Posts Tagged ‘thyroid disease’

What No One Tells You About Menopause

menopauseMenopause, a women’s worst nightmare or is it? By simply understanding the basic science, we can clear the myths of this dreaded change and make it the most empowering years of a women’s life.

The two predominant hormones are Estrogen and Progesterone. Menopause is nothing more than a mirror image of menarche, or the start of menses.

In the pubertal years, the E2 (Estrogen) and P4 (Progesterone) begin to increase in quantity in preparation of future pregnancies. During this time, there is an imbalance of E2 and P4 which occurs that results in PMS, development of female habitus, acne, mood changes and so on.

During the 20’s and 30’s, E2 and P4 are in prime balance which allows the opportunity for the woman to conceive. When in equilibrium, a woman feels her best.

Around 35 years of age, the body begins to prepare to slow down. This is the time, the change STARTS.

E2 and P4 levels begin to biologically drop. Progesterone declines twice as fast as Estrogen. It is this imbalance between the lower Progesterone in relation to the higher Estrogen that causes menopausal symptoms.

Walking around with higher than needed Estrogen leads to higher risk of breast, uterine, or ovarian cancers, blood clots,  and heart disease. Progesterone is there to keep Estrogen from over stimulating the cells. Progesterone also helps with sleep, balances your mood, acts as a diuretic, and gives an overall sense of calm.

When Progesterone declines in respect to Estrogen, it creates a phenomena known as Progesterone Deficiency or Estrogen Dominance.

This is when women experience acne, mood changes, sleep issues, cravings, slowed metabolism, weight gain around mid-section and hips. In essence, menopause is a mirror reflection of menarche.

The solution? That is the million dollar question. Pre-menopause, Peri-Menopause, Menopause, Post-Menopause-whatever phrase you choose to describe this phase is irrelevant because the concept is the same.

Crossing the turbulent rivers of menopause is much easier and simpler than we think because we now understand why the body is changing the way it is.

So how do we get through these years? Here are few things to remember:

  • Breathe. This is not a permanent! The hormones are trying to find their balance and they eventually will. No one can predict how long this will take. And nothing can be done to speed up the process. The body is only trying to protect you. Allow it to do so. Don’t condemn the changes you are experiencing. The body is your armor, your voice and your friend. Understand what it is trying to tell you when it speaks to you in the form of symptoms.
  • Stop worrying about the weight. The weight is a symptom like anything else. Weight gain occurs due to Estrogen Dominance/Progesterone Deficiency. There are alpha and beta receptors throughout our muscle and adipose layers in the body. Depending on how those receptors are activated in each person, is where the weight change will occur.
  • Watch your diet and move your body. Our foods are coated with Estrogen and other chemicals which worsens Estrogen Dominance. It is imperative to cut out gluten, sugar, dairy. Eat clean and as unprocessed as possible. Additionally, without exercise don’t expect the body to change. Your body will not respond how it did was few years prior. And that’s ok. But it doesn’t mean that it won’t change. This will just become the new norm. One of the places Estrogen is converted is in adipose tissues. So the more fat you carry, the more estrogen it will convert, thereby again, worsening Estrogen Dominance. Striving towards optimal body fat will help keep Estrogen Dominance controlled. Focus on feeling balanced, not skinny.
  • Make sleep a priority. Without sleep the adrenal glands cannot function at their best. The disruption to the cortisol results in further Progesterone depletion. Turn off the devices and sink yourself into restful slumber.
  • Meditate. When the mind is silenced amongst the chaos of life, we are able to center and align to the root of our existence. Take 5-10 minutes a day, close your eyes and go to the places that feel off balance and listen for the guidance given.
  • Use hormones. I am all for using hormones, IF AND WHEN IT IS NEEDED. Treating with hormones during menopause is certainly not mandatory. The fundamental question to ask is, “are my symptoms debilitating enough that it is affecting my quality of life?” If the answer is yes, use the smallest amount needed for optimal results. Hormones are like the waves of the ocean. Anything can affect them – sleep, weight, seasonal changes, stress levels, nutritional habits, exercise commitment. You may need hormones for a while and decide later they are not needed. And depending on what’s going on in life, may need them again. There is no one answer. The correct answer always is what your body tells you it needs. Hormones are not the magic solution to these symptoms. They are only a crutch to lean on while working on lifestyle modifications.
  • Stop comparing. Don’t compare yourself to your past self. Menopause is a beautiful opportunity for growth and experience. Just keep remembering the symptoms we experience is the body protecting us. This cloud WILL pass! Learn to dance in the rain and embrace the glory of being a woman. This is a period of transformation, revitalization and rejuvenation.

Menopause is the process of shedding the layers of struggle. But just be patient my friends because the wings of healing are opening to reveal the vastness of all that is authentically you.

Dr. Raman’s Concierge Medical Practice is focused on holistic care and good health maintenance. For more information on healthy eating habits and achieving and maintaining OPTIMAL health,  CONTACT our office today to schedule your appointment. You can also learn more by following Dr. Raman on FacebookTwitterLinkedIn and Pinterest.

Why Am I So Tired? The Truth Behind an Improperly Functioning Thyroid

There are so many articles out there about an improperly functioning thyroid, it is hard to know where to begin! Let’s start at the top. How many of these symptoms describe you?Improperly Functioning Thyroid

  • Extreme fatigue
  • Weight gain
  • Irritability
  • Muscle aches
  • Depression
  • Rapid hair graying
  • Decreased libido
  • And too many other “little issues attributed to aging”

These little issues could be caused by a small gland with some big responsibilities. That gland is your thyroid.

The thyroid gland produces and stores hormones through an integral and complex pathway that is directly linked to your hormones and adrenals. The thyroid plays a part in EVERYTHING AND EVERY CELL IN YOUR BODY. It is butterfly-shaped and is found in the lower part of the neck, wrapped around the trachea.

Hypothyroidism: A Common Condition, But Frequently Misdiagnosed

Hypothyroidism is a condition where the body, for various reasons, doesn’t produce enough thyroid hormone or is unable to utilize the thyroid at a cellular level. No matter what the cause, this diagnosis has debilitating and frustrating consequences.

Being diagnosed with hypothyroid myself in 2002, I have spent the last 13 years researching, studying,
and understanding the complexity of this “little gland.”

According to the U.S. Department of Health and Human Services, about 4.6 percent of the U.S. population (approximately 18 million people) age 12 and older has hypothyroidism. As prevalent as hypothyroidism is, most people are not correctly diagnosed when they first present symptoms to their doctors because there is not a standard interpretation criteria for screening tests—meaning that one doctor may think a slight dip below the normal range is acceptable while others would argue otherwise.

Your thyroid can be affected if your adrenals are not balanced or if your hormones are constantly fluctuating. Due to the minute-to-minute variability of ALL the hormones in your body, patients are often under-diagnosed.

A single thyroid level test is insufficient to make the determination of hypothyroidism.

Many other thyroid levels also need to be checked. These could include TSH, Free T4, Free T3, Thyroid Peroxidase Antibody, Thyroglobulin Antibody, Magnesium, Iron, Zinc, Vitamin D, Hormones and Cortisol.

A patient who self-educates and self-advocates is in the best position to work collaboratively with his or her doctor to determine the best course of treatment for the symptoms and diagnosis of hypothyroidism. Self-advocacy is much easier when you choose a doctor who has experience in recognizing the symptoms of hypothyroidism as well as other hormonal conditions such as diabetes and adrenal gland issues.

Treatment of Hypothyroidism

Once hypothyroidism is diagnosed, there are many treatment options that need to be considered. Synthetic thyroid (Synthroid or Levoxyl) medication is not the only option. There are T3-only medications such as Cytomel or combination of T4 and T3 medications such as Armour Thyroid or Nature Thyroid. Patients even have the option of having their thyroid medication compounded with an accredited compounding pharmacy.

Hypothyroidism is not a cookie-cutter diagnosis and neither should be the treatment.

It is extremely important to work closely with your physician to monitor symptoms and continue to regularly check your thyroid levels.

The discussion of thyroid disease is more extensive than I can capture in a single blog post. In my 15 years of practicing primary care, I have diagnosed and corrected misdiagnoses of many patients with hypothyroidism. I understand and have experienced every symptom you may be having. I know the frustrations, I understand the suffering and I continue to live with this diagnosis everyday.

If you are suffering from any symptoms that are interfering with your life, Please contact our office today to schedule an appointment.

Dr. Raman’s Concierge Medical Practice is focused on caring for each person as a whole, not just a list of symptoms. Our office is committed to helping our patients stay well and maintain good health rather than treating patients only after they become ill.

For more information or to schedule an appointment with Dr. Raman, please contact us today.

How Hormones Affect Hair, Skin & Nails

Hormones can have a major affect on your hair, skin and nails. Skin, the single largest organ in the human body readily tells the story of what is really going on beneath those layers.

hormones hair skin nails

Do any of these symptoms sound familiar?

 

  • Hair loss in clumps or strands
  • Slow or no hair growth
  • Thinning eyebrows
  • Sparse eyelashes
  • Brittle or cracked nails
  • Nail ridges
  • Dry skin
  • Fine lines and wrinkles
  • Eye circles
  • Acne

Contrary to popular belief, these symptoms are not from getting older. While aging causes a decline in hormones, environmental and dietary factors also have a hand in speeding up the aging process. While we can’t control our biological clock, what if we could get a handle on things we can control? It starts with our endocrine system.

The endocrine system is comprised of eight main glands:

  • Pituitary
  • Pineal
  • Thymus
  • Thyroid
  • Parathyroid
  • Adrenals
  • Pancreas
  • Gonads

The glands, located in separate areas of the body, must work in perfect alignment and synchronize to achieve optimal balance. If any part of the pathway “short circuits,” the body immediately signals its distress and begins the healing process. The symptoms you experience are nothing more than indications of the dysfunction occurring at the cellular level.

So why do we develop these symptoms and what can we do to reverse them?

Good question. The reasons are many. The most important thing to identify is WHY you are having the symptoms? For example, the emotional impact of hair loss is likely the same for everyone, but the cause of why it is occurring is starkly different for each individual.

Here are some of the most common causes of endocrine imbalance and its effect on the hair, skin and nails.

  1. Declining Estrogen. Estrogen stimulates collagen production and blood flow and contributes to the smooth, firm appearance of skin. As estrogen levels drop, so does collagen production. Without adequate collagen, the skin loses its elasticity, hence developing the appearance of wrinkles.
    Treatment: Topical estrogen use has shown some improvement in appearance, but the risks of estrogen outweigh the benefits. Although not a permanent solution, some temporary options to enhance collagen stimulation include:
  • Tretinoin
  • Vitamin C
  • Alpha hydroxy acids
  • Chemical peels
  • Dermabrasion
  • Laser resurfacing
  1. Elevated Androgens. Estrogen dominance results when estrogen is higher in RELATION to progesterone. Although the absolute value of estrogen declines, the estrogen/progesterone ratio favors estrogen dominance. Estrogen dominance causes estrogen to convert to testosterone. Elevated levels of testosterone triggers a chain reaction which ultimately leads to the typical “male pattern baldness” in both men and women.
    Treatment: Balance estrogen/progesterone ratio with natural compounded progesterone. Restoring depleted progesterone levels helps decrease estrogen dominance and thereby decreases conversion to testosterone.
  1. Bacterial/Fungal Infection. Any compromise to the immune system can weaken hair follicles and dermal layers of the skin. While treating the infection is important, it is even more important to identify WHY an infection is present. Infections are red flags that there is something more going on.
    Treatment: Oral Nystatin may be used to treat if there is any suspicion of a systemic fungal infection. Antibiotics for bacterial infections must be used with caution and only given once a definitive cause is identified. Developing antibiotic resistance only worsens the problem. Use with caution.
  1. Everything is blamed on the thyroid. Whether the thyroid gland is under functioning (Hypothyroid) or over functioning (Hyperthyroid), the wrath it leaves on the hair and skin is emotionally scarring. IT IS IMPERATIVE THAT THYROID LEVELS ARE TESTED IN ITS ENTIRETY. Too often the diagnosis of thyroid disease is missed due to an inadequate testing of thyroid panel. To fully evaluate a thyroid condition, the following levels should be done: TSH, Free T4, Free T3, Total T3, Thyroid Peroxidase Antibodies, Thyroglobulin Antibodies, Magnesium, Vitamin B12, Vitamin D, Iron levels.
    Treatment: Once an accurate diagnosis of Hypothyroid or Hyperthyroid is made, appropriate treatment is given and monitored. If hair and skin continues to be effected after thyroid is in balance, LOOK FOR ANOTHER CAUSE.
  1. Medication Side Effects. Answers we seek the most often sit right under our nose. Always, always assume a medication can cause side effects, until otherwise proven. Even if the symptom is not listed in the package insert, don’t assume that is can’t happen. Simple to identify and simpler to reverse.
    Treatment: Revisit all medications and ALL SUPPLEMENTS.
  1. Leaky Gut. This requires a whole article in itself. GI health and “Leaky Gut” are single handedly catapulting modern medicine to all new heights. EVERYTHING STARTS WITH THE GUT. LET ME REPEAT………HEAL THE GUT…..HEAL THE BODY! Foods we consume are infested with hormones, antibiotics and other unknown chemicals. Going up against the food industry to change their habits can leave us frustrated and defeated. But changing OUR habits can leave us complete and empowered. As the gut flora is disrupted, it creates a “hole” in our ozone in the gut. This leak causes release of many known and unknown cytokines. The inflammatory nature of the cytokines triggers a disruption in the normal hormonal pathway. As mentioned above, we can now understand what happens when hormones are not aligned. Assume even the healthy foods you consume contribute to the leak.
    Treatment: Navigating through the lumen of the GI tract is a winding tortuous ride to unknowns. Begin by decreasing consumption of high reactive foods: gluten, sugar, dairy, non-organic meats and produce. To track your body’s response, maintain a food journal and monitor any physical or emotional improvements. You can also restore the gut’s natural flora with a pro-biotic. You may also consider having an extensive food sensitivity panel testing done. The MRT Leap test measures 150 of the most common food sensitivities.

The complexity of the endocrine system and its effects on the body is quite extensive and many entities are still unknown. The points discussed here are only a mere entry point into the depths of what lies within our cells. Skin is that glorious organ that blankets and shields us from the daily trauma we endure. Waiting around for science to discover the answers will only leave us feeling more impatient and confused. But taking charge of our own health proves to be our greatest ally.

LISTEN TO YOUR BODY! THE SYMPTOMS YOU EXPERIENCE ARE YOUR BODY’S ATTEMPT TO GET YOUR ATTENTION. Every symptom is just as important as the next. Don’t ignore when your body is talking to you. It could be the most important conversation you will ever have! If you are listening to your body and ready to move forward with healing, contact our office today!

Diabetes: Balancing Nutrition and Hormones for Better Health

Diabetes ConceptWhile the media was recently heaping attention on the few people in the United States who had been exposed to or infected by the Ebola virus, a condition which is approaching true epidemic proportions continues to affect more than 20 million Americans. Type 2 diabetes currently affects nearly 8% of the U.S. population and new cases are diagnosed every day. Obesity, which the Centers for Disease Control have identified as an actual epidemic in this country, increases your risk of type 2 diabetes. To make matters worse, type 2 diabetes can lead to additional health complications including congestive heart failure, heart attack, stroke, and kidney failure.

A System Out of Balance

Diabetes occurs when the hormone insulin is out of balance.  Many factors can affect insulin imbalance, including perimenopause, stress and poor nutrition. Diabetes is almost always preceded by pre-diabetes, which is a condition where blood glucose levels are higher than normal, but not as high as those that result in a diagnosis of diabetes. If steps are taken to balance hormones at the pre-diabetes stage or even earlier, it’s possible that diabetes may never be a threat.

Hormonal balance plays an important role in treating diabetes. Each hormone in your body affects the other hormones. When insulin is out of balance, there’s a ripple effect on all your hormones, resulting in a confusing array of health problems. One treatment that can directly address hormone imbalance is bioidentical hormone therapy. In addition to the benefits it has on a variety of health issues, in some cases, bioidentical hormone therapy has been shown to reverse type 2 diabetes. Thyroid dis

Diabetes and Thyroid Disease

Thyroid disease is also commonly correlated with diabetes, as evident in the table below:

thyroid

Table from: http://journal.diabetes.org/clinicaldiabetes/v18n12000/Pg38.htm

Treatment for hypothyroidism and other thyroid dysfunctions has been found to effectively treat and prevent diabetes. If you haven’t had your thyroid checked, but you’re experiencing symptoms such as:

  • Fatigue and low energy
  • Depressed, down, or sad
  • Skin that becomes dry, scaly, rough, and cold
  • Hair that is coarse, brittle, and grows slowly
  • Excessive unexplained hair loss
  • Sensitivity to cold in a room when others are warm
  • Difficulty sweating despite hot weather
  • Constipation that is resistant to magnesium supplementation
  • Difficulty losing weight
  • Unexplained weight gain
  • High cholesterol resistant to cholesterol-lowering drugs

You should talk to your doctor as soon as possible. Controlling thyroid disease is essential for living a healthy, balanced life.

The Impact of Nutrition and Weight Management

The direct link between obesity and type 2 diabetes means that weight management also plays an important role in treating and managing diabetes. If you are pre-diabetic, weight management is also the most natural way to prevent the transition to becoming diabetic. When nutritional imbalances are addressed, weight management is much easier. When foods that negatively affect nutritional balance are removed from the diet, foods that have a strong positive effect can do their work, which is to keep you healthy.

Better health is within reach for everyone, but many people are resistant to making the lifestyle changes that are required. Chronic health conditions like diabetes can only be fully managed with comprehensive medical care, a nutritionally balanced diet, and consistent moderate exercise. Caring support as you take steps toward good health is often all the help you need in order to succeed.

Prevent and Control Diabetes by Finding a Path That Leads to Balance

I practice holistic care and promote staying well and maintaining good health instead of treating patients only after they become ill. My concierge medical practice in St. Louis offers Bioidentical Hormone Therapy, Thyroid Hormone Therapy and I am launching a new Medically Supervised Weight Management program.

If you have been diagnosed with type 2 diabetes or if you are concerned that you may be at risk, contact our office to learn more about how our personalized care programs can get you on a path that leads to balance.

From A to Zinc

ZincThis month truly focuses on one of the most critical elements to our functioning. You can’t walk through an isle of a store without coming face to face with one supplement or another. Each one promising to be the miracle cure for all of your ailments. But how much has science really proven the benefits of these pills? Do we really understand their benefits or are we just loading the shopping carts because it happened to be Dr.Oz’s drug of the week?

I absolutely believe and advocate supplementing our already deficient diet. The more help the better right? Maybe or maybe not.

The flavor of the month for May is Zinc. Zinc has earned rave reviews for its healing properties for the nagging cold or the sore that just won’t heal. What if I told you Zinc holds greater power than just helping with the sniffles?

The past 4 months have tail spinned me into the worst thyroid relapse I have had since I was diagnosed with hypothyroidism 12 years ago. I really felt I had a handle on the understanding of the thyroid, its functions, its nuances and its treatment. But when my symptoms came raging forth in April of this year landing me in the ER, I realized I have only begun to understand the true depth of the thyroid. After running a battery of tests, my Zinc levels were depleted to a staggering low of 45 (Optimal 100-150). This Zinc deficiency brought me to the worst hypothyroid symptoms I have ever experienced-severe fatigue, excruiating muscle pain, massive hair loss, unbelievable weight gain, extreme acne (I could have been a spokesperson for Proactive).

Because of the zinc deficiency, my thyroid took a direct hit and ceased to do any of its required functions. I began taking Zinc supplements over the last month and am only now slowly starting to see a mild improvement. With these recent events, I delved deeper into areas of the thyroid and I clearly underestimated the impact it has on our lives.

Several reports and documented studies suggest that zinc deficiency is a cause of subclinical hypothyroidism. If you have gone through your symptom check list and find a lot, if not all, mirror the symptoms related to thyroid but your thyroid levels register “normal”, zinc deficiency could very well be hindering optimal thyroid balance.

Zinc deficiencies are more prevalent in well-developed countries. Because zinc is a natural element found in muscles and everywhere on earth, eating a diet that includes lean red meats can help increase the levels of zinc. However, in many well-developed countries where health conscious individuals shun red meats, zinc deficiencies are a commonality

Significant relationships between thyroid volume and serum zinc levels showed low release of TSH, T3 and T4 as well as increasing thyroid antibodies in patient’s with autoimmune hypothyroidism.

Now before you go and start popping Zinc, request your doctor to check your levels. Although serum and plasma concentrations of Zinc are often times not 100%, it will at least give you a baseline. With Zinc, MORE IS NOT BETTER. Zinc toxicity actually worsens hypothyroid. Start with caution and monitor levels every couple of months. True Zinc deficiency often takes 4-6 months to balance. Patience, as with anything else, is key. You can’t rush optimization!

So all supplements are not bad and all supplements are not needed. Understand why you take what you take. Ask the questions and listen to the answers and if you are not content with those answers, ask again. Knowledge is power and understanding is key!

And of course, if you have any questions, do not hesitate to contact my office.