Stress- The Long And Short Of It

• Fight-Or-Flight effects
• Cortisol and an under-active thyroid

In my previous blog, I began introducing the topic of stress as a hormone response.   The stress hormone response is actually one of the, if not, the most powerful hormone responses we have. It is a response that is intended to save our lives in a variety of natural scenarios both long term and short.  Examples of short term stressors would be if Norman Bates was standing at your shower door with a 20 inch knife when you get out of the shower or running from a lion etc.  These are obviously dramatic, but illustrate my point.  These kinds of stressors come on quickly, result in a powerful response but also subside relatively quickly once the stressor is gone.  The body’s responses are varied eg. raising blood pressure, raising blood sugar, constricting arteries, raising heart rate and dilating pupils etc.  These responses are intended to give us a better chance of survival in the short term and result in very few long term problems in healthy individuals.  Theses are the “fight or flight” responses.  The kinds of stressors that are more deleterious on our health are the long term responses.

Hormones and The Balancing Act

     

The short term response is primarily due to the hormone Adrenalin.  The long term stress response is mediated in large part by Cortisol.  An example of a long term stressor that has been normal for mankind historically (and currently in some parts of the world) is starvation. Elevated levels of Cortisol in this situation stimulates the body to store fat and increase sugar cravings and carbohydrates in general.  One of the other issues that can occur simultaneously with elevated Cortisol is a down regulation of the hormone TSH or Thyroid Stimulating Hormone.  This hormone is what the brain uses to control Thyroid hormone output.  If you are starving to death in a cave the last thing your body would want to do is increase your metabolic rate (rate at which you burn calories).  Your body would want to conserve and store energy(fat).  Chronically elevated Cortisol can reduce the hormone TSH which tells your thyroid to make less Thyroid hormone.  Less Thyroid hormone lowers our metabolism which can affect many things including weight and energy.  Elevated Cortisol can also affect thyroid hormone at other points that lowers your metabolism.  All of this would be fine if you really were starving but this rarely occurs in most modern countries.  In fact, the opposite is more common.  We have relatively unlimited amounts of food, especially foods high in sugar and simple carbohydrate.  Adding to this fact, much of the food that is available is largely void of nutritional value and we have a Cortisol crazed society living with stress levels that didn’t exist 100 years ago. 

We welcome your questions and comments, and we encourage each reader to share their experiences.

Stress and the New Year

     
In contemplating the topic of Stress and deciding what to write about, I wanted to provide an overview and framework  that I could build on.  The concept of stress and the way we use the term is very generalized. We say, “I did that because I was stressed” or “ I feel this way because I am stressed.”  Stress becomes a garbage can filled with events, feelings, moods, emotions, and outcomes that we throw away and chalk it up to stress.  But what really defines stress? Is it a subjective overall feeling or is it scientifically characterized into specific components?  Although the former is how we perceive stress, the latter becomes the framework by which we can build a model that can lead to healing.
Stress Defined
     How is stress defined or more importantly, what conditions does our body perceive as stress?  Stress is defined as the body’s reaction to a change that requires a physical, mental or emotional adjustment or response.  Many things can cause the above responses like jobs, bills, kids, spouses etc. but is there more ? The answer is yes.  There are many other things that our body considers  stress eg. toxin overload(mercury, lead, BPA, aluminum, uranium, household and work place chemicals etc.), metabolic stress (sugar disregulation),  surgeries, injuries and injuries resulting in chronic pain, post traumatic stress, deaths of loved ones, caregiving, etc.  You can see that the list can go on and on. Many people experience multiple issues simultaneously which further compounds the problem.  So how does stress manifest itself in the myriad of different symptoms both mental and physical that so often accompany it?
Stress- A Symptom, Not A Cause
    Stress is primarily a hormone response.  Our brain perceives stress and initiates a complex string of chemical reactions which lead to the production of various hormones.  One of the most important of these is Cortisol.  If you look at the pdf. file that we have on our website listing symptoms and hormone disregulation you’ll notice many symptoms under Cortisol.  Elevated or deficient levels of Cortisol can cause a wide variety of symptoms that can seriously erode quality of life. In some extreme instances it can even cause death.  With the New Year upon us many people are making resolutions on weight loss.  In my next blog I will discuss some of the issues relating to stress and weight gain.  There is a direct connection which we will explore. 
   Feel free to ask questions and subscribe to this blog.  We’re here to help.  If you would like to see specific topics addressed, please send an email to let us know!

The Whole Truth

• Do you feel like you’re at the top of your game?
• What would you say is preventing you from feeling your best?
• Have you ever wondered if you could give your doctor better information to help them provide care that is more accurate for YOU?
• If there was a way you could easily increase your quality of life, now or long term, wouldn’t you want to know?

Are You At Risk?

Hormone testing, whether saliva or blood serum testing, can only tell the practitioner so much.  There are normal fluctuations in hormones from day to day and in some cases hour to hour.  Falling within a “normal range” on a lab test does not mean that you are at an optimal level for YOUR body.  It can become even more unclear when you factor in that there can be many interactions between hormones.  For example, if one hormone is at the high or low end of its range (specifically, out of its normal range) there can be a blunted or exaggerated response in other hormones.  This is not intended to debunk hormone testing, but rather, to temper our sole dependence on it.  A good clinician needs to look at all evidence related to a person’s condition.  This includes a comprehensive analysis of symptoms. 

The Bigger Picture

On my website, I have a Pdf file that shows a cross section of various symptoms that can be caused by different hormones when they are not at optimal levels.  Using a comprehensive analysis of symptoms and hormone test results along with a review of other factors such as lifestyle issues and unusual amounts of stress, the discerning practitioner can begin to wade through some of the intricate details needed for an accurate diagnosis. 

Other Factors

At this point we are assuming the symptoms reported are only related to hormone disregulation.  There are other factors that can be involved in the genesis of many symptoms that you see on the Pdf file.  For example, exposures to toxic compounds have a direct effect on hormone regulation.  Toxins are becoming more ubiquitous in our environment every day.  Do you know that another example is the food we eat?  Food can have a direct effect on our genetic expression. This is an emerging science called Nutrigenomics. 

It’s Your Health, Take Charge

Your quality of life can depend on the information you provide your doctor.  Don’t wait for the doctor to ask about your symptoms.  Be assertive.  Use our questionnaire to know which symptoms pertain to you.  Think about how much your life would change if you didn’t have these issues.  If you think they don’t impact your life all that much, track them.  Get the ball back into your court, call and set up your analysis today!  Make 2012 YOUR year.

The New Year is just around the corner, and so is the stress of trying to get off to a good start.  We will be posting our “exploring stress” series next month.  How it affects your health, ways to minimize your stress, and what to do when you can’t avoid it.  As always, feel free to comment or ask a question.  You may also come into the store, email us, or contact us directly at 303-772-1551.  Please let us know you read the blog!

BHRT - part 2

I stated that hormone testing is the first and most critical part of a successful Bio Identical Hormone Therapy regimen.  I need to clarify first that only you and your doctor can determine if BHRT, or conventional hormone therapy for that matter, would be appropriate.  Some people have pre-existing conditions e.g.- breast of prostate cancer, etc.  This may preclude you from replacement therapy, at least in the short term.  However, if hormone replacement is deemed to be beneficial after consultation with your doctor, then BHRT is the logical choice.

So how do you know which hormone(s) you need and at what dose?  There are a variety of testing modalities that can be used.  The two most common are serum blood testing and saliva testing.  The most traditional and best known among providers is serum blood testing.

The amount of hormone in your blood has well established ranges.  These normal ranges hold up well when they are measuring a hormone level that is being naturally produced by the body and not supplemented.  Serum blood testing is fine for testing someone who is not supplementing with hormones and is being tested for "baseline" levels.  Baseline levels are the concentration of the hormone(s) when they are being produced by your body.

Saliva testing is another type of hormone level test.  Instead of looking at hormone levels in the blood, we are looking at concentrations of hormone outside of the blood in the saliva gland.  This level better mirrors the levels of hormones found in other glands and organs that produce hormone related symptoms including the brain.  Saliva hormone levels correlate well to clinical symptoms.

Discrepancies between saliva and serum blood test results begin to occur when you are testing patients who are supplementing with hormones, especially topically applied creams and gels.  An example of what I am talking about here would help highlight the dilemma.  Young men produce approximately 5-10 mg of testosterone daily.  A typical commercially available pharmaceutical product recommends 25-100 mg of testosterone be applied as a gel.  Why is it 5-10 times more than when a young man produces it naturally?  The pharmaceutical company says that this is what it takes to produce the same blood level that a young man has while producing 5-10 mg's daily naturally.  Why is there such a large discrepancy?  A saliva test on the other hand shows 5-10 times higher levels than it would be at baseline.  Which testing modality should you use?  While the controversy roars, I personally would rather start low and go slow when it comes to hormone dosing.

Please feel free to comment or ask questions.  We will be glad to address every one that we receive.

Bio Identical Hormone Replacement Therapy

If you, like many others, are trying to figure out if hormone replacement is appropriate or even safe for you, it is important to educate yourself the best you can.  With all the available information it is overwhelming to figure out where to start.  The true answers are only found in the scientific studies.  Over the years there has been important scientific evidence that has been published discussing the difference between conventional hormone replacement and bio identical hormone therapy.

A large government funded study known as the Womens Health Initiative linked the long term use of  conventional hormone replacement therapy(CHRT) in menopausal women to an increase of heart disease, stroke and breast cancer.  Incredibly,over half of the women in the study quit prematurely due to side effects before the study was shut down early due to the more serious problems that developed.  From studies we have learned that synthetic hormones (commonly a component of CHRT) differ in their activities at the receptor level.  In many cases synthetic hormones will have different effects or even opposite effects as compared to their Bio Identical counterparts.  Therefore synthetic hormones do not provide the same total physiologic activity as the hormones they are intended to replace and may encourage undesirable side effects not found with BHRT. 

Many men and women along with their physicians have been leaning in favor of BHRT that in many cases are compounded by a Pharmacist especially for the individual.  The reason for this is simple. Bio Identical hormones are molecularly identical to your naturally occurring hormones.  When  properly dosed, they are significantly better tolerated. There is the rub.  Even Bio Identical hormones can cause problems if dosed improperly.  So how do you know what your hormone levels are at baseline and after replacement has started?

Hormone Testing

This is the first and most critical part of a successful BHRT regimen.