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Hormone Balance

Hormone Balance. Hormones like estrogen, testosterone, adrenaline, and insulin are vital chemical messengers that affect many aspects of one’s health. Hormones are secreted by various glands and organs, including the thyroid, adrenals, pituitary, ovaries, testicles, and pancreas. The entire endocrine system works together to control the level of hormones circulating throughout the body. And if one or more is imbalanced, it can cause major health problems.

The most common symptoms of hormone imbalance include:

  • Infertility and irregular periods
  • Weight gain or weight loss (unexplained, not due to intentional changes in one’s diet)
  • Depression and anxiety
  • Fatigue
  • Insomnia
  • Low libido
  • Appetite changes
  • Issues with digestion
  • Hair thinning and loss

Symptoms of hormonal imbalances can range depending on what type of disorder or illness they cause. For example, symptoms of diabetes include weight gain, appetite changes, nerve damage, and eyesight problems. Conventional treatments for hormone imbalances include synthetic hormone replacement therapies, i.e., insulin injections, thyroid medications.

However, with these types of treatments comes negative effects, such as medication dependency, serious side effects like stroke, osteoporosis, anxiety, reproductive problems, cancer, and more. And with these synthetic treatments, the symptoms aren’t treated but only masked.

Fortunately, there are ways to acquire hormone balance naturally. For example, stay away from oils high in omega-6 fats (safflower, sunflower, corn, canola, soybean, and peanut). Instead, utilize rich sources of natural omega-3’s (wild fish, flaxseed, chia seeds, walnuts, and grass-fed animal products).


Dr. Alex Jimenez Presents: Assessing Hormones

Dr. Alex Jimenez Presents: Assessing Hormones


Dr. Alex Jimenez, D.C., presents how to assess different hormones in the body and how different hormone tests can be used to determine the level in the body. This presentation allows many individuals to know what to expect when they are being diagnosed by their primary doctors. We refer patients to certified providers incorporating various hormone therapies to ensure optimal health and wellness. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is an excellent way when asking our providers intricated questions at the patient’s request and understanding. Dr. Alex Jimenez, D.C., only utilizes this information as an educational service. Disclaimer

Assessing Hormones

Dr. Alex Jimenez, D.C., presents: Welcome to everything you need to know about assessing hormones and how to do the testing. We have decided to do this as a webinar because we only have a little time to do it during the module. After all, that’ll make your life easier. You’ll need to have this information under your belt because here is the most important thing you need to know. Hormone therapy is an art, not a science. If you find five or six practitioners who do hormone therapy, you will find five or six different ways to make a prescription and way more ways than that actually to do testing to monitor it.

Dr. Alex Jimenez, D.C., presents: The important thing is that you keep in mind what we know scientifically is a better or not-so-good way of taking care of the patients in terms of testing. Then find what works for you and become the expert in that. Because if you are consistent over time, you can work around the pros and cons of every given testing modality and figure out what you need to do, regardless of what type of test you end up doing. All right, so what do we need to worry about? There are many potential problems in measuring hormone levels because so many hormone levels fluctuate significantly. In order to evaluate hormones in the body, doctors need to know what, when, and who to test. So we’re going to talk about all of that.

Diagnosing Hormones In A Patient

Dr. Alex Jimenez, D.C., presents: Some vary during the day, some vary during a cycle, and some hormones don’t vary at all. So you need to remember which ones you need to worry about in terms of fluctuation. The studies that have been done don’t measure hormone levels. So, finding normal hormone levels is sometimes problematic. It may be different from what the labs currently use. And in the studies where they have come up with normal hormone levels, a lot of them are much older studies, and the methodology was more unreliable than what we use now. So by keeping that in mind regarding what people call normal hormone levels, many of these studies also would average out non-comparable groups. What this means is that they would be comparing, let’s say, a group of apples, oranges, and grapes and put them all together and say, oh yeah, so this average is going to work.

Dr. Alex Jimenez, D.C., presents: So it’s like doing a meta-analysis, and if you are taking a bunch of different data, you can’t necessarily say that this average makes sense. You probably are already aware of the fact that other labs end up developing different reference ranges. And so if you use multiple different labs, you can’t necessarily compare the test results you’re getting because the reference ranges are different. And, sometimes, even within a given lab, depending on which test kit patients use, like a test from Quest, they may one day use one test kit. So a reference range will be XYZ, and they went to the same lab another day, but they used a different test kit and have an entirely different reference range. And so you have to the point that out to the patients. If you’ve got a smart patient trying to track what’s happening with themselves, they may have the wrong impression during an examination.

Estrogen & Progesterone

Dr. Alex Jimenez, D.C., presents: If you’ve got different reference ranges showing up on your test results, it is best to keep track of that in case you need to remember. Now there are big variations between individuals and even within the same individual. The serum concentrations of both natural and synthetic steroids might need to be clarified between other individuals. There’s a huge variation irrespective of the root of the administration of the hormones. What you expect from one person may be different from the next person. And, of course, within any individual, you’re going to get levels of fluctuation throughout the day based on lots of different things. Everything from perceived or actual stress that will change their hormone levels to foods they were eating that day can make a difference. Hydration status can make a difference. So some of the variations you see within a person, but with different blood draws, can be based on what was going on that day.

Dr. Alex Jimenez, D.C., presents: So try to impress upon your patients as you’re getting testing done to keep the blood draw days the same. Now measuring in different body fluids like serum, urine, or saliva doesn’t necessarily tell us about concentration in other tissues, and doctors need to keep this in mind because the patient may get a false sense of security, and it won’t necessarily have anything to do with the tissue they are trying to treat. Now, many doctors must remember all the different kinds of estrogens they might need to keep track of during examination. So, when they notice estrogen, there’s an estrogen pool. There is free and bound estrogen in the body and estrogen production in the woman or a man in themselves. There are exogenous estrogens that you may be giving them. There are stored estrogens, metabolites, and all these different estrogens doctors need to keep track of. So this is just one example of having many estrogen levels in the body, and the patient is wondering, what is it the doctor is looking at? Could one test give me all this different information? And this is only estrogen. The same thing is true, although not quite as complicated. The same thing is true about the other hormones in the body.

Dr. Alex Jimenez, D.C., presents: Now for progesterone, it is the same ordeal. Other results look like this for estrogens and testosterone, and this is to remind us of all the different variability there is. By showing the variation between different people at their biological stages, for example, premenopausal and postmenopausal. The results that the doctor presents to the patient establish a lighter shade of green on the outside of the intercycle variability from within a given woman. And then the yellowy green is the inter-woman variability, meaning one woman to the next. And then that blue line in the middle is the average; this provides what information they might need to diagnose.

Testing Hormone Levels

Dr. Alex Jimenez, D.C., presents: All right, so let’s look at testing and assessing hormones as we look at all the hormone types, the different ways of testing them, and the pros and cons. There are decades of well-validated research on serum hormone levels. So for the estrogens, estrone, estradiol, and estriol, as well as the estrogen metabolites in the serum, the good news is it measures endogenous hormone production. So if you get a serum hormone level, we know what those results mean.

Dr. Alex Jimenez, D.C., presents: The bad news is these results give you the free and bound hormone. It shows you the total estrogens. However, you can’t order total estradiol and free estradiol test as they don’t offer them. There are limited data regarding serum levels of these metabolites in terms of prediction for health risk. And it can be difficult for some labs to get accurate quantification in postmenopausal women because the estrogen levels are very low. So, keeping that in mind is a matter of knowing your lab and how accurate they are. Now when it comes to saliva, the good news is it’s non-invasive. Patients can do this at home, making it convenient if doctors try to do a serial measurement of estradiols across a whole cycle in a premenopausal woman. Cause no one in the right mind will go to the lab and get blood drawn daily.

Dr. Alex Jimenez, D.C., presents: Knowing that salivary estradiol correlates well to free estradiol in serum allows doctors to see what’s in the saliva and what they want to see in the serum. The bad news about saliva is that there are fewer validation studies than serum. There are still quite a few, so it’s a valid testing method. It’s just that it’s not as well validated as a serum because it still needs to be done. Again, it can be very challenging for some labs because the estrogen levels in the saliva are much lower than in the serum. So doctors must ensure the lab is doing a good enough job assessing these very low levels. All saliva testing can be contaminated by blood from the oral mucosa.

Saliva Testing

Dr. Alex Jimenez, D.C., presents: So if the patient has periodontitis or something along those lines, doctors don’t want them to salivary levels; it is important to tell them to do it before they brush their teeth, not after, in case they bleed when they brush their teeth. But that’s true of any salivary test; you can’t get estrogen metabolites done through the saliva. And the bigger problem in a postmenopausal woman is that many get dry mouth after menopause. And so, it can be really difficult to do the test because they need to produce more saliva to get an adequate specimen. Now, if that happens, they can go for a 24-urine test. The 24-hour urine testing for estrogen and estrogen metabolites can be helpful if you’re trying to get the total daily production of the hormones. You can get measurements of estrogen metabolites, which are stable for a long time.

Dr. Alex Jimenez, D.C., presents: You have plenty of time for processing and get both free and conjugated estrogen measurements. So that’s helpful. The bad news, which is true for any 24-hour urine test, is it relies on accurate volume measurements and complete collections by the patients. Many patients will inadvertently screw that up. When they have a busy day, they’ll go pee and need to remember what they are supposed to do, which can be a problem. So, making sure the patient understands can help with the test results. You cannot use this for people with renal dysfunction because it’s based on creatinine correction. So if their creatinine is abnormal, they will need to be able to give you an adequate, appropriate level and sometimes give you some of these tests that do 24-hour urines will provide you with many metabolites that could be more clinically useful but are not.

Dr. Alex Jimenez, D.C., presents: Now for dried spot, you’re in testing, and you can get estrogen metabolites, which is good because the metabolites are stable for a long time, so that’s no problem. And you can measure both the free and conjugated estrogens on these spots in urine tests. The biggest problem here is that it has the least clinical validation studies. So, it’s a newer way of testing. It is popular and easy for patients, but there is little concern because of the few clinical validation studies they’ve done. Now, additional challenges are mentioned: to think about what a lab has to do; the measurements they need to be able to provide can vary enormously because there are very low levels of estrogen in older women, not on hormone replacement therapy.

Dr. Alex Jimenez, D.C., presents: And then up to measuring these super high doses in women getting ready for IVF. And, you know, the levels can vary by 10,000. Is it reasonable to assume that any test will be accurate for all those circumstances? It is also difficult to assess estrogen levels in women treated with aromatase inhibitors because they will likely have very low estrogen concentrations. So that may not be accurately detected by standardized testing. And then specificity is a problem because we talk about how estradiology focuses mostly on how it gets broken down into estrone and then how the estrones get broken down. But the reality is that estradiols convert it to more than a hundred different metabolites, which may interfere with accurate quantification.

Serum Testing

 Dr. Alex Jimenez, D.C., presents: So, labs must keep that in mind and ensure that they’re getting adequate specificity for you. Another interesting tidbit is that exogenous sources of S-trial can lead to falsely elevated estradiol levels. So keep that in mind if you have a funny test result that makes no sense.

Dr. Alex Jimenez, D.C., presents: Progesterone and progesterone metabolites in the serum; there’s lots of literature to support using a progesterone level drawn hopefully on day 21 of a 28-day cycle to confirm ovulation. Progesterone has problems as it differs from estradiol. So it is acceptable to use serum progesterone levels for that, as the reproducibility of serum levels is limited if the serum levels are low. So if what that means is if you were to take a person in the first half of her cycle and draw a progesterone level three days in a row at the very beginning of the process and the progesterone should be low, you may not get similar numbers just because the hormone levels are low.

Dr. Alex Jimenez, D.C., presents: So the reproducibility makes doctors a little crazy, but that’s something they need to keep in mind with the serum. Again, saliva testing is not invasive; it’s convenient if you want to follow an entire cycle in a premenopausal woman. Also, research shows that a salivary level of 17 alpha hydroxyprogesterone is just as acceptable as a serum level for diagnosing congenital adrenal hyperplasia. Now the downside for progesterone’s metabolites salivary levels of progesterone in its metabolites is that you’ve got a rapid fluctuation of progesterone levels in the saliva. So, if you’ve got somebody who doesn’t wanna get their blood drawn and doesn’t mind spitting into a tube, you can use this instead.

Dr. Alex Jimenez, D.C., presents: So you should use more than one test result to make a decision; you may need serial sampling to get a feel for the average. There’s also a problem with cross-reactivity that might interfere with immunoassays and affect the results. And again, the same problem is having much lower progesterone levels in the saliva than in the serum. So for some labs, that can be challenging to get preliminary analysis and the same problem in terms of contamination by blood; however, that’s true of all cellular tests. The 24-hour urine and the spot dry urine testing for progesterone have the same problem because the progesterone metabolites will correlate with symptoms. So they’ve studied, for instance, allopregnanolone in urine. The level of that does connect with the sleep quality in perimenopausal women.



The Different Implications Of Hormone Testing

Dr. Alex Jimenez, D.C., presents: The implication is that if it’s correlating, it’s probably an accurate level; however, progesterone is hard to quantify in urine. And so, they use metabolites for assessment and determine the progesterone level based on the metabolites. That’s great, except there’s no literature describing the clinical utility of progesterone metabolites. So progesterone in the urine is relatively problematic regarding the accuracy and what you are getting. Part of the issue with serum progesterone is that very little of it is available, and non-protein ground, most of it is bound to all and other proteins; it’s the free progesterone that is available to the target tissues and also to saliva. So the progesterone that you’re measuring in the serum is mostly the bound-up progesterone, not what is clinically important.

Dr. Alex Jimenez, D.C., presents: Transdermal progesterone is extremely difficult to measure because anyone gets metabolism by five alpha reductases in the skin. It’s rapidly absorbed by red blood cell membranes and delivered to the tissue. And really, it comes down to that after the patient uses exogenous progesterone cream or gel, they get these crazy high levels of progesterone in the saliva and the capillary beds, but not in the serum. And so there could be a better way to measure what’s happening to the patient. So transdermal progesterone, trying to follow that with any testing is difficult.

Dr. Alex Jimenez, D.C., presents: There are decades of research on serum hormone levels. In serum testing, testosterone, and its metabolites, you can get both a total and a free hormone level test, and you can also get a DHT level, which is helpful. There are established serum ranges for the diagnosis of androgen insufficiency. So serum levels for testosterone are fine in general. It can be difficult to assist the whole serum if the levels are low, like in women and kids and hypogeal men. So, you need to know your lab and its methodology. Suppose you’re assessing testosterone in women, hypogeal men, or kids because they must ensure they’re doing the appropriate serum test to get these really low levels accurately.

Dr. Alex Jimenez, D.C., presents: For saliva testing, it is very convenient to obtain the sample. There are established ranges for diagnosis of antigen insufficiency, and it’s easy to use this testing for differentiating between gonadal and hypogonadal men. And you can get a free hormone level as lots of published research on using salivary levels for assessing testosterone. However, the problem is like with progesterone; you get this rapid fluctuation in saliva. You might need more than one saliva test result to get reliable information. So you don’t necessarily want to decide based on just one result. And again, you need to know your lab because the levels are much lower than in the serum. So it is challenging to get an accurate story and be careful about blood contamination. In urine testing, the 24-hour and spot urine have slightly different issues.

Dr. Alex Jimenez, D.C., presents: The 24-hour urine testing for testosterone can be used to get a total daily testosterone production. Patients will get a free hormone level and metabolites, which is nice. They can use that information to indirectly assess five alpha-reductase and aromatase activities based on how many different metabolites they’re getting. Only a few data support the clinical utility of all the measured metabolites. There is a polymorphism of UGT to B17; if the patient has that, their urinary testosterone level will return to zero, so keep that in mind if you ever get a test result. After all, it’s so low because it may be that your patient has this issue. Now spot urine will give you some of the same pros as you will get free hormone levels and metabolites. This allows you to use that information to assess the five alpha-reductase aromatase activities; however, the problem is there; like with the other hormones we’ve discussed, this testing generally has fewer clinical validation studies because it’s a newer form of testing, so keep that in mind.

Cortisol

Dr. Alex Jimenez, D.C., presents: Cortisol and its metabolites in the serum are similar to the other hormones mentioned, as there are validated reference ranges for cortisol. Lots of peer review literature detailing the use of this test, and patients can feel comfortable getting these results. It will tell them just total cortisol, not their free cortisol. So by keeping that in mind, they’ll get the diurnal pattern. They can only get a four-point test as they would with saliva because they don’t have normal ranges for four different times in the day. And many patients mention to their doctors as they get the serum cortisol, they go, “Wait, you don’t understand. I am so scared of my blood being drawn that it shoots my cortisol up, and I don’t normally look this bad.”

Dr. Alex Jimenez, D.C., presents: Keep in mind that in serum, they only have normal reference ranges for two times of the day, 7 to 9:00 AM and 3 to 5:00 PM. So you have to ensure that if you use serum cortisol, they go in fasting before nine o’clock, or they can go later in the day. And if they go later in the day, they don’t have to fast. So if you get cortisol at 10 or 11 in the morning, it isn’t very helpful to the results. Now the salivary testing, lots of people are becoming familiar with this.

Dr. Alex Jimenez, D.C., presents: You can get your diurnal pattern because many companies have kits where you’ve got four or five samples throughout the day. There is abundant peer-reviewed literature detailing the use of this. And this is for cortisol, not for the cortisol metabolic. It reflects the unbound plasma concentration, which is not what we’re seeing with the serum. The problem is that 11 beta hydroxy steroid dehydrogenase is an enzyme in the salivary glands that significantly converts cortisol to cortisone. So there are some questions about the results doctors are getting in the salivary cortisol and what’s happening or did it get converted to cortisone, and you’re not picking that up in the test?

Dr. Alex Jimenez, D.C., presents: So when looking at cortisol metabolites in the saliva, which some companies do and some don’t, the salivary cortisone correlates with cortisol exposure over 24 hours. There’s a moderate level of literature using this test but enough that you should feel comfortable. There are issues when your serum cortisol is really low, making it seem like the patient is crashing or under hydrocortisone therapy. That makes the salivary cortisone a superior serum marker compared to the salivary cortisol. Under these circumstances, because of how this is being processed, only a few companies are even looking at cortisone directly in the saliva. So at this point, because especially of the moderate literature level, you will primarily be doing cortisol levels in the saliva.

Urine Testing For Hormones

Dr. Alex Jimenez, D.C., presents: So let’s move on to the urine test. Now, in a 24-hour urine test, you can assess the cortisol ratio, which can be helpful when diagnosing. And 24-hour free cortisol correlates with the serum-free cortisol level; however, the only problem is there are limited clinical validation studies for this. And, in the 24-hour urine test, you’re not getting a diurnal cortisol pattern. And, in the spot urine, you can get the cortisol ratio, which can be helpful. You can have the patient do the spot urine test multiple times a day so you can get the diurnal change just like you would with saliva. But unfortunately, the spot you’re in testing has the least clinical validation studies. So you have to keep that in mind. So with this, primarily, people feel most comfortable with using either serum levels done at the right time of day, understanding that you’re not getting the unbound cortisol, or they’re doing a four-point salivary test.

Dr. Alex Jimenez, D.C., presents: The four-point salivary test could see a pattern between what the patient told their doctors about their energy level throughout the day and how they felt and compared that with what the result returned. Many doctors note what they had expected the test result to be before the national labs even had it available.

DHEA Testing

Dr. Alex Jimenez, D.C., presents: We will discuss DHEA and DHEA sulfates separately since DHEA in the serum has many clinical validation studies that can make you feel comfortable getting adequate results. Now, DHEA has a diurnal pattern. So you have to ensure they get it done at the right time of day since this is fasting before nine o’clock in the morning, just like with cortisol. A DHEA done later in the day means nothing; however, a DHEA sulfate in the serum doesn’t follow a circadian pattern, so a single test done at any time is okay.

Dr. Alex Jimenez, D.C., presents: There are numerous clinical validation studies about DHEA; unfortunately, there is a problem with DHEA sulfate since it has a little circadian pattern. You may miss small variations in a DHEA over time in a person based on how they’re feeling and stressed out. So occasionally, it’s nice to check the DHEA in a patient as long as they’re done in the morning because then you’ll get a feel for the changes over time in the same individual you wouldn’t see with the DHEA sulfate.

Dr. Alex Jimenez, D.C., presents: Salivary testing for DHEA is where you measure free DHEA in the body, which is great. There’s a correlation with serum levels, and it’s not invasive. The problem is that the concentration is inversely related to the salivary flow rate and is also affected by the salivary pH. An example would be someone walking past the bakery, starting to salivate heavily based on what they just smelled. This could change their results for their salivation rate when they are doing their DHEA test. DHEA sulfate has the same basic problem in the saliva, related to the salivary flow rate and the salivary pH. So keep that in mind if you’re looking at salivary levels in urine, whether this is 24-hour or spot urine; there are no clinical validation studies about looking at either DHEA or DHEA sulfate in the urine. So, keep that in mind if you’re doing urine testing and they’re giving you a whole panel that includes DHEA or DHEA sulfate, you may need to know what those results mean.

Dr. Alex Jimenez, D.C., presents: For pituitary hormones, the preferred testing is the FSH, LH, and prolactin serum. Not convenient for serial measurements throughout the day to detect the LH surge, for instance, but the results are very accurate. And in saliva, there’s limited peer-reviewed literature detailing salivary pituitary hormones and whether or not they’re adequate. LH detection kits at home are convenient for urine tests since they are widely used and have been around for a long time. The LH surge correlates with the urine and works well with the LH surge’s serum. So if you’re trying to help people figure out where they are in their cycle and whether or not they’ve ovulated, this test is the way to go. It doesn’t do a good job of quantifying it; it just tells you there’s a surge because these are bigger hormones, so they don’t get into urine very easily.

Dr. Alex Jimenez, D.C., presents: So you’re going to know whether or not you’ve gotten the surge, you’re not going to know what the actual level is, and that’s okay because most of the time, it doesn’t matter what the hormone level is. So essentially, unless you’re just trying to find out if they got an LH surge, you want to use the serum for either FSH, LH, or prolactin. For sex hormone-binding globulin, most clinical validation studies are in the serum; you can’t measure it in saliva or urine, so that’s easy to remember. So we’ve already talked about the issues with different forms of testing, and there are only a few forms of testing that will give you everything you need to know about every hormone you need to know.

When Is The Best Time For Hormones?

Dr. Alex Jimenez, D.C., presents: So now, when is the best time to test hormones? Early morning is when the hormones will be the highest for most hormones. So, the best way to go and test hormone levels like cortisol and gonadal hormones is first thing in the morning since you have to be consistent and fast because what you’ve eaten can change hormone levels. So if you’ve always fasting, at least you’ll find consistency between specimens and the same person. You also need to know where they were in their cycle for certain tests. So, women patients who are still cycling need to record the first day of their next period to know what day you did their testing. Otherwise, they’ll have to use ovulation kits to know exactly where they are.

Dr. Alex Jimenez, D.C., presents: And of course, the downside here is that if you’re trying, for instance, to get a day-21 progesterone, and she typically has a 28-day cycle, so you tell her to go on day 21, but that particular month she has a 35-day cycle, you didn’t get the level that you were looking for. So it can be a little problematic, but remind them to keep track of it so that you won’t be able to look back and know where they were when they had their tests done. So, when do we want these tests in pre and perimenopausal women? Suppose you want progesterone on day 21. You can also do a sex hormone-binding globulin on that day. Menstruating women shoot for as close to day three for estradiol, estrone, FSH, testosterone, or a sex hormone-binding globulin.

Dr. Alex Jimenez, D.C., presents: Now, even though these are ideal, can you get them on other days of their cycle? Yes, but they will have different accuracy. And, of course, it may be an additional day than day three because what if day three happens to land on the weekend and the lab’s not open? So, please consider that what you are looking for here is to test the hormone levels when they’re at their highest. And that’s why we’re shooting for three and 21. So, you know, here’s day three and four. And so the FSH is going to be a nice level here. The estradiol bounces around a lot at this point, so trying to get it in this part of the cycle would be less helpful. And, with progesterone, you’re going to get your peak here, so that’s why you want to try to shoot for 21 days because you know that’s going to be the easiest way to ensure you’re getting it. And also, it’ll help you be more consistent from cycle to cycle if you’re always trying to get it at the same time of the process.

Hormone Replacement Therapy

Dr. Alex Jimenez, D.C., presents: Now here’s where it gets tricky since it’s one thing to find out where the person is before you put them in any hormone replacement therapy; however, monitoring hormone replacement therapy gets more problematic still. If you’re using oral estrogen, it is recommended to get a serum baseline before HRT and then monitor during treatment; if you’re doing oral estrogen, the salivary levels don’t reflect the exogenous estrogen use at all, so they’re not very helpful.

Dr. Alex Jimenez, D.C., presents: And oral estrogen or any hormones that undergo this test must accurately reflect the liver’s first-pass metabolism and the urines’ levels. So if you’re doing oral estrogen replacement therapy, the only way to assess it is with serum because doctors will convince the patient with the module, so you probably don’t want to use oral estrogen anyway. If you’re using sublingual estrogen, the levels will rise and fall rapidly within hours. And so the serum’s not effective in terms of measuring. The saliva will make no sense if you’re doing sublingual because you just had your estrogen there. So what does it mean? It means that 24-hour urine and drive urine testing with sublingual hormones aren’t recommended because there’s always a question of how much you are swallowing and how much is getting absorbed sublingually.

Dr. Alex Jimenez, D.C., presents: Now, if you notice that it says in sublingual, there could be better testing methods. Since you don’t know how much was swallowed and got the first-pass metabolism effect, the result in a 24-hour or dried spot urine may need to be clarified. So that’s problematic. You can still do sublingual estrogen replacement therapy; it just means there’s no great way to test it. If you’re using estrogen creams, serum testing can be effective, and we know that clinical parameters correlate to serum levels when using estrogen creams, so we can do that. In saliva, estradiol and estriol are actively transported into the saliva; the levels are way higher than you would see in the serum and are highly variable. So salivary levels for creams don’t make sense, and there are no good peer-reviewed studies detailing the effective estrogen cream on urinary levels.

Using Hormone Creams & Patches

Dr. Alex Jimenez, D.C., presents: It is probably not a great idea to use urine levels for someone using estrogen creams at the time. If you’re using labial or vaginal estrogen, the serum test appears to be the best choice for monitoring absorption. The salivary levels don’t reflect any dose changes. So basically, it’s probably a waste of time to get a salivary level trying to do urine testing; using vaginal or labial estrogen might be problematic because how do you know you didn’t contaminate the urine specimen. And if you’re using a patch, serum values will rise dose-dependently and then rapidly decline the following removal. It may be helpful, we know that the serum values change based on when you put the patch on and when you take it off, but it is still problematic.

Dr. Alex Jimenez, D.C., presents: There’s no peer-reviewed evidence showing that salivary estrogen can be used to monitor the estrogen patch. And when it comes to the urine testing and the estrogen patch, it does appear that the values in the urine will go up dose-dependently. It may be relatively accurate, but it’s not the best clinically validated test for an estrogen patch. The take-home message here is that no testing is perfect and many of us adjust the dose to the lowest amount, the lowest level we can get, and still have our symptoms controlled. That doesn’t mean they don’t test; you must try to ensure you’re not overdosing on this person. But keep in mind that there are a lot of limitations around what testing can be helpful depending on what form of estrogen replacement you’re using.

Dr. Alex Jimenez, D.C., presents: Now, progesterone and oral progesterone, if you’re using that, the levels rise and fall quickly. You may not be able to catch a serum level that makes sense if you’re taking your progesterone in the evening and then measuring in the morning. Because most women, if they’re taking oral progesterone, will take it in the evening because it helps them sleep. There’s also a problem with the cross-reactivity of metabolites with the immunoassays. So progesterone replacement therapy, if oral, you must take the serum levels with a grain of salt. The same thing with saliva and 24-hour urine testing. We talked about how you’re not getting progesterone; you’re getting progesterone metabolites, so that might be useful. But there’s the problem of how clinically valid the use of progesterone metabolites is. So oral use of progesterone, getting a level, and following it is a little tricky.

Dr. Alex Jimenez, D.C., presents: Now with creams and transdermal progesterone, none of the tests makes any sense because you get mentally increased levels in the serum that don’t rise in any particular way that makes sense. Like all steroid hormones, these are fat-soluble, so if it goes and sits in adipose rather than getting into the bloodstream, it doesn’t necessarily reflect a serum level. Doesn’t necessarily reflect the tissue levels in the uterus and the breast, which is where we care about it. So a serum level for progesterone cream is problematic. Salivary levels after progesterone cream go way up and don’t correspond to symptoms at all. So don’t bother getting salivary level after a progesterone cream. There’s some evidence in urine testing that you can get small increases in the pregnant dial three glucosides if you use progesterone cream. And so it may turn out that we can use that as a measure of what your progesterone is doing.

Dr. Alex Jimenez, D.C., presents: But this still needs some more testing. So it would be best if you remembered that there needs to be a reliable method to track what’s happening when a person uses progesterone cream. So please take your time with getting a level and making a decision based on it. Now, vaginal progesterone suppositories have the same problem. You get minimally increased levels in the serum, which will not give you an adequate result. Progesterone melts or atrocious; you can use serum levels in at troche because you get a more accurate level in the serum than if you had taken it orally. There’s a lack of peer-reviewed research on salivary levels after vaginal progesterone suppositories. And you have to be careful if you’re trying to do urine testing because how do you know you didn’t contaminate the sample?

Dr. Alex Jimenez, D.C., presents: You can’t use a salivary level because you just had the troche or the melt in the person’s mouth. And then, there is at least a potential problem with getting a urine level for a troche or melt because, like a sublingual, how much of this are you swallowing? Individuals may consume some of it and are subject to first-pass metabolism, which means you won’t be able to pick it up in the urine. The larger portion will be absorbed into the capillary blood and probably be accurate in the 24-hour or dry urine test. But that needs to be adequately studied, so keep that in mind if you’re using atrocious or melts. And this is a study that showed that after applying topical progesterone, the saliva and the capillary blood levels were very different compared to those seen in the serum or whole blood.

It’s Important To Do Research

Dr. Alex Jimenez, D.C., presents: So this is just an important research study to remind you of the reliance on serum levels for progesterone. If you’re monitoring, topical dosing can lead to underestimated tissue levels, so you’ll give more than you need. So, be careful about relying on serum levels for topical progesterone because you’re going to overdose people like crazy. And remember, if you overdose on progesterone, it’s high up in the steroid hormone pathway, and you don’t know what this person’s body will do with it; they might turn it into pretty much anything else. Now, testosterone replacement therapy creams or gels can cause blood levels, and the serum level rapidly increases with the application and doesn’t reliably reflect dose changing, any dose changes. So the serum and blood levels are probably not the great way to go. In the saliva, the levels are much higher than the serum and are highly variable since they may give a false indication of overdose.

Dr. Alex Jimenez, D.C., presents: In the urine testing, there’s not good in the 24-hour urine. You probably want to use something other than 24-hour urine. The good news is the dried urine. Now in dried urine, the epitestosterone can be measured if there’s going to be suppression due to exogenous testosterone production if that’s what you think is going on. You can measure the epitestosterone in dry urine testing, which will tell you whether or not, you’ve suppressed this person’s production of testosterone by giving them some. Now, vaginal or labial application of testosterone, there’s no good way to get a blood level that makes sense. The salivary levels, like any other cream or application we might have on your hands, you have to be careful because if you’re handling the specimen vials, to get the saliva, you might get it into the testing medium.

Dr. Alex Jimenez, D.C., presents: And then, just like any vaginal or labial application, if you’re trying to get urine specimens, you have to be careful that you’re not contaminating the urine and getting a falsely elevated level. Blood levels are good if you’re doing testosterone injections, either injection or pellet. Get one-third baseline, and use them for monitoring. It gives you adequate levels. You’ll get a significant elevation in saliva after an IM injection, but there’s wide variability from person to person. So you must take that with a grain of salt regarding how accurate your result might be. The same thing happens in the 24-hour urine specimen. You’re going to get an elevation after an IM injection, but then, there’s a great deal of variability, so who knows how accurate it is?

Dr. Alex Jimenez, D.C., presents: With a salivary level, there’s only some correlation to the bioavailable testosterone. If you’re using a testosterone patch, you can get adequate levels, and there are good studies to show that a blood level will be okay. If you’re using a testosterone patch, the urinary levels, both in 24-hour urine and dry urinary levels, will reflect the increasing doses. You’re getting a reasonably good level with using that. Now, if you’re using DHEA treatment or oral DHEA, you’re going to get a rapid increase in the blood levels right after the oral supplementation as you get with the saliva. You get that also in saliva and also in urine. So you’re picking up on the fact that you took the DHEA test.

Conclusion

Dr. Alex Jimenez, D.C., presents: The problem is variability in the blood, saliva, and urine results. Many don’t particularly appreciate using a lot of oral DHEA anyway because, like all steroid hormones, your body’s going to take it to the liver, and the liver has the opportunity to change it into something else before it even gets into the bloodstream to do its job. Other applications may be more helpful, like transdermal DHEA or topical DHEA; you’ll have to see how the patient feels in terms of symptoms because if you use topical DHEA, the blood levels you’ll get a big rise right after the initial application.

Dr. Alex Jimenez, D.C., presents: So what does that mean because it drops right away? Then, in the saliva after transdermal application of DHEA, the levels will increase, but not linearly. So that doesn’t make any sense. And there is no peer-reviewed research detailing what happens in DHEA levels in the urine after transdermal application. The bigger issue then becomes you might want to keep an eye on what the downstream breakdown products are doing because if you’re not able to get a good DHEA level, you might want at least look at testosterone and estradiol. And that’ll give you some fuel if you’ve overdosed or underdosed on the DHEA. Now, with the vaginal or labial application, the levels in the blood don’t go off at all.

Dr. Alex Jimenez, D.C., presents: There’s no research detailing levels after vaginal application looking at salivary or urinary levels. So you can’t use that as a way of monitoring it. So again, this will be just a matter of following the person and how they feel after using it. You’re not going to need to worry about getting any measurements afterward. It’s simply clinical. The test you choose depends on what you’re giving the person, the form you’re giving it in, and then what you’re trying to find out. By finding a treatment form you like and feel comfortable with, understand whether or not to get testing depending on the structure and replacement you’re using. And then, make sure that you are getting helpful information and not misleading information.

How Cushing Syndrome Affects The Body

How Cushing Syndrome Affects The Body

Introduction

In many situations, stress or cortisol in the body allows the host to go into a “fight or flight” response that works together with the sympathetic nervous system. In its acute form, stress enables the individual to experience various symptoms quickly and doesn’t last very long. However, when there is residual stress still in the body over an extended period can cause havoc to the body and affect a person’s well-being is known as chronic stress. To that point, when the body is dealing with chronic stress, over time can become at risk of developing chronic disorders associated with chronic issues affecting the endocrine system. One of the endocrine disorders that correlate with chronic stress is Cushing syndrome. Today’s article examines Cushing syndrome, its symptoms, and ways to manage Cushing syndrome in the body. We refer patients to certified providers specializing in endocrinology treatments to aid individuals suffering from Cushing syndrome. We also guide our patients by referring them to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

What Is Cushing Syndrome?

 

Have you been experiencing abnormal weight gain around your midsection? What about feeling tired throughout the entire day? Or has your mood been changing all day? Many of these symptoms that you are experiencing could potentially make you at risk of developing Cushing syndrome. Cushing syndrome is an endocrine disorder that causes the brain’s anterior pituitary to produce excessive ACTH (adrenocorticotropic hormone), leading to excess cortisol release from the adrenal glands. In the endocrine system, cortisol is a hormone produced in the adrenal glands above the kidneys. These hormones help the body by:

  • Maintaining blood pressure
  • Regulates glucose levels
  • Reduces inflammation in the body
  • Converts food into energy
  • Manages respiration

When the adrenal glands overproduce cortisol, it causes the body to be on high alert and can become a risk of developing chronic symptoms associated with Cushing syndrome. Studies reveal that Cushing’s disease (a condition where the pituitary glands overproduce ACTH and turn into cortisol) becomes associated with an increased risk of cardiovascular and metabolic disorders that overlaps chronic symptoms, thus affecting the body.  

The Symptoms

When the body is dealing with Cushing syndrome, studies reveal that chronic exposure to excess cortisol could potentially be involved with its associated comorbidities that contribute to decreasing a person’s quality of life. When a person has the signs of Cushing syndrome, the symptoms are unmistakable as the symptoms vary in different people. One of the prominent symptoms of Cushing’s syndrome is rapid weight gain along the face, abdomen, back of the neck, and chest. Some other symptoms associated with Cushing’s syndrome include: 

  • High blood pressure
  • Purple/red stretch marks along the abdomen
  • Fatigue
  • Weak, thin muscles along the arms and legs
  • Excessive hair growth in some regions of the body
  • Cognitive difficulties

 


An Overview Of Cushing Syndrome-Video

Have you been experiencing rapid weight gain along your face, neck, and abdomen? What about feeling stressed constantly? Or have you noticed that your memory is declining? Many of these symptoms are associated with an endocrine disorder called Cushing syndrome. The video above explains what Cushing’s syndrome is, its causes and symptoms, and how to treat Cushing’s syndrome. Cushing syndrome is developed when the adrenal glands produce an excessive amount of cortisol in the body. When the body is suffering from too much cortisol caused by Cushing syndrome, one of the symptoms is bone fractures associated with Cushing syndrome. Studies reveal that the skeletal system is one of the common targets that cause glucocorticoids to attach themselves to the skeletal joints. To that point, Cushing syndrome causes structural and functional impairment to the skeletal system associated with morbidity and disability to many individuals. Fortunately, there are many ways to manage Cushing syndrome and lower cortisol levels in the body.


How To Manage Cushing Syndrome

 

Since stress/cortisol is beneficial and harmful to the body, it has a causal relationship with the organs and tissues in the body. The body needs cortisol to regulate the metabolism and functionality of the endocrine organs. Too much cortisol causes the development of Cushing syndrome, and fortunately, there are ways many individuals can manage this endocrine disorder while keeping an eye on their cortisol levels. Many individuals suffering from weight gain from Cushing syndrome should try to find an exercise regime that their primary physician recommends to lose weight and improve their muscle strength little by a little. Other ways that individuals can manage Cushing syndrome are by:

  • Eating nutritious foods that are anti-inflammatory and taking supplements that have calcium and vitamin D.
  • Meditation or yoga can help calm the mind, and taking deep breaths can help relax the body while lowering cortisol levels.
  • Incorporating massages and chiropractic care to alleviate muscle and joint pain caused by Cushing syndrome. Chiropractic care and massages can help loosen stiff muscles and support the joints to regain their range of motion in the body.

Slowly incorporating these lifestyle changes can lower cortisol levels and help prevent Cushing’s syndrome from progressing further in the body while helping the individual get back on their health journey.

 

Conclusion

The body needs cortisol or stress to get through stressful situations that a person is going through. Cortisol is a hormone formed from the adrenal glands that help regulate the body’s metabolism and provide the functionality to the organs and tissues. In its acute and chronic form, cortisol can range from mild to severe depending on the body’s situation. The body risks developing Cushing’s syndrome when the adrenal glands overproduce cortisol. Cushing syndrome is an endocrine disorder that causes an increased risk of metabolic disorders associated with chronic symptoms like weight gain around the face, neck, and abdomen. Luckily, there are ways to manage Cushing’s syndrome and lower cortisol levels by incorporating an exercise regime, eating anti-inflammatory foods filled with calcium and vitamin D, meditation to calm the mind, and incorporating deep breaths to lower cortisol levels. Utilizing these small changes can significantly impact the body while helping the individual better manage their cortisol levels.

 

References

Buliman, A, et al. “Cushing’s Disease: A Multidisciplinary Overview of the Clinical Features, Diagnosis, and Treatment.” Journal of Medicine and Life, Carol Davila University Press, 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5152600/.

Faggiano, A, et al. “Spine Abnormalities and Damage in Patients Cured from Cushing’s Disease.” Pituitary, U.S. National Library of Medicine, Aug. 2001, pubmed.ncbi.nlm.nih.gov/12138988/.

Kairys, Norah, and Ari Schwell. “Cushing Disease.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 2 Feb. 2022, www.ncbi.nlm.nih.gov/books/NBK448184/.

Nieman, Lynnette K. “Cushing’s Syndrome: Update on Signs, Symptoms and Biochemical Screening.” European Journal of Endocrinology, U.S. National Library of Medicine, Oct. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4553096/.

Disclaimer

Hypothyroidism May Affect More Than The Thyroid

Hypothyroidism May Affect More Than The Thyroid

Introduction

The body is a functional being with the brain to control the host’s movements when going to places or resting, the immune system to battle viruses that enter the body, digest food through the gut system, and the endocrine system regulate hormones that maintain the body. The thyroid secretes hormones out and has a vital role in the body’s functionality, and when it gets affected, it can cause issues associated with the body. When the thyroid doesn’t produce more hormones in the body, it can be at risk of developing hypothyroidism. Today’s article looks at the thyroid’s role in the body, how hypothyroidism affects the body, and how to manage hypothyroidism in the body. We refer patients to certified providers specializing in endocrinology treatments to help many individuals with hypothyroidism. We also guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

What’s The Thyroid’s Role In The Body?

 

Have you been experiencing fatigue out of nowhere? What about having constipation issues in your lower abdominals? Or have you been experiencing frequent and heavy menstrual cycles? Some of these symptoms are associated with hypothyroidism. The thyroid is located at the neck’s base and produces hormones. Studies reveal that this small organ is mighty as it has a massive responsibility to the body by controlling its metabolism, growth, and functionality. As the thyroid secretes hormones for the body, these hormones travel with the bloodstream to different organs, muscles, and tissues throughout the body. Thyroxine(T4) and triiodothyronine (T3) are the two main hormones the thyroid gland produces. While the hypothalamus produces TRH (thyrotropin-releasing hormone), and the anterior pituitary glands produce TSH (thyroid-stimulating hormone). All three of these organs work in synchronized harmony with the body by maintaining the proper mechanism and homeostasis. The thyroid hormone affects not only the body but the vital organs like:

  • Heart
  • Central nervous system
  • Autonomic nervous system
  • Lungs
  • Skeletal muscles
  • Metabolism
  • GI tract

 

The Effects Of Hypothyroidism In The Body

Since the thyroid helps regulate hormones in the body, environmental factors play a role in hormone production. When environmental factors begin to affect the body, they potentially involve hormones. When the thyroid gland cannot produce sufficient hormones in the body, it risks developing hypothyroidism. Hypothyroidism is defined as a common condition that is the result of low hormone production overlapping various conditions and manifestations. When left untreated, hypothyroidism could associate with sympathetic and parasympathetic dysfunction. Studies reveal that the thyroid hormone influences the autonomic nervous system. Individuals suffering from hypothyroidism correlate to a dysfunctional autonomic system overlapping sympathetic reactivity. This means that hypothyroidism will cause the body’s metabolism to slow down and cause various symptoms to affect each vital organ. 


An Overview Of Hypothyroidism-Video

Have you been experiencing chronic fatigue? How about muscle weakness in your arms or legs? What about feeling cold all the time? Individuals experiencing these symptoms are dealing with a condition known as hypothyroidism. The video above explains hypothyroidism, how it is diagnosed, and its symptoms in the body. Many environmental factors do play a role when it comes to the development of hypothyroidism. Some of the symptoms associated with hypothyroidism include:

  • Constipation
  • Decrease in sexual function
  • Depression
  • High cholesterol
  • Weight gain
  • Chronic fatigue
  • Brain fog
  • Hashimoto’s

When the body is being affected by environmental factors correlating with hypothyroidism, studies reveal that factors like spinal cord injuries do cause an impact on the body’s metabolic function and derange various hormonal axes. This causes issues that could potentially involve co-morbidities like urinary tract infections. Fortunately, there are ways to manage hypothyroidism and regulate the hormones to make the body functional again.


Managing Hypothyroidism

 

One cornerstone in managing hypothyroidism and reducing its associated symptoms is following a proper treatment for health and wellness. Maintaining healthy hormone levels in the body is achievable regarding hypothyroidism. Taking thyroid medication as prescribed by a doctor help improve symptoms associated with hypothyroidism while regulating T3 and T4 hormones. Eating nutritious foods may help relieve some symptoms of hypothyroidism. Exercising helps enhance energy levels and strengthen weak muscles for individuals with hypothyroidism. Incorporating chiropractic care can help reduce somato-visceral disorders associated with hypothyroidism through spinal manipulation. Utilizing these treatments to manage hypothyroidism benefits one’s health and wellness journey.

 

Conclusion

The thyroid is an organ at the neck’s base as part of the endocrine system. This organ is mighty as it helps the body by secreting hormones for all the various organs, muscles, and tissues. When the thyroid can’t produce sufficient hormones to regulate the body, it risks developing hypothyroidism. Hypothyroidism is a common condition that results in a low hormonal count, triggering symptoms that affect the body. If left untreated, it could become the mediator for sympathetic and parasympathetic dysfunction. Luckily, treatments are available to manage hypothyroidism and regulate hormonal secretion in the body. This allows the individual to incorporate healthy habits to maintain their hormones while their health and wellness journey continues impacting their lives.

 

References

Cheville, A L, and S C Kirshblum. “Thyroid Hormone Changes in Chronic Spinal Cord Injury.” The Journal of Spinal Cord Medicine, U.S. National Library of Medicine, Oct. 1995, pubmed.ncbi.nlm.nih.gov/8591067/.

Hardy, Katie, and Henry Pollard. “The Organisation of the Stress Response, and Its Relevance to Chiropractors: A Commentary.” Chiropractic & Osteopathy, BioMed Central, 18 Oct. 2006, www.ncbi.nlm.nih.gov/pmc/articles/PMC1629015/.

Mahajan, Aarti S, et al. “Evaluation of Autonomic Functions in Subclinical Hypothyroid and Hypothyroid Patients.” Indian Journal of Endocrinology and Metabolism, Medknow Publications & Media Pvt Ltd, May 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3712377/.

Patil, Nikita, et al. “Hypothyroidism.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 19 June 2022, www.ncbi.nlm.nih.gov/books/NBK519536/.

Shahid, Muhammad A, et al. “Physiology, Thyroid Hormone – StatPearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 8 May 2022, www.ncbi.nlm.nih.gov/books/NBK500006/.

Disclaimer

An Early Indication On Hyperinsulinemia

An Early Indication On Hyperinsulinemia

Do you feel:

  • Agitated, easily upset, nervous?
  • Like you crave sweets during the day?
  • That eating sweets does not relieve cravings for sugar?
  • That you must have sweets after meals?
  • Hormone imbalances?

If you are experiencing any of these situations, then your blood glucose levels are dramatically fluctuating up and down. It might be an early indication of hyperinsulinemia in your body.

When it comes to the body, many people often try to make sure that their body is healthy and strong by eating the right food, exercising regularly, and even getting a routine check-up from their primary healthcare providers. Even though people can achieve this, sometimes harmful pathogens like autoimmune diseases, metabolic syndrome, and chronic illnesses can affect the body. When harmful pathogens attack the body from the inside, it can cause the body to dysfunction, especially the body’s system. Many people have found ways to dampen the effects that harmful pathogens have caused in their bodies. However, there are some people who are autoimmune compromises or even have diabetes have taken the necessary precautions to make sure that they are in control of their bodies.

It is surprising that when people are controlling their insulin levels, they are accustomed to think that insulin is a blood sugar-regulating hormone. Research shows that when the blood glucose rises in the body, insulin is being secreted in the body to help bring the blood glucose down a bit. This is a partial stimulation known as insulin-sensitive glucose transporters, and this is one of the many roles that insulin provides that are unrelated to the body’s blood glucose. When the blood glucose levels are rising and falling dramatically in the body, it can cause anyone who has diabetes to go into DKA or diabetic ketoacidosis.

Chronic Hyperinsulinemia

Studies have found that when diabetic individuals are keeping an eye on their blood glucose levels, they go on a ketogenic diet to keep their ketones under control. It is a surprise to many people that insulin is not required for cellular glucose uptake. The research study mentioned that when individuals are in a deficient carbohydrate diet, their bodies can regulate and control the production of the ketone bodies, causing a harmless physiological state known as dietary ketosis. The study even mentioned that when ketone bodies are flowing from the liver to the brain, it can be used as fuel. When this happens, spare glucose metabolism is very similar to the mechanism of spare glucose that is oxidizing fatty acids as an alternative fuel.

Picture-of-woman-doing-injection-with-insulin-pen_MEDIUM

There is another study that shows that the use of exogenous insulin in individuals who have type 1 diabetes may need to suppress the free glucagon secretion that facilitates glucose transport into their cells. The hormone glucagon has a stimulatory effect on fuel production from the liver and can even modulate the hepatic glucose uptake and the hepatic glycogen synthesis in the body. The study even shows that the hormone glucagon has been longed dismissed as a minor contributor to metabolic diseases in the body. Not only that, but glucagon can even increase hepatic glucose from the liver to the brain and ketone production in the body.

Research on Hyperinsulinemia

What is interesting is that when insulin�s myopic focus is related to blood glucose. Research shows that many people have missed a host of health problems that can occur in the presence of average glucose in the body, but it is known as chronically elevated insulin. The research study showed that when there is a lack of insulin in the liver, it causes glycogenolysis and gluconeogenesis are being activated. When this happens, it can further enhance an overproduction of hormones like glucagon and cortisol, which can stimulate the process of insulin deficiency. A study has found that when a person has chronically elevated insulin or hyperinsulinemia, it can develop cardiometabolic diseases even if elevated glucose is absent. This is due to fasting glucose being part of a routine check-up and chronically elevated glucose.

Studies have shown that chronic hyperinsulinemia is the main factor in POS (polycystic ovarian syndrome) and that there is a high prevalence of undiagnosed insulin resistance with patients who have Parkinson’s disease. Chronic hyperinsulinemia can contribute to insulin resistance, as studies show that this factor can alter lipid metabolism in the body. The research study even shows that insulin sensitivity can be determined by hyper-insulinemic and can lead to weight gain, raised plasma triglycerides, and free fatty acids in the body.

Chronic hyperinsulinemia can be present long before there is a rise in blood glucose. Research shows that there are at least five stages in the progression of diabetes, and it can indicate any metabolic dysfunction that is happening in the body. In one study, it showed that there is an association between hyperinsulinemia in the fasting state and the development of diabetes. The study mentioned that basal hyperinsulinemia in adults who are normoglycemic could constitute an independent risk factor for metabolic deterioration to dysglycemia and can even help identify healthy subjects that may have an increased risk for diabetes.

Conclusion

All in all, if someone wants to make sure that their insulin levels are functioning correctly, they will have to be in a very low-carbohydrate ketogenic diet and keep an eye on their blood glucose levels. Individuals that are living with a condition due to chronic hyperinsulinemia, there are effective ways to manage this condition and even preventing it. Many people should start eating healthy, nutritional food, exercise regularly, and start developing healthy habits in order to achieve an overall sense of health and wellness. Some products are beneficial to regulate blood glucose by providing support to sugar metabolism with hypoallergenic nutrients, enzymatic cofactors, metabolic precursors, and phytonutrients.

The scope of our information is limited to chiropractic, musculoskeletal, and nervous health issues or functional medicine articles, topics, and discussions. We use functional health protocols to treat injuries or disorders of the musculoskeletal system. Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. To further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.


References:

Dankner, R, et al. �Basal State Hyperinsulinemia in Healthy Normoglycemic Adults Heralds Dysglycemia After More Than Two Decades of Follow Up.� Diabetes/Metabolism Research and Reviews, U.S. National Library of Medicine, July 2012, pubmed.ncbi.nlm.nih.gov/22865584/.

Hogg, Elliot, et al. �High Prevalence of Undiagnosed Insulin Resistance in Non-Diabetic Subjects With Parkinson’s Disease.� Journal of Parkinson’s Disease, U.S. National Library of Medicine, Feb. 2018, pubmed.ncbi.nlm.nih.gov/29614702/.

Manninen, Anssi H. �Metabolic Effects of the Very-Low-Carbohydrate Diets: Misunderstood �Villains� of Human Metabolism.� Journal of the International Society of Sports Nutrition, BioMed Central, 31 Dec. 2004, www.ncbi.nlm.nih.gov/pmc/articles/PMC2129159/.

Morita, Ippei, et al. �Chronic Hyperinsulinemia Contributes to Insulin Resistance under Dietary Restriction in Association with Altered Lipid Metabolism in Zucker Diabetic Fatty Rats.� American Journal of Physiology. Endocrinology and Metabolism, U.S. National Library of Medicine, 1 Apr. 2017, www.ncbi.nlm.nih.gov/pubmed/28143857.

Sonksen, P., and J. Sonksen. �Insulin: Understanding Its Action in Health and Disease.� British Journal of Anaesthesia, 1 July 2000, bjanaesthesia.org/article/S0007-0912(17)37337-3/fulltext.

Team, DFH. �Hyperinsulinemia: An Early Indicator of Metabolic Dysfunction.� Designs for Health, 12 Mar. 2020, blog.designsforhealth.com/node/1212.

Unger, Roger H, and Alan D Cherrington. �Glucagonocentric Restructuring of Diabetes: a Pathophysiologic and Therapeutic Makeover.� The Journal of Clinical Investigation, American Society for Clinical Investigation, Jan. 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3248306/.

Weir, Gordon C, and Susan Bonner-Weir. �Five Stages of Evolving Beta-Cell Dysfunction During Progression to Diabetes.� Diabetes, U.S. National Library of Medicine, Mar. 2004, pubmed.ncbi.nlm.nih.gov/15561905/.


Modern Integrative Wellness- Esse Quam Videri

The University offers a wide variety of medical professions for functional and integrative medicine. Their goal is to inform individuals who want to make a difference in the functional medical fields with knowledgeable information that they can provide.

Balance Hormones Naturally

Balance Hormones Naturally

Keeping hormones in balance can be a tough challenge. There are many individuals with hormonal imbalances and they don’t even know it. Despite�tests for abnormal thyroid function, they don’t always acknowledge a thyroid that isn�t functioning properly. The same can be said for the adrenals. When they are overtaxed, the imbalance that follows can be quite challenging. There are top-quality natural remedies for hormonal imbalance.

 

11860 Vista Del Sol, Ste. 128 Balance Hormones Naturally El Paso, Texas

How to tell

Under-producing glands will have some symptoms that are different from glands that are over-producing. But there are some symptoms that are shared across the board.

If you notice that you experience several of these symptoms, it could point to a hormonal imbalance:

  • Aches and pain in the muscles
  • Anxiety
  • Confusion and lack of mental clarity
  • Depression
  • Fatigue
  • Memory loss
  • Migraines
  • Muscle weakness
  • Sexual dysfunction
  • Swelling
  • Weight loss or gain without doing anything new/different

A chiropractor, naturopath, or specialist can help you determine if you have a hormonal imbalance. Medical doctors often prescribe medications, but in most cases, the imbalance can be corrected with a natural treatment. These treatments are highly beneficial in treating hormonal imbalances. They can be done separately or combined.

 

Herbs & Oils

There are several herbs and essential oils that work wonders when it comes to balancing hormones. Ashwagandha is at the top of the list for treating overactive or sluggish thyroid as well as overtaxed adrenals. It’s available as a tablet, capsule, in powder form, or as a liquid. Mixing � to � teaspoons of powder into some milk with honey and drinking it just before bed can help sleep, calm stress and balance the hormones. Various oils like clary sage, lavender, and sandalwood help reduce stress and promote wellbeing. Hormonal balance comes as a natural result. Put 3 to 5 drops in a diffuser and breathe in.

 

11860 Vista Del Sol, Ste. 128 Food Sensitivities and Gut Health El Paso, TX.

Nutritional Balance

Hormonal imbalance can often be the result of stress, whether emotional stress from everyday life or physical stress from poor habits like not getting the proper amount of sleep and not maintaining a proper diet. Omega 3 and 6 fatty acids are vital for heart health, vibrant skin and hormonal balance.

Other nutrients include vitamin D, B complex, and magnesium. If not getting enough in the foods you eat, then consider supplements. Give the body a great boost by taking probiotics and reaping the healing properties of bone broth. Bone broth is available in powder or liquid or you can make your own. There is intense nutrition in broth so incorporating it into your diet is a very wise decision.

Natural Balance

Chiropractic is a powerful treatment for hormonal imbalance. It focuses on the heart of factors that cause the body to go out of balance and treats the problem at the root. It can relieve stress in the body and reduce and eliminate pain, which can contribute to hormonal imbalances. It is considered one of the best natural treatments for hormonal imbalance because it brings the body back into balance.

The whole-body approach that chiropractic offers means that you get recommendations on:

  • Healthy diet
  • Exercise
  • Lifestyle changes

All of these work together to balance your body and balance hormones for a healthier, happier you.


 

Back Pain Treatment


 

NCBI Resources

 

Metabolic Syndrome: Home Solutions

Metabolic Syndrome: Home Solutions

Metabolic Syndrome affects many people. In fact, more than a quarter of the United States has it! Metabolic Syndrome is not a disease, but instead a cluster of disorders. These disorders on their own are not necessarily alarming but when you have more than one, the body starts to feel the repercussions.

Symptoms

Those with metabolic syndrome often suffer from frequent headaches, inflammation, nausea, fatigue, joint pain, and many more. On top of these symptoms, metabolic syndrome can put individuals at a higher risk for Type 2 Diabetes, Heart Disease, Stroke, Obesity, Sleep Apnea, and Kidney Disease.

Risk Factors

Individuals who have an “apple or pear” body shape, are at an increased risk for developing metabolic syndrome. There are no “obvious” signs of metabolic syndrome, but rather one with metabolic syndrome has 3/5 of these risk factors.

  • A fasting blood glucose level of 100 mg/DL
  • High Blood Pressure, measuring 130/85
  • High Triglycerides
  • Low HDL (Good Cholesterol)� measuring <40mg/DL Men & <50mg/DL Women
  • Excess Waist Fat (>40in Men & >35in Women)

What Can You Do About It?

Of course, no one wants to be left feeling sick and stranded. There are ways to help prevent metabolic syndrome at home. Below there are five tips for each risk factor and how to prevent/reduce your symptoms.

A Fasting Blood Glucose Level Of 100 mg/DL

  • Ketogenic Diet
  • Increase Fiber
  • Control Portions
  • Set “Carb Goals”
  • Choose complex carbs over simple carbs

High Blood Pressure, measuring 130/85

  • Reduce Sodium
  • Lower caffeine
  • DASH diet (Dietary Approaches to Stop Hypertension)
  • Boost Potassium
  • Read Food labels

High Triglycerides

  • Limit sugar intake
  • Increase fiber
  • Establish a regular eating pattern
  • Eat more “tree nuts” ( almonds, cashews, pecans)
  • Switch to unsaturated fats

Low HDL ( Good Cholesterol) measuring <40mg/DL Men & <50mg/DL Women

  • Reduce Alcohol
  • Do not smoke
  • Choose better fats
  • Purple Produce (antioxidants to help inflammation)
  • Increase fish consumption

Excess Waist Fat >40 in Men & >35 in Women

  • Ketogenic Diet
  • Exercise Daily
  • Walk after dinner
  • Grocery Shop without Aisles
  • Increase in Water Consumption

Solutions

Aside from doing these tricks and tips at home, a doctor or health coach will be able to further assist one in healing. The main goal is to take these symptoms and disorders and correct them before they become a full-blown diagnosis.

Rather than just running a basic blood panel, they now have tests that allow us to see multiple different levels and numbers. these elaborate blood tests provide great insight to allow us to see the full picture. By completing these labs, it allows the doctor to evaluate the patients better and provide a more specific treatment plan.

In addition to detailed lab work, there are all-natural supplements that have been shown to help improve these symptoms along with proper diet and exercise. Some of these supplements include Vitamin D, Berberine, and Ashwagandha.

On top of these things, there is also an app that is available to download. This app is called, “Dr. J Today”. This app connects you directly to our clinic and allows us to monitor your diet, supplements, activity, BMI, water weight, muscle mass, and more! This app also gives you a direct portal to message Dr.Jimenez or myself.

As stated before, our main goal is to help you decrease your symptoms before they turn into a full-blown diagnosis. One thing we want to surround our patients with is knowledge and a team atmosphere. With the right team, anything is possible and better health is more attainable than you think!

Having Type 1 Diabetes, I have experienced metabolic syndrome before. It is one of my least favorite feelings that exist. I want our patients to know that they do not have to feel that way and there are treatment plans that can help! I will help to create a personalized plan that is tailed to you, so success is the only option. – Kenna Vaughn, Senior Health Coach�

The scope of our information is limited to chiropractic, musculoskeletal, and nervous health issues or functional medicine articles, topics, and discussions. We use functional health protocols to treat injuries or disorders of the musculoskeletal system. Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. To further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

References:
Mayo Clinic Staff. �Metabolic Syndrome.� Mayo Clinic, Mayo Foundation for Medical Education and Research, 14 Mar. 2019, www.mayoclinic.org/diseases-conditions/metabolic-syndrome/symptoms-causes/syc-20351916.
Sherling, Dawn Harris, et al. �Metabolic Syndrome.� Journal of Cardiovascular Pharmacology and Therapeutics, vol. 22, no. 4, 2017, pp. 365�367., doi:10.1177/1074248416686187.

Functional Endocrinology: Menopause and Osteoporosis

Functional Endocrinology: Menopause and Osteoporosis

Do you feel:

  • Perimenopausal?
  • Inflammation in the joints?
  • Alternating menstrual cycle lengths?
  • Hot flashes?
  • Hormonal imbalances?

If you are experiencing any of these situations, then you might be experiencing menopause and its symptoms.

When a woman hits their late forties and entering their early fifties, they go through the natural aging process known as menopause. Menopause is when a woman has not menstruated in about twelve consecutive months as well as can no longer become pregnant. With menopause comes uncomfortable symptoms like hot flashes, vaginal dryness, and hormones imbalance. For women, hormone imbalances can range from having too much or too little hormones in the body’s bloodstream. When menopause occurs, the loss of the ovarian function in a female’s body can have an impact on their skeletal health, causing osteoporosis in the joints.

Osteoporosis and Menopause

Surprisingly though, the hormone estrogen can play a role in the development of osteoarthritis and when a woman is under the menopausal phase. They can experience a decline in their estrogen levels, and osteoporosis will begin to wreak the bones and joints, causing chronic inflammation. Studies have found out that when estrogen hormones begin to change during healthy menopausal changes, they will begin to fluctuate then suddenly drop. They stated that estrogen helps prevent bones from getting weaker through the natural breakdown. Any fractures from accidents can cause pain, decreased mobility, and normal function of the female body due to osteoporosis.

osteoporosis-cropped

There is even more evidence that the fluctuation of estradiol that may even be more pronounced in the perimenopause and might not be able to correlate well with bone density and loss for the body. So, during the menopausal stage, the bone density will deteriorate when females have osteoporosis. There have been rumors that osteoporosis is something that a person should not have to worry because it only happens if there is a family history of osteoporosis. Sadly though, osteoporosis is a common bone disease, and having a family history of the disease can increase the chances. However, there are also other risk factors that can cause osteoporosis like:

  • Excessive alcohol
  • Amenorrhea
  • Smoking
  • Low body weight

Research shows that osteoporosis does start when a woman is at the start of the menopausal stage and has stopped ovulating, her monthly menstrual cycle stops. Her estrogen levels will dramatically stop, as well. It stated that women could have a total bone loss within the first ten years that follow menopause. When there is a lack of estrogen in the body due to menopause, bone density loss is much more significant and can cause fractures in the body. Studies have found out that local health care professionals will ask women about the amount of bone density that has been lost during their menopausal transition and when they begin. They even found out that the follicle-stimulating hormone in women has changed as well during their menopausal transition.

Bone Remodeling

Furthermore, studies found that over 20 American individuals are affected by osteoporosis, and this can lead to about 1.5 million bone fractures each year, thus making osteoporosis to be one of the leading public health problems. More studies even found that women would lose at least fifty percent of their trabecular bone, and about thirty percent of their cortical bone in their body will eventually be lost during the first ten years during their postmenopausal stage. Women must at least take vitamin D supplements to make sure that their bones are healthy and are not prone to bone loss or fractures.

There is information about why bone loss seems to accelerate after a woman�s menstrual cycle has ended and why bone remodeling can help replace the old bones that have been lost due to osteoporosis or due to fracture. Surprisingly though, bone remodeling is a process to replace old bones with new bones for the body, and it is consists of five phases. They are:

  • Activation: During this phase of bone remodeling, osteoclasts are being recruited to the surface of the bone.
  • Resorption: In this phase, the osteoclast is being generated into an acidic microenvironment on the surface of the bone, thus dissolving and resorbing the bone�s mineral content.
  • Reversal: In this phase, the osteoclast then undergoes apoptosis and then is being recruited onto the bone�s surface.
  • Formation: This is the last phase of bone remodeling as the osteoclast deposits collagen and then being mineralized to form a new bone in the body.

Conclusion

Menopause is a natural part of hormone levels to drop, and women cannot get pregnant any more. One of the most common signs that menopausal women encountered is osteoporosis. Osteoporosis is when bones become brittle and can break from falls or injury. Women need to take supplements for bone health so that way the bones and the body is functioning correctly. Some products are designed to help support the estrogen metabolism in both the female and male bodies as well as products to help support the hormonal balance and the normal menstruation for females in the reproductive age.

The scope of our information is limited to chiropractic, musculoskeletal, and nervous health issues or functional medicine articles, topics, and discussions. We use functional health protocols to treat injuries or disorders of the musculoskeletal system. Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. To further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.


References:

Duggal, Neel. �What�s the Connection Between Menopause and Arthritis?� Healthline, 11 May, 2017, www.healthline.com/health/menopause/menopausal-arthritis.

Finkelstein, Joel S, et al. �Bone Mineral Density Changes during the Menopause Transition in a Multiethnic Cohort of Women.� The Journal of Clinical Endocrinology and Metabolism, The Endocrine Society, Mar. 2008, www.ncbi.nlm.nih.gov/pmc/articles/PMC2266953/.

Rodriguez, Diana, et al. �The Osteoporosis-Menopause Connection.� EverydayHealth.com, 16 Feb. 2016, www.everydayhealth.com/menopause/osteoporosis-and-menopause.aspx.

Rosen, Clifford, and Ramon Martinez. �Post Menopause and Osteoporosis.� Hormone Health Network, Mar. 2019, www.hormone.org/diseases-and-conditions/menopause/post-menopause-and-osteoporosis.

Sowers, MaryFran R, et al. �Amount of Bone Loss in Relation to Time around the Final Menstrual Period and Follicle-Stimulating Hormone Staging of the Transmenopause.� The Journal of Clinical Endocrinology and Metabolism, The Endocrine Society, May 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC2869543/.

Team, Penn Medicine. �Menopause And Osteoporosis: What’s The Connection? � Penn Medicine.� � Penn Medicine, 18 Mar. 2016, www.pennmedicine.org/updates/blogs/womens-health/2016/march/menopause-and-osteoporosis.

Tella, Sri Harsha, and J Christopher Gallagher. �Prevention and Treatment of Postmenopausal Osteoporosis.� The Journal of Steroid Biochemistry and Molecular Biology, U.S. National Library of Medicine, July 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4187361/.


Modern Integrative Wellness- Esse Quam Videri

The University offers a wide variety of medical professions for functional and integrative medicine. Their goal is to inform individuals who want to make a difference in the functional medical fields with knowledgeable information that they can provide.