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woman with menopause and hot flash

Is Menopausal Hormone Replacement Therapy Safe?

By | Blogroll

Are you having menopausal symptoms, but you are worried about hormone replacement because you have heard that it is dangerous? 

You may have heard that it causes breast cancer or heart attacks, and maybe your doctor has even advised against it. 

So you suffer with hot flashes, vaginal dryness, fatigue, depressed mood, irritability, poor sleep, changes in your hair, your skin, your sex life and the shape of your body.   How you feel may be affecting your family, your career and your quality of life. 

Hearing that women are suffering like this makes me very frustrated, because the risks of estrogen have been over-stated, mis-construed and mis-understood  – resulting in unnecessary suffering as well as unnecessary deaths. 

Did you know that consistently, across many studies, estrogen replacement has NOT been associated with an increase in the risk of breast cancer? 

Estrogen has also been shown to reduce the risk of heart attacks and death!

But wait a minute, how many times have you heard that it increases risks?  How can this be?

A study done at Yale looked at women aged 50-59 who had had a hysterectomy. Estrogen therapy (ET) was actually associated with a REDUCTION in deaths from heart attacks and breast cancer in these women. They estimated that 90,000 women have died because they did NOT continue on hormone replacement therapy.  Pretty shocking!

Philip M. Sarrel, Valentine Y. Njike, Valentina Vinante, and David L. Katz.  The Mortality Toll of Estrogen Avoidance: An Analysis of Excess Deaths Among Hysterectomized Women Aged 50 to 59 Years. American Journal of Public Health: September 2013, Vol. 103, No. 9, pp. 1583-1588.

The Women’s Health Initiative Trial (or WHI) is the study that started the controversy.  In this study women were given a pill that contained estrogen that was not bio-identical (meaning it wasn’t exactly the same as the estrogen that your ovaries make) and a synthetic progestin (a man-made chemical that mimics human progesterone).  The progestin in the pill was the main problem – it contributed to an increase in breast cancer and heart disease risks (more on that later). 

For now, lets focus on estrogen, since that is the one that seems to have gotten a bad rap.

Here is what we know.  Estrogen is good for your bones (it helps reduce the risk of osteoporosis) and is the most effective therapy for hot flashes.  These facts are not in question.

Here is what else we know: 

  1. WHEN you start hormone replacement matters.
  2. HOW you take your hormone replacement matters.
  3. What FORM of hormone replacement you take matters

Let’s explore each of these issues, so you can become an expert.

WHEN you start hormone replacement matters.

1.  In the WHI study, some women were given estrogen only (these women had had a hysterectomy).  They were all given the same form of estrogen (it was not bioidentical) and took it the same way (an oral pill).  But WHEN they started it varied, and made a big difference.

Women who were given estrogen only, and started it between age 50-59 had LESS Heart disease, LESS strokes, LESS breast cancer, and LESS risks of death

Women on estrogen only, who started between age 60-69 had less heart disease and less breast cancer, but they had a slightly increased risk of blood clots and stroke.  There was no statistical change in overall mortality (no increase or decrease in death compared with women who did not receive hormone replacement).

Women on estrogen only, who started when they were older, between ages 70-79 had  increased blood clots, stroke and heart disease, and increased overall mortality, but no increased risk of breast cancer.

Starting estrogen within 10 years of menopause gives the best results.  Starting when you are less than than 60 can decrease the risk of heart attacks, strokes and death! 

Here is how the Endocrine Society interprets this information:

“Heart attacks, heart failure and death are reduced by 40% when HRT is initiated in women aged less than age 60 or within 10 years of menopause. “

Postmenopausal Hormone Therapy: An Endocrine Society Scientific Statement. JCEM July 1, 2010 vol. 95 no. 7 Supplement 1

And note that women had a decrease in breast cancer no matter how old they were when they started! This data is from the same WHI study that trumpeted all over the news that hormones increase breast cancer.  Remember, this was due to the progestin, and this info is coming up.  But let’s talk a little more about the timing of estrogen use.

For women who start on oral estrogen over the age of 60, there is an increased risk of heart attacks in the first year.  If you haven’t taken hormone replacement (probably because you were told it was dangerous!) then in the years since menopause you may have had plaque building up in your arteries.  Oral estrogen increases matrix metalloprotein, which is a compound that causes the plaque to become “unstable” and increase the risk of plaque rupture causing a stroke or heart attack. 

The risk of plaque rupture is increased in the first year of starting oral estrogen, but if you don’t have a stroke or heart attack in the first year, then over time your risk decreases because the estrogen affects the plaque making it gradually smaller.   By year 5, the risk of heart attacks and strokes is less than in women who are not on hormone replacement. 

This remains controversial and research is still ongoing, but the risks are less if you transdermal estrogen instead of oral estrogen.  So we can still use estrogen even if you are over 60, but we want to consider your heart disease risk factors,  will recommend transdermal estrogen, and need to have a more in depth discussion of this topic so you can make an informed decision.

woman with menopause and depression
HOW you take your hormone replacement matters.

Oral estrogen increases the risk of blood clots, especially when it is not bioidentical (like the one in the WHI study).  Using oral estrogen with a synthetic progestin increases the risk even further.  Other things that further increase the risk including being older, obese, and smoking.  There are other less common risk factors that can be considered (such as a genetic factor called Factor V leiden). 

Transdermal (absorbed through the skin) estrogen does NOT increase the risk of blood clots.  So avoiding estrogen pills can reduce this risk, especially in women with additional risk factors.

What FORM of hormone replacement you take matters

In addition to increasing blood clot risk, synthetic progestins all increase the risk of breast cancer slightly.  This includes the progestin that was used in the WHI study.  Estrogen with bio-identical progesterone (meaning it is the same as your ovaries used to make) does NOT increase the risk.  Estrogen alone (without progesterone) DECREASES the risk of breast cancer. 

There is some concern that using estrogen alone for more than 10 years can cause a slight increase in breast cancer, and it is well known that using estrogen alone can increase the risk of uterine cancer, so I recommend combining estrogen with bioidentical progesterone (which prevent uterine cancer).

Dr Josh Trutt did a great job writing a blog to help his patients understand how to make sense of studies that seem to show risks of hormone replacement. This is the gist of how he explained things:

Was there an increase in blood clots?  They used oral estrogen instead of transdermal in women with other risk factors like hypertension, obesity, or smoking, or the oral estrogen was combined with a synthetic progestin.  Blood clot risk doesn’t go up if transdermal estrogen is used.

Was there an increase in heart attacks?  They used oral estrogens in women who were more than 10 years from menopause,  and they had other risk factors like smoking, hypertension and obesity.  If they had used transdermal estrogens in women less than 10 years after menopause then the risk of heart disease would have gone DOWN.

Did breast cancer incidence go up?  They used synthetic progestins instead of bio-identical progesterone.  Breast cancer does not increase if bio-identical progesterone is used.

Did breast cancer risks decrease?  They either used estrogen alone, or with bioidentical progesterone.

What about dementia?  We know that estrogen protects your memory, and they tried to prove that in the WHI study.  But instead they found women had an increase in dementia as early as 12 months after starting HRT.  But there was no increase in mild cognitive impairment (which happens in the early stages of Alzheimers).  This suggests that the dementia may not have been due to Alzheimers.  So what is the explanation?

All of the women in the arm of the WHI study looking at Alzheimers were over 65.  Since we know that older women starting hormones have a greater risk for blood clots and unstable plaque (especially with oral estrogen and synthetic progestins, which is what they were given), they were likely having mini-strokes and this was causing the fairly sudden onset of dementia.  Studies have shown that using transdermal estrogen (less risk for blood clots) and starting estrogen at a younger age actually results in a significant reduction in dementia. 

Let’s look at some of the studies that showed the benefits of hormone replacement.

1.  In Denmark, they studied 1000 women who were within a few years of menopause.  Half the women received hormone replacement with an oral estrogen (that was bioidentical) and if they had a uterus they also received a synthetic progestin (not bioidentical) 10 days out of the month to protect their uterus.  The other half of the women were the control group and did not receive hormone replacement.  The women were treated for 10 years, but when WHI study results came out they were told to stop because of safety concerns.  The women were followed for another 6 years even after stopping (16 years total).

Did they have a rash of breast cancer diagnoses?  Were they dropping from heart attacks?  Not in the least.  In fact, they had a 50% reduction in heart attacks, heart failure and death.

Women on estrogen only (the ones without a uterus) had a decrease in breast cancer, women on combined estrogen/progestin had no increase in breast cancer (they only took the progestin for 10 days per month, so we did not see the increase in breast cancer risk that is seen in women who take progestins daily).

In total, 26 women in the control group died, compared with 15 women on HRT = 42% reduction in the risk of death in the women on hormone replacement (even though they used oral estrogen and a synthetic progestin).

After stopping HRT for 6 years, the reduction in death dropped to only 33% (in other words, after the women stopped the hormone replacement the benefits started to diminish)

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e6409  Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women: randomised trial

2.  Researchers in Finland looked at the effect of estradiol (bio-identical estrogen) on longterm health in postmenopausal women.  Almost half a million women were studied.  The results were pretty convincing.

Risk of death from heart disease was reduced by 18-54%.  The longer the women had used hormone replacement, the lower their risk, that is why there is such a large range.

Risk of stroke death was reduced by 18-39%.  There was no change in the risk based on duration of treatment.

Risk of all cause mortality (death from ANY cause) was reduced by 12-28%, in an almost linear relationship with duration of exposure – meaning the longer the women used the hormones, the lower their risk of death.


In this study, all of these reductions were comparable in women starting hormone replacement before 60 years and women starting at 60 years or older.

In absolute numbers, there were 19 fewer heart disease deaths and 7 fewer stroke deaths per 1000 women using hormone replacement for at least 10 years.

Menopause. 2015 Mar 23.

Here are several more:

3.  “Over-interpretation and misrepresentation of the WHI findings have damaged the health and well-being of menopausal women by convincing them and their health professionals that the risks of HT outweigh the benefits.”

Climacteric. 2014 Jun;17(3):215-22.

4.  “For healthy women aged 50-59 years, estrogen therapy decreases coronary heart disease and all-cause mortality”

Climacteric. 2014 Oct;17(5):540-56. doi: 10.3109/13697137.2014.933411

5. “Breast cancer risk increased marginally with estrogen/progestogen therapy, related to duration of use, but with estrogen-alone therapy, breast cancer risk decreased significantly, as did mortality. For younger women receiving estrogen alone, there is great consistency between all randomized trials, including the WHI and observational data showing a coronary benefit and a decrease in all-cause mortality.”

Climacteric. 2014 Dec;17 Suppl 2:12-7.

6.  “In this paper, we review data supporting the use of HT administered to postmenopausal women, showing it to have more benefit than risk for symptom control, prevention of bone mineral loss and fracture, and improvement of the metabolic profile in women who began HT when they were less than 60 years of age and had their last menstrual period less than ten years previous. In hysterectomized women treated with estrogen only, a reduction in breast cancer risk was noted in all age groups”

J Steroid Biochem Mol Biol. 2014 Jul;142:4-11.

7.  “The totality of data converges to show a consistency between randomized trials and observational studies that when started in women at or near menopause and continued long-term, HRT decreases CHD and overall mortality compared with women who do not use HRT.”

J Steroid Biochem Mol Biol. 2014 Jul;142:68-75. doi: 10.1016/j.jsbmb.2013.06.011.

8.  “Unlike oral estrogens, transdermal estradiol has been shown not to increase the risk of blood clot or stroke, and to confer a significantly lower risk for gallbladder disease. Unlike some progestogens, [bioidentical] progesterone is also not associated with an increased risk of blood clot, or with an increased risk of breast cancer. “

CLIMACTERIC 2012;15(Suppl 1):3–10

Hormone replacement has important benefits for women. In the media, all types of hormone replacement therapy have been lumped together as though they have the same risks, with the message being HRT increases the risk for breast cancer and heart disease.  

But now YOU understand that there are lots of variations in HOW hormones are prescribed, and the risks are NOT the same.  There are important benefits to hormones, and starting early makes a big difference.  It’s important to have a conversation with your doctor to understand your personal risks and benefits. For most women, there is no need to suffer with symptoms of hormone imbalance due to fear!  Empower yourself with information, make smart choices and you can feel like yourself again!

Yours in health,

 

Dr Deb Matthew MD

The Happy Hormones Doctor

 

PS:  You can find more information about menopausal hormones in my book This is NOT Normal!  A Busy Woman’s Guide to Symptoms of Hormone Imbalance.  You can find a copy on amazon

PPS: If you want to learn more about how my team and I may be able to help you, please schedule a free no-obligation discovery call!  You can email us at drdeb@signaturewellness.org, call us at 704-752-9346 or schedule here

Feet Standing on a Scale

3 Natural Appetite Suppressants to Help With the Quarantine 15!

By | Blogroll, Uncategorized

Losing weight can be tough.  Sometimes we just need a little help…..

Many Americans struggle with their weight, especially now!  The Quarantine 15 is a real thing!  Sticking to healthy eating habits can be challenging, especially when you are starting new changes.  Taking something to help reduce your appetite can seem like an appealing option, but isn’t so simple.

Another weight loss drug gets yanked….

In February 2020, the FDA pulled another weight loss drug (Belviq) from the market due to an increased risk of cancer.  Belviq was FDA approved in 2012, and was the first weight loss drug that didn’t increase the risk of heart problems.  The increase in cancer risk was small, and mostly found after extended use of the drug.  If you’ve taken Belviq, you should stop using it, but no special cancer screenings or check ups are necessary.  Some other weight loss drugs have been found to increase the risk of suicide.   

With so many problems from weight loss drugs, what can be done if you feel like you need a little help getting started?

Good news!  Here are 3 natural appetite suppressants that not only help you stick to your diet, but they actually make you healthier!

Woman grabbing excess belly fat

Struggling with belly fat?


1.  Stay feeling full with 
Glucomannan

This soluble fiber comes from a plant called Konjac root.  It absorbs water in your stomach and swells to make you feel full.  It also helps slow down stomach emptying, so the full feeling lasts longer.  It can help reduce your appetite and overall food intake.

Added bonuses:

It also feeds your healthy gut bacteria, reduces constipation, lowers cholesterol and improves blood sugar levels.

Caution:

It can slow down the absorption of medicines, so don’t take your medicines at the same time.

You don’t have to swallow a pill!

How to take it:

Glucomannan is available in capsules or as a powder you can mix into smoothies.  But here is an even tastier way!

Try Japanese Shiritake Noodles, which are made from glucomannan.  They taste good (a little bit rubbery, but surprisingly good nonetheless), are very low in calories, and contain no carbs.   They can fit into almost any nutrition program: low carb, keto, plant based, paleo, vegan……

The noodles are available at most grocery stores and are typically in fluid filled packages (not dry like most noodles).  Common brands include Skinny Pasta and Miracle Noodles. Just heat and serve! 

Add veggies and tomato sauce, season with curry powder, or try this keto/paleo recipe for pad thai.

2. Ditch the sugar cravings with Gymnema 

Gymnema sylvestre is an herb from India that has been used for thousands of years to help with blood sugar control. It reduces the taste of sugar, reduces sugar cravings, and reduces sugar absorption in your gut.

 

sugar

Here’s a party trick you can try.  Open a gymnema capsule and drop some of the powder onto your tongue (warning: it tastes nasty).  The herb will affect your taste buds to block the taste of sweet. If you eat something sugary, it won’t taste sweet!

Added bonus:

It is also anti-inflammatory and helps to lower blood sugar

gymnema plant

Caution:

Because gymnema can lower blood sugar levels, you need to use caution if you are on blood sugar medications so your blood sugar doesn’t drop too low, which can be dangerous.

 

How to take it:

Traditionally in India the leaves from the gymnema plant were chewed or brewed into tea.  In the west it is typically taken as a nutritional supplement.

3. Boost metabolism with Green tea

Green tea is one of the healthiest foods on the planet.  It contains nutrients called Catechins (such as ECGC) which boost metabolism and promote fat burning.  For example, in one study men burned 17% more fat if they took a green tea extract before exercise (compared with men who didn’t take the supplement).

Added bonuses:

Green tea contains L-theanine, which reduces anxiety. 

It is also a great source of antioxidants and studies suggest drinking more green tea may help prevent heart disease, cancer, diabetes, and memory problems…

The catechins in green tea help with blood flow. Increased blood flow to your brain can help maintain your memory.  Increased blood flow to the nether regions could help boost sex drive.  Not promising anything, but just saying….

The caffeine in green tea ALSO increases fat burning and decreases appetite because it affects hunger hormones.  Black tea has more caffeine than green tea, but is is more processed and has less antioxidants and therefore less overall health benefits.

Here is some more good news – coffee works too!cup of coffee

Caffeine (whether in coffee or tea) is an appetite suppressant. 

1 cup of green tea has about 40mg of caffeine, and 1 cup of coffee has about 95mg.  The dose used for weight loss is about 200mg (2 cups of coffee or 5 cups of green tea).  Too much caffeine is not a good thing, and not everyone tolerates caffeine the same due to variations in our genetics.

Cautions:

When consumed in excess, the ECGC in green tea can bind iron and reduce iron absorption.  This is probably only really important for people with underlying digestive challenges who are already struggling to maintain their iron levels.

Excess caffeine has well known side effects, including jitteriness, rapid heart rate and increased blood pressure.

How much green tea is too much?  Generally green tea is incredibly healthy and more is better.  But probably best to limit to no more than 5 cups/day to avoid the extra caffeine.

How to take it:

Some of the important nutrients in green tea, such as ECGC and l-theanine, are available in capsules.  I recommend just drinking the tea! You can add some lemon for flavor (and extra anti-oxidants), but probably best to skip the honey for now if you are trying to lose weight.

Bottom line:

No pill can make up for an unhealthy diet.  These suggestions are just to help you stick with your good intentions.

If you ARE sticking to healthy lifestyle habits and still not losing weight, there may be other issues preventing you from success.  You may need a Functional Medicine evaluation to help resolve the problem.

Yours in Health!

 

Dr Deb

Why is my brain foggy?

By | Blogroll

If you’ve never had brain fog, you probably have no idea what I’m talking about. But if you have, you know!

It kind of feels like cotton in your brain. Like your brain is not firing on all cylinders. Like the lights are on, but no one is home.

Brain fog is annoying, and it kills productivity – its hard to make decisions, learn new things, remember things or compute stuff in your brain. You need to write everything down, and feel like you need sticky notes for your sticky notes!

I used to notice brain fog in the late afternoon if I was really busy and missed lunch.  Someone could ask me a question, and I would look like I was thinking through possible answers, but the truth was, nothing was going on in my brain!  Just a big blank.  It was hard to make decisions, I was inefficient and it was frustrating.  When I recognized the problem, I’d go have something to eat and in about 30 minutes I’d feel much better.  This is a common scenario! Thankfully once I got my hormones back in balance, the problem disappeared.

Things that can make brain fog worse:

  • Stress.sugar
  • Lack of sleep
  • Multitasking (just too many things going on in your brain at once!)
  • Low blood sugar  (that was my problem when I couldn’t think in the afternoon)
  • Excessive alcohol
  • Junk food

The important thing to know is this is a symptom! Something is causing the brain fog, and you have to know what the underlying cause is, so you can fix it!

Common underlying causes of brain fog

As you can see, getting to the root cause is important to getting your brain back online and getting you back to feeling like yourself again!

Here’s where to start

healthy diet with fruits and vegetables

  • Give your brain healthy food, so it will have the fuel it needs!
  • Avoid common brain toxins, like too much sugar or alcohol
  • Exercise to get more oxygen to your brain
  • Try breathing exercises or meditation to calm your brain so it can work for you

If you already have good lifestyle habits and you’re still struggling with brain fog, it’s important to start looking for the underlying reasons!  If this is something you need help with, please let us know – we’re here for you!

Yours in health,

Dr Deb

Functional Medicine Doctor and Patient

Why Won’t My Doctor Measure My Hormone Levels?

By | Blogroll, Hormones

You’re at your annual appointment, talking to your doctor about how you just aren’t feeling like yourself lately. 

You’ve been feeling guilty for screaming at the kids because they left their book bags in the middle of the floor.  One minute you think your husband is the best guy ever, the next minute you can’t believe you actually married the barbarian.  A couple of hours later he’s back to being a pretty good guy again.  Quite honestly, he doesn’t know what to do with you, and you’re not sure what to do with yourself!  You know this is not you.  It really doesn’t feel normal.  Maybe it’s your hormones?

It seems like a simple request, “Could you just check my hormone levels to make sure everything is ok?”. 

Here are some common responses women have told me they got from their doctor:

“We don’t do that”

“You aren’t old enough to have a hormone problem”

“Just try these birth control pills”

“Here are some antidepressants”

Maybe you’re lucky enough that your doctor does measure at least some of your hormones.  More often than not, you’ll just be told that everything looks normal.  If everything is so normal, why are you feeling off?  How frustrating!

We know that approximately 30% of women have a hormone imbalance, and 100% of women go through menopause (some with more symptoms than others), so why is it so hard to have your hormone levels tested to see what’s going on in your body?

 

5 reasons most doctors aren’t so eager to measure your hormone levels

1.  Doctors are trained that if your labs are in the “normal” range, you are normal.  The normal lab ranges are very wide – unless you have a tumor (which you probably don’t because those are rare) you will probably land somewhere in the normal range.  That doesn’t mean it is normal for you, or that your levels are ‘optimal’ or balanced.  It just means that you probably don’t have a tumor.  Good to know, but not very helpful.  For example, many labs start the normal range for testosterone at 0.  So you could have practically zero testosterone in your body (and zero interest in sex), and you technically would still be considered “normal”.

2.  If you are pre-menopausal, your hormone levels change over the month.  They are low while you are on your period and until you ovulate in the middle of the month.  At ovulation, your estrogen level spikes up.  Then for the next 2 weeks until your period, your progesterone levels are higher.  It is absolutely critical to know where you are in your cycle, otherwise the lab results are meaningless.  It is not enough to just have your blood drawn on the random Thursday afternoon that you happen to have your annual doctor’s appointment.

3.  If you have functioning ovaries, but aren’t having periods, this can make things tricky because we can’t know where you are in your “cycle”.   For example, if you have an IUD, have had a uterine ablation (a procedure where the lining of your uterus has been treated to reduce bleeding), a partial hysterectomy (they took out your uterus, but left at least one ovary), or if your periods are very irregular and unpredictable – then how can you know WHEN in your “cycle” to do the test?  While complicated, it is not impossible to get the right information, but most doctors don’t even bother to try.

4.  If you are menopausal, the lab changes the normal ranges!  Menopausal women typically have lower hormone levels, so they just lower the lab range.  Even if your hormone levels have dropped very low (and you feel tired, cranky, have painful sex, have to write everything down on sticky notes and haven’t slept for months), you’ll come back “normal” on the test. 

5.  Your doctor is responsible for interpreting the test results and then treating you appropriately.  Unfortunately, in medical school they simply didn’t teach us what we need to know to help you!   We were taught to give you birth control pills if you are less than 45, and hormone replacement therapy if you are older than 45 (with or without a side of antidepressants, based on how much you are complaining).  We are taught to prescribe “the pill” without measuring your hormone levels, because the pill basically turns off your hormones and replaces them with synthetic drugs that mimic your hormones.  If that’s not what you want (and another day we can talk about why that may not be the best choice), they don’t have other options.  So why would they bother measuring your hormone levels?

It’s not your doctor’s fault.  This is how they were trained, and it’s all they know.  It was all I knew – until my own hormone issues led me to learn a completely different approach to women’s health.

By measuring your hormone levels, we can learn what’s going on in your body and explain a lot about how you are feeling.  We can also get to work to get your hormones back into balance so you can sleep soundly, wake up feeling refreshed, have patience with your kids, and enjoy intimacy with your spouse. You can get back to feeling like yourself again! 

Happy woman

If your doctor isn’t able or willing to help you, don’t give up! Look for a doctor trained in Functional Medicine – they’ll help you get to the root cause of your symptoms and get your hormones back in balance so you can get WELL, get OFF prescription medicines, and  LOVE the way you feel!

Yours in health!

Dr Deb

PS:  If you’d like more help, here are a few ways we can help you.

  1. To learn about becoming a patient at Signature Wellness, schedule a free consultation with one of our Patient Coordinators at 704-752-9346 or schedule online here.
  2. Follow me on facebook @signaturewellnessNC or instagram @drdebmatthew for more info about hormone health and ways to naturally balance your hormones.
  3. Read my book,  This is NOT Normal!  A Busy Woman’s Guide to Symptoms of Hormone Imbalance for more information, including quizzes to see if your hormones are out of whack.  You can get a copy on Amazon or download a free e-book at IsItYourHormones.com
donuts

Tips to help with stress eating

By | Blogroll

Stress eating can be tough

Are you starting to worry about gaining the “quarantine 15”!  Stress causes an increase in cortisol (our stress hormone) and cortisol causes food cravings (and belly fat…..).  

 

When we’re stressed, it’s very easy to turn to food for comfort.  There’s a reason they call certain foods “comfort foods”, right?  But this often equates to extra calories, and usually foods that aren’t the healthiest (like ice cream, mac n’ cheese, chips…).  The truth is no one turns to broccoli and kale when they’re stressed out! 

 

Stress eating is emotional eating.  And it often makes the problem worse – you end up feeling guilty about the foods you just ate or the scale reading the next day.  And since hunger isn’t driving your desire for food, nothing you eat really makes you “full”.  Thats why you can end up eating the whole bag of cookies and still end up searching in the freezer for ice cream to top it off!

 

Here are some tips to help you avoid stress eating:

 

1.  Be mindful of why you are eating   

Do you eat when you sad or upset?  Do you eat when you are not hungry?  Do you reward yourself with food?  Being aware of your motivation to eat is an important first step. 

 

2.  Identify triggers

If you had a particularly hard day at work, do you turn to food when you get home?  Consider a food journal to help you identify your triggers and get a more accurate picture of what you are eating/drinking throughout the day.

 

3. Find distractions

When you’re craving the chocolate bar, instead try calling a close friend, making yourself a cup of herbal tea, going for a walk, or purposely diverting your mind to a new task or topic.  It’s possible 20-30 minutes later the food may be forgotten!

 

4.  Set yourself up for success 

Try to minimize unhealthy foods or snacks in your household.  Stock your  fridge and pantry with healthier items instead.

 

5. Balance stress

We all have stress in our lives.  Finding healthy ways of coping with stress is important.  Meditation, deep breathing, and exercise can all help to reduce stress and help you stay in control.

 

6.  Avoid rewarding yourself with food

Use food as medicine to support and heal your body, not as a reward.  Sometimes you deserve a reward!  Consider treating yourself to a movie, or a pedicure, or a mini shopping trip!

 

7.  Stay hydrated

OK, we’ll admit that a glass of water does not hold the same appeal as a hot fudge sundae when you’re stressed out.  But when you’re dehydrated, the messages sometimes get a bit mixed up and you can think you’re hungry.  Drinking more water through the day can help you have more control over your hunger and eating behaviors.  Try adding some lemon or lime to the water, or try different herbal teas if you’re tired of water.

 

8.  Ask yourself if you’re hungry

If you’re hungry, it’s ok to have something to eat.  If you aren’t really hungry, this is the time to use those distractions!

 

9.  Try intermittent fasting

Eat your meals within a 12 hour window (for example have breakfast at 8am and finish eating for the day by 8pm), then fast for 12 hours overnight.  This has some great health benefits, including helping with weight loss, but it also has some psychological benefits too! Most of us do our worst stress eating at night.   If the kitchen is “closed” after 8pm, it helps us avoid mindless snacking or searching through the pantry for a treat. 

 

10.  Be kind to yourself

Sometimes you are going to eat things that you know aren’t good for you.  Don’t beat yourself up.  Don’t allow that voice in your head to tell you that you’re a failure.  Think about what you would say if a good friend confided in you that they were having trouble with stress eating.  You would be understanding and supportive!  Make sure that voice in your head is treating you like a good friend.  If you’re having trouble with this, please reach out for help.  

 

Yours in health,

 

Dr Deb

If you’d like to learn more, here are some ways that I can help you:

  1.  You can find more information on our website www.signaturewellness.org
  2. You can sign up for our FREE online Stress Rescue Program here
  3. If you’d like to learn more about whether a hormone imbalance could be the cause of your symptoms, please read my book, This is NOT Normal! A Busy Woman’s Guide to Symptoms of Hormone Imbalance.  You can find a copy on Amazon, or you can get a free copy of my e-book at IsItYourHormones.com
  4. If you’d like more info about working with Signature Wellness, please call 704-752-9346 or you can schedule a free consultation with one of our Patient Coordinators here
Coronavirus Update

What to do if you’ve been exposed to someone with COVID-19?

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Now that more people are starting to get sick and (importantly!) more people are starting to get tested, more and more of us are going to be faced with knowledge that we have been exposed to someone with the virus. 

How worried should you be?

According to the Dept of Health and Human Services, here is a breakdown of your risk:

  • No risk:  Walking by, or briefly being in the same room as a person who has symptoms (fever and cough) and tested positive for COVID-19
  • Low risk:  Being in the same room as a person with symptoms who tested positive, but not within 6 feet
  • Medium risk: Sustained close contact (for 10 minutes or longer) within 6 feet of a person with COVID-19 while they had symptoms
  • High risk: Close household contacts of someone with confirmed COVID-19

What should you do if you have been exposed to someone with COVID-19?

Stay home to help reduce the spread of the infection (even if you don’t have symptoms, you could spread it to someone else!)

What should you do if you get sick?

CALL your doctor or the health department.  Please don’t go (unless you are having trouble breathing).

  • at this time they have no medicine to treat this anyway
  • there is a shortage of safety equipment like masks to protect medical staff.  We need to save the equipment for hospital staff who need it the most and not use it up seeing people who are only mildly ill
  • we still only have limited tests (we just can’t test everyone). 

 

More masks and tests are coming, but right now we just don’t have the equipment we need.  If you are only mildly ill, please CALL your doctor and let them help determine whether you need to be seen or tested.  Only go to the ER if you are having breathing problems or are seriously ill.

Please stay home and practice social distancing.  The more we slow the spread of the virus, the more lives we can save.  Please think of the healthcare workers who are working in the hospital without adequate masks and protections, the elderly (including your relatives!) and people with underlying conditions who are at increased risk.  

For patients of Signature Wellness: if you have questions and are looking for guidance, please send us message in the portal and we’re happy to help.

Stay home and stay safe,

Dr Deb

 

 

Woman with the flu in bed

Coronavirus – what to do?

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It’s March, and while ‘flu season’ is coming to an end, ‘coronavirus season’ has just begun in the US.

While coronaviruses aren’t new, the one that is spreading more easily right now is a new strand that our body’s haven’t seen before or built antibodies to yet. This means we’re more susceptible to catching it.
So while many people are concerned about getting sick, and stocking up on food in case they are quarantined at home for weeks on end, let’s shift our focus to prevention. Here’s what can we do to stay healthy, prevent our own exposure, and prevent it from spreading to others if we do get sick.
Did you know that most of your immune system is in your gut? Specific cells in the lining of the gut spend their lives excreting massive quantities of antibodies to help fight off bacteria and viruses we are exposed to every day. It makes sense to say that if you have a healthy gut you are able to fight off infections more easily.

Here are some easy ways to keep your gut healthy:

  • Probiotics

Our body is made up of trillions of bacteria, most of which are in our gut lining. The more diversity of good bacteria we have, the more easily we can crowd out the bad guys when they get inside.

Pro Tip: change up the strands of bacteria in your probiotic every quarter to ensure you’re getting enough diversity

  • Eat your veggies!

The more variety in vegetables you eat, the more you feed the good probiotic bacteria so they can grow and fight off infections more easily.

  • Avoid sugar.

Sugar is pro-inflammatory which means it hurts the gut more than helps it, allowing bad guys in and increasing risk for getting sick. Stick with fruits like berries (which are high in antioxidants) if you’re craving something sweet.

Tips to avoid catching the virus

Reducing our own personal risk of getting infected with Coronavirus will help prevent it from spreading to those at higher risk. Given what we know about how this virus is contracted, here are simple tips to avoid exposure:

  •    Wash your hands!

Did you know most people aren’t doing this right? It’s important when using soap and water to wash both sides and under your finger nails for at least 20 seconds – an easy way to do this is to sing the “Happy Birthday” song – when you’re done, rinse and dry off.

  • Walk away

Infections like coronavirus and flu are spread when someone coughs or sneezes and the tiny droplets in the air are ingested or inhaled. Keeping a distance of at least 3 feet from others – think about having a hula hoop around your waist. Also avoid enclosed areas with large crowds whenever possible.

  • Avoid face touching

On average we touch our faces over 20 times an hour. Our hands come in contact with potentially bad bacteria and viruses all day long from touching door handles to shaking hands. Since the gateway to your gut is through your nose and mouth, it’s important to avoid giving the bad guys a head start into our gut and keeping your hands away from your face.

Man down…Now that you’re sick, what do you do?

  •  Stay Home!

If you have symptoms or have been diagnosed with a contagious bug, it’s important that you stay home to reduce the spread and exposure to others. Typically, once you are fever free for 24hrs or more you can get back to life as usual, but check with your doctor on what they recommend is the necessary amount of time at home before it’s safe to go back to work or school.

  • Sleep

Rest is one of the best ways to help you recover fast and feel better. Your body heals and recovers when your sleeping so getting plenty of rest will aid in a quick recovery

  • Hydrate

The Solution to Pollution is Dilution… Hydrating with water throughout the day and avoiding dehydrating fluids (caffeine, soda, alcohol) will help you recover sooner and feel better faster.

If you have questions, please call to talk to a member of our team at 704-752-9346 or email us at questions@signaturewellness.org.  You deserve to LOVE the way you feel!

Which natural disinfectants work for coronavirus?

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The coronavirus is generating a lot of fear. While public health officials are worried about public gatherings, most of the infections will likely come from close contact within families.   

Here are some tips for protecting yourself and your family

Hand washing with soap (for at least 20 seconds) is the still best protection.  Avoid touching your face with your hands. Hand sanitizer will work in a pinch. 

Disinfect surfaces in your home and workplace

Doorknobs, stair railings, refrigerator handle…..you know the spots.  But make sure to do it right!  Not all cleaning products will kill the virus.  The EPA has released a list of effective products

If a product isn’t on the list, it doesn’t mean that it doesn’t work.  For example store brands that are equivalent to Clorox or Lysol products are not listed, but should work.  Compare the labels to make sure the ingredients look the same.  

A problem with these cleaning products is that while they kill viruses, and no one wants to get sick, they are full of chemicals.

Some people don’t tolerate the chemicals in many of these cleaning products, and get irritated eyes, skin or lungs.  Some people are concerned about exposing their family to more chemicals and prefer natural disinfectants.  

Some natural disinfectants work and some don’t

The EPA didn’t include natural products on it’s list, so here is a rundown of what works:

  • Vodka actually works well as a natural disinfectant for bacteria but doesn’t have high enough alcohol content to kill coronavirus.  Vodka is only 40% alcohol, but >60% alcohol is required.  Everclear vodka is 75.5% alcohol and could be used!  Put it in a spray bottle, and spritz over a surface that has been cleaned with soap and water,  It is important to allow it to dry – if you spritz and then wipe it off immediately it won’t have a chance to disinfect.
  • Rubbing alcohol (isopropyl alcohol) works well as long as it is >60% alcohol (it will say right on the bottle).  Spray on a clean surface and allow to dry.
  • Hydrogen peroxide works to kill viruses.  Clean with soap and water, then spritz peroxide and let it dry.  It’s important to keep the hydrogen peroxide in the original brown bottle (just attach a spray nozzle right to the bottle).  If you transfer peroxide to a clear bottle where it is exposed to light it will lose effectiveness.
  • Vinegar kills some viruses, but it may not be a strong as chemical disinfectants, and isn’t recommended on it’s own.  Combining vinegar and hydrogen peroxide works better than either alone, since they work on the virus in different ways.  Some people think this combo may work even better than bleach.  It’s important to use them one at a time and not mix them together – spritz a clean surface with vinegar, allow to dry, then spritz with hydrogen peroxide.  

Disinfect your tech too!

While you’re cleaning, don’t forget to disinfect your phone.   Your phone has more germs than a toilet seat!  Wearing a mask doesn’t really help protect you, but cleaning your phone could.  

Apple is now saying that it is ok to clean your phone with clorox wipes (previously they warned that this could damage the screen)  Another option is to spray rubbing alcohol (>60%) on a soft cloth and wipe the surfaces of your tech.  Don’t spray directly onto your phone or keyboard.  If you have a screen protector this will protect the surface from the cleaning products, and if the protector is damaged at least it is inexpensive and easy to replace.

Since we are now finding that the virus can be spread via feces, don’t use your phone while you’re on the toilet! (There, I said it….)

No need to panic….

While coronavirus is consuming the news these days, this is the same advice we give to protect yourself from the flu and other viruses.  No need to panic, become a germophobe or spend your entire day disinfecting your house. Common sense still rules the day.

Boost your immune system by eating your veggies, avoiding sugar, and not allowing yourself to get too stressed out.  Wash your hands.  And disinfect that phone!

Does Estrogen Protect Women From Coronavirus?

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New information about how estrogen may be protecting women from serious infection!

The new coronavirus has only been around for a few months, so research is just beginning and there is still so much we don’t know.  A new Chinese study looked at the receptor used by the virus to get inside our cells and gives us a glimpse into who is more susceptible and why.  Please be aware that this information is not yet peer reviewed so it is only preliminary and the facts could change.  

When looking at the current COVID-19 pandemic, we see that children they tend to have mild disease.  The risk of serious disease increases with age.  Women are less likely to have severe disease than men.  People with pre-existing diseases, such as diabetes, heart or lung disease or weakened immune systems are also at higher risk. The highest risk category are elderly men with multiple pre-existing conditions. This new research helps explain why.

 

Photo by CDC on Unsplash

How does the virus get into our cells?

We know that the virus uses a receptor called ACE2 as a doorway to get into our cells.  It would make sense that the more of these receptors (doorways) you have, the greater your risk for disease.   

In fact, the study found the exact opposite! People with the most ACE2 receptors had the least risk for disease. We don’t understand why people with more receptors are more protected, so we’ll have to keep learning.

Why children and women have lower risk 

I attached a link to the study at the bottom, but it is not easy reading so here is a summary of the findings:

AGE:  Young people have more ACE2 receptors (lower risk) and the number of receptors goes down with age (increased risk).  This may explain why children are at such low risk of severe disease – they are protected by having lots of these ACE2 receptors.

SEX:  Women have more ACE2 receptors than men, and in fact we see women tend to have less severe disease than men.

HORMONES:  The researchers surmised that estrogen may be protecting women.  They looked at women on estrogen treatment and found that women on estrogen had more ACE2 receptors (associated with less risk).  They also looked at men on testosterone therapy and found a slight increase in receptors (although not nearly as much as with estrogen).  When they looked at male to female transgender people (on estrogen replacement and testosterone blocking medicine) they found significantly higher ACE2 receptors. 

DIABETES:  People with type 2 diabetes have significantly fewer ACE2 receptors, and more risk for disease.  The study did not include information about other diseases but perhaps other disease conditions also reduce receptors – more research will be needed here.

MEDICATION: ACE inhibitor medications are often used for high blood pressure.  These medicines block the effect of the protein produced when the ACE2 receptor is activated  We don’t yet know what effect the medications could have (if any) on disease risk.  It is possible that ACE inhibitors could reduce risk, but we just don’t know.   It is not recommended to change medications at this time since we just don’t have enough information yet. 

How does this information help?

We can’t change our age or our sex.  I am not recommending that anyone run out and start estrogen or testosterone therapy to avoid coronavirus infection. 

If you have type 2 diabetes, you can certainly take charge of your health and improve your lifestyle habits. It’s not too late to start today!  We don’t know yet how blood sugar control will affect the number of these receptors, but we know that poor blood sugar control weakens your immune system, and better blood sugar control allows your immune system to be stronger.  

We don’t really understand why having more ACE2 receptors reduces the risk of severe disease, but perhaps this will help us to learn how to prevent or treat coronavirus infections in the future.  

Yours in health,

Deb Matthew MD

https://www.preprints.org/manuscript/202003.0191/v1

Menopausal Woman Doing Yoga

Why testosterone is important for women too!

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Hormones play a role in the health of your skin, hair, and bones, and they play a role in protecting your muscles as well.  Many women notice a change in how they look after 40, with less muscle tone, which can be very frustrating if you’ve been trying to live a healthy life and take care of yourself!

A recent study looked at the effect of hormone replacement on maintaining muscle mass in postmenopausal women.  But once again, researchers dropped the ball on women’s health and failed to ask the right questions.

They looked at women on estrogen-only hormone replacement (HRT) or estrogen/progestin HRT. And they found no difference in muscles compared with women, not on HRT.

Here’s the main problem with the study: while estrogen has a lot of important benefits in your body, and so does progesterone, the hormone that is most important for your muscles is testosterone – which they did not look at or replace!

Testosterone is just as important for women’s health as estrogen and progesterone. Here are some reasons why:⁣

👉It helps keeps your bones strong, so they don’t snap like a twig when you fall down.⁣

👉It helps prevent stress incontinence (urinary leakage when you cough, sneeze, jump or run) and a future dependent on Depends⁣

👉It’s a mood stabilizer and helps us avoid crying at every Hallmark commercial⁣

👉It helps boost motivation and competitive drive (so you have enough “get up and go” to get to the gym and feel like working out!)⁣

👉It boosts interest in sex (so you actually care about it), which is important in relationships.⁣

👉It helps with vaginal lubrication, so sex is not painful ⁣

👉It helps with skin tone, to prevent saggy, droopy jowls and chicken wings under your arms⁣

👉It helps maintain your muscle mass so you can stay strong and vital as you age gracefully…..⁣

Happy woman

Some women are able to make some testosterone naturally after menopause, so not everyone needs testosterone replacement. But if you’re having any of these symptoms it’s important to be tested so you can prevent turning into a frail little old lady with barely enough strength to stand up from your chair!

The “normal” range of testosterone for women is very controversial.  Some labs actually say that the normal range goes down to zero!  A testosterone level close to zero may not be flagged as abnormal by the lab, but it is certainly not optimal for your health and how you feel!

There are currently no FDA approved testosterone replacement products for women, so many doctors don’t treat low testosterone in women. There is one form of synthetic testosterone available in combination with a synthetic form of estrogen in a pill (called Estratest).  Since this is not the natural form of either hormone, the risks and benefits are not the same, and the results are not the same (and therefore I don’t recommend this product).

It’s important to work with a medical provider who is knowledgeable about the options to support your own testosterone production, or the use of bio-identical testosterone products. Testosterone is available as a topical cream or sublingual lozenge (called a troche) from compounding pharmacies and is also available as a pellet that is inserted under your skin in a quick office procedure.

If you aren’t feeling your best and would like to be evaluated to see if a hormone problem such as low testosterone could be a problem for you, please find a Functional Medicine practitioner to help you.  If you are in the Carolinas, we are happy to help, and you can reach us for more info at 704-752-9346 or contact us here.

Please don’t suffer from symptoms unnecessarily!  Your family, relationships and career won’t flourish when you aren’t the best version of you.  Taking care of yourself benefits everyone you care about.  And you deserve to LOVE the way you feel!

Yours in health!

 

Dr. Deb