From the Doctor’s Desk: Salivary Hormone Testing Backed by Science

Posted by on February 25, 2013 · Leave a Comment 

Saliva testing for hormones first appeared in the medical research literature in the early 1980′s. Salivary testing is becoming the testing method of choice for many reasons including: saliva testing seasons

  1. Saliva testing evaluates the “free” (active) hormone levels. A hormone has to be unbound to elicit a physiologic action. Saliva testing looks at the active hormone inside the cell, at the site of action. Saliva testing has been validated as a testing method for measuring the hormones cortisol, estradiol, progesterone, DHEA, and testosterone to name a few.
  2. Saliva testing requires no needles.
  3. Saliva testing has been shown to be well validated and superior than blood, with sensitivities and specificities exceeding 100% and 97.4% respectively.  Other than perfection, you can’t get much better than that.
  4. According to the National Institute for Health, saliva testing is useful in “detecting various cancers, heart disease, diabetes, periodontal disease…”
  5. Saliva testing is also useful in disease evaluation. Saliva testing of cortisol has been recommended as the first-line test for Cushing’s syndrome due to “high diagnostic accuracy.”

Testing hormones through saliva is backed by science. But don’t take my word for it. In fact, it’s well supported in medical literature and is the right thing to do. Below are links to several abstracts regarding salivary hormone testing. Read them for yourself and learn about the science behind this form of hormone testing.

These articles are published in well-respected journals; and if you notice, they are not recent. Salivary testing of hormones has been well published in the medical literature for some time now.

Here are a few quotes from these studies:

  • “…salivary cortisol may be used as an alternative parameter in dynamic endocrine tests.”
  • “…assessment of ovarian function…can be performed precisely with the saliva estradiol assay.”
  • “…saliva collection has provided the medical and research community with an excellent medium for the monitoring of plasma steroid levels.”

Nowhere else in medicine do we blindly treat people without assessing a baseline and post treatment level(s). Balance is the key; not one individual hormone. Unfortunately, the medical field is very slow to learn and change.

For more information about salivary testing, read Evaluating Hormones Requires More Than Just a Blood Test.

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Pulling Back The Curtains On Dr. Oz: The Truth About IV Nutrition Therapy

Posted by on January 31, 2013 · Leave a Comment 

Dr. Oz ShowRecently on his daily television show, Dr. Oz discussed IV nutrition therapy. I was very disappointed when Dr. Oz questioned the validity, benefit, and safety of this invaluable therapy. He had a guest physician on his show to defend IV therapies, but his guest talked in generalizations with no specifics and no scientific data. Dr. Oz’s conclusion at the end of the show, and I will paraphrase, was: “I guess if the Hollywood celebrity types are doing it, there must be some benefit.”

Wow! Now that’s scientific (insert sarcasm). We live in day where we have instant access to data and scientific research, and that is his closing statement?

As physicians, we often forget that we are scientists. Our testing and therapies should be based on science, not opinion. Yet, neither Dr. Oz nor his guest presented any scientific data to support their statements in favor or opposition. So, allow me to do the job that Dr. Oz and his guest did not.

Intravenous nutritional therapy has been around since IV vitamin C was first used for treatment of polio in 1949. Is it something everyone needs? Of course not. Should everyone take insulin? You get my point.

At Seasons, we evaluate a client’s needs based on symptoms. The symptoms lead us to extensive metabolic testing to determine the specific presence and severity of deficiencies of amino acids, fatty acids, vitamins, minerals, etc. Only then do we recommend IV nutritional therapies using the metabolic test results combined with the client’s symptoms. That is what medicine is all about – using the art and science of medicine for the patient’s benefit.

Another reason to use IV nutritional therapy is that for most Americans, our guts are a wreck (and that is putting it mildly). Absorption problems are a major concern for Americans. If you can’t absorb a vitamin or nutrient, it doesn’t matter how good the source or the dosage of therapy is, it just won’t be absorbed. If you are dealing with severe deficiencies, then you’ll never catch up.

woman administering iv nutritional therapyHow about an analogy to paint a clearer picture? A patient seeks help from a physician for severe dehydration. The patient just can’t keep anything down. Is the physician going to give the patient a pat on the back, tell them to just drink more water, and send them on their way? Of course not. The physician knows that the patient cannot tolerate oral therapy at that point. The deficiency is severe. The physician knows that he/she must catch the patient up, and then instruct the client to drink more water. And how does the physician “catch” the patient up? Well, IVs of course.

Does Dr. Oz question the safety, validity, and benefits of this therapy? Of course not. That is because it is standard practice. Standard practice is defined as: whatever everyone else is doing. I remember my mom often asking me, So…if everyone else jumps of a cliff, are you going to do that too?

And the testing to determine dehydration? Very limited. Usually, a urinalysis, complete blood count test (CBC), maybe a general chemistry, and of course a physical exam. From experience and training, I can tell you that the IV fluids are started based on the physical exam, before the test results get back. That is not how we approach IV nutritional therapy at Seasons. Dr Oz gave the impression that people just walk into a Doctor’s office to order IVs as one would a hamburger at a fast food drive-through. We customize therapy to specific needs and match it with their specific metabolic demand.

So, what does the science say about IV nutritional therapy? The science is overwhelmingly in favor of IV nutritional therapy.

The research below looks at surgical patients. It is well known that poor nutritional status of the patient undergoing surgery effects outcome. These studies showed that IV nutritional therapy improved outcomes. This is not total peripheral nutrition (TPN). TPN is therapy to replace all nutrition. Intravenous nutritional therapy is just to replace vitamins, minerals, and maybe some targeted macronutrients.

So, what about the other benefits of IV nutritional therapy?

During Pregnancy

First trimester miscarriage

Viral illnesses

Critical Illness

Liver Damage

Pain

Cancer

Blood Pressure

Autoimmune Disease

Parkinson’s Disease

Neuropathy

As you can see, the benefits of IV nutritional therapy are abound. That is not my opinion, but scientific fact.

How safe is IV nutritional therapy? The studies below showed the safety of IV nutritional therapies in all states of health, including pregnancy.

Just because Dr. Oz (the great and powerful, Dr. Oz) says it is so doesn’t make it so. I hope I’ve helped pull back the curtain and expose the real science supporting IV nutritional therapy.

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New Perspectives On Hormone Balance Ahead

Posted by on December 19, 2012 · Leave a Comment 

DecNewsletterHeaderFARPerspective. It affects everything. Take, for example, the beauty of the earth. Some might look at the magnificence of the earth and think of Darwinian theory. But as I stand in my back yard, I am amazed by God’s creation. When I look out of the window on my many plane flights, I am amazed by God’s creation. And when I see the perspective from space as seen by astronauts, I am still amazed at God’s creation.

Perspective colors the way we see everything around us. For those, like myself, who believe in the God of creation, I view the world a certain way. And for those who choose to believe otherwise, they view the world a certain way.

Perspective is an important part of the medical world as well. As technology improves, the amount of information available to me as a physician changes the way I treat my patients because I now have more data than I’ve had in the past helping me make a better decision.

So, let’s talk about how perspective is an important part of evaluating hormones! (And you thought the only important perspective about hot flashes was “where’s the air conditioner”!)

If men were only about testosterone and women were only about estrogen, life would be easy and all would be symptom free. Unfortunately, that is, in a nutshell,  the current perspective on treatment of hormone imbalance issues. It is not, however, an accurate perspective based on physiology. Just watch an hour of TV in the evening. The pharmaceutical companies are inundating us with ads about testosterone creams and the like. Regardless of clever marketing, looking at the reality of physiology based on the latest testing methods reveals that hormones are a lot more complicated than treating the level of just one hormone.

When it comes to hormones, there are four important components necessary for physiologic function and symptom-free living.

  1. Hormone levels need to be in the “normal” range. We don’t need the respective hormone levels too high or too low.
  2. Hormones need to be balanced. This is where many in the medical field get it wrong since all hormones work together to communicate to the body.
  3. Your body needs to effectively use the hormones present. Hormone metabolism is a key element in evaluating hormones in the body.
  4. Hormone receptors must appropriately respond to the signal sent by the hormone to your body.

The past (and current) perspective of the medical community is that the absolute levels of individual hormones are what is important and little attention is given to balance between hormones. Very little attention is given to the balance between hormones. For example, women, post-hysterectomy, are prescribed estrogen only. But we know that prior to the hysterectomy, all hormones are needed for a normal, functioning cycle, not just estrogen alone.

Some of the risks associated with estrogen therapy pertains to how the individual metabolizes or detoxifies the estrogen. Hormone metabolism can be affected by internal factors like genetic variations, or SNPs (single nucleotide polymorphisms), located in the detoxification pathways. These are small genetic coding errors. Hormone metabolism can also be affected by external factors such as magnesium and zinc, co-factors in those same internal detoxification pathways of hormone production and metabolism. Just the presence of the detoxification pathways does not a functional detoxification pathway make.

Finally, and the purpose of this post, are the receptors. Hormone receptors determine how the hormone’s signal to the body is then interpreted. Here’s an analogy to help you understand hormone receptors. I have four beautiful children. As with any parent, getting them to clean their room is an ongoing battle. The signal I give them is a verbal instruction such as “Kids, it’s time to get your rooms cleaned.” How that signal is interpreted is quite different. That signal may be interpreted differently based on the environment or pre-existing conditions. If my children are in one of their “moods” (side note: all four of my kids are redheads), then they may just not clean their rooms out of defiance. There is a reason we call the youngest one “the spicy tomato.”

All this to illustrate one important fact — how the signal is interpreted is just as important as the signal that is to be interpreted.

Scientifically speaking, hormone receptors are defined as “a large family of ligand-activated nuclear transcription regulators, which are characterized by organization into different functional domains and are conserved, to differing degrees, between species and family members.”

Was that as clear as mud? In plain English, hormone receptors are how the external signal, hormones, provide to the internal genome a message to turn genes on or off. There is also non-genomic signaling, but a large portion of signaling is actually done with your DNA. This is what hormones do — interact and turn on and off the expression of your DNA. Pretty amazing, huh? And you just thought hormones floated through your blood causing hot flashes in women or ED in men. That is the way most, including physicians, see hormones. However, that just couldn’t be more further from the truth. There’s so much more to it than that.

 Hormone receptors are being used in the medical vocabulary today. If you know someone with breast cancer, you might be familiar with the term ER/PR positive or negative. This is in reference to estrogen receptors and progesterone receptors. This evaluation occurs from an actual tissue sample from the tumor itself and allows the medical team to determine the best course of action for that particular individual. In ER/ PR positive tumors, hormone therapy is used in contrast with ER/PR negative tumors where no hormone therapy is used.

The medical community is addressing the realities of hormone receptors and the role they play in disease. But what about those individuals with hormone imbalance symptoms like hot flashes or erectile dysfunction? Stay tuned. This testing hasn’t made it to the clinical setting yet, but animal testing holds great promise in helping to complete the full picture and improve the perspective that we have on hormones and all their related issues and factors.

Hormone receptors are my current area of research, and I’m writing articles on estrogen, progesterone, and androgen (male hormones) receptors as part of that research. Visit the Seasons Wellness Clinic blog often in the upcoming months so that YOU can become more educated on the body’s communication system — hormone and their receptors.

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Reflections From Nan: Six Months To Sixty

Posted by on October 25, 2012 · 2 Comments 

Even though my 60th birthday is a little over 6 months away, I am planning now for better health, mental acuity, energy, and sense of well-being!  My goal is to improve all of the test results that I have previously had at Seasons. You may remember that I did a Telomere test several months ago –  a fascinating test revealing how rapidly one ages relative to a normal population. Those results showed that I was above average for my age range; however, there was definitely room for improvement!

For my birthday countdown, I have chosen to begin with a detailed cardiac evaluation measuring specific markers in my blood. My total cholesterol has always been slightly elevated; however, over 50 percent of patients hospitalized with acute myocardial infarctions had normal lipid levels as defined by the traditional blood tests. Functional medicine has identified over 400 risk factors, but they are all exacerbated with inflammation, oxidative stress, and immune dysfunction (chronic infections).

Cholesterol is not the villain portrayed in the statin commercials! It is a biological necessity for creating vitamin D, our steroid hormones, estrogen, progesterone, and testosterone, as well as other tasks. High levels are not a sure sign of cardiac disease, nor are low levels a promise of heart health. Our bodies manufacture most of our cholesterol with a smaller amount coming from the food we eat.

Since cholesterol has to travel through the blood which is watery, the body packages it in various “containers” called lipoproteins. Lipoproteins vary according to the amount of protein, fat, and cholesterol they contain. Those with more protein and less fat/cholesterol are called high density lipoproteins or HDL.  Those with less protein and more fat/cholesterol are called low density lipoproteins or LDL. A third type carries even more cholesterol and fat with less protein and it is called very low density lipoprotein or VLDL.

The LPP test measures not only the type but also the number and size of all these particles. LDL has at least five types and sizes. The smallest size is the most dangerous while the largest size is least harmful. Obviously the number of these particles is also a risk factor. Lipoprotein (a) or Lp(a) is a type that increases risk of heart disease. Apolipoprotein B (Apo-B) deposits cholesterol in the artery wall which can be a marker for atherosclerosis. HDL is similar in that the larger size is the most protective.

So what did my test reveal and how can I get healthier? 

First of all, my inflammatory markers – C (reactive protein, insulin, and homocysteine) were all in the normal ranges; however, the latter was borderline for being too high. My total number of LDL particles was elevated but the sizes were in the normal range. However, my Apo-B was borderline which meant I have a risk for atherosclerosis. My VLDL and my Lp(a) were normal. Whew!

With these results and several inflammatory markers from a recent ION Panel – my plan includes the following:

  1. Reduce inflammation with Omega 3 fatty acids. Studies have shown that this will also increase my levels of HDL, increase LDL particle size, and decrease LDL particle number.
  2. Drink more green tea which will decrease oxidation of LDL, decrease Apo-B secretion, and increase HDL
  3. Increase consumption of Vitamin E (which I get in a customized vitamin mix) to reduce Apo-B and lower LDL and increase HDL.
  4. Add Niacin (B vitamin) to lower LDL particle number and Apo-B as well as increase HDL.
  5. Stop smoking (just wanted to see who is still reading this!)  I don’t smoke, but I can always improve my diet with less refined carbohydrates.
  6. Have an occasional glass of red wine which will increase the powerful antioxidant, resveratrol. This has been proven to reduce LDL oxidation, decrease inflammation, and improve the lining of cardiac vessels. Another way to obtain this is with red grapes and purple grape juice (but be careful on the sugar content).
  7. Exercise during the cold months. I love to be outside. But now that the weather is getting colder, I have made a commitment to go to the gym after work. I’m fine once I get there, but I’ll need some accountability to be consistent. Feel free to ask me!
  8. Continue with other cardiac tests. Seasons will be getting a Heart Rate Variability Test which every patient will have access to.
  9. Find joy every day and keep stress levels in balance. Studies have shown that heart disease is linked to depression.
  10. Retest my cardiac markers in May, 2013!

Helen Keller said “life is either a daring adventure or nothing at all.” May we live this one life with hearts full of gratitude and wonder for the countless blessings our Creator has lavished on us!

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Yes, Virginia, There Are Zombies About

Posted by on October 1, 2012 · Leave a Comment 

It is a Thriller night. “Darkness falls across the land, the midnight hour is close at hand…”

Dr. Nathan Goodyear

It seems everywhere you turn, there are zombies on the move. There are zombie TV commercials, zombie games, zombie novels (the best I have read, by the way, is an unpublished zombie book written by my brother), and even dancing zombies. Michael Jackson showed us how well zombies can dance – better than myself, I might add.

But, of course, zombies are not a part of reality. Who really believes a soul-less human exists, a living body moving about but devoid of the qualities such as a conscience that make us human? Zombies just live in the world of fiction, right? Or do they?

I think, perhaps, the zombies we encounter today are different than those of Hollywood. Maybe zombies don’t roam earth terrorizing whole cities, but there are many who have become emotionless and mindless individuals, none the less. These zombies are just a product of the current medical paradigm, a point of view that works for the disease model of medicine but fails in a health-and-wellness model.

A recent analysis by Medco Health Solutions, Inc. revealed that 1 in 5 Americans take prescription medications commonly used to treat psychiatric and mood disorders. That statistic is even worse for women. One in 4 women take the same prescribed medications. The majority of those mood-altering medications are anti-depressants, with 20 percent of American women on some type of anti-depressant. According to the CDC, the use of anti-depressants has increased 400 percent over the last two decades, with the fastest-growing age group being middle-aged women. The question we need to ask is this: do 20 percent of American women need antidepressant therapy?

Even the bravest among us, our military, are not immune to this trend. The Army’s 5th Mental Health Advisory Team revealed that 12 percent of combat troops in Iraq and 17 percent of combat troops in Afghanistan are on prescription anti-depressants and sleeping pills.

As bad as the numbers appear for psychiatric medications, prescribed painkillers are the fastest growing addiction today. According to statistics from the U.S. Department of Health and Human Services, the abuse of painkillers increased by 400 percent from 1998 to 2008. Prescription opiate abuse results in 13,000 deaths per year. In Toronto, oxycodone prescriptions increased by over 850 percent from 1991 to 2004. In the same time period, there was a 500 percent increase in deaths due to oxycodone. Prescription drugs account for an estimated 38,000 deaths annually. These numbers are staggering.

Don’t get me wrong. The purpose of this post is not to bash the use of these types of prescription medications. I am, however, strongly opposed to their misuse and abuse. For many people, these medications can and do change their lives. However, should that number be 20 to 25 percent of the population?

I advocate solution-based healthcare as opposed to band-aid based healthcare. I use the zombie analogy to make a point. Is our current status quo of healthcare in this country creating a legion of zombies? And what if there are alternatives, which I know there are, to treating the underlying issues which produce the symptoms these drugs are intended to minimize or alleviate? Don’t mask the problem. Solve the problem.

In my medical practice, which focuses on an integrative approach to medicine combining the latest advances in medicine with the most natural approach possible, I see patients daily who suffer from the list of symptoms these medications (particularly anti-depressants) are typically prescribed for. With proper testing and analysis of the results, we are able to treat these patients with pharmaceutical-grade vitamin supplements and reverse and/or eliminate their symptoms, returning them to a state of wellness. Wouldn’t it make sense to utilize that approach instead? According to the U.S. Poison Control Center annual analysis, no deaths have occurred from the use of vitamin supplements over a 27-year time period. Compare that to over 3 million deaths occurring from prescription drug use during the same time period (1983-2009).

While it’s the time of the year that zombies and scary things capture our attention, let’s not forget that zombies really do exist and that number is growing fast. With middle-aged adults being the fastest growing age group of users of anti-depressants, anti-anxiety, and sleeping pills, the age of zombies is just beginning. I can only hope that more people will seek alternatives and look for solutions to the symptoms beyond prescription medication. We can solve these problems without simply masking symptoms.

Yes, Virginia, there are zombies about.

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Navigate Your Health Journey With Good Reading

Posted by on September 17, 2012 · Leave a Comment 

 

Because Tennessee ranks 39th in overall health of its citizens [according to America’s Health Rankings], we are passionate about educating the community on how to improve their health. I spend time daily reviewing the latest findings from scientific studies related to health and wellness topics to insure that Seasons is always offering the latest and best solutions for pursuing wellness.

Contrary to the belief of many, good health is not something that can be mandated from government or given to you by a physician. Health is a personal journey acheived only through education and self-awareness. At Seasons, our goal is to provide you with the resources you need to improve the health of you and your family.

Here are five books that are easy reads and are rich in good information for your health journey.

Inflammation Nation by Floyd H. Chilton, PhD

Inflammation Nation was written by Dr. Floyd H. Chilton in 2005. While the book goes back a few years, it is still incredibly relevant. Inflammation is one of the primary problems/obstacles to health today. Inflammation, in the short term, is a necessary part of the healing process. When you are cut, the “inflammation” present through redness, pain, and swelling works to protect the body from invasion and to start the process of healing. But the inflammation subsides quickly. However, in some, inflammation rages on and promotes disease.

It would make sense that if something, certain types of food for example, were causing inflammation in our body and ultimately leading to disease, we would want to eliminate the problem, reduce the inflammation and prevent disease, right? Dr. Chilton discusses the immune system and how our diet affects it. The old adage “you are what you eat” definitely applies here.

Inflammation Nation is an easy read and provides many easy recommendations to incorporate into your daily life.

The Wheat Belly by William Davis

The Wheat Belly is written by William Davis. Very rarely do I encounter clients that have not read or heard of this book. This book touches on a growing problem in America and the world today – an adulterated food supply. Not food supply that is adulterated with parasites or bacteria, but that is adulterated from within. What does that mean? In The Wheat Belly, Dr. Davis touches on the fact that the wheat of today is not the wheat our parents ate. Not only is the nutritional value present in wheat lost, but the genetic modification is likely contributing to inflammatory problems.

The problem with genetically modified foods (GMO) is we have limited knowledge of their impact on the body. And the federal government and its agencies have never done a good job of investigating these items before rushing them to market. Just look at the history of environmental toxins such as phthalates, parabenes, and other volatile solvents, all brought to market labeled as safe only to be removed from the market when revealed as seriously dangerous toxins.

This book is also a very easy read and provides easy dietary recommendations to immediately bring positive changes to your health.

What Your Doctor May Not Tell You About Breast Cancer by John R. Lee, M.D., David Zava, Ph.D., and Virginia Hopkins

This was the very first integrative medicine book I read in 2006. This book goes back to several founding people in the integrative medicine movement like Dr. John Lee, an oncologist who led the movement in bioidentical hormones and saliva testing. Dr. Lee was ostracized by the medical community, but his commitment to his patients and to true scientific evidence is an example for all to follow. In fact, Dr. Zava believed in this movement so much that he started a saliva-testing company.

As it relates to breast cancer, there are few more published than Dr. Lee and Dr. Zava. I have met Dr. Zava personally on several occasions, and there are few that I would put above his in both scientific integrity and commitment to true science.

This book lays out a different approach to breast cancer, one focusing on prevention instead of early detection. Traditional medicine focuses instead on early detection and cancer treatment. Don’t get me wrong. We need that, but true prevention is where we should first focus.

The book is deep at points, but is a good discussion of biochemistry and physiology as it relates to breast cancer. Its focus on more natural ways to prevent breast cancer is based on the scientific research. The book clears up much of the misinformation about hormones and breast cancer and equips the reader to be advocate in the prevention of breast cancer.

The book’s authors were unafraid to take on traditional medicine, but do so with a good foundation of science.

The Blood Sugar Solution by Dr. Mark Hyman

Dr. Hyman is a great proponent of wellness and a pillar in the integrative medicine community. This book, published earlier this year, is an easy weekend read with numerous tools to incorporate into everyday life. The focus of this book is nutrition, sugar, in particular.

Obesity is at epidemic levels in the United States. According to CDC data, 13 states now have an obesity rate greater than 30 percent, while in the year 2000, NO states reported obesity rates greater than 30 percent. This book takes the major culprit head-on: diet.

The Blood Sugar Solution delves into diet, insulin, insulin resistance, and a host of other factors contribute to poor health. The book provides many tools to succeed in the “battle of the bulge,” and even includes recipes to help you succeed in your personal health journey.

What Your Doctor May NOT Tell You About Hypertension by Dr. Mark Houston

If you ever have the chance to meet Dr. Mark Houston, you will surely be impressed. Mark Houston, M.D., is Associate Clinical Professor of Medicine at Vanderbilt University School of Medicine, Director of the Hypertension Institute and Vascular Biology, and Medical Director of the Division of Human Nutrition at Saint Thomas Medical Group, Saint Thomas Hospital in Nashville, Tennessee.

While his list of credentials are a mouth full, to hear him speak will fill your ear! As a cardiologist focused on an integrative approach, there are few that speak so eloquently on the deep biochemical disease found in cardiovascular disease.

While the subject matter might sound intimidating, this book, is a very easy read and focuses on the underlying dynamics of hypertension and associated complications. Dr. Houston defines the problem and lays out solutions with his wildly successful program for treatment of hypertension using an integrative medicine approach.

Dr. Houston also provides a health discussion of hypertension medications, when needed, and the mode of action and side effects of each. This a definite must-read for anyone on hypertension medications. You might just become more informed than your own physician!

While this book is a self-help guide to natural treatments of hypertension, it is based on sound science and the approach has been extremely successful. This book is also heavily referenced, allowing you the option of pursuing deeper learning if desired. This book removes every obstacle to reducing hypertension except you. It’s your job to act on what you read.

The Naturally Healthy Woman: Whole Health for the Whole Woman by Shonda Parker

Yes, I know I said five and this is number six! But this is a very good manual for women and their health. As an OB/Gyn, my first passion was women’s health. The author, Shonda Parker, whom I have met, is a true blessing to know. There are few who have a passion for health that exceeds hers, and she has an ever better spirit. Shonda is a nurse midwife, has authored many books, and speaks nationally on health and other related topics. This book highlights many of the health issues facing women today, and I predict that the edges of this book will become tethered due to your repetitive use after reading it.

As a nurse midwife, the author’s first passion is pregnancy. This book begins by touching and then builds into many other health issues affecting women. The author provides many natural remedies at the end of each section for the different health issues discussed. The book not only provides natural therapies for the mother/wife, but also for the rest of the household.

Every pathway to health is different. Every journey to wellness is unique. At Seasons, our desire for wellness for all begins with education and knowledge for you. I hope that these books will become additions to your library and provide you with the knowledge you need in your personal journey toward wellness.

Filed under Bioidentical Hormone Replacement Therapy, Bioidentical Hormone Replacement Therapy, Book Reviews, Breast Cancer, Cancer, Etcetera, Etcetera, Food Sensitivity, Food Sensitivity, From The Doctor's Desk, GI Balance, GI Balance, Health & Wellness Resources, Healthy Living, Healthy Living, Heart Health, Heart Health, Hormone Balance, Hormone Balance, Hormone Symphony, Immune Balance, Immune Balance, Men's Health, Menopause, Mind, Perimenopause, Post-Pregnancy Rebalance, Pre-Pregnancy Wellness, Women's Health · Tagged with , , , , , , , , , , , , , , , , , , , , , , , ,

Evaluating Hormones Requires More Than Just a Blood Test

Posted by on August 20, 2012 · Leave a Comment 

Dr. Nathan Goodyear

“I just don’t feel right.” These are frequently the first words I hear a patient say. “I’m so hormonal…I know I’m not balanced. I’m tired, cranky….” and so goes the list of symptoms, all of which indicate hormone imbalance.

It’s amazing to me that most patients know intuitively that they don’t feel good and it has something to do with hormones, but they’ve had a blood test by their physician and everything checked out “okay.” That blood test, however, didn’t change the fact that they still feel terrible.

There is a lot of debate these days regarding the different methods of evaluating hormones: blood, saliva, and urine (oh my). In a few short weeks, school will start. So to get back in the swing of things, today school is “in session” and a science lesson is the order of the day. The topic? How are hormones evaluated and which is the best test for you?

Hormone Delivery and FedEx?

Understanding complicated topics is often made simple with a great analogy. My good friend, Dr. Eldred Taylor, uses the analogy of FedEx trucks to explain hormones and their delivery to the cells of the body. And I especially like this analogy because my dad has been a pilot for FedEx for many years!

FedEx trucks are everywhere during the month of December. It wouldn’t be unusual for a lot of trucks to pass your house during that month. But, if the FedEx trucks don’t stop at your house, it doesn’t really matter how many trucks have driven by your house or how many packages each truck contained. The fact remains that none stopped for delivery. It only takes one FedEx truck to stop at your house and the Christmas tree is full.

I’ll take it one step further. The day after Christmas, the boxes and wrapping paper are piled up at the road-side for pickup. You might comment as you drive by your neighbor’s house “It looks like the Jones’ had a good Christmas” based on the curbside aftermath. You can even make out what the gifts were based on the leftover boxes and debris on the curb.

What does it all mean? The FedEx trucks symbolize hormones in transport in the blood. It doesn’t matter how many hormones are transported through the blood (FedEx trucks), they are inactive (the truck didn’t stop at your house). When the FedEx truck stops at your house, it symbolizes when hormones are dropped off for action inside the cell. One truck can drop off 100 packages or 100 trucks can drive by, dropping off no packages. Finally, the post-Christmas driveway debris represents the hormones after the body has broken them down into metabolites.

Hormones can be evaluated through three different testing methods: blood, saliva and urine. Blood testing evaluates the number of FedEx trucks in your neighborhood. Saliva testing evaluates the number of packages delivered at your house. And urine testing evaluates the post-Christmas driveway debris to identify what packages were delivered and opened.

So what does the science say about the hormone testing methods of blood, saliva, and urine?

Blood Testing

Testing hormones present in the blood has been used to develop the current reference norms that we use in the diagnosis and management of many diseases. It has been around a long time. This kind of testing is effective in the disease model of medicine. However, in the wellness model of medicine, we are looking for dysfunction, not just disease. And this is where the effectiveness of blood testing breaks down.  By identifying physiologic dysfunction, we hope to prevent disease. It is the move into true preventative medicine, not just early detection, the wellness model of medicine has found the blood testing of hormones to be lacking.

There are three main problems with blood hormone testing.

  1. First, is the whole idea of a needle. If we can evaluate hormone levels without puncturing the skin, then we should.
  2. Blood testing evaluates hormones in transport. This is typically reported as “total” hormone levels and the “free” active levels are calculated. Transported hormones are inactive. Hormones in the blood are bound to proteins (estimated at 95-99%) and inactive. Going back to the FedEx truck analogy, blood testing tells me how many FedEx trucks there are and how many packages they have to deliver. But it doesn’t tell me how many packages were delivered at your house. And that’s a very important piece of information. Are your hormones coming or going? And is your body utilizing the hormones you have?
  3. It is not the most accurate form of testing. Saliva testing is proving to be superior to blood testing for measuring hormones (see Saliva below).

Urine Testing

The use of urine to evaluate cortisol has been present for awhile.  And this is a valid method to test cortisol, one of your body’s hormones. The problem with this form of testing is that most people don’t want to carry a jug around collecting urine for 24 hours.

Currently, the interesting research on urinary testing of hormones is in the measurement of metabolites. Think back to our analogy. Urinary testing is best used for looking at the curbside debris to see what presents were opened at Christmas. By measuring metabolites, we can see how effectively your body is metabolizing hormones. If your body is ineffectively metabolizing hormones, the resulting symptoms and conditions can include Chronic Fatigue Syndrome, obesity, fatigue, and increased breast cancer and prostate cancer risk to name a few. These issues are all treatable at Seasons Wellness Clinic with a customized wellness plan based on your test results.

Saliva Testing

Saliva testing for hormones first appeared in the medical research literature in the early 1980′s. Saliva is becoming the testing method of choice for many different reasons. Going back to our analogy, saliva testing measures the number of packages that are delivered by the FedEx truck at your house.

  1. Saliva testing evaluates the “free” (active) hormone levels. A hormone has to be unbound to elicit a physiologic action. Saliva testing looks at the active hormone inside the cell, at the site of action. Saliva testing has been validated as a testing method for measuring the hormones cortisol, estradiol, progesterone, DHEA, and testosterone to name a few.
  2. Second, saliva testing requires no needles.
  3. Saliva testing has been shown to be well validated and superior than blood, with sensitivities and specificities exceeding 100% and 97.4% respectively.  Other than perfection, you can’t get much better than that.
  4. According to the National Institute for Health, saliva testing is useful in “detecting various cancers, heart disease, diabetes, periodontal disease…”
  5. Saliva testing is also useful in disease evaluation. Saliva testing of cortisol has been recommended as the first-line test for Cushing’s syndrome due to “high diagnostic accuracy.”

Saliva testing gives me the information I need to diagnose what’s going in your body. And while that is my opinion based on my training, it’s also opinion based on scientific fact according to hundreds of research articles (see links to additional articles below). Saliva testing is now considered the “gold standard” for hormone evaluation.

Today you have learned about the three methods physicians use for evaluating hormones: blood, saliva and urine. You’ve also learned that each test is useful for measuring different things. We can evaluate hormones many different ways at Seasons and determine not only the amounts of a specific hormone in your body, but also how effectively your body is actually using (or not using) those hormones with saliva and urinary testing.

Most important is the clinical relevance of each test. Testing the hormones at the site of action provides the best physiologic approach (saliva testing). Testing the hormone metabolites provides the next best approach (urine testing). Through the evaluation of the body’s metabolism of hormones, the physiologic mechanisms of how the body removes hormones can be evaluated.  The evaluation of hormones in transit (blood testing) provides the least physiologic assessment.

While each test provides an appropriate measure, the question is, does that measure provide insight into physiologic dysfunction? And, can an appropriate therapeutic intervention be undertaken to effect a change? At Seasons, we provide answers using those test results, creating a customized wellness plan that will put you on the road to a life with more energy, balance, and, ultimately, happiness.

Cheers to the pursuit of wellness.

To read the scientific literature supporting saliva testing, click here.
For more posts about saliva testing, click here.
For more posts about hormone imbalance, click here.
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Record Highs Noted this Summer!

Posted by on July 13, 2012 · Leave a Comment 

The outside thermostats are definitely rising this summer. But the heat outside shouldn’t mean sudden bursts of “personal” heat, otherwise known as hot flashes!

Oddly enough, I have personally experienced fewer hot flashes when I am at the beach! Is that a strange but true fact? Indeed it is. But there is a great explanation. It’s not the outdoor temperature which contributes to those hot flashes, it’s actually Cortisol fluctuations that wreak havoc on our internal thermostat.

Many women are surprised to discover that their saliva tests indicate significant imbalance with their adrenal glands. These tiny glands located right above each kidney secrete a number of hormones to help the body deal with stress. Cortisol is commonly called the “stress hormone” due to its involvement in your response to stressful situations.

Adrenal fatigue from chronic stressors such as blood sugar imbalance, inflammation, insomnia, as well as emotional issues can manifest itself through intense hot flashes and/or night sweats. Unless Cortisol levels are measured, it’s difficult to treat because both high and low levels can have the same symptoms. Healthy adrenal glands significantly improve a sense of well-being!

Insulin resistance also contributes to those personal internal fireworks. Because insulin, like cortisol, is a major hormone, it is very difficult to establish hormone balance between estrogen, progesterone, and testosterone until your insulin metabolism is balanced. In other words, those relentless surges of heat will continue to bombard your body if too much insulin is allowed to build up.

Excess blood sugar from simple carbohydrate intake causes our body to release more insulin. This initially allows our cells to receive glucose and keep blood levels normalized. After a while, our cells become resistant to insulin, and so levels increase. Prolonged elevations of glucose and insulin eventually disrupt cellular metabolism and spread inflammation. The good news is that we can evaluate both hormones at Seasons and implement healthy changes.

Most people believe that low Estrogen can be the major culprit for hot flashes. While this can certainly be a factor, the opposite is also true! Many health care providers prescribe transdermal hormones and then remeasure with a blood (serum) test in a few months. When levels have not improved, doses are increased. Symptoms may become exacerbated with new ones such as breast tenderness, weight gain, depression, acne, and hair loss noted.

Transdermal hormones quickly enter the bloodstream but then are transported to hormone receptors in tissues all over the body. Serum (blood) tests will not measure these levels.Saliva testing will reveal more accurate levels as well as identify how your body metabolizes each hormone. At Seasons, we will design a customized wellness plan to balance your hormones using such strategies as removing excess hormones through detoxification or safely providing accurate doses for symptom relief and optimum health.

If you have noted record highs with your internal thermostat, give us a call. We would love to help you adjust the temperature with our restorative health plans. There are many variables causing similar symptoms, not just the summer weather!

In the meantime, identify stressors and change your routines. Don’t forget to play and have fun this summer, eat your veggies, stay hydrated, and get plenty of sleep! And if you have had record highs but were able to quench them, share your comments with us. Hot flashes don’t have to be inevitable during the summer months…or anytime, for that matter.

 

Nan Sprouse, RN, MSN, FNP-BC

Nan Sprouse, FNP-BC, received her Bachelor of Science in Nursing degree at University of Tennessee, Knoxville and her Master of Science in Nursing degree from Carson Newman College. Nan is currently completing a fellowship in Anti-Aging and Regenerative Medicine. Nan is a member of the Tennessee Nurses Association.

Nan has been married to Randy Sprouse for over 30 years. Their family consists of 4 sons of whom three are married to incredible young ladies! She has one granddaughter and another one soon to be born.

Nan’s desire is to help people have abundant life through all stages of life. Many health issues ranging from weight gain, depression, sleep issues; sex drive, energy, and self esteem have strong correlations to hormone balance. Using innovative testing through saliva and blood work, accurate measurements can be obtained and then corrected.

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It’s Not Depression…It’s Stress!

Posted by on May 31, 2011 · 2 Comments 

Dr. Nathan Goodyear

I am amazed at the number of clients that I see who are prescribed anti-depressants these days. I have only been in practice for 6 years, but I have seen these drugs used excessively to treat everything from PMS to stress.

The major problem with these medications is there are no long-term studies on the impact these drugs have on the body. Don’t forget that these medications have side effect profiles that rival the novel “War and Peace.

Aside from the litany of side effects, anti-depressants typically don’t treat the actual problem. And what I’m finding is that it’s not depression…it’s stress.

Sure, there are people out there that undeniably suffer from depression. But most are struggling with overwhelming stress. It is well accepted that 90% of doctor visits today are due to stress or some stress-related condition.

Let’s look at physiology to see how stress affects the body.

Our stress response is a protective mechanism. It is our body’s way to help us run from that tiger or turn and fight that tiger. It is our fight or flight response. Therein lies part of the problem.

We aren’t running from any tigers, at least not on this continent. But our stress level is constant and higher than ever…bills, economy, family. From the time we wake up to the time we go to sleep, we are under stress. The body doesn’t know the differences between types of stress — whether tiger chase or financial pressure — it just responds to the stress.

We cannot discount the impact of stress on the body. The stress response comes from our adrenal glands. Epinephrine, norepinephrine, cortisol, and DHEA are the main components of the stress response. Under intense stress, our body releases norepinephrine and epinephrine. These neurotransmitters stimulate cortisol and DHEA release from the adrenal glands. This results in dilated pupils, fast heart rate, edginess…all physical manifestations of the fight or flight response.

It doesn’t stop there. That same long-term elevated cortisol will cause a depletion of the stimulators norepinephrine and an inverse drop in the serotonin levels. And THAT is the cause of depression.

The extended exposure to stress is the problem. And the band-aid solution of treating with anti-depressants is not a good solution.

The alternative? As a metabolic specialist, my approach is to support the the body’s stress response with a customized prescription of vitamins, minerals, bioidentical hormones, amino acids first. Then, we develop a healthy living plan that will help reduce stress and restore the body to normal function so that it is no longer non-functional from extended periods of stress overload.

While exercise and proper nutrition go a long way, the long-term affects of a stress-filled life require customized medical care to reverse their effects. And that’s what we do here at Seasons Wellness Clinic – customized wellness.

Cheers to the pursuit of wellness!

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Hormones And Their Effects On The Body

Posted by on April 27, 2011 · Leave a Comment 

Dr. Nathan Goodyear

People ask me all the time for more information about hormones and why we need them. Hormones are the communication tools of the body. They deliver messages. So here is a list of a few hormones and what they contribute to your body.

Estrogen

  • Protects against osteoporosis, heart disease, memory loss, colon cancer, incontinence and tooth loss
  • Enhances sleep, emotional well-being, mental acuity and focus, memory, attention span, communication ability, vision, hearing, taste, touch, smell, digestion, libido and skin tone.
  • Relieves menopausal symptoms and depression
  • Increases tolerance to pain

Progesterone

  • Has a calming effect and enhances mood
  • Regulates fluid balance
  • Increases blood sugar, thyroid function and mineral balance
  • Relieves menopausal symptoms
  • Decreases risk of endometrial cancer and may help protect against breast cancer and fibrocystic breast disease
  • Protects against osteoporosis and heart disease

Testosterone

  • Builds muscles and promotes muscle tone
  • Increases energy and libido
  • Enhances sense of well-being
  • Helps strengthen bone

DHEA

  • Helps protect against heart disease, osteoporosis, diabetes, cancer, memory loss, lupus, and rheumatoid arthritis
  • Can increase and enhance energy levels, libido, memory and immunity
  • Protects against the effects of stress
  • Aids weight loss and healing of burns
  • Helps to prevent wrinkles and dry eyes

Cortisol

Balance

  • Helps in responding and coping with stress, trauma, and infection
  • Increases energy and metabolism
  • Helps regulate blood pressure
  • Enhances the integrity of blood vessels
  • Reduces allergic and inflammatory response

Balance of each of these hormones is a key element of optimal health and absence of disease. Proper testing, a customized treatment plan for out-of-balance hormone levels, and follow-up testing are all important for achieving healthy hormone levels in your body.

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