Wisdom Wednesday: Female Health Concerns

I attended a seminar last weekend in Miami and thought I would share some of the high points. My chiropractic license requires 40 hours of continuing education every two years. However, my nutritional diplomat requires 12 hours each year. Some of the hours can overlap, but for the most part I take different classes for each requirement. The nutrition classes are by far the more interesting.

The class composition is always quite eclectic when nutrition is the topic. We had MDs, DOs, acupuncture physicians, naturopathic physicians, registered dieticians, a few chiropractors, and some of the staff from the UM School of Medicine. The instructor, Michelle J. Pouliot, ND practices naturopathic medicine in Connecticut. She specializes in women’s issues and over 80% of her practice is comprised of adult females.

The seminar focus was on PMS, perimenopause, menopause, osteoporosis and female sexual issues.

On the surface all these health issues appear to be hormonal and to a great extent they are. Dr. Pouliot frequently uses botanical herbs like Chaste Tree, Black Cohosh, White Peony, and Wild Yam to treat her patients. She is even more enthusiastic about Chaste Tree than I am. However, she also provided great information about the neurological aspects of female health concerns.

The Evolution of Sleep: 700 Million Years of Melatonin

Scientists at the European Molecular Biology Laboratory in Germany study the activity of genes involved in making melatonin and other sleep-related molecules.

They have compared the activity of these genes in vertebrates like us with their activity in a distantly related invertebrate – a marine worm called Platynereis dumerilii.

As 2-day old larvae, these worms float near the ocean surface at night, feeding on algae and other bits of food. Then they spend the day at lower depths, where they can hide from predators and the sun’s ultraviolet rays.

Scientists discovered that cells on the top of the larvae make light catching protein – the same ones we make in our eyes to switch melatonin production on and off. These same cells also switch on genes required to produce melatonin.

They wondered if the worms were using this network of melatonin genes the way we do. To find out, Dr. Maria Antonietta Tosches and her colleagues tracked the activity of the genes over 24-hour periods.

They found that the worms didn’t produce melatonin all the time. Instead, they made it only at night, just like we do. In addition, the scientists found that this nightly surge of melatonin allowed the worms to move up and down in the ocean each day.

The worms travel by beating tiny hairs back and forth. During the day, they rise toward the surface of the ocean. By the time they get there, t he sun has gotten so faint that the worms start making melatonin.

The hormone latches onto the neurons that control the beating hairs and cause them to produce a steady rhythm of electrical bursts. The bursts override the beating, causing the hairs to freeze and the worm to sink. When dawn comes, the worms lose their melatonin and start to swim upward again.

Standard Treatment for Underactive Thyroid Gland Still Best

A expert panel reviewing treatments for hypothyroidism has concluded that the drug levothyroxine (L-T4) should remain the standard of care.

The updated guidelines from the American Thyroid Association were published recently in the journal Thyroid.

The thyroid gland produces hormones that control the way every cell in the body uses energy. For example, thyroid hormones control how fast you burn calories and how fast your heart beats. If the thyroid gland produces too little thyroid hormone to control these activities the condition is called hypothyroidism.

A task force convened by the thyroid association reviewed available medical literature and found no evidence that other types of thyroid hormone replacements are better than L-T4, which has long been the standard of care for patients with hypothyroidism. Brand names for L-T4 include Synthroid and Levoxyl.

However, while L-T4 is effective in most patients, some do not regain ideal health when taking L-T4 alone, the authors noted.

The guidelines “provide useful, up-to-date information on why to treat, including subclinical disease, who to treat, and how to treat hypothyroidism,” Dr. Hossein Gharib, president of the thyroid association, said in a journal news release.

“Information is evidence-based and recommendations are graded. I think they will be used extensively by all clinical endocrinologists, especially by our members,” added Gharib, a professor of medicine at the Mayo Clinic College of Medicine in Rochester, Minn.

Wisdom Wednesday: Ashwaganda

This is the most commonly prescribed herb in my office. I’m surprised that I have waited so long to write about its virtues. Ashwaganda is an Arevedic herb from India. Its use dates back 6,000 years. The name means “to have the strength of a thousand horses”.

In China, the same herb is called Withania. In TCM (traditional Chinese medicine), the herb is prepared as a tea. In India (western herbalogy) the active ingredients are extracted in alcohol over the course of several days. This is very important as alcohol is an organic solvent. Many of the organic compounds in Ashwaganda do not dissolve in hot water but will dissolve in alcohol. So although the names are interchanged frequently, they are not really the same herbal preparation.

Ashwaganda is an herbal adaptogen. Please review my blogs on The Endocrine System and Hidden Adrenal Issues. Adaptogens must be able to restore the adrenal cortex and medulla in addition to facilitating DNA repair. Only a few substances have been found on the planet that are capable of this level of healing and all of them are herbs.

The major components of the Ashwaganda are steroidal compounds and alkaloids. The plant stores these chemicals in the root which is the only part of the plant used in herbal preparations. It has no known interactions but is contraindicated the first trimester of pregnancy as studies with female mice have shown some antifertility effects.

New Clues to How Colds Can Spur Asthma Attacks

Scientists have pinpointed a molecule that may trigger potentially life-threatening asthma attacks brought on by colds.

The researchers say this finding could offer a target for new drugs to be developed to treat these attacks.

Most asthma attacks (80-90%) are caused by viruses that infected the airways, according to the British researchers. Most of these are rhinoviruses which are the main cause of the common cold.

The researchers found that a specific molecule called IL-25 may play a major role in asthma attacks caused by colds. The findings are published in the Oct. 1 issue of Science Translational Medicine.

“Our research has shown for the first time that the cells that line the airways of asthmatics are more prone to producing a small molecule called IL-25, which then appears to trigger a chain of events that causes attacks,” study co-lead author Nathan Bartlett, of the National Heart and Lung Institute at Imperial College London, said in a college news release.

“By targeting this molecule at the top of the cascade, we could potentially discover a much-needed new treatment to control this potentially life-threatening reaction in asthma sufferers,” he added.

Sense of Smell May Predict Longevity

A defective sense of smell appears to be a good predictor of longevity, a new study has found.

Researchers tested a nationally representative sample of 3,005 men and women age 57 to 85 on their ability to identify five smells: rose, leather, orange, fish and peppermint. The study appears online in PLOS One.

They controlled for many factors – age, sex, socioeconomic status, smoking, alcohol intake, education, body mass index, race, hypertension, diabetes, heart attack, emphysema, stroke and diet. But still, people who could not detect the odors were more than three times as likely to die within five years as those who could. The lower their scores on the odor test, the more likely they were to die. Only severe liver damage was a better predictor of death.

The researchers believe that the decline in the ability to smell is an indicator of some other age-related degeneration, and is not itself a cause of death.

The lead author, Dr. Jayant M. Pinto, an associate professor of surgery at the University of Chicago, said that loss of smell should not be ignored. “There are treatable causes of olfactory loss,” he said, “so if people have problems, they should get evaluated. This is a gross indication of your health, so if you’re having some trouble, you should see a doctor.”

Wisdom Wednesday: Visceral Referred Pain

Visceral referred pain (VRP) is an important concept in the evaluation and treatment of patients. In brief, it is a location on the skin of referred pain from an internal organ. Virtually all organs have VRP locations. Even though you may not realize it, you are familiar with some of them.

When someone is having coronary insufficiency or a heart attack, their heart does not hurt. The referred pain (angina) is generally into the left arm but can also include the left chest, mid-back and into the jaw and teeth. In appendicitis, the pain is referred to the skin over the pancreas. Gallbladder problems often refer pain into the right shoulder. When the kidneys are inflamed (think kidney stone) the pain is referred down the sides into the outer aspect of the thighs.

We use these VRPs initially as diagnostic tools. When a new patient comes in with right shoulder pain, the gallbladder is in the differential diagnosis. If they also note right sided abdominal pain late at night, especially after a heavy evening meal, gallbladder moves to the top of the list. Treating the right shoulder as a mechanical issue with manipulation and therapy will often provide good temporary relief. However, the pain will always return if the gallbladder is the real issue.

VRPs are also used in muscle testing challenges. Pinching a VRP stimulates the nociceptors (pain receptors in the nervous system) and stimulates the sympathetic system (fight or flight). Rubbing a VRP stimulates the parasympathetic system (increases digestion, calms everything else).

Challenging a VRP helps locate the source of a health issue. It can also be used to temporarily negate a reflex. If, for example, I find a histamine response to wheat sensitivity has an active VRP to the small intestine, I can stimulate the VRP, temporarily shutting the reflex off. This allows me to move forward in the QA (Quintessential Applications) protocol. Otherwise, I would have to wait weeks or even months until the histamine issue was resolved to test further.