Managing Multiple Disorders in One Body

Managing Multiple Disorders in One Body

Women with PCOS exhibit a very high degree of medical complexity, including dysfunctions of key metabolic and immune mechanisms, affecting a wide range of organ systems. Such dysfunctions can manifest as multiple disorders in one body! Identifying the root causes and common conditions that weave their way through these multiple disorders will facilitate finding a unifying remedy, and eventually a cure, for PCOS and its related conditions.

By understanding how foundational dysfunctions develop and then lead to a myriad of manifestations, we can take those crucial first steps. Conditions found at higher rates in PCOS women than in the general population includeautoimmune thyroid disease (Hashimoto’s Thyroiditis), endometriosis, uterine fibroids (leiomyomata), adenomyosis (uterine lining glands within the muscle of the uterus), and several cancers.

Are women with PCOS simply unlucky to have so many medical maladies in one body, or is there a common theme to explain this? Once you delve beneath the surface, you come to recognize that all of these conditions have similar underlying mechanisms. Uniting all of them are the following: an abnormally functioning immune system, marked by chronic inflammation with elevations of inflammatory signaling agents called inflammatory cytokines, early age exposures to environmental toxicants (chemical endocrine disruptors), nutritional deficiencies, and gut microbiome abnormalities (dysbiosis). The ultimate unifying and underlying cause for all of these maladies in PCOS women is a foundational hormonalproblem: a major dysfunction of estrogen and its receptors, including its production and metabolic degradation. Estrogen is the master hormone, essential for metabolic health,and this requires a properly regulated immune system.  Sadly, PCOS women do not have proper metabolic or immune health.

Let’s begin with a quick overview of the conditions mentioned above. Endometriosis involves a severe localized inflammation in the pelvis, with high levels of inflammatory cytokines within the intra-abdominal (peritoneal) fluid. Interestingly, most menstruating women have some uterine contents flow backwards with each menses, with fluids and tissue passing through and out the Fallopian Tubes. The body’s immune system normally dissolves and gobbles up that tissue, but in women with endometriosis, this process malfunctions, and little holes in the lining of the pelvis (the peritoneum) are created, allowing living cells from the uterine lining to implant and thrive.

This process is controlled by a system of enzymes, called Matrix Metalloproteinases (which remodel tissue) along with immune cells of the body. These cells and processes are under the control of estrogen, which in PCOS women is not functioning correctly. One type of theseimmune cells – the Mast Cell, which isalso controlled by estrogen – accumulates within the pelvis of women with endometriosis, releasingmassive quantities of inflammatory cytokines and chemokines (signaling agents which call other inflammatory white blood cells to the scene.) Thiscreates and sustainslocalized inflammation, promotinglocal estrogen production, and further stimulating growth of the ectopic endometrial cells.

In the case of uterine fibroids, malfunctioning Matrix Metalloproteinases and abnormal local production of estrogen and progesterone cause the muscle cells of the uterus to grow abnormally, creating muscle tumors – fibroids (leiomyomata). Likewise, adenomyosis involves the dysfunction of both the Matrix Metalloproteinases and of estrogen, resulting in the invasion of the endometrial (lining) cells into the muscle of the uterus.

Hashimoto’s Thyroiditis, an autoimmune disease, also involves dysfunction of the immune system, gut dysbiosis,and impaired gut permeability (leaky gut), all related to abnormal estrogen function. Lastly, cancer, the ultimate immune dysfunction, involves uncontrolled inflammation and estrogen malfunction or deficiency. Not surprisingly, the incidence of many cancers is substantially higher in women with estrogen dysfunctions – PCOS, adenomyosis, fibroids, and endometriosis – compared with the rest of the female population.

And what connects PCOS with those other conditions? What is the root cause of PCOS? We now understand that it involves chronic inflammation, gut dysbiosis, and leaky gut;and that estrogen malfunction is at the root of those problems. The cause for this estrogen malfunction involves exposures to endocrine disrupting chemicals at critical points of development – in utero, during infancy, and at puberty, in genetically susceptible women. This inflammatory state is exacerbated by continued chemical exposures and the consumption of a high fat/high sugar diet, filled with processed foods.

Despite all of this, there is substantial reason for hope. A fiber rich diet, stress control, exercise, timed eating and periodic fasting, along with the judicious use of bioidentical hormones, can ameliorate these problems. More on my PCOS protocols for health will be forthcoming in future articles.

References:
Nielsen NM et al. Hum Reprod. 2011;26(6):1555-9
Smarr MM et al. FertilSteril. 2016 Jul 15. Soo15-0282(16)61389-4
Khoufache et al. Minerva Endocrinol. 2012;37(1):75-92
Burney et al. Fert and Steril, 2012;98(3):511-19
Konno et al. Human Cell. 2003;16(3):144-49
Cuevas et al. Reprod Sci.2012;19(8):851-62
Theoharides.ExpDermatol. 2017
Nat Rev Immunol. 2010
Hart, David. 2015. Intern J of Inflam. 2012;452095
Urb et al. PLOS Pathog. 2012;8(4)
Abraham et al. Nat Rev Immunol. 2010;10(6):440-52
Menzies et al. Hum Reprod Update. 2011;17:383-96
Binda et al. ExpOpin on Ther Targets. 2017;21(1)67-75
Vliagoftis et al. Immunol Rev. 2005; 206:190-203
Qiao et al. Blood. 2006;107:610-18
Plos Pathog.2012;8(4):e1002619
Alvarez et al. Neuroscience. 2014;258:111-120
Hart, David. 2015. Intern J of Inflam. 2012;452095
Bulun et al. SmeRepr Med 2004;22(1):45
Sharpe-Timms et al. Ann NY Acad Sci.2002;955:147-56
Smarr MM et al. FertilSteril. 2016 Jul 15. Soo15-0282(16)61389-4
Bayoglu et al. Eur J Ob GynReprod Biol. 2015;184:1-6
Ozcan et al. GyncolEndocrinol. 2015;31(3):219-24
Yavuzetal.J Cancer Res Ther. 2014;10(2):324-9
Cao et al. Evid Based Complement Alternat Med. 2014;781684
Wang et al. Angiogenesis. 2013;16(1):59-69
Ricci et al. Hum Reprod. 2013;28(1):178-88
Xu et al. FertilSteril. 2011;96(4);1021-8
Jackson et al. Hum Reprod. 2005;20:2014-20
Halpam et al. Rev Assoc Med Bras 2015;61(6)519-23
Agostinis et al. Mediators Inflamm. 2015; 918089
Mojzis J et al. Pharmacol Res 2008. 57(4):259-65
Maia et al. Int J of Women’s Health;2012;4:61-65
Kim KA et al. PLOS one. 2012;7(10):47713
Heard ME et al. Endocrinology. 2016 Jul;157(7):2870-82

Eating fresh vegetables and oils help reduce risk of cardiovascular disease

Eating Fresh Vegetables and oils help reduce the risk of cardiovascular disease

A recent edition of the Journal of the American Heart Association stated that eating healthy fats lowers the risk of a cardiovascular event just as much as the use of statins does .

In most cases, I do not recommend statins, particularly for women with no history of a cardiovascular event, such as a heart attack or a stroke. There are definite downsides to the use of statins, including muscle pain, increased risks of diabetes and dementia, and rarely muscle breakdown – a condition known as rhabdomyolysis. That event can lead to renal failure and permanent kidney damage.

However, no such risks occur with eating fresh vegetables and their oils. I’d like to make a plea, however, to refrain from buying non-organic oils or oils chemically extracted. Only organic expeller-pressed oils should be eaten … or better yet … eat the whole food … like whole olives! I am a big believer in whole foods, so even oils are second-rate compared with the entire food entity, which has all the wonderful fiber and nutrients still within it!

It’s great to see a published article in a mainstream journal extol the benefits of food, and compare favorably the benefits of eating food with a pharmaceutical!! Hooray!!

Reference:Replacing Saturated Fats With Healthy Fats Lowers CVD Risk

Depression Improved with Diet and Lifestyle Changes

Depression Improved with Diet and Lifestyle Changes

A True Story

Today I met with a patient whose 17-year old son had been diagnosed with depression. When we’d last met, his son had been seen by a psychiatrist who determined from a short visit that he required treatment with an antidepressant. As none of the SSRI drugs ultimately worked, it was next decided to give tricyclics a try.

They were unsatisfactory as well and so atypical antipsychotics were begun.

On that regime, the son rapidly gained 45 pounds! These are very toxic drugs! And to make matters worse, he didn’t improve! And on that note, I happened to meet with my friend, the Dad.

I informed him that much data exists that depression can greatly be improved with the implementation of a healthy, plant-based diet and lifestyle changes. I recommended that his life activities be scheduled and adhered to every day.

The boy was sent to a wilderness camp for 2 months and he was weaned off the meds. He lost over 40 pounds and began to feel energy and joy again. He ate “real” food and hiked miles each day, in beautiful nature.

Back home again, he has continued to exercise daily and avoids all processed foods and sugars. He watches little television and isn’t on the computer too much. He’s doing well in school, has lost another 5 pounds, and has a fabulous relationship with his dad.

Yes … the brain needs proper care and nurturing!! Give it sunlight, proper nourishment, exercise, a loving environment with purpose … and it will thrive!! The epidemic of psychiatric illness is greatly impacted by our awful lifestyles, chemical food devoid of nutrients, sedentary existences, lack of human contact, a world of electrical devices, and poor sleep! These are modifiable factors and once things are placed in the right … the brain can recover!

This story so resonated with me that I felt the need to share it with you! This applies to children and adults with ADHD as well. Mental health isn’t an option to having a good life – it is life itself!