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Unwanted side effects of (bioidentical) hormone replacement therapy

Posted in common conditions, remedies, tagged , , on February 3, 2010| 402 Comments »

The use of bioidentical hormones got a lot of press after Suzanne Somers (Three’s Company cast member and promoter of the ThighMaster™) began touting them as an alternative to synthetic hormone replacement. I wholeheartedly agree that bioidentical hormones are preferable to synthetic hormone replacement therapy (HRT). Recall the large experiment on the female population known as the “Women’s Health Initiative Postmenopausal Hormone Therapy Trials”. If you aren’t familiar with the results of that study, here is a summary provided by the National Institutes of Health:

Compared with the placebo, estrogen plus progestin resulted in:

•Increased risk of heart attack
•Increased risk of stroke
•Increased risk of blood clots
•Increased risk of breast cancer
•Reduced risk of colorectal cancer
•Fewer fractures
•No protection against mild cognitive impairment and increased risk of dementia (study included only women 65 and older)

Compared with the placebo, estrogen alone resulted in:

•No difference in risk for heart attack
•Increased risk of stroke
•Increased risk of blood clots
•Uncertain effect for breast cancer
•No difference in risk for colorectal cancer
•Reduced risk of fracture
(Findings about memory and cognitive function are not yet available.)

Just because synthetic hormones come with proven risk, it seems that people have decided bioidentical hormones are totally fine to take. Bioidentical hormones are crafted to be the exact molecular structure of the hormone(s) your body produces. Synthetic hormones, on the other hand are not. Synthetic hormones are typically a bit different from the exact structure that your body makes because that way it can be patented by the manufacturer.

The purpose of this article is not necessarily to compare and contrast synthetic from bioidentical HRT; but to alert you as to how the body responds when bioidentical (and synthetic) hormones are taken. Well, really to alert you on the downside consequences of taking ANY hormones. The physiology is simple and logical. It can be more in depth, but I’ll focus on the basics. By the way, I’m referring to the pathways of the most commonly replaced hormones, steroid (e.g.: estrogen, testosterone, progesterone, cortisol, DHEA, etc.) and thyroid hormones.

Most hormones work in the body via a negative feedback loop. This means that as the level of a hormone rises, a signal is mediated that ceases that hormone’s production and release; in order to prevent the production of the hormone from getting out of control. Let’s begin with an example using thyroid hormone.

The three main glands involved in thyroid hormone production are the hypothalamus, pituitary and thyroid. The hypothalamus releases “thyroid releasing hormone” (TRH), which stimulates the pituitary gland to release “thyroid stimulating hormone” (TSH), which in turn stimulates the thyroid gland to manufacture and release thyroid hormones (thyroxine or T4 and triiodothyronine or T3). Once the thyroid hormone begins to do its job throughout the body, production begins to decline, so as not to produce too many hormones. So, as the level of thyroid hormone increases, the levels of TRH and TSH decrease. It’s called a negative feedback loop because the rise in hormone levels results in a decreased production; as opposed to a positive feedback loop where a rise in hormone levels would produce an even greater rise in the level of that same hormone. The only example of a hormone that works on a positive feedback loop that I can think of is oxytocin.

Because these hormones work this way, you may be able to guess what happens when you are exposed to (i.e.: ingest) exogenous hormones. Exogenous (as opposed to endogenous) refers to those taken in from outside the body, and can be any type of hormone. So, if you take a hormone, you can be sure that those negative feedback loops will still function as usual. The result…your body stops (or significantly slows) its own production of these hormones. What’s wrong with that? Eventually, you’ll be dependent on these hormones as your glands have “gone to sleep”, because “someone” else is doing their job. It’s simply not necessary for the glands to have to do anything.

So if you stop taking them, it may be extremely difficult to get your body’s own production back up to par. Now, considering people often take hormones because they’re not producing enough on their own in the first place, you can imagine how difficult it would be to begin the production process after taking exogenous hormones and suppressing your hormone production even further. Therefore, people usually become completely dependent on hormones, bioidentical or not. In general, as long as you’re okay with taking a hormone for the rest of your life, there is no need to worry. However, most (if not all) of my patients shun that idea.

The next issue is that of hormone receptor insensitivity. Generally speaking, each hormone docks into a receptor on it’s target cell. It’s as if the receptor is the lock and the hormone is the key. Once the cell “door” opens, the hormone goes on to carry out it’s function (usually turning on or off genes). The problem with bombarding the cells with large doses of a hormone is that eventually it’s as if the cell decides to change the lock on the door. The result is that it is harder and harder for the hormone to open the cell door, and therefore more and more of the hormone is needed each successive time you want to make an effect on the cell/genes. It’s almost as if you need enough hormone to knock the cell door down, because it doesn’t want to open. This is especially prevalent with the use of hormone creams (usu. progesterone). However, if you make no lifestyle changes it typically happens with any hormone. That’s why people on thyroid hormone often have to continue increasing the dose to get the same effect; the same goes for those who take insulin. Have you ever known of diabetic or person with hypothyroidism (except for autoimmune thyroid disease/Hashimoto’s) that had to decrease their dose, without making lifestyle changes? So, taking a hormone for the rest of your life may not even do the trick, especially insulin. You may be familiar with how well diabetics fare without changing their lifestyle, and continually increasing their doses of insulin. By the way, hormone receptor sites often “run out” of the vitamin and minerals that are necessary to allow them to function properly, due to the constant bombardment of hormones they are subject to in these cases.

This is not to say that no one should be on HRT, bioidentical or synthetic. There is a time and place for everything. And when these hormones are necessary, they can be miraculous. The big question is: When are they necessary? That’s a debatable issue and can certainly vary between individuals. So I am not absolutely against HRT, though I definitely prefer bioidentical over synthetic when possible.

The point I’m trying to get across is that I wouldn’t recommend anyone start with HRT, unless they are in a very unmanageable state. In these instances, one option may be to start with HRT to “prime the pump” and then eventually wean off them. Unfortunately, with all the books written about HRT and the attention it gets these days, many people (and doctors) go straight for hormones (with or without lab tests). Don’t get me wrong, chances are you’ll feel like a million bucks if you take hormones that you are deficient in, or insensitive to. But don’t forget to ask the million dollar question just because you feel like a million bucks: How long does that last? Well, there is no single answer to that question because everybody’s condition and lifestyle is a bit different. But, from what I’ve seen, it lasts about six months at best, before they have to adjust the dose upward. You may eventually find yourself always having to increase the dose to get the same effect. And finally, your cells just may not respond adequately, despite the dose. That’s not say there is no hope though.

I’m currently working with a patient who had low testosterone and used testosterone replacement therapy for over a year. Sure enough, he had to continually increase the dose, until it eventually stopped giving him the results he needed (i.e.: absence of musculoskeletal pain, strength, libido, and an erection). In this case (and others), I determine if the hypothalamus, pituitary, gonads (when it comes to testosterone), and/or cell receptors need support. Fortunately, in the above mentioned case, the patient got immediate results that according to him, showed via the number of plates he kept adding on the machines at the gym.

In some cases, it may not be easy to get everything back up and running like new. But with the proper nutritional support and lifestyle improvements, it certainly is an attainable goal. The willingness of the patient to change their lifestyle and the length of time the person has been on hormones are two very important factors that will help to determine the outcome. Fortunately, I haven’t seen a “lost cause” yet; but I sure have seen people feeling miserable after the hormones stop giving the desired effect. Remember, there’s no such thing as a free lunch!

Not to go into politics…but I’m a big advocate of being able to buy supplements over-the-counter. Although I truly believe that hormones should only be dispensed through licensed health care practitioners who know how to use them.

PS: There are more problems associated with HRT (bioidentical or not) than what I mentioned above. For example, many men who take testosterone can eventually wind up converting it into estrogen (just about the opposite effect they are looking for)…that’s enough on that for now.

PSS: I’m not saying that bioidentical hormones are never necessary. They certainly can be in some instances…just consider the potential side-effects and work with a licensed, competent, qualified health care professional who knows how to use them appropriately. They can be very useful to “prime the pump” when other lifestyle changes are implemented.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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Potentially hazardous whole foods

Posted in food, tagged on January 11, 2010| Leave a Comment »

The idea that whole, unadulterated foods are healthy is accepted as truth for the most part. And rightfully so, because generally speaking, processed foods typically are not healthy; as they can rob the body of vital nutrients while stressing different organs and glands. However, there are some whole foods that may actually be harmful to certain individuals. I’m not referring to foods that people are allergic or sensitive to. It should be obvious that those are harmful. There may be more, but these three came to mind first.

Peanuts
Peanuts have often been found to contain a toxin known as aflatoxin. Aflatoxin can grow on peanuts (and other legumes, nuts, and grains) during preharvest, storage, and/or processing periods. And the amount of aflatoxin will vary depending on the geographic location and agricultural practices of the plant. The problem with aflatoxin is that it is a potent carcinogen (cancer-causing substance), and has been associated with liver cancer. Even though you probably won’t get liver cancer from eating peanuts here and there, they can still be a stressor to your body that you may be best off avoiding.

Goitrogenic foods
A goitrogen is a substance that can inhibit thyroid function and possibly lead to the formation of a goiter. A goiter is an enlargement of the thyroid gland that results from a lack of thyroid hormone. In the case of a goiter, the lack of hormone is (most often) due to insufficient iodine uptake. Goitrogens contribute to insufficient iodine uptake. Iodine is an essential component of thyroid hormone. But fortunately, goitrogens can be inactivated by cooking. So if you are going to consume goitrogenic foods, you may want to avoid eating them raw, especially if you are prone to (or have) hypothyroidism. Click here for a list of goitrogenic foods. Unfortunately, these foods are also some of the healthiest cancer-fighting foods like broccoli; again cooking them will solve the problem.

Grapefruit
Grapefruit contains a substance called naringin that is known to interfere with certain detoxification pathways in the liver. And because of this, people taking certain medications need to be extremely careful when eating grapefruit (or drinking grapefruit juice) because it may prevent the breakdown of those medications. In addition to metabolizing medications, these detox pathways are also necessary to breakdown certain chemicals. Unfortunately, I do not have a list of those chemicals. But the simple fact that it can impair detox pathways may be a good enough reason to avoid eating a lot of grapefruit.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

sources: http://www.ansci.cornell.edu/plants/toxicagents/aflatoxin/aflatoxin.html#Aflatoxins

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TMJ dysfunction, applied kinesiology, and chiropractic

Posted in Applied Kinesiology, chiropractic, common conditions, tagged , , , on December 6, 2009| 2 Comments »

The temporomandibular joint (TMJ) can be considered the most important joint in the body. In the 1950’s, two neurologists, Penfield and Rasmussen, stated that almost half of the motor and sensory nerves in the brain relate to the dental area. With this much attention being devoted to the dental area, you can be sure the TMJ has a large effect on overall body function.

Symptoms of TMJ dysfunction typically include the following: jaw pain, clicking or popping in the joint, decreased mouth opening, headaches, neck pain, tinnitus (ringing in the ears), and vertigo or dizziness. However, because of its large representation in the brain, I check it in on almost all my patients. Other than musculoskeletal complaints, endocrine gland imbalances can also result. This is because the “master” endocrine glands, the pituitary, hypothalamus, and pineal reside in the skull. And because structure determines function, these glands can dysfunction (and affect other glands they control) if the cranium is distressed due to muscular imbalances in the TMJ. Symptoms can vary and include but are not limited to: infertility, insomnia, hypo/hyperthyroidism, adrenal stress syndrome, PMS, increased or decreased appetite, digestive disturbances, etc..

Causes of TMJ dysfunction include muscular imbalances in the head and neck, faulty posture, malocclusion (irregular contact of the upper and lower teeth), grinding or clenching the teeth, chewing on only one side, pelvic imbalances, and even over-pronation in the feet.

Treatment of the TMJ generally includes leveling the head on the neck through chiropractic adjustments to the cervical spine, in addition to balancing the muscles of the neck and jaw. However, as stated above, the pelvis and feet can play a role in TMJ function as well.

The TMJ usually becomes dysfunctional because of other areas of the body that affect it; unless there has been direct trauma to it, as in boxing or a head injury. Therefore, I rarely go straight to the TMJ. But it is certainly worth checking no matter what the patient suffers from.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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Causes of chronic fatigue and exhaustion

Posted in common conditions, food, tagged , , , on September 17, 2009| Leave a Comment »

Yesterday I was reading an article titled “Yawning? 6 surprising reasons why you are exhausted“, on the “Shine” section of Yahoo®. So now I’ll share my comments on it, and expand on some more ideas on why you may be exhausted. Before I get into the reasons mentioned in the article, I want to quickly share some of the biochemistry and physiology about energy production and fatigue in the body. I’ll keep it simple so don’t worry. By the way, I’ll use the words fatigue, tired(ness), and exhaustion interchangeably.

First, there are really only two basic reasons that a person will be exhausted or have low energy. These are a simply a deficiency in nutrients required to run the energy cycles, or a toxic reaction in the body. Both of these represent a “stress” to the system. And keep in mind that there can (and usually) will be a combination of both. Because a lack of sufficient nutrients will cause toxins to accumulate and toxins will cause a depletion of nutrients (required for detoxification). When I talk about toxins I am  referring to both chemicals internally produced and from environmental or food exposure. A “true”, so to speak exhaustion or fatigue can often be relived by rest, once the body gets the energy cycles up and running again. Of course you still need nutrients. However, you can be tired and feel exhausted because of temporarily burning through them (especially in reference to exercise). If you find that rest (or sleep) doesn’t relieve your fatigue, there is a good chance that you are toxic, especially after a sufficient amount of sleep. Generally, if you don’t feel rested after 9 hours of sleep, there is a good chance you are toxic to some degree.

When I think of biochemicals and the cycles run in the body that are necessary to produce energy I think of these four basic things: 1) ATP (adenosine triphosphate) – one main “energy” molecule; 2) the citric acid (or Kreb’s cycle); 3) the electron-transport chain; and 4) a process known as glycolysis. OK, that’s as technical as I’ll get, promise. The nutrients required to allow ATP to be produced and the three processes mentioned include: magnesium; manganese; phosphorus; lipoic acid; co-enzyme Q10; and vitamins B1, B2, B3, B5, and B6. There may be some more, but that’s a great start. Do you now see why many people say B-complex supplements give you energy? OK, now that we have that out of the way we can talk about the 6 reasons for exhaustion from article. They do say “6 surprising reasons”, so I am acknowledging that they are not claiming them to be the only reasons.

1) “A hidden UTI” (urinary tract infection) – the article states: “In some cases, fatigue may be the only sign of a urinary tract infection, reports WebMD. If you suspect something’s up (and you have pain and burning when you pee) talk to your doc.”    This is surprising isn’t it. I simply want to add that any hidden (or overt) infection can cause exhaustion including fungal, yeast (candida), bacterial, viral, parasitic, and protozoal. The main reason for this is that chemicals (mainly known as cytokines) produced from stress to the immune system can cause the Kreb’s cycle to malfunction. These organisms may also produce fatigue-inducing chemicals independent of the immune system.

2) “Your diet” – The article says that not eating enough calories (calories are “more or less” energy, measured in Joules) could cause fatigue. Do you think that’s most of the “developed” world’s problem though? Come on now, I believe the obesity rate in America is around 2/3’s of people, and something tells me it’s not from eating too little calories. Obesity is often associated with fatigue. According to a study published in the Archives of Internal Medicine, obesity accounts for a significant portion of fatigue symptoms. Try getting double the recommended calories you truly need from pasta, bread, soda, and sugary desserts and let me know how that goes. The foods I just mentioned are empty calories from processed foods. The key is to eat enough calories through a variety (to ensure a wide range of nutrient consumption) of whole-foods.

3) “Food allergies you didn’t know you had” – This will cause the some of the same problems as #1, because of the stress on your immune system. Please see my article titled “Food Allergies and Sensitivities.”

4) “Caffeine overload” – They say: “You probably reach for more coffee when you’re tired, but experts say that too much caffeine can sometimes backfire, causing you to feel more fatigued. Maybe skip the triple-venti today.” I agree, although 1 cup (normal-sized mug), which is not “overload”, should be fine (but not in all cases). Generally this will cause adrenal gland burn-out as it can affect the release of stress hormones. These hormones (and the caffeine) will burn through detoxification nutrients in order to clear them from the bloodstream. This will also tax your blood-sugar handling mechanisms which will always result in energy imbalances (later if not sooner). Everyone in modern society has some degree of adrenal gland stress – it just depends if it is eustress (beneficial – glad to wake up out of bed type of stress) or distress. It’s a huge topic I’ll discuss in-depth another time.

5) “Undetected thyroid problems” – Here the article notes: “Fatigue is one symptom of a thyroid condition called hypothyroidism. Fortunately, this is such a treatable thing (I have it, and just pop a pill each day–no biggie). Most health experts concur that every woman should have her thyroid levels tested every few years (just a simple blood test) to rule out any such conditions (they’re common in women).” You can read my two articles titled “Hypothyroidism” and “Potential causes of hypothyroidism“. And in case you weren’t sure, I’m not so keen on the “just pop a pill each day – no biggie” idea. No, definitely not thrilled they wrote that. And I’m not saying medication is “bad” and no one needs it. And… moving forward. Please read my two articles on the topic.

6) The sixth was added at the end and is “your snoring man”. Obviously sleep is a no-brainer, and please recall what I said above about sleeping, and then waking up feeling un-rested…

Briefly, remember that it’s any toxin – which includes toxic (heavy) metals, pesticides, fragrances, artificial sweeteners, etc.; and let’s even throw in radiation which is hopefully not the problem.

One last thing, the article states this in the beginning: “Sure, getting enough sleep is the biggest way to beat the 4:00 yawning session (I swear, there is something about this time–weirdly, I could fall asleep at 4 p.m. everyday!), but did you know that several other surprising things could be making you sleepy? Here are some unlikely yawn-inducers…”. It’s never a good idea to say 100% of the time. So, I’ll say 90%+ of the time, if you are sleepy at 4:00pm, it is a blood-sugar imbalance. This is an extremely common complaint. And reaching for the coffee, soda, or chocolate bar will simply exacerbate the problem unknowingly. The other give or take 10% of the time…check what you ate for lunch. By the way, yawning excessively without fatigue is an acid-alkaline imbalance usually; as the body is naturally “blowing off” a highly acidic build-up of carbon dioxide. For this you look to the diet, nutrient deficiencies, and the diaphragm (for better breathing capacity).

Good luck, and see if you can identify your source(s) of fatigue. By the way, I could probably add a few things to the list, but let’s rule those out first.

Sources include: Yahoo®, material published by Walter H. Schmitt, DC, DIBAK, DABCN and Chris Astill-Smith, DC, DIBAK.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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Potential causes of hypothyroidism

Posted in Applied Kinesiology, common conditions, tagged , , , , , , , on September 15, 2009| 3 Comments »

The previous article titled “Hypothyroidism” was written to allow for an understanding of the function of the thyroid gland; the symptoms of hypothyroidism; and the medical approach to treatment. In this article I will focus on what I see as the potential causes of hypothyroidism in the first place based on my experience. Remember, many people have the same “diagnosis” but for different reasons. That is why I focus on treating patients and not their diagnosis or blood tests. By the way, I have yet to see the cause as a deficiency of taking drugs.

OK, in the first article I mentioned 7 different possible reasons for clinical or sub-clinical hypothyroidism. Let’s begin.

1) Structural imbalances in the cranium or TMJ (possibly affecting the pituitary)
The pituitary is nestled in the brain and sits in a little “saddle” that’s part of the sphenoid bone. This bone happens to be the center of cranial bone motion. If there are muscular imbalances in the muscles of the neck and TMJ, you can be sure that undue stress will be placed on the pituitary. Remember, structure determines function, not the other way around. There is even a particular cranial fault, which is corrected via the “pituitary drive technique” in applied kinesiology. It targets sphenoid bone motion specifically. But you must correct the muscle(s) involved as well, as muscles move bones; the “heart” of applied kinesiology principles. Just like adjustments to the spine and extremities; if the muscles haven’t been balanced, you can be sure the joint problem will come right back. I unfortunately don’t have research on this topic, as I wouldn’t be surprised if the government or drug companies are NOT handing out grants to people interested in researching structural stress on the pituitary. I could be wrong though.

2) Weakened/stressed out adrenal glands
The adrenal glands are the “stress” glands. They produce the hormone cortisol (and others) and neurotransmitters adrenaline and noradrenaline. One quick mention about thyroid hormone first. T3 is a much more (perhaps 90-95%) metabolically active hormone than T4. T3 is “made” by a conversion of T4 into T3, by removing one of the iodine molecules on the T4 (hence 3 molecules instead of 4). This is enormously important for the thyroid hormone to ultimately do its job appropriately. High or low levels of cortisol can however inhibit that conversion of T4 to T3. As a result, the circulating thyroid hormone will not work very effectively, and often cause the symptoms of hypothyroidism. One more thing – high or low cortisol can cause the body to convert T4 into “reverse T3”. This is when the iodine is pulled off the wrong part of the T4 molecule. This will result in a metabolically inactive hormone, that may even get tallied into the total T3 reading on blood tests. So it may look like there is plenty, but much of it may be inactive “reverse T3”. Reverse T3 can be ordered on blood tests, but I’ve never seen it, unless I instructed the patient about it and they asked for it to be ordered. There are ranges of normal on the test results for reverse T3, but there is usually a clause saying it’s not been studied enough to determine it’s accuracy. I would still look to get it in normal ranges if this is the suspected cause (you’ll see how soon). By the way, the reasons for imbalances in cortisol levels are too plentiful to mention here; but poor blood sugar metabolism is of prime importance (this does not mean you need to be diagnosed with diabetes or hypoglycemia). Most people have faulty have blood sugar metabolism (and stressed adrenal glands) to some degree.

3) Heavy metal toxicity
By now you probably know that heavy (toxic) metals can cause a wide array of problems. Well, here’s one more. Just like high or low cortisol, heavy metals can cause an inhibition in the conversion of T4 to the more active T3. Especially consider mercury, cadmium, and lead; but I wouldn’t stop there. By the way I often say “toxic” metals because aluminum is not “heavy”, it is actually “light” in molecular weight – and I wouldn’t want to avoid including it, as it is certainly toxic. [aside: check those salt packets you get from the deli – you just may find an aluminum compound on the list of ingredients]

4) Imbalances in estrogen and progesterone (commonly thought of as female hormones) – however, males also produce these hormones
According to Janet Lang, DC, an imbalance in estrogen and progesterone can lead to thyroid hormone being inactive at the cellular level. I’m not sure of the exact mechanism she proposes, but I agree, as I’ve seen it in patients who have these imbalances (usually a condition known as “estrogen dominance”). Janet Lang has dedicated almost all of her research to (functional) hormone problems.

5) Vitamin, mineral, and amino acid deficiencies
First, the amino acid tyrosine and the mineral iodine are the raw material to make T4 and T3. The “T” stands for tyrosine and it is an essential (must be obtained from diet) amino acid we get from eating protein. The number “4” or “3” refers to the number of iodine atoms attached to the tyrosine. So these are obviously necessary. Next, the mineral selenium in necessary for the conversion of T4 into the more active T3. A deficiency in this mineral would not allow for that conversion. Additionally, there are a number of vitamins and minerals that are necessary for the thyroid hormone receptor (where it “docks” in to the cells) to function properly; and for the manufacturing of the hormone. These include, but are certainly not limited to: iron; zinc; potassium; manganese; vitamins A, B1, B2, and E. Don’t forget digestion and absorption of these nutrients.

6) Imbalances in the output of pituitary and/or hypothalamic hormones
I spoke about this above regarding cranial and TMJ imbalances. The hypothalamus, which “controls” the pituitary can also be a problem in hypothyroidism. In addition to cranial treatments, there are some specialized supplements that can help the function of these glands.

7) Liver toxicity or malfunction
The liver is one of the main sites where the conversion of T4 to T3 takes place. An imbalance in liver function, for any number of reasons (usually toxicity or a build up of fat) can impede this conversion. For these cases, detoxification through diet, lifestyle and targeted nutrition is usually necessary.

Notice how the list of 7 problems above, doesn’t even mention the thyroid! That’s because I’ve never encountered a problem with the thyroid directly that causes a problem. I suppose that makes sense because most problems that exist arise through lifestyle (nutrition, stress, etc.) complications. Even a liver, adrenal, nutrient deficiency or absorption, or structural problem isn’t THE problem – it is the result. There is usually a combination of the factors mentioned that contribute to thyroid problems; which of them is primary depends on the person.

By the way, there are many people taking thyroid hormone in the form of drugs, and they still exhibit the signs and symptoms of hypothyroidism. I find that this is usually a nutrient deficiency that presumably prevents the thyroid hormone receptors from working properly. Unfortunately, the conventional approach to this is usually to simply increase the dose, which may help temporarily.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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Hypothyroidism

Posted in Applied Kinesiology, chiropractic, common conditions, tagged , , , , , on September 11, 2009| 4 Comments »

The thyroid is a butterfly-shaped endocrine (hormone secreting) gland located in your neck beneath the cricoid cartilage, or “Adam’s apple” (as it’s referred to in  males). Essentially its job, or the hormones it secretes, is to control your body’s metabolism. That is, it determines the rate at which your body builds, maintains, and breakdowns biochemicals (and ultimately energy). It is controlled by hormones released from the pituitary gland, which in turn is controlled by the hypothalamus. It secretes three hormones – T4(thyroxine), T3(triiodothyronine), and calcitonin. This article will focus on a common disorder known as hypo-thyroidism (decreased output of thyroid hormone), which refers to the levels of T4 and T3, as they are the two associated with metabolism. The “T” refers to the amino acid tyrosine, and “3” or “4” refers to the number of iodine atoms atttached to it. Calcitonin as its name implies helps regulate calcium metabolism.

Some of the thyroid’s main functions are to convert food into energy, help control body temperature, and basically affect the speed and efficiency of all biochemical processes. Additionally, it can have a profound effect on emotions, mood, cravings, and addictions because T3 influences brain chemistry.

I won’t go into the exact mechanisms of how these hormones exert their effects on the body, but I will discuss the end results. This leads me to the main signs and symptoms of hypothyroidism. The main thing you want to think about is fatigue. Typically, the person with hypothyroidism will experience fatigue ALL day long. There is one major caveat regarding this however. These people may not completely notice how fatigued they really are. I say this because based on my experience in working with patients, they’ll tend to pack their day with things to do in order to keep going and going. Obviously they may be tired, but it won’t be as noticeable because they often stay so busy and can become preoccupied. Aside from fatigue, the next major symptom would be weight gain (or inability to lose weight); don’t be fooled by this though, as many normal or underweight individuals have (sub-clinical) hypothyroidism. Cold hands and feet is another common one; and I still have yet to see this symptom related to circulation, especially in people under 60 years-old. Dry skin, poor memory, constipation, goiter (swelling of the gland), muscles cramps (and musculoskeletal pain), high cholesterol, swelling of the extremities and face, carpal tunnel syndrome, depression and addictions, and chronic colds and flu can also be added to the list. Some cases will result in a loss of the outer-third of the eyebrows. This is not known why to my knowledge, however it’s interesting to note that the acupuncture meridian related to the thyroid ends at the outer edge of either eyebrow.

OK, so what causes hypothyroidism or a low output of thyroid hormones? According to the Mayo Clinic, the most common reported cause is Hashimoto’s thyroiditis. This is an inflammation of the thyroid due to an autoimmune reaction when the body attacks its own thyroid gland (no cause of this condition is mentioned). The next are medical treatments for hyperthyroidism (designed to slow the thyroid), radiation treatment for cancers of the head and neck, thyroid surgery (removal of some or all of the gland), or side effects of drugs for other conditions.

Great, so now what? I was expecting the medical community to at least mention iodine deficiency. But all the major medical information I found basically states the same as Mayo Clinic as the “cause” for hypothyroidism. No wonder the first thing patients are recommended is drugs that contain synthetic (or sometimes natural) thyroid hormone.

Unfortunately, sub-clinical hypothyroidism is very common. This is when the blood tests show normal levels of thyroid hormones but the patient (sometimes, not always) has “all” (or some) of the signs and symptoms of an under-functioning thyroid. The obvious problem here is if a patient accepts that there is nothing wrong with them because their thyroid hormone levels are normal (sometimes the pituitary hormone- TSH is elevated, but not always). So then what? The usual scenario is that they go back year after year (while slowly getting worse, assuming they haven’t changed anything in their lifestyle) until the tests finally pick it up – then it’s “official”; and there is something that can be done about it. Drugs of course – again, synthetic or natural thyroid hormone. OK, it’s time to stop whittling people down to numbers on a piece of paper!!! Let’s pay attention to our patient’s symptoms and concerns, and not just their blood test results. Let’s look for the causes and begin treating ASAP! Keep in mind that some doctors will immediately start the patient on drugs (usually only if the TSH is high).

Here is what I see as the major contributors to sub-clinical or clinical (shows up on blood tests) hypothyroidism; in no particular order.

1) Structural imbalances in the cranium or TMJ (possibly affecting the pituitary)
2)Weakened/stressed out adrenal glands
3) Heavy metal toxicity
4) Imbalances in estrogen and progesterone (commonly thought of as female hormones) – however, males also produce these hormones
5) Vitamin, mineral, and amino acid deficiencies
6) Imbalances in the output of pituitary and/or hypothalamic hormones
7) Liver toxicity or malfunction

In order to not make this article too lengthy, I’ll leave it there and get into those 6 specific things in the next article.

I first wanted to get you familiar with the functions of the thyroid; the signs and symptoms of hypothyroidism; and the medical approach. See you soon.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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ALL FISH CONTAIN TOXIC MERCURY!

Posted in common conditions, food, tagged , , , , , , , on August 20, 2009| 5 Comments »

According the Associated Press (AP), every single fish tested from nearly 300 streams in the US were found to be contaminated with the toxic metal mercury.  However, “only about a quarter had mercury levels exceeding what the Environmental Protection Agency says is safe for people eating average amounts of fish”.  The EPA states on their website that “a variety of fish and shellfish can contribute to heart health and children’s proper growth and development”.  And then go on to say the following “women and young children in particular should include fish or shellfish in their diets due to the many nutritional benefits”.  “For most people, the risk from mercury by eating fish and shellfish is not a health concern.”  “Yet, some fish and shellfish contain higher levels of mercury that may harm an unborn baby or young child’s developing nervous system.”  Finally they state the obvious – “The risks from mercury in fish and shellfish depend on the amount of fish and shellfish eaten and the levels of mercury in the fish and shellfish.”

Some more specifics of what the EPA has to say: “Do not eat Shark, Swordfish, King Mackerel, or Tilefish because they contain high levels of mercury.  Eat up to 12 ounces (2 average meals) a week of a variety of fish and shellfish that are lower in mercury.  Five of the most commonly eaten fish that are low in mercury are shrimp, canned light tuna, salmon, pollock, and catfish.  Another commonly eaten fish, albacore (“white”) tuna has more mercury than canned light tuna. So, when choosing your two meals of fish and shellfish, you may eat up to 6 ounces (one average meal) of albacore tuna per week.  Check local advisories about the safety of fish caught by family and friends in your local lakes, rivers, and coastal areas. If no advice is available, eat up to 6 ounces (one average meal) per week of fish you catch from local waters, but don’t consume any other fish during that week.”

Before I continue on the dangers of ingesting mercury, I want to mention how mercury winds up in fish to begin with.  Basically, it is from coal-burning power plants that emit smoke stacks of pollution.  These emissions obviously get into the air and then settle into the oceans, lakes, rivers, streams, and ground near this water.  Oh wait, I presume the mercury in that pollution must also get into our reservoirs, but I haven’t seen that mentioned.  Perhaps because people are focusing on fish, when it comes to mercury.  Anyhow, the legislation that was supposed to be implemented forcing companies to control those emissions has been disgustingly delayed.  About.com had an article stating this: “By law the Environmental Protection Agency is obligated to require power plants to cut roughly 90 percent of their emissions of mercury and other toxic pollution by 2008. Instead, in March 2005 the agency let polluters off the hook, requiring much smaller reductions and giving electric companies more than two decades to accomplish them. What’s more, the agency essentially allowed polluting companies to do nothing for the next 12 years.”  Please see the link as there are more facts about fish and not just the politics behind the pollution.

Mercury is known to be extremely toxic to the nervous system in particular.  The EPA states that mercury can cause harm to the brain, heart, kidneys, lungs, and immune system in people of all ages.  For fetuses, infants, and children the major effect is impaired neurological development.  Lastly, the EPA says (and I can’t get over this one!): “In addition to the subtle impairments noted above (referring to the previous sentence), symptoms of methylmercury poisoning may include; impairment of the peripheral vision; disturbances in sensations (“pins and needles” feelings, usually in the hands, feet, and around the mouth); lack of coordination of movements; impairment of speech, hearing, walking; and muscle weakness. People concerned about their exposure to methylmercury should consult their physician.”  Bold type-face, underlining, and statement in parentheses added by me.

OK, now I’ll comment.  How does the EPA know what’s safe for you?  What symptoms must occur for certain amounts to be considered unsafe?  Also, I unfortunately can’t find information on how they determined safe levels, and of course, the state of the health of those people (presuming tests were done on humans?).  Please comment if you know.  But regardless, do they know the toxic burden (of all toxins) that already exists in you?  Do you know?  Remember, we ALL have some level of a toxic burden of chemicals and metals in us; from simply breathing the air, consuming conventionally grown foods, etc….the list is endless.  Do you have all the necessary nutrients to drive the kidney detoxification pathways?  We often think of the liver as the main detox organ, however, toxic metals are water-soluble and will be excreted through the kidneys into the urine.  As an aside, any time I find a patient’s most “stressed” organ(s) to be the kidneys or bladder, I think toxic metals first.

My points above are meant to reflect the concept that you probably won’t experience the above OVERT and OBVIOUS symptoms of mercury toxicity as reported by the EPA, by consuming fish alone.  That is from my personal experience with patients.  The problem arises when people have sub-clinical symptoms from mercury toxicity.  These might include fatigue, irritability, “foggy-headedness”, depression, anemia, hypothyroidism, digestive complaints, and more.  Sub-clinical mercury (or other toxic metal) toxicity often results in the scenario of: “Mr./Mrs. Smith, all of your tests came back normal”. Let me expand on this.  It will be extremely uncommon for a person to have mercury levels elevated in their blood.  To date, out of literally hundreds of patients of I’ve seen with mercury-related symptoms, or other toxic metals, ONLY 1 actually showed elevated levels on blood tests.  And this is how conventional doctors often go about checking for it.  The problem is often that the metals get lodged into the cell/soft tissues and don’t get fully released into the bloodstream.  When in the cells/soft tissues, they can cause impairments of normal functioning leading to the above symptoms.  Fortunately, there are functional lab tests (especially urine) that can be used to detect levels of metals in the soft tissues.  Even though urine is a reflection of blood, the test involves “provoking” the metals out of the cells to get an accurate measurement of total body burden in the soft tissues.

The amount of mercury-laden fish you can consume without harm or causing symptoms will depend on a variety of factors; mainly your current “toxic-burden” and detoxification abilities.  And as you know, your symptoms may already be stemming from mercury (or other toxic metal) exposure; so perhaps you shouldn’t consume any fish at all.  It would be prudent to have functional (in-office and lab) tests performed to find out!  Lastly, I have helped many patients with symptoms related to toxic metal exposure by correcting simple and easily identifiable nutrient deficiencies, and education on avoiding further exposure.

I still can’t understand why some practitioners in the dental community consider it OK to put mercury in their patients’ mouth!!!  By the way, there is a right way and a wrong way to have mercury amalgams removed.  It can be more harmful to have mercury fillings removed, when done “improperly”.  Feel free to e-mail me if you have concerns about that.

One more thing.  You may go “MAD” if you are exposed to too much mercury.  The phrase “mad as a hatter” comes from the hat-making industry dating back to the 1800’s when some hat-makers apparently went “mad” because of breathing mercury fumes from a solution they used to make fur into felt.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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