Add supplements that are depleted when you are under stress, like Vitamin C, B
Vitamins, Vitamin E, Alpha Lipoic Acid, CoQ10, Omega Fatty Acids, Magnesium and
Calcium.
Vitamins
Don't
forget to take your supplements. Nutrition, which includes both the foods you
eat and the supplements you take, are an integral factor in you feeling well.
Above we list supplements that are good for particular stress or thyroid needs.
Daily we recommend Vitamin C, Vitamin B, Calcium/Magnesium, Essential Fatty
Acids, Co Q 10, and antioxidants.
We carry a
line of pharmaceutical grade vitamins. We are very impressed with their purity,
effective and cost. They are available in the office or online, but we support
your use of high quality name brand over the counter vitamins as well.
Vitamin
Testing
We are
happy to offer vitamin testing in our office. Spectracell
Laboratories, based in Texas, patented FIAŽ analysis measures levels of
selected vitamins, minerals, antioxidants, and other essential micronutrients
within your white blood cells. Testing can reveal nutrient deficiencies often
missed by traditional blood testing. Such deficiencies could impair your health
by contributing to the development or progression of chronic diseases.
Your blood
is collected in the morning prior to noon, but no fasting required, and we will
receive a report on 31 nutrients. Covered by most PPO insurance plans, and
require an $105 copay payable to Spectracell Laboratories on the date of
collection.
Food
Allergy Testing
What
is the significance of food allergy testing?
It is important to remember that most autoimmune diseases and chronic
conditions that we all suffer from are caused by responses in the digestive
track due to delayed food allergies.
Sage
Medical Laboratory developed
a new patent-pending Elisa test to pin point delayed food
allergies causing many autoimmune diseases and chronic illnesses.
It is a unique multi-pathway test. A
comprehensive picture of the allergic foods can be identified quickly and more
accurately than any present Elisa test on the market. Eliminating all allergic
foods from the diet can immediately alleviate symptoms and improve the health of
the patient. The Sage ELISA
Test has proven to be clinically effective over 80 percent of the time.
This high incidence of success and the outstanding consistency of this test will
continue to set the standard for delayed food allergy testing.
We have kits available for
testing for delayed food allergies. It is a simple blood draw, non fasting, then
the blood is sent to Sage Medical Laboratory. When testing is completed you
receive a comprehensive report on all foods, food additives and dyes that are
positive for delayed food allergies. Information from the Sage Chef on
elimination of these foods from your diet is provided as well.
Please visit Sage
Medical Laboratory's website for more information on testing and insurance
coverage, or call them at
800-491-9511.
Come In
For Your Evaluation
Make an
appointment today with Dr. Cowen or Barbara Buckley, NP to discuss your symptoms
and get you on the journey to feeling better. Appointments last approximately
30-60 minutes, depending on each individuals concerns. With a detailed and
comprehensive history, a physical exam and measurements, and saliva testing, we
can help you start your journey to a healthier lifestyle.
Glossary
Estrogens -
a family of hormones (estradiol, estrone, estriol) secreted by the female
ovaries. They are necessary for maintaining the health of the reproductive
tissues, breasts, bones, skin, and the brain.
Progesterone
- an essential female sex hormone produced by the ovaries after ovulation and in
lesser amounts by the adrenal glands which promotes healthy functioning of the
female reproductive system. It has many vital functions, from maintaining
pregnancy to regulating menstrual cycles; has calming and diuretic properties,
and enhances the beneficial effects of estrogens while preventing problems
linked to estrogen excess. Progesterone facilitates balance of other steroid
hormones. (Not the same as progestins, a synthetic
form of progesterone found in birth control pills and Provera)
Progestins
- synthetic hormones that act partially like progesterone in some ways but are
structurally different; suppress normal ovarian production of progesterone and
many have negative side effects.
Testosterone
- one of a group of hormones known as androgens produced in both males and
females. It builds and maintains bone and muscle mass, skin elasticity, sex
drive and cardiovascular health in both sexes.
DHEA _ (dehydroeplandrosterone)
hormone made by the adrenal glands, it converts to androgens, like testosterone
and estrogens. Its actions influence energy, stamina, mental outlook and immune
function.
Cortisol -
produced by the adrenal glands; it regulates the stress response, glucose
metabolism, and immune function. Cortisol has a catabolic (breaking down) action
on tissue when levels are too high or out of balance.
Adrenal
imbalance - This occurs when the adrenals no longer produce enough hormone to
meet bodily demands and is a result of prolonged stress (emotional, viral,
physicl). Adrenal support includes adequate rest, exercise, nutrition, and
supplementation.
Estrogen
dominance - an excess of estrogen in teh absence of adequate levels of
progesterone. It can result from estrogen replacement therapy, hysterectomy,
birth control pills, and/or decline in ovarian progesterone production. The
symptoms range from breast tenderness and bloating, to mood swings and
depression.
Bioidentical
- hormones that have the exact structure and function of hormones produced
naturally within the body.
Thyroid -
gland that produces hormones that regulates metabolism; imbalances lead to
weight gain, cold body temperature, depression, hair loss, etc...
TSH -
Thyroid stimulating hormone, pituitary hormone, signals the thyroid to produce
T4 (Thyroxine) which converts to active T3 (Triiodothyronine).
Phytoestrogens
- plant compounds (e.g. soy, black cohosh) with mild estrogen-like activity; are
used as natural alternatives to relieve menopausal symptoms.
Insulin
resistance - a term used to describe the failure of the tissues to respond
(resistance)
cholesterol
- a waxy, fatlike substance in your blood, necessary for hormone production
LDL - (low
density lipoprotein) cholesterol - the "bad" cholesterol that builds
up in your arteries
HDL _ (high
density lipoprotein) cholesterol - the "good" cholesterol that helps
carry away LDL cholesterol to prevent buildup
triglycerides
- another blood fat that increases your risk of heart disease if levels are high
Helpful
Links
www.realage.com
www.hormonewell.com
www.eatcleandiet.com
www.lowglycemicdiet.com
www.zrtlab.com
www.womeninbalance.org
www.oldwayspt.org
www.johnleemd.com
www.hopkinshealthwatch.com
www.pccarx.com
www.lascolinaspharmacy.com
Recommended
Reading
The Eat Clean Diet,
Tosca Reno, CD
Are Your
Hormones Making You Sick, Eldred B. Taylor, MD, Ava Bell-Taylor, MD
Dr. John
Lee's Hormone Balance Made Simple, John R. Lee, MD, Virginia Hopkins
You, The
Owner's Manual, Michael Roizen, M.D., Mehmet Oz, M.D.
You, On
A Diet, Michael Roizen, M.D., Mehmet Oz, M.D.
From
Belly Fat to Belly Flat, C.W. Randolph, M.D.
From
Hormone Hell to Hormone Well, C.W. Randolph, M.D.
Awakening
Athena, Kenna Stephenson, MD
Adrenal
Fatigue: The 21st Century Stress Syndrome, James L. Wilson, ND, DC, PhD
You've
Hit Menopause: Now What? George Gilson, MD
HRT: The
Answers, Pamela Wartian Smith, MD, MPH
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