wellness tips

Read this week’s edition of Grand Rounds at Health Business Blog – there are more posts on wellness this week, and a very interesting post on the real dangers of Accutane, the drug commonly given for acne. Check it out! Pretty interesting to see what those within the medical community are thinking and doing.

Check out this week’s addition of Grand Rounds at Dr. Wes, an interesting and varied collection of posts ranging the scary – a health blogger being harassed by a big-shot lawyer who does not like her posts about mercury in vaccines, to the hilarious – a TV commercial exposing how physical activity is simply not in our mindset – and everything in between. Well worth the read!

Okay, I’m feeling a bit the fool. You see, on Tuesday April 1, Grand Rounds came out, and my post that I had submitted was not included, or so I thought.

Now just to explain, Grand Rounds is published every week on a host’s blog, and it highlights the best posts of the medical blogosphere each week. Now I have submitted many posts to Grand Rounds, and most of the time my posts don’t make the grade, and I’m not included. Once I made it when HealthBlawg was hosting, when I submitted my post on cholesterol, mortality and cholesterol-lowering drugs, and that made my day. 🙂 Since that time I have not been so lucky, so this week, when once again my post wasn’t included, I decided to ask for feedback so I could learn what the criteria are for inclusion. So, on April 1 first thing in the morning, I popped off an email question to GruntDoc, who was hosting this week’s edition of Grand Rounds, and then immediately headed off for a 3-day mini ski vacation to Whistler.

When I got home, I noticed that the baton of Grand Rounds was passed around amongst 7 different hosts this week, and my post showed up on the MedGadget segment. Yeah! I also found an email in my inbox from GruntDoc, explaining to me what had happened with this week’s edition, so, I guess it was April Fools on me! I simply wasn’t patient enough.

So, check out this week’s fun edition of the Roving Grand Rounds, starting at GruntDoc, then to “dregs” Grand Rounds at Dr. Val’s, then to “masterpieces” Grand Rounds at David E Williams Health Business Blog, then to “well conducted research” Grand Rounds at medgadget, and then onto “video” Grand Rounds at Dr. Anonymous, then to Dr. Rob and “Mutant” Grand Rounds at Musings of a Distractible Mind, and we finish up with “Valley Girl” Grand Rounds at Emergiblog.

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It’s December, and that means that in my neck of the woods in southwestern Canada we are getting a lot of dark, dreary, rainy days. The sun comes up after 7h30am and goes down around 4h30pm. Many of us long for a nice sunny vacation at this time of year to cope with the lack of light and the winter blues. "The winter blues" is mild compared to what those that suffer from Seasonal Affective Disorder (SAD) go through – severe depression in the winter time that then clears up in the spring when there is more light. Seasonal Affective Disorder is not something to be taken lightly, as it can impair one’s life to the point of not being able to function. People that are affected not only feel depressed, but frequently also feel lethargic, sleep excessively, are more sensitive to pain, tend to withdraw socially, crave sugar and often gain considerable weight.

Just as we need adequate dark time each night, we also need adequate light during the day for good hormone function. It seems that those who suffer from SAD need bigger differences in light and darkness for their hormonal systems to function appropriately, and interestingly enough, a far larger percentage of SAD sufferers than would be expected by chance, were born in the fall and the winter when there is less bright light during the day, and fewer light-time hours. I wonder if the lack of light exposure in the first few months of life has anything to do with developing SAD later. If we consider primitive humankind, it would make sense to time the birth of children to when food would be plentiful to encourage survival, just like in the rest of the animal world. And plentiful food usually occurs when there is more daylight and plants are growing. That said, snow-cover in the winter can be extremely bright, but most of us in our modernized world do not spend all day everyday outdoors when it is cold and snowy.

The hormones melatonin and cortisol and the neurotransmitters serotonin and probably dopamine are involved in SAD. Melatonin doesn’t seem to turn off adequately at dawn, causing morning drowsiness and oversleeping. Cortisol doesn’t seem to rise adequately in the morning which may contribute to lethargy during the day. Melatonin and cortisol influence serotonin function, and low serotonin levels are linked to depression in general. So gaining control over cortisol and melatonin is key to feeling better.

The most successful treatment method for SAD is using a full-spectrum fluorescent light box that provides about 10,000 lux of light each morning upon awakening for half an hour to an hour. Such a light box provides about 25 times more intense light than does most indoor lighting, and research shows that this boosts morning cortisol and suppresses melatonin. These light boxes can be purchased for home use, and they need to be used consistently each morning for at least three weeks before most people suffering from SAD will begin to feel better. It makes sense to me that the opposite side of the equation should be addressed too – complete darkness at night, and a good nine hours of darkness to boot. Black-out drapes are very helpful. Because SAD seems to be a circadian rhythm dysfunction, being very consistent with bedtimes and wake up times may help get the body clock back on track. So, turning out the lights at 10pm and using the light box at 7am consistently should work well.

As I have explained before, light and darkness play a fundamental role in our desire for carbohydrates. The later the lights are on at night, the higher our evening cortisol, the more we want to snack on carbs and sugar, the fatter we get. The cortisol connection may explain why SAD sufferers crave carbohydates and gain so much weight. Eating quality fats when wanting carbs may help suppress the cravings.

Morning exercise would probably also be extremely helpful, as exercise would not only boost morning cortisol, but would also reduce depression.

Related Tips
Is going to bed too late making you fat?
Depression
Melatonin, our rest and repair hormone
Cortisol, our stress hormone
Light pollution messes with our hormones

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Before leaving on this backpacking trip, it would be accurate to say that I was somewhat apprehensive. It was explained to me that when a trail is described in the trail guide as “exciting” or has “considerable exposure”, that is code for “you are walking along a cliff edge, and a slip here could hurt badly.” The trails that we had committed to were considered “extremely strenuous – for experienced Grand Canyon hikers only”, which of course I was not. And the fact that my quads had still become quite sore after my training hike the week prior to leaving did not inspire much confidence that I was actually ready for the big show. Our plan was to hike north down the Tanner trail from the east end of the Park on south rim to the Colorado River, then continue north along river following the Beamer trail, hopefully to the confluence of the Little Colorado, and then retrace our steps out. Then we would drive around to the wilder north rim, and explore the Nankoweap trail, the so-called most challenging trail in the canyon, for a day or two. I spent so much energy worrying about my readiness for the trip, that I didn’t get excited about what I would experience, until we arrived at the rim.

If you didn’t know it was there, you would have no idea by looking out the car window on the drive to the Grand Canyon that it actually existed at all. The land is generally flat, with small stubby trees. Occasionally one would catch a glimpse of a small gorge cut out of the plateau, but nothing to indicate the grandeur that awaited us. Even when the three of us reached the sign for the Grand Canyon National Park, there was no indication that the canyon was so near. We arrived at the south rim mid afternoon Sept. 29th, set up camp in the Desert View campground. After eating lunch, we walked through the amphitheater of the campground to the rim, and I got my first breathtaking view. WOW! What struck me immediately was the size and beauty of the place. You know how people that have been to the Grand Canyon tell you that it is so big? Well it is SO BIG!!! No photograph can capture the vastness of the place – somehow it is too big for photographs. Not that that stopped us from trying.

We then went to the Desert View Watch Tower, where we could see parts of the trail that we would be following the next day, and the Colorado River, our destination. At that time we did not realize that we would almost always be in view of the watch tower while we were hiking on the south side.

We awoke to thunderstorms the next chilly morning. We were at Lipan Point, at the Tanner trail-head by 7h30am, but thought it best to wait out the storm. I got a great picture of a rainbow over the Canyon, and by 8h30 we headed down the trail through the juniper and pinyon forest. The trail was not nearly as difficult as I thought it would be. Yes, it was steep in places, but there were also long traverses. The path was very obvious the whole way, and I found that contrary to the creek beds that I was hiking on in BC that were filled with slippery, roly-poly rocks, this trail was made up mostly of broken, sharp scree, so my shoes practically stuck to the trail. There were no scary cliff edges. I imagine they call this trail very strenuous because in the heat of summer there would be no break from the sun, which would wear one down. But, we were hiking in October, and the morning was cloudy. We sat out another thundershower in our rain-gear half way through the morning, but after that the weather cleared into a sunny afternoon.

The scenery was simply beautiful. Not only the cliff faces all around us, but also the huge red boulders that dotted the landscape, the black, twisted tree trunks, the cacti, the colour of the soil, which kept changing depending upon what layer of history we were traversing. Even the rocks and small stones were crazy beautiful. You know those rock halves one can buy in gift shops where one side is a collection of crystals? Well, these kinds of rocks were lying on the path! I couldn’t believe what I was seeing. We got to the river about 5h30, set up camp, heated water to pour into our dinner bags, ate, and were in our sleeping bags by 6h30 or 6h45 because it was dark, and there wasn’t anything else to do.

The next day we packed up camp and were on the Beamer trail by 8h30. The trail did not stay low, but rather climbed the cliffs above the river, and involved much going in and out of drainages. This trail was not as obvious, and since one in our party was French Canadian, we were looking for “inukshuks” rather than “cairns”. At about 1 o’clock, we came to a beautiful beach on the Colorado, which became our home for the next two days. It was hot, and we stripped out of our funny-looking safari outfits (we hiked in long pants and long-sleeve shirts to protect us from the vicious cacti, agave, and other thorny vegetation, as well as to protect us from the burning rays of the sun.) and into shorts and T-shirts, and spent a splendid afternoon wading in the ice cold water, doing laundry, and playing in the sand and mud. River rafters joined us on our beach that evening, and offered us food and wine – having already eaten, we enjoyed their wine.

The following day our hope was to make it to the confluence of the Little Colorado. The guidebooks said the trip was long, so we set out early with light packs filled only with food and water. Once again, the trail climbed above the river 50 to 100 feet, and zigzagged in and out of drainages. The drainages looked like big red-rock amphitheatres, complete with a stage and seating, and they were usually shady. I was developing a hot-spot on one of my toes, so we had a shoe-off break so I could apply moleskin. Shoe-off breaks in the shade became a treat. Such a pleasure to be able to wiggle one’s toes around!

We had just come out of another drainage and were rounding a butte above the river, when we saw that the trail ahead of us was right along the edge of the cliff. SCARY! And this bit seemed long! We were stopped in our tracks, not sure what to do. Going forward seemed too dangerous to be worth while, going back seemed to be a shame, so we decided to try and find another way around the butte and meet up with the trail at the next drainage. So we climbed up and over the gently sloping butte, and after picking our way down the drainage, re-found the trail. I’m not sure how long our waffling indecision and detour took, but probably at least an hour. So, we were forced to turn around by about 1 without having reached the confluence, so that we would make it back to our beach before dark. We didn’t want to be walking on the edge of cliffs in the dark!

The following morning we packed up our tents, loaded our packs with filtered Colorado River water, said a regretful goodbye to our lovely beach, and headed back the way we came to Tanner beach, and then up the Tanner trail to Cardenas butte where we were to camp for the night. After dinner I was regretting that I had not packed sandals on this trip, as I was dying to get my hiking shoes off my feet. My fellow trekkers suggested that I take the insoles out of my shoes and put them in my socks! Brilliant idea! My toes were free! I loved my slippers!

We had the tent fly off that night, as it was clear, and there is nothing quite like lying in a sleeping bag looking up at a sky dense with stars. I was wishing I could remember all the constellations my dad taught me as a kid, but all I recognized was the big dipper on the western horizon. At about 1 in the morning, the wind picked up. Not just a little, but a lot. We thought that if we left our tent, the tent would blow away, and we even wondered if the wind would blow us with the tent over the edge of the butte! Happily, with the tarp off, the wind blew through our tent so it didn’t act quite so much like a sail, and it tempered the noise a bit. I don’t remember sleeping much the rest of that night, and packing up the next morning was a hilarious challenge. We took movies of the tent coping with the wind – pretty funny!

The next day we hiked out of the Tanner at roughly noon, and immediately hit the showers at the campground, ’cause phew, did we stink!

Driving to the Nankoweap trail-head on the north rim, we came across a big sign stating that we were entering the Kaibab National Forest, which I found to be particularly funny, as there was not a tree to be seen. Only open land with sage brush. Finally we got to the end of the dirt road, and we repacked our backpacks for the trek to the trail-head. They were predicting snow that night, and a low of 23 degrees, so we attached an extra fleece blanket each to our packs before heading off through what was looking more and more like that North Kaibab forest that the sign had announced. Two hours later we reached the rim, just before sunset. And yes, it was cold! We were decked out in our warmest clothes and jumping around in the dark and singing songs trying to get warm before slipping into our sleeping bags.

We did not wake up to snow, thankfully, but it was definitely chilly. We ate our ziploc bag breakfasts overlooking the north rim and into the beautiful Nankoweap creek basin, and did not take off too many clothes before setting out on our day hike to Marion Point. This trail was very different from the other two we had done – it was very narrow and overgrown in places, different vegetation and a lot more of it, and footing was tricky in places, but it was also breathtakingly beautiful. This was the day that I had fretted the most over before leaving, as there is the famous scary bit where one is stuck between a rock wall and a cliff edge on the way to Marion Point. Falling there would mean certain death. I had decided to take a wait and see attitude, not being sure I would be able to coax myself to do it. But when we got there, somehow it was no problem, even though the path was only about 4 inches wide at the narrowest, and right at that narrow point was a big boulder that stuck out, which meant to pass it we had to turn in to face the cliff. I certainly didn’t enjoy walking that particular 15 feet, but we all managed it twice, as we had to take the same trail back. I honestly think that had we not done the Tanner and the Beamer first, I would not have made it past that point.

The little bit of the Nankoweap that we saw was wild and beautiful, and so unlike the Tanner of the south rim, and the Beamer along the river. Perhaps because the north rim is 1000 feet higher? Perhaps because it falls more steeply to the river? I don’t know. But I can now understand why people who hike the trails are seduced by the Grand Canyon, and yearn to go back. With each trail being so different, affording different kinds of beautiful vistas, it is hard to be satisfied with just hiking one, or two, or three. Let’s just go a little bit further to see what is around the bend …

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Just as many of us need "light therapy" in order to cope with SAD (Seasonal Affective Disorder), I would bet that many more of us actually need "dark therapy", and some of us probably could use a combination of both.  In today’s world, we often don’t spend much time outdoors in the day, and we tend to live by artificial light at night.

Every cell of our body is sensitive to light and darkness, and now that we no longer tend to live according to the rising and setting sun, our health is suffering.

Melatonin, synthesized from the neurotransmitter serotonin and secreted by the pineal gland in the brain, is one of the victims of our current modern lifestyle. It has a big job to do – to help us recuperate from our day, and prepare us for tomorrow.

It is activated by darkness and inhibited by light, so before the invention of the light bulb when we actually lived according to the cycles of daylight and darkness, melatonin had adequate time to get its nightly job done. When it gets dark outside, it is supposed to be “melatonin time”.

Turning on the lights at night and staying up late tricks our body into thinking it is day, keeping the day hormone levels (like cortisol) higher. Then, when we finally go to bed and turn out the lights, melatonin may not have enough time to do its job before daybreak.

And if the bedroom is not completely dark – an outdoor street lamp is shining through the window onto our skin for example, melatonin may not be activated at all.

This is why working night-shift is so devastating to health.  Many scientists believe that inadequate melatonin is a primary cause of many diseases like type 2 diabetes, heart disease and cancer, because then there is nothing to stop the run-away train that too much stress causes in the body.

The light of yang is no longer balanced by the dark of yin hormonally (cortisol / melatonin), in the CNS (sympathetic / parasympathetic), psychologically (stressed / relaxed) and even on a societal level (work / play). Work and productivity are valued highly in our society, whereas people that live a more balanced life are often considered "slackers" or lazy.

Melatonin is a very powerful antioxidant that works in watery as well as fatty environments, and unlike other antioxidants, melatonin is able to cross the blood brain barrier.  So, at night, melatonin’s job is to sop up those free radicals before they do too much damage to other tissues.

Melatonin helps control the menstrual cycle in females, controls estrogen levels (thereby playing a key roll in preventing hormonal cancers like breast, ovarian, uterine and even prostate cancer), and is important in controlling circadian rhythms.

Melatonin is also synthesized by the immune system for its many roles within that system, including enhancing T cell production. Melatonin even seems to be involved in regenerating injured tissue, as seen in this study on rat degenerated intervertebral disks.

Melatonin, among other things, helps us sleep (or is supposed to!)

As someone who has a real problem sleeping, I completely disagree with the advice frequently given to insomniacs to get up, get out of the bedroom and read or do something if one can’t sleep because that would entail turning on a light, which would then shut down melatonin, resulting in less rest and repair happening.

Getting up certainly won’t help you get to sleep! I know from experience what putting in a full day of work feels like after lying in bed awake from 10pm to 7am, but turning on a light I think will just mess up the hormones more. You certainly don’t want to fire up cortisol at 2 in the morning!

Listening to relaxation CDs may be helpful. What helped me enormously when I wasn’t sleeping four out of seven nights for months on end, was listening to the relaxing Insight CD, which lowered my brain waves to delta, so even though I wasn’t sleeping, I was getting some rest. I honestly think that without that CD I would have had to cancel many a work day.

If you suffer from insomnia, it may be very tempting to rely on melatonin supplements to help you sleep. Personally, I think that apart from very occasional use to aid in jet-lag recovery, this is a bad idea because if you are providing external melatonin, your body will sense it in the blood stream and stop producing it.

Over time your pineal gland will shrink, and you may no longer be able to produce your own melatonin, which would leave you stuck taking the supplement for life. Far better to decrease sympathetic load (reduce your stressors), get lots of light during the day, and then lots of dark time at night.

Frequently addressing cortisol circadian-rhythm problems will also make a big difference, as high cortisol levels at night make it pretty hard to sleep! (Small aside, for those of you are keeping track – cortisol does not suppress melatonin, but melatonin does not suppress cortisol either.

That means you can have high cortisol levels when its dark and you are lying awake stressing, but melatonin is not active when it’s light. Therefore, cortisol is still the kingpin, as it is functional 24/7.)

In the winter time especially, our bodies probably need a good 9.5 hours in complete darkness.  No light, TV sets, computers or night lights at all. Get that TV out of the bedroom! 

That does not mean that we must be in bed sleeping for that length of time – dark time can provide an opportunity for meditation, contemplation or listening to music for example. This way it is easier to quiet the mind before trying to sleep.

If in the night you need to use the bathroom, don’t turn on the bathroom light. Use a red night light (not white, blue or green), or a flashlight with a red bulb.

Black-out drapes can make a huge difference to the darkness of a bedroom, or in a pinch you can put foil on the windows. Many people have said that they didn’t realize they were sleeping poorly until they slept in a completely darkened room.

Related Tips
Breast / prostate cancer prevention
Light pollution messes with your hormones
Is going to bed too late making you fat?
The autonomic nervous system and fat loss
Adrenal fatigue

Formby and Wiley; Lights Out! Sugar, Sleep and Survival Books, New York, NY, 2000

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Insulin’s job is to take sugar out of the bloodstream and feed it to the cells which use the sugar as fuel. When there is more sugar in the bloodstream than can be actively used immediately, the sugar is stored as fat for future use in case of starvation.

Insulin also stores protein in muscle cells, so it can be considered an anabolic hormone. And insulin stores magnesium, an important mineral that aids in keeping blood vessels dilated and muscles relaxed.

The bad news is that chronic problems with insulin have DEVASTATING effects on our health, but the good news is that insulin is one of the easiest hormones for us to control.

We have all kinds of hormones that raise blood sugar – cortisol, glucagon, epinephrine, aldesterone etc., but insulin is the ONLY hormone that lowers blood sugar, so our body has no back-up system if insulin stops working. Why would that be, do you think? Does it not strike you as odd that in the fabulous system that is our body there is no back-up system for insulin, when our body tends to have all kinds of fall-back plans if something should fail?

Perhaps it is worth looking at the question through the eyes of primitive humankind. Not having lived at that time I can’t be certain, but I would imagine that there would have been times of limited food, and being able to increase blood sugar levels would have been critically important in order to fuel the body when there was very little or no food being consumed.

Just like many other animals, in the spring and summer when fruit, plants and grains were available, it was advantageous to have insulin store some fat to aid chances of survival through the lean winter months.  Fruit would be dried, and other foods fermented, but especially in the colder climates, people would rely on wild animals or fish for most of their food in the winter. Meat and fat do not induce a big insulin response.

So, perhaps in the body’s wisdom, it did not think it needed more than one method to lower blood sugar, as high carbohydrate (plant food) diets simply did not happen day in day out all year round except possibly in tropical climates.

I think it is very interesting to note that Weston A. Price, who traveled the world examining the diets of primitive cultures before they came in contact with "white man’s food", found NO vegetarian peoples, even in the tropics.  All the cultures he studied had no signs of the chronic diseases that plague our society, (even those that ate extremely high fat diets!) had excellent bone structure, and very few cavities.

Fast forward to today’s world, a blink of the eye in evolutionary time, and suddenly, even in colder climates, we have access to carbohydrate (another word for sugar) all year round in huge quantities, much of it highly processed and far sweeter than would have been consumed in primitive times.

We are being told that eating large amounts of grains in the form of breads and cereals is healthy, and practically every processed food in the supermarket has some form of sugar in it – no wonder our insulin is having trouble coping! It was never meant to deal with this amount of sugar! On top of that, we are told to eat low fat, so there is frequently nothing to slow the sugar into the bloodstream, which makes insulin’s job even harder.

When genetically one’s body is built to handle relatively few carbohydrates, and instead we are eating far more than our body can handle, it is no surprise that disease is a result.  The Inuit are a perfect example.  Having moved away from their traditional diet high in seal blubber, salmon, sea weeds, and cranberries when in season, to a diet high in processed carbohydrate all year round, they are currently dealing with rampant type 2 diabetes. Biochemical individuality plays a huge role in how well our bodies can cope with carbohydrates.

Eating large amounts of high glycemic foods (foods that turn into sugar in the body quickly) is problematic on many fronts. High blood sugar causes large amounts of insulin to be secreted into the blood, and insulin is very hard on the arteries, damaging them, and causing the body to call on cholesterol to try and fix the problem.

High insulin levels also increase blood pressure by increasing sodium retention and increasing sympathetic tone.  High insulin decreases T3 production affecting the job of the thyroid, suppresses glucagon and growth hormone levels, and decreases DHEA levels, which in turn decreases progesterone and testosterone levels.

If insulin levels are chronically high, the body starts ignoring insulin, down-regulating the receptors on the cell surfaces, and now, because insulin is no longer working, blood sugar levels are also too high (insulin resistance or pre-diabetes). High blood sugar also damages arterial walls through glycation creating Advanced Glycation Endproducts increasing arterial inflammation, and once again, cholesterol is summoned to repair the damaged arteries. Frequently the sugar in the blood glycates with cholesterol, making the situation worse. This is how type 2 diabetes and heart disease are linked.

So, insulin has a direct affect on the thyroid hormones, and the sex hormones. Guess what hormone has a direct affect on insulin? You guessed it – cortisol. Cortisol decreases insulin secretion as well as insulin sensitivity, which is logical, because if you are stressed, it is not helpful to have insulin remove the sugar that you need to help you fight or run!

So, if the reason you are stressed is you are sitting in a traffic jam, that increased blood sugar is not being used – it is just damaging your arteries. This is another way stress causes heart disease. As far as I can tell so far, cortisol is the kingpin hormone. I have found no other hormone yet that suppresses cortisol. If I find one, you will be the first to know!  So, decreasing stress levels in order to control cortisol will have the biggest impact on our health, and lowering insulin levels is not far behind!

There are two ways to lower insulin levels:
1) Avoid eating foods that cause a large insulin response, like all products that contain any form of sugar, flour products, starchy below-ground vegetables, and fruit juice. Avoid all processed food. If you are insulin resistant, pre-diabetic or already have type 2 diabetes or heart disease, it may also be a good idea to limit whole grains and fruit for the time being, and eat lots and lots of above-ground, colourful veggies and sea vegetables as your carbohydrate source. Make sure that you add a little quality fat (butter, ghee, olive oil) to your veggies so you can absorb the vitamins and minerals in them.
2) Exercise uses up the sugar in the blood stream so it does not get stored as fat. Resistance exercise or weight training is particularly useful, as it increases insulin-receptor sensitivity. If you set up your weight-training program in a circuit format and move quickly between exercises you will keep your heart-rate up as well, so additional cardiovascular exercise is unnecessary.

Related Tips
Sugar, the disease generator
Blood-sugar regulation
How hormones, neurotransmitters and steroids work
Type 1 diabetes – a new discovery
Another “healthy heart guide” that got it wrong
Food-Guide Fallacy
Cortisol, our stress hormone
Stress and cardiovascular disease

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Interesting how we learn in layers. In my pursuit of understanding as completely as I can how the body works, first I learned how we can develop health complaints by eating the wrong foods, exercising too little or too much, and not getting enough sleep. But the reason our lifestyle is so fundamental to our health is because everything we do – every mouthful of food, every bout of exercise or lack thereof, every thought and emotion we have, as well as how much light or darkness we expose ourselves to has a hormonal consequence in the body.

Because an imbalance in one hormone affects the others, poor lifestyle choices have far-reaching impacts on our systems, and cause widespread, seemingly unrelated symptoms.  For example, we may get insomnia or feel lethargic a lot, we may put on weight and be unable to lose it no matter how much exercise we do, we may become depressed, we may feel too hot or too cold a lot, if female, we may have difficult periods and the worse our hormone balance is the worse our symptoms at menopause.

AND it works the other way! If our hormones are off, we crave particular foods (usually the ones that will make us worse), we are not tired at night so we don’t want to go to bed, we feel down so we start thinking thoughts that bring us further down. If we don’t improve our lifestyle in order to bring our hormones back into balance, over time we may get a disease. So, because of how vital hormone balance is to our health, I have become fascinated by the endocrine system, a topic I found hopelessly boring in physiology class way back when.  I am no expert in this, so any endocrinologists or biochemists out there reading my tips, if you see a mistake please let me know so I can correct it.

We have four endocrine glands that spit out hormones as needed – the thyroid, the pancreas, the ovaries/testes, and the adrenals. The thyroid puts out T4, the pancreas is responsible for insulin, the ovaries and testes give us our sex hormones, and the adrenals put out adrenaline otherwise known as epinephrine, aldesterone and cortisol. After a woman has gone through menopause and the ovaries are out of commission, the adrenals also make estrogen and progesterone although in lesser amounts.

All of these hormones interact with each other, so if one hormone is out of whack it affects the amounts and functions of all the others. The endocrine glands not only communicate amongst themselves, but they also talk to the nervous system and the immune system as was scientifically proven by Dr. Candace Pert and discussed in her book Molecules Of Emotion: The Science Behind Mind-Body Medicine.

Because in my estimation, problems with cortisol are the most common and underlie so many health complaints, I figure it is the best place to start. As I have said in many other tips, cortisol is the hormone that gets secreted when we are under physical, emotional and spiritual stress.

Physical stress includes acute stressors like a car accident or medical emergency, and chronic stressors like constant pain, poor nutrition or food sensitivities, dehydration, too much or too little exercise, too little sleep. Emotional stress is usually chronic and includes stuff like financial stress, relationship stress, work stress, time stress, and spiritual stress may include things like conflicts between one’s religion and one’s sexuality, one’s choice of life-partner (different religion possibly), or one’s occupation.

No matter what the source of stress, cortisol is released into the blood stream to help us cope by increasing sympathetic tone (fight and flight response), and to put sugar into the blood stream so our muscles and brain have the fuel needed to react.

When we look at that list, it becomes pretty obvious why so many of us may have problems with cortisol! Cortisol should be high in the morning, but should subside by evening when our rest and repair system (parasympathetic system) is supposed to take over.

Cholesterol is the base material  from which many of our hormones are made.  Cholesterol gets converted into pregnenalone, which then manufactures cortisol, estrogen, progesterone, DHEA and testosterone.  So, when cortisol is needed to help us cope with stress, cortisol gets prioritized at the expense of the other hormones. Your body figures that if you are under stress, reproduction is not important, so progesterone and DHEA (which builds testosterone) are sacrificed to make cortisol, for example. This causes major PMS symptoms in females, as progesterone is needed to balance estrogen.

Adrenal fatigue eventually occurs if one is under prolonged stress. In Stage 1, cortisol and DHEA levels increase, but if the stressors don’t go away and one moves into Stage 2 adrenal fatigue, cortisol levels remain high, but DHEA becomes depleted. Finally in Stage 3, the adrenals give up. They simply cannot sustain the prolonged need for cortisol, so both cortisol and DHEA levels drop. At this point, one can’t handle much. These people often can’t work, and after one short activity or appointment they are done for the day and have to go home and rest. Frequently the diagnosis of chronic fatigue or fibromyalgia is given.

So can you see that taking sleeping pills to help one sleep, taking Midol to relieve PMS symptoms, taking stimulants like caffeine and sugar to get through the day, Synthroid for low thyroid, or anti-depressants to boost mood may really only be addressing symptoms of problems with cortisol, but not the cause?  By removing various stressors through improving the lifestyle factors described in these tips, one can help the body return to hormonal balance.  Using functional medicine to measure circadian cortisol, DHEA, and sex hormones, interventions can be made to help the body return to homeostasis.

Much of the info in this tip came from Bev Maya, a medical herbalist in the Vancouver area that practices functional medicine.

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In last week’s tip I began a mini-series on the endocrine system by trying to explain the role of cortisol in our bodies, and trying to get across the fact that problems with cortisol, either lack of, too much of, or an inappropriate circadian rhythm, can cause a very wide variety of symptoms because of its interaction and effect on our other hormones.

Because cortisol is the hormone that is released when we are stressed, and considering we have not evolved very much from the time of primitive man when stressful events were almost always life-threatening, our brains prioritize the role of cortisol over the other hormones.

Like I said last week, if you are running from a lion, reproduction, digestion and sleep are not high on the priority list, so why waste the body’s resources on those hormones! Same thing in today’s modern world, except our “acute lion stress” is now chronic work stress, time stress, relationship stress, chronic pain etc.

The body only sees the stress, and figures you don’t need much of the other hormones because cortisol is needed now in order to save your life.

But to be healthy and to function well, we DO need those other hormones. For example, the thyroid hormones are in charge of our metabolism or our energy production, which in turn helps regulate our body temperature. Our body chemistry works best at 37 degrees Celsius or 98.6 degrees Fahrenheit, and if the temperature isn’t right, enzyme and catalyst activity is compromised. Pretty important stuff! 

We hear of people say they have "sluggish thyroids", and frequently they have difficulty controlling their bodyweight.  Or we say "that person has a high metabolism – they can eat absolutely anything and they won’t gain a pound." 

People that know me know that I am always cold. I wear long underwear until about May, and really struggle to stay warm in the winter no matter how many layers of clothes I’m wearing.  I like it hot – 25 to 28 degrees Celsius and I’m happy.  It only occurred to me very recently that maybe I have a thyroid issue.

I have a few of the other symptoms – very dry, scaly skin generally, and "chicken skin" on the upper arms and legs (yuck)!  Other symptoms of thyroid problems include  fatigue, depression, osteoporosis, infertility, muscle weakness, too hot, hair loss, memory problems, constipation, inability to sweat, heart-rate disturbances, increased homocysteine and C-reactive protein levels which are both risk factors for heart disease.

The thyroid gland sits on the front of the neck and secretes calcitonin which is needed for calcium absorption into the bones, which is why impaired thyroid function can lead to osteoporosis.

The thyroid also secretes thyroxine (T4) at the urging of thyroid stimulating hormone (TSH) which comes from the pituitary gland.  T4, the inactive form, is made up of four iodine molecules. It goes to the liver, which through liver enzyme activity, converts it into T3 by dropping an iodine molecule. 

T3 is the active form of thyroid hormone which regulates metabolism and body temperature.  If for some reason the liver does not have enough of the enzymes needed, Reverse T3, another inactive form of T3 is made.

If too little T3 is made, one has hypothyroidism, and if too much is made, one has hyperthyroidism.  Thyroid problems can stem from prioritizing cortisol so T3 does not get made, from inadequate iodine in the diet, or from a liver that is struggling in its detoxification role and can’t make the enzymes necessary to convert T4 to T3. 

The other halogens like chlorine and fluorine have a higher affinity for the iodine receptors than iodine does, so drinking chlorinated and fluoridated water may be responsible for an inability to absorb iodine, and thereby affect thyroid function. Another important reason to filter our water! 

Goitrogens like processed soy and peanuts also block the absorption of iodine.  Omega 6 vegetable oils are usually already rancid when consumed, and the oxidative processes seem to damage enzyme activity, increase inflammation, and block production of thyroid hormone. 

Coconut oil, a medium-chain fatty acid seems to aid thyroid function.  Mercury in the body displaces selenium, which is needed to convert T4 to T3.

To diagnose thyroid issues, the doctor must do more than simply measure Thyroid Stimulating Hormone (TSH), as even if TSH is below 2, thyroid problems may exist.

Request that your doctor also measure free T3 and free T4 levels, as then it is easier to figure out where in the chain the problem is occurring.  It is quite possible that T3 is low and T4 is normal. In this case, the body is unable to convert T4 into T3, so the problem may be due to a liver or an adrenal/cortisol issue. 

Treating with a drug like Synthroid is completely useless in this scenario, as it only provides T4 and does nothing to aid the conversion into T3. Taking one’s temperature 3, 6 and 9 hours after rising for a few days can also be helpful to your physician in determining thyroid problems.

If you are getting your thyroid checked, to me it makes sense to also run a circadian cortisol test, because treating the thyroid if the cause is poor adrenal function is an exercise in futility.

Much of the info in this tip came from Bev Maya, a medical herbalist in the Vancouver area that practices functional medicine.

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Those of you that have been reading my tips for a while may have gotten the idea that I am not a huge fan of western conventional medicine.

I became disillusioned when allopathic medicine was never able to explain why I had stomach aches every day of my life for about 35 years, despite going to doctor after doctor searching for an answer, and having every diagnostic procedure in the book come back clean.

I didn’t think it was normal to get stomach aches every day, occasionally so bad that I had to lie down. Food-sensitivity testing just wasn’t on the radar of the physicians I saw, despite the fact that I told them that most of the time my stomach aches came on during or shortly after a meal.

Conventional medicine is absolutely fantastic at acute care and life-saving emergency care. If one has a heart attack, breaks bones, suffers from wounds or infections, or urgently needs a cancerous tumour removed for example, allopathic medicine is best, because it is excellent at diagnosis of the big stuff.

Imaging and diagnostic technology is amazing these days, and once the diagnosis is made, a life can be saved by quick, appropriate care.

Where conventional medicine falls down in my opinion, is dealing with sub-acute and chronic health problems.

People regularly see their doctor for help with fatigue, aches and pains, depression etc., and usually they leave with a prescription that treats the symptoms complained about, (pain killers, anti-inflammatories, anti-depressants etc.), which is a band-aid solution, but rarely is the actual cause of the problem addressed (what is causing the inflammation?).

People are given a diagnosis of heart disease or arthritis which then dictates a particular treatment protocol, but looking for the underlying causes of why the person developed heart disease or arthritis in the first place does not always happen.

I don’t think that allopathic medicine asks the question "why" enough. You go to the doctor for heartburn, you are given an antacid. But why did you develop heartburn? Is an antacid going to cure the cause of the problem? No.

There are many causes of heart burn, each requiring a different treatment. For some, the stomach is pulled up too high up against the diaphragm and is holding open the valve between the food pipe and the stomach itself, allowing acid to go into the food pipe. (There should be at least 2cm of esophagus (food pipe) below the diaphragm.)

For others, particular foods are a problem. Still others actually have too little stomach acid, and the acid they do have is floating on top of the other stomach juices, splashing up into the food pipe when the valve opens.

Each case above needs a different solution to resolve the heart burn. The first needs to see a visceral therapist that can draw the stomach down so the valve is no longer being held open. The second needs to avoid offending foods, and the third actually needs to supplement meals with betaine, to increase HCL. Antacids and GERD medications do not address the cause of the problem in any of these three cases.

You have toe fungus, you are usually given a topical fungus treatment. But clearly toe fungus is a manifestation of an internal fungal infection that needs to be treated also. The band-aid does not fix the problem, but merely controls the outer manifestations.

And pretty much all drugs have side effects that disrupt other physiological pathways in the body not related to the area being treated, leading to the body further away from homeostasis and to further potential problems.

Treating symptoms rather than causes is not always the fault of the doctors – many patients want quick symptom relief and are looking for a drug to solve their problems rather than exploring further for underlying causes.

There are some physicians however, that are becoming disillusioned with the “treat the symptom/disease rather than the cause” allopathic approach, and they are now practicing Functional Medicine, which is a whole new paradigm for medicine.

Functional Medicine is not considered "alternative" or "complementary", but is a different approach based on sound science to addressing sub-acute and chronic health conditions.  Functional medicine tests for and treats the imbalances in the autonomic control systems of the individual, so the treatment is personalized for the individual rather than based on a treatment protocol for a particular symptom or disease.

Functional Medicine believes that the root cause of all disease can be traced to problems in the digestive, hormone,  immune and/or detoxification systems, which causes chronic stress to our bodies.

Once there is an imbalance or problem in one of the physiological pathways, compensations occur in other physiological pathways in order to try and resolve the problem.

These compensations cause further adjustments in other pathways creating a cascading effect, and eventually over many years if balance is not restored, small aggravating symptoms turn into full blown diseases. Catching the imbalances in homeostasis early enough would therefore likely prevent disease.

For example, if an individual is highly stressed, adrenal fatigue and problems with cortisol may result. Cortisol affects the function of insulin, estrogen, progesterone, testosterone, DHEA, and thyroid among others, so if there is a problem with cortisol, widespread seemingly unrelated symptoms due to dysfunctions in all those other hormone pathways may result.

A simple example of how this can lead to disease is: high cortisol increases blood sugar, which increases insulin levels, which clogs arteries. So a root cause of atherosclerosis may be due to a problem with cortisol.

Another example would be someone that continues to eat a food that he/she is allergic to would cause a destruction of the microvilli in the gut, leading to an inability to absorb nutrition, which would weaken the individual.

Over time due to gut irritation, gaps would open up in the walls of the intestine allowing food particles and pretty much anything else full access to the blood supply and the entire body. This could cause a full-blown immune response and inflammation in the body, and also make the already weakened person very susceptible to illness.

Depending on the symptom presentation of the individual, circadian rhythm hormone tests, mucosal barrier or other GI tests, food-sensitivity tests, immune tests, metabolic tests, heavy metal, chemical toxicity, fungus or parasite tests are ordered, and treatment is based on the results of those tests with the aim of finding homeostasis in the basic physiological pathways that underlie the body’s autonomic control systems.

I am certain that over time once this style of medicine becomes known, more and more doctors will make the switch.  Functional Medicine is great at coaxing the body back to homeostasis, but it requires active participation of the patient in improving lifestyle factors so that homeostasis can be maintained.

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Copyright 2007 Vreni Gurd