You may have asked yourself one of the following questions:
* Are my hormones out of balance and if so, are they affecting my health?
* Can a medical elucidation still exist to explain my symptoms even when my doctor says "your laboratory blood tests are all within normal range"?
* Are you feeling depressed but not responding to standard anti-depressant medications?
* Do you find it difficult to lose weight despite excess exercising and calorie counting?
* Still constipated despite adequate fibre and fluids?
* Feeling tired but unable to find out why?
Suboptimal hormone levels or hormone imbalances can be the cause.
Fatigue, menstrual changes, bone loss, menopausal symptoms, cravings, weight gain or loss, metabolism dysfunction, cardiovascular disease, low immunity and mood changes may all be related to hormones imbalances.
In fact, hormones play a role in ALL health problems. The same hormones that keep us healthy are the same hormones that may cause emotional and physical distress when not in balance.
To help patients achieve hormone balance, I recommend a 3-step approach:
* Step 1: Obtain a diagnosis even when you are told "labs are all normal"
When an insult on the body (eg uncontrolled inflammation) occurs for long enough it starts to injure cells. In turn, tissues (groupings of unique cell types found in organ or body parts) can become damaged. At this stage, a pathological disease state occurs in the body that can be diagnosed using conventional laboratory tests. Such tests help to diagnose and monitor progress for conditions such as diabetes, Cushing's syndrome, hyperthyroidism (eg Graves disease), hypothyroidism, polycystic ovarian syndrome, glandular tumors (cancer), etc...
Commonly, unpleasant symptoms may still be present even though laboratory values may be within the 'normal' range.
Underactive thyroid (a condition called hypothyroidism) for example, can cause weight gain, fatigue, and depression. Diagnosis is mainly based on TSH levels (TSH is released from pituitary gland to stimulate thyroid hormone production). Thyroid function is said to be normal if TSH has a value between 0.4 to 5 mU/L (note: values may vary slightly between different laboratories). A diagnosis of hypothyroidism is based on TSH values above 5mU/L (and on low thyroid hormones levels).
These present laboratory standards for thyroid evaluations are too broad. The American Association of Clinical Endocrinologists (2003) stated that TSH level between 3.0 and 5.0 mU/L should be considered suspect. In my practice, I commonly observe patients who are symptomatic despite TSH levels remaining below the cutoff of 5 mU/L.
Helping patients achieve optimal levels of hormone production (TSH of 1 to 2.5 rather than 0.4 to 5 for example) is one example that can alleviate many symptoms.
I encourage people not to wait too long to address their health concerns. Both conventional and naturopathic doctors have a deep understanding of the body's physiology (the study of the functions of the human body). Recognizing when the body has shifted outside of physiological norms can be observed at any stage of disease. As doctors, this knowledge can help us treat patients even when laboratory results alone cannot explain symptoms.
In addition to standard laboratory tests and complaint oriented physical examinations, it is important to include a complete review of all symptoms (not just a patient's chief concern) and of all systems and organs in the body. Only when we look at the whole can we gain a complete perspective of one's state of health.
Hormone saliva testing conducted by naturopathic doctors is another useful tool for diagnosing abnormal hormone patterns that may be missed by conventional blood tests.
* Step 2: Find out the cause of your hormone imbalance(s)
Once an explanation is obtained to describe your symptoms or disease, the next step is to figure out why your body became out of balance in the first place.
If hormone imbalances are observed, it is crucial to determine which of the following hormone disruptors are most involved:
1. Chronic inflammation
2. Chronic disease
3. Low weight or excess weight
4. Food sensitivities/irritants/allergies
5. Digestive tract malabsorption or inadequate elimination
6. Excess sugar/refined carbohydrates/saturated fats/caffeine/alcohol
7. Toxicity - chemicals/xenoestrogens/heavy metals
8. Physical or mental stress
9. Inadequate sleep
11. Poor eating habits (irregular eating, or missing meals, not eating on schedule)
12. Liver dysfunction (the liver metabolism many hormones including cortisol, DHEA, estrogen, testosterone, progesterone, and thyroid hormone).
13. Iatrogenic (surgeries, medications side-effects, etc...).
I have already discussed a number of these topics in previous articles (please see www.monctonnaturopathic.com for previous columns). Although it is beyond the scope of this article, stay tuned for upcoming articles that may cover more of these topics.
* Step 3: Consider a unique treatment approach
To explain the concepts behind my treatment approach, let's look at low thyroid function (called hypothyroidism) as an example. The standard treatment is simply replacing thyroid hormone to make up for the lack of production. In this case, Synthroid medication is commonly prescribed.
A new model for medical practitioners is to adopt a multifaceted approach to treating hormones imbalances. It should aim to: a) address underlying causes (examples are described in Step 2); b) support other organs that that are interconnected to the issue in question (eg liver); c) support the organ in question such as replenishing nutrients that the gland requires to make hormones (eg L-tyrosine for the thyroid); and d) use hormone replacement therapy (eg Synthroid) if necessary for severe cases (ie the gland is beyond repair) or when symptoms are severe thereby providing relief and buying time while the causes and organ dysfunction are addressed.
Using hormone replacement therapies or only treating the gland in question as the first line of treatment is the most common mistake in treating hormone imbalances. Such a narrow approach can suppress the glands ability to produce its own hormones and may even weaken the gland over time. As Dr. Natasha Turner, ND puts it, it's like "building a house on sand. The foundation would constantly be shifting and would require constant repair."
Treatments may start by improving liver and digestive function thereby improving hormone metabolism and increasing the absorption of key nutrients to manufacture hormones in the body. Balancing blood sugar levels will result in more appropriate insulin and cortisol levels. Improving sleep will reduce stress hormones and improve the body's ability to repair at night.
In some cases, a person may achieve overall hormonal balance even without specific treatments for the gland in question.
That is, if the foundation is secure and strong, the body is much more able to self-regulate and heal itself. In many cases, naturopathic treatment strategies are also aimed to the gland itself to accelerate the healing process.
As I've often mentioned before, chronic health conditions and related hormonal imbalances are complicated and should be evaluated based on the greater context of your care. Work with your medical doctor or naturopathic doctor to assess the effect of hormones on your health.
* Dr. Martin Gleixner, MSc, ND owns the Moncton Naturopathic Medical Clinic located at 90 Weldon Street in Moncton (382-1329). Fluent in French and in English, Dr. Gleixner offers professional health care for the whole family. Using his unique understanding to learn how your body is working (or not), he creates individualized treatment programs that will make a difference in your health. Are you ready to be healthier? Dr. Gleixner is a qualified naturopathic doctor presently accepting new patients. Additional information can be found on www.monctonnaturopathic.com. His column appears every fourth week in Life & Times.