Hormone Testing: A Deeper Look

There are a number of symptoms that prompt me to recommend hormone testing—such as chronic fatigue, mood changes, stress intolerance, sleep disturbance, fertility challenges, weight gain, acne, hair loss, and menstrual problems like heavy periods or irregular bleeding.   Hormone testing can be the key to unlocking some of these problematic issues.   Depending on the type of testing used, we can get a good window into the hormonal picture, which can help refine treatment recommendations to be more precise and aimed toward the origins of the imbalance.

TESTING METHODS

There are three main methods of hormone testing: serum, urine and saliva.

Serum hormone testing can be a good first assessment of estrogen, progesterone, DHEA and testosterone to look for overt imbalances. This is the type of testing typically used in conventional medicine offices. Serum testing is well validated, and I use it when I think it will be helpful, often as a ‘first-look’ at hormonal status and when looking for frank imbalances.

Salivary hormone testing is used in many functional medicine offices.   For sex hormones, I almost never use salivary testing because it is not as precise as urine or blood testing.   On the other hand, for adrenal testing, salivary cortisol is considered a reliable assessment of adrenal output.  When performed correctly, it can indicate whether cortisol rises appropriately upon awakening and falls appropriately at night.  However, if there is an imbalance in cortisol clearance (rather than cortisol production), salivary results can be misleading, veering someone toward to misdirected therapies.

For a more nuanced assessment of hormone levels, I generally prefer urine testing, which can detect individual hormone levels as well as hormone metabolites.  Metabolites provide an indication of how quickly or slowly the body is moving hormones out of circulation.  In the case of cortisol, it can identify the difference between a dysfunction in hormone production or issues with clearance.  In the case of sex hormones, urine metabolites provide a window into hormone conversion and detoxification pathways. It can reveal whether hormones are preferentially transformed into either more protective or problematic metabolites in terms of potency and risk.  When using hormone therapy, we can help identify whether someone is being over or under-treated, and whether steroid hormones are being safely metabolized.

In my experience, urine testing provides the most holistic and reliable assessment of hormonal status. While testing isn’t always essential to addressing hormone balance, I find it helps refine our understanding and provide quantitative data to track progress.   This information it provides can help pinpoint therapeutics to address current health concerns and prevent future issues.

 

For a more technical look and information about the specific lab I use, read on.

Fire Protection Essentials, Part 2 — As the Dust Settles

As I wrote in my first blog on Fire Protection, the smoke that we’re experiencing in the Bay area is filled with the combusted contents of homes and businesses- things like plastic siding, wires and pipes, computers, flame retardants, carpeting with stain repellants like Teflon, lead paint from old houses, pressure treated lumber, and the list goes on. Even when the bulk of the particulate is from burning plant matter, there can be a substantial amount of mercury released into the environment from bioaccumulation. It’s easy to go into freak-out mode here.

I can also find the silver lining in the midst of the devastation, which is an opportunity to realign our priorities and get our houses in order on as many levels as we can.   This is an opportunity for a paradigm shift — to make the changes we’ve each been debating for years, whether it means changing an unhealthy lifestyle pattern, assessing our consumption patterns particularly around the use of toxic materials, and helping to address some of the social and economic issues that are now more acute in our county.

How we take care of ourselves and each other now is one of the most determining factors of our overall health in the future.

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Fire Protection Essentials

You are probably feeling it- a scratchy throat, dry cough and irritated eyes or that whoozy, nauseous feeling from breathing something you shouldn’t be. It smells like a campfire out there, but with homes and businesses burning, we are exposed to so much more. On top of the wood particulate, carbon monoxide and carbon dioxide, the air and the ash is littered with synthetic chemicals released from the combustion of building materials and the contents of buildings and yards. We’re dealing with a toxic load of exceptionally nasty stuff like dioxins, heavy metals, styrene, toluene, polycyclic aromatic hydrocarbons (PAH’s), nitrogen oxides, sulfur dioxide, acid gases, etc. This is serious business.

The first objective is to limit your exposure as much as possible, by staying indoors and sealing your house. Avoid drawing any air into your house from outside- limit the use of fans or dryers. Put towels around any drafty doorways or windows. Get that air purifier you’ve been contemplating – you need it now. If you must go outside, wear a respirator mask, such as an N95 or P100, preferrably the latter.  Your lungs are better equipped to deal with the air born toxins than your oral mucosa and digestive tract.  So breathe through your nose, not through your mouth, and avoid eating or drinking in any area that has compromised air quality.  After being outside, rinse nasal passages and lubricate afterward with aloe-saline, or coconut or sesame oil.

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Food Sensitivity Testing Just Got Better

Food sensitivity can contribute to gastrointestinal inflammation and systemic inflammatory burden.  It can be an underlying cause of nagging symptoms like fatigue, brain fog, sinus congestion, chronic pain, headaches, and weight gain.

Determining whether you have food sensitivities and which foods you are sensitive to can be an arduous process. The best way to diagnose which foods are causing problems is by doing a trail of an elimination-challenge diet, where suspect foods are removed for a period of time and systematically re-introduced. While there are some common culprits like gluten, dairy, soy and eggs, it can be difficult to know which foods to eliminate beyond that, because one can be sensitive to less commonly antigenic foods, like carrots or zucchini- things you wouldn’t necessarily think to eliminate. Food sensitivity testing takes some of the guesswork out of this process. Seeing results on paper can be a real motivator for plunging into an elimination trial.

Sublingual Therapy for Allergies

The best time to address your allergies is before allergy season starts.  

Dr. Bridget offers Sublingual Immunotherapy, a very effective treatment for reducing environmental allergies.

 

What is Sublingual Immunotherapy and what is it good for?

Sublingual Immunotherapy (SLIT) is an allergy desensitization technique, where dilute blends of allergens are administered under the tongue in order to improve immune tolerance. SLIT is effective for the treatment of respiratory allergies, including allergic rhinitis, allergic conjunctivitis, mild to moderate asthma, and bronchial hyper-reactivity. There are a number of randomized controlled trials and several meta-analyses demonstrating the benefits of SLIT for various types of allergies.

 

Got a Sweet Tooth?

The key to balancing sugar is to surround it with goodness…

Spice it up:
Most aromatic spices, such as ginger, cardamom, cinnamon, fennel and clove can improve how well you digest your food and tend to be anti-inflammatory. Many spices, especially cinnamon, are well known for blood glucose lowering effects. Add them to desserts, or along side in a cup of tea!

Imbibing more than usual? 

In excess, alcohol can really deplete your antioxidant pathways and contribute to inflammation. If you have systemic inflammation or leaky gut, drinking alcohol can stand in the way of your best efforts to repair that.  So if you’re going to enjoy a drink or two, try some of these tips:

Love your Liver
If you drink enough to feel inebriated or you feel yucky in the morning, it’s a good bet that your drinking has caused inflammation. Supporting your liver with milk thistle can be a good place to start. Milk thistle is well known for it’s hepato-protective effects. Simply put, it can help you process alcohol better, protecting your liver from oxidative stress. And, it can potentially can reduce hangovers. Pop a couple capsules before going to a party, and then again afterward. It’s generally safe for everyone, but if you’re on any medications, check with your doctor.

Tea for your Health

My rule of thumb is that before I eat something sweet, I try to offer myself a cup of tea first. Often times, the sweet cravings subside. If not, then a good cup of tea can help undo some of the impacts of indulging.

Aromatic spices tend to enhance digestion, reducing the tendency for post-meal gas and bloating.   Most of the aromatics are also anti-inflammatory and have some blood sugar lowering effect.  Chai tea is the quintessential aromatic blend. There are a number of decaf and sugar-free chai blends available, and include herbs like cinnamon, cardamon, clove, fennel, orange peel, turmeric, and ginger.

Boost your Immunity in the Shower

Hydrotherapy has been used for centuries to support immune health. Using hot and cold water in succession can enhance the movement of blood and lymph, helping your body deliver nutrients and carry wastes more effectively — keeping you healthier and more resistant to colds and flus. This technique, called contrast hydrotherapy, can be especially helpful if you are feeling run down or chronically fatigued, though it’s also great for general enhancement of immune health.

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Be Less Allergic!

Tips to Improve Your Allergic Threshold

  • Stay hydrated! As the weather becomes cooler, some people tend to drink less water even though they need it. Our bodies need water to deliver nutrients, flush out waste, and to maintain healthy mucous membranes.
  • Reduce inflammation with essential fatty acids, in the form of chia seeds, fish oil, and leafy greens.
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