hormones - Page 8

Blind Faith, No Longer Blinded: Tales of Thyroid Illness

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At 11-years-old, you hardly understand the complexities of life and the implication of any diagnosis. My doctor told me I had Hashimoto’s Thyroiditis, and that it was insignificant… a pill, every day, and blood tests, every 6 months. Simple. My mother, a pediatric nurse, brought me to the best pediatric endocrinologist in the NYC area. With blind faith, I went about life veiled by ignorance about thyroid disease.

I professed my Hashimoto’s at every medical visit. Yet, it was never considered in any treatments. I was told I was depressed and prescribed anti-depressants. I had irregular periods and was prescribed birth control pills. I had dry hair and told it was from processing and products. My skin was like that of a crocodile. Must be genetics, as I shared so many similar behavioral, mood and medical similarities to my father. I accepted my genetic fate, but never once made the connection to our shared diagnosis of Hashimoto’s. That is, until the Hashimoto’s emerged and demanded recognition.

My doctors called it postpartum depression. I could not seem to manage my moods and anxiety, but I was not depressed. This was my third child and the baby weight was not coming off. Something was wrong, I could feel it in my soul. I was driven to research my disease. Soon, I realized all of my idiosyncrasies were symptoms of my “insignificant” disease and my hormone imbalance was distorting my reality.

In the 24 years since my diagnosis, the field of Endocrinology has improved the treatments of Hashimoto’s and other thyroid conditions, yet my treatment remained the same. I encountered countless others who also had their lives forever shifted due to these “insignificant” disorders, but I also discovered treatment options that alleviated those symptoms. My blind faith that my physician knew best dissolved. My doctor transformed into a human with flawed knowledge of a rapidly changing field, and from the once naive patient emerged a woman who refused to accept this was acceptable.

This shared experience with innumerable thyroid dysfunction patients also suffering from symptoms of a disease, yet labeled with minimizing terms such as depressed, mentally unstable and hypochondriacs. This motivated me to action. If we demonstrate and express our experience, if we grab the ear of our physicians who dedicate their lives to healing us – then I have faith we can change our future and heal the next generation. This new found faith inspired me to write, “Endocrinologists: Patients with Thyroid Dysfunction Demand Better Treatment.”

This international petition amassed over 3600 signatures from over 65 countries. It inspired, Denise Rodriguez, an amazing woman with a different, yet similar, thyroid journey, to shape and mold my raw petition into the amazing movement it is today (a little less than 3 months later). We just launched ThyroidChange™, a web-based initiative, to unite the voice of thyroid patients worldwide.

Hormones matter! I have faith that our voices, when strengthened with worldwide support, can change the future of thyroid care. Please join us on our journey.

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BPA in Plastic Bottles: What’s the Big Deal About ‘Little Beards’?

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“The only thing that I heard is if you take plastic and put it in the microwave and heat it up, it gives off a chemical similar to estrogen. And so, I mean, in the worst case, some women might have little beards”   

~Paul LePage, Governor of Maine

Long ago, I cut a deal with my best friend: if one of us is on our death bed unable to care for ourselves, the other will tweeze her friend’s “man hairs.”  It may sound vain to some, but there is dignity even in death. When my mom lay dying in her hospice bed, I plucked the dark hair from her chin and upper lip, trimmed her nails, and brushed her hair, because I knew she wouldn’t want to “be seen like that”.  It was the least I could do after all those years she spent caring for and grooming me.

So I took great offense when Maine Governor Paul LePage–exhibiting astounding ignorance (even for a politician) of the delicate balance of human chemistry–made his remark about “women might have little beards.”  As if a woman having a little beard was no big deal, right?

Now before you go accusing me of over-reacting to media and environmentalist hype about the side effects of BPA–or bisphenol A- a compound added to plastic bottles and other packaging materials to increase flexibility, transparency, durability–first consider what a “big deal” it is in the scientific community.Two recent studies in Italy and Germany show that suboptimal storage conditions—such as prolonged exposure to sunlight and high temperatures—can cause leaching of BPA in plastic bottles into fluid contents resulting in high levels of estrogenic activity in plastic-bottled water. In other words, plastic bottles can leach chemicals that disrupt the endocrine system.

The endocrine system is responsible for making our hormones. Hormones are substances that help to control activities in your body. Different types of hormones control reproduction, metabolism (food burning and waste elimination), growth and development, and yes, even facial hair. Hormones also control the way you respond to your surroundings, and they help to provide the proper amount of energy and nutrition your body needs to function.While too few studies have been conducted to know with certitude about potential human health effects of drinking plastic−bottled beverages, as Lisbeth Prifogle of Hormones Matter reported previously, investigators have found that BPAs combined with the xenoestrogens in our environment cause male fish to grow eggs in their testes, female deer mice to pick males who weren’t exposed to BPA in a controlled environment, hyperactive rats (some scientist speculate that endocrine disruptors could be linked to the rise in ADHD amongst school children) and many other strange behaviors in the animal kingdom.

The National Toxicology Program’s Center for the Evaluation of Risks to Human Reproduction, suggests, in response to the European studies, that people move away from polycarbon−ate plastics [due BPA concerns].

In women with PCOS or other hormone problems, BPA can be especially problematic. Researchers from Athens report:

“Blood levels of BPA were nearly 60 percent higher in lean women with PCOS and more than 30 percent higher in obese women with the syndrome when compared to controls. Additionally, as BPA levels increased, so did concentrations of the male sex hormone testosterone and androstenedione, a steroid hormone that converts to testosterone.”

So Governor LePage, if you’re reading this, let me see if I can help you understand what the “big deal” is. Suppose you were exposed to an everyday chemical that made your breasts “a little” larger or your testes produce eggs. Or what if BPA led to sexual dysfunction in men? No big deal, Right? What’s a little Viagra between friends.Sources:

International Journal of Hygiene and Environmental Health, March 2009
Environmental Science and Pollution Research, March 2009

Environmental Health Perspectives, “Estrogens in a Bottle?”, June 2009

This image (or other media file) is in the public domain, per US public domain laws, because its copyright has expired. For more information see the file at wikimedia commons.

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Why Hormones Matter to Me

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The Problem

A few days ago, I received a text from my older sister, Megan. “Becca [our younger sister] is in the hospital. She started bleeding so heavy she couldn’t leave the bathroom and has cramps so bad she was puking. She was at band and they called an ambulance! I’ll keep you posted.”

My first thought was, oh my god, how embarrassing. My second thought, oh my god, not Becca too. As I’ve written about before, my periods are less than normal. Oh how I envy those women who menstruate like clockwork. Those who can plan weddings, vacations, military exercises, etc. around their cycle without worrying that their bodies will evoke a surprise visit from that miserable old hag, Aunt Flow. As I have also written, I cannot take birth control to regulate my hormones. The various times I have tried, like Becca, I ended up in the ER from extreme heavy flow.

The Consistent Answer – Birth Control

Becca is eighteen years old and not sexually active and has never had a need to be on birth control. Between our mother, who had the same reactions that I did years ago, and my horror stories, I doubt she will ever be tempted to try. Still, I said to Megan and Mom prior to her doctors appointment, “They are going to try to force her to take birth control.” I know because that is the ONLY option I have ever been given. More than once I have had medical professionals glare at me and respond, “Well if you don’t want to take birth control there is nothing I can do for you.”

Becca went to her first gynecologist appointment today (congrats Becca you are a woman now!). Sure enough, Megan called me furious saying, “All they are willing to do is give her more pain killers and prescribe her birth control.”

I responded, “Not that I want to say I told you so, but I told you so. I knew that’s all they would do without any other tests ruling anything more serious out. Ugh, I freaking knew it!”

Side note: We are Irish, German, Scottish (and my Dad swears we’re of Viking descent on his side) and on top of that our hormonal imbalances; needless to say, anger management is not one the Prifogle Women’s strong points.

Becca explained my experiences with birth control to the doctor and expressed that she didn’t want to do that, but the doctor told her and Mom that it was her only option. They scheduled an ultrasound to rule out ovarian cysts, but in all likelihood it will just be something poor Becca has to live with as well.

A multivitamin that has maca root, chaste tree berry and red raspberry leaf tea, as well as acupuncture, have help me, but we’ll see what Becca and Mom decide to do.

Why Hormones Matter and Why I Write

When I started writing for Lucine’s online magazine, Hormone’s Matter, Chandler Marrs told me the statistic that <30% of clinical practice guidelines in OB/Gyn are evidence based. I was in shock, but then I thought of all my horrible experiences with my periods and doctors lack of willingness to do anything about it outside of synthetic hormones (and for some women this is great – I just don’t happen to be in that category of women). As busy and exhausted as I am (and aren’t we all) I continue to research, write and help build this online community because that statistic is ridiculous. Hormonal birth control cannot be the band-aid, cure-all for women’s health any longer! We have to start figuring out what the problem is and dealing with the cause, not the symptoms? It could be as simple as eliminating endocrine disruptors and hormones from our diet/lifestyle or adding exercise, or it might be something more complicated and un- or misdiagnosed. For Becca’s sake, I hope it’s something as simple as a diet change.This isn’t just a female problem either. As John-Brandon Pierre wrote in Why Men Should Care About Women’s Health:

“It is our duty as men to help care for and help provide security for our women. To help strengthen them so that they can live out their lives in the most meaningful way they choose. To support them and help them find answers to the problems that plagues them. In doing so we enrich our future and we do our part to better understand what we cherish the most – our women.”

Thank you for your support and please continue to spread the word about Lucine Biotech and that HORMONES MATTER!

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I’m Sexy and I Know It, Sometimes – Sexual Attraction Chemistry

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sexual attraction and oral contraceptives

Have you, or possibly your partner, ever wondered if there really was a link between your menstrual cycle and sexual attraction? Perhaps you have noticed that during certain times of the month something is not quite right and whatever it is, it seems to affect your ability to concentrate. Scientists have as well.

Evolution, the Menstrual Cycle, and Sexual Attraction

Since the dawn of humankind, women have been programmed to think and act in such a way that helps us find the perfect mate with the best genes to make the best babies; survival of the fittest. However, the conditions and interactions are not as clear-cut today as they were during caveman times. Women are educated and have careers. We work hard and we play harder. In other words, we might be too busy to think of finding a man and having children, at least on a conscious level.

Researchers have found that reproductive hormones are still at play when it comes to how we feel about certain situations, view the world, and interact with others. During the week before ovulation, women have improved memory, perhaps to signify the right time to find “The One,” but also to help you make better decisions and navigate your environment. Near ovulation, women may have a heightened sense of smell, possibly to sniff out potential toxins. Additionally, several studies have shown that women who are in the fertile window tend to dress and feel more attractive as compared to other times in their cycles. A major drawback to this process is that some women may be highly sensitive to to the cyclic rise and fall of their hormones and experience negative mood symptoms, increased food cravings, and susceptibility to stress, particularly during the premenstrual phase.

Oral Contraceptives and Sexual Attraction

What about the pill? Oral contraceptives (OCs) contain synthetic hormones that may also affect women’s social behavior and psychological functioning. In my own research, I have found that women who are on the pill show greater attraction toward current and potential mates across all phases of the cycle. Naturally, this could be due to the simple fact that women using OCs expect to have more sex than those who are not. However, we also found that an increase in androgens, a side effect of the pill, was significantly related to this increase in attraction.

Because of our genetic make-up, women must go through regular shifts in their cognitive abilities, moods, and behavior. In other words, we think, feel, and react differently based on what our hormones are doing. This may translate to women’s approach to relationships, sexual arousal, and motivation to seek out mates. But also, it affects how we work, talk to friends, and deal with our problems.

Does this mean women should plan their activities accordingly? That may be a tad extreme, but maybe it will help both men and women understand why sometimes we are just not in the mood.

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Redefining Healthcare for Women

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As the dust settles on the Komen Foundation decisions of last week, I am reminded once again how compartmentalized and politicized the notion of women’s health has become.  Boobs and wombs seem to represent the sum total of interest in women’s health.  And if the Komen fiasco is any indication, one can’t care about both, because where one stands or one’s employer stands on reproductive issues is now becoming the litmus test that permits or denies access to care. If you are a woman, that is. No such criteria exist in men’s health.

Women’s health is inherently political. We carry the responsibility of continuing the species. With that responsibility inevitably comes intrusion (no pun intended). We seem to forget, however, that women have cancer (not just breast), heart disease, diabetes, immune diseases and the whole host of illnesses that are unrelated to whether or not we bear children. Certainly, whether we have born children impacts these diseases, more so than many are willing to admit, but what we think about birth has nothing to do with our health and should have nothing do with our access to healthcare.

As a private organization, Komen has every right to change its mission. It has every right to fund only those organizations that align with their political or religious views. If it believes strongly in those views, then it should change its mission and hold to it.  However, Komen should be prepared for mass defunding from those who don’t share the same ideology. Early signs of this were evident last week.

There is no delicate or politically adroit way around this issue for Komen and other organizations who believe that views on reproductive rights trump a woman’s access to healthcare or an agency’s access to research funding. If that is the litmus test, however, then say so. Take the stand and own the results. Tell the world that your organization provides preventative healthcare, supports breast cancer research and other activities only for some women and only for organizations that share your views.

Then let the rest of us get on with the business of providing healthcare and research for all women.

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Data Matter

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A dirty little secret in medical literature, systematic reviews are only as strong as the individual studies they examine. And when negative data are not published in the major medical or scientific journals, as is commonly the case, these reviews cannot help but be skewed.  A report by the British Medical Journal found that when outcome data were re-analyzed to include the unpublished data for 42 previously FDA-approved drugs, a whopping 93% of the outcomes changed.

All data matter, especially in medicine.  With systematic reviews and meta analyses, the gold standard in scientific publishing, researchers seek to make claims about a particular drug or health event based upon the totality of the published research. Physicians and other scientists use these systematic reviews to guide decision-making. Prescribing a drug based upon the positive findings of a systematic review gives one considerably more confidence than doing so based upon a few unrelated studies. When the systematic reviews are based upon insufficient reporting of negative or null results, the review is likely inaccurate.

Publication bias, as it is called in research circles, is a well known problem to many. By nature, scientific journals gravitate toward positive and novel results, in much the same way TV news reporting tends toward negative, salacious events. Both are clamoring for market share. Unlike in TV news, bias in the research industry can and does have serious consequences when medical-decision making rely on those results. Noted physician and medical blogger Harlan Krumholz, contends that medicine’s biggest threat is not some exotic virus, but missing data.

Case and point, when data about adverse events are withheld from publication, bad drugs, such as Vioxx are released into the market place and presumed safer than they actually are.  A similar scenario is emerging for Yaz/Yasmin. These birth control pills are currently facing a bevy of lawsuits  for some serious adverse events.

So what is one to do, who does one trust?  I don’t know the answer to that question, but I think that good first steps include transparency and open access to data and research. As a patient, this includes access to scientific and medical research as well as access to our own medical data. As we report in the stories below, access to research is at risk if the Research Works Act passes.

A next step is to demand all data be published in drug studies, the good, the bad and the ugly. The British Medical Journal reports, those data are available in many, but not all cases, through FDA and other repositories. However, culling and analyzing those data along side the published reports is no easy task.

Perhaps a third option, is post-market crowdsourcing. Granted, not the best option when dealing with potentially dangerous therapeutics, but in this new environment of empowered patients and big data, crowdsourced research is becoming more common. The organization adverseevents.com is aggregating patient-reported adverse reactions to medications. It’s freely available to patients and physicians globally. A myriad of other companies have come on the market in recent years to crowdsource the research for all sorts of medical conditions. These companies offer patients the opportunity to participate and learn directly from the research conducted. Unlike traditional clinical research, the data and results are not cloistered, but are open and readily accessible.

In the end it all comes down to data and how we use it to make decisions about our health.  I believe data matter. I believe data ought be open and accessible. What do you think?

Participate in Crowdsourced, Post-Market, Adverse Events Research

Take a few minutes to complete a survey about the medications and surgical procedures you have utilized. Take as many health surveys as are applicable and share the surveys with your friends. All surveys are anonymous and completely voluntary. We’re adding more surveys every month, so check back frequently or sign up for our weekly newsletter to keep abreast of the latest research news.

Take one of our health surveys:

Crowdfund Research on Medications that Matter to You

Lucine Health Sciences and Hormones Matter, are unfunded and run by Dr. Chandler Marrs along with a cadre of dedicated volunteers. We know the work we do is important and needed and so we’re doing it anyway, despite the lack of funding. We’re bootstrapped to the nth degree, but determined to fill the critical data void in healthcare, one study at a time.

We’ve set up an unsubscription model to fund our education and research programs. We call it an unsubscription because it is not really a subscription in the true sense. It’s just a mechanism to fund the work that maintains our commitment to open access health information on Hormones Matter.  By purchasing an unsubscription you are supporting our continued operations and research; research and health information we all need but can’t get anywhere else. To help fund additional research: Crowdfund Us.

 

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The Stress of Modern Living

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I’m stressed, my friends are stressed, and let’s face it, the entire nation is stressed. In modern life, we’re bombarded with the daily list of to dos, the noise of 24 hour news and cable, the incessant activity of the internet and in the current economy, the constant threat of job loss and financial insecurity. True, the stressors we face today compared to those faced by previous generations are not generally life-threatening, but they are deadly, just over a longer period of time.

Chronic stress, the underbelly of modern life (pun intended), is perhaps as much to blame for the increased rates of obesity, cardiovascular disease, and diabetes as are other lifestyle variables such as diet and exercise. Our physiological responses to stressors were meant to be acute, short-term adaptations that allowed us to survive an immediate threat. The chronicity of modern stress has turned a very basic survival mechanism into a death trap and I’m not sure we’ve fully evolved to adapt to this new, never-ending state of stress.

Think about what happens to the body when it is faced with a stressor; it mounts a physiological response against the stressor. It doesn’t necessarily matter what the stressor is, the physiological responses are quite similar. Have you ever noticed that the early stages of illness look a lot alike, GI disturbances, heart rate changes, loss of appetite, sometimes fever, aches and pains- that general feeling that you are coming down with something? This is your body reacting to an internal stressor, an illness.
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Cortisol: The Stress Hormone

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Cortisol is a steroid hormone produced in the cortex of adrenal gland. It belongs to a class of hormones called glucocorticoids and plays an important role in regulating cardiovascular function, blood pressure, glucose metabolism, sugar maintenance, and inflammatory response. Cortisol is best known as the stress hormone. It is released in response to stress, and is part of the fight or flight system.

Under normal conditions the body regulates cortisol levels which are usually high in the morning and low at night. But under stressful conditions more cortisol is secreted. Small increases in cortisol produce positive effects such as increased sustained energy, diminished pain sensitivity or memory enhancement. But a prolonged cortisol increase during chronic stress results in negative side effects: increased blood pressure, sugar imbalance in blood, decreased bone density, cognitive problems, and reduced thyroid function. It also slows down healing processes and suppresses the immune system, perhaps the reason we are more apt to get sick when we are stressed.

Continuously, stress-induced elevated cortisol levels lead to an increase in the level of other hormones (testosterone, estradiol, insulin).  High cortisol levels are often linked to insulin resistance (Type 2 Diabetes), weight gain and general inflammatory conditions. High cortisol is toxic to the brain and can cause memory loss and contribute to Alzheimer’s disease or senile dementia. Elevated cortisol levels and lack of diurnal variation have been identified with Cushing’s disease. Low cortisol levels are found in primary adrenal insufficiency (e.g. adrenal hypoplasia, Addison’s disease).

Cortisol and progesterone bind to common receptors in cells. Cortisol blocks progesterone activity, and some suggest, that high levels of cortisol, initiated by chronic stress, dispose one to a condition called estrogen dominance.  Estrogen dominance is condition where women cease to ovulate regularly and progesterone concentrations are lower than necessary during the second half of the menstrual cycle. Many suspect estrogen dominance underlies PMS and other cycle related symptoms.

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