The Link: Anxiety, Depression, Hot Flashes, and Hormones

This BLOG will be very popular, I can guarantee.  Why?  Because anxiety, panic attacks, and depression are so common to hear about in our society today and I see the prescriptions for antidepressants and anti-anxiety growing like never before.   These are such common concerns for me to hear in my consultations with women as they come in seeking answers for what they think might be hormonal imbalance.  It's interesting to me now after all of these years in this field, that even psychiatrists and psychologists are referring patients for hormone evaluations in addition to general practitioners and OB/Gyn's.  That's a good thing and I hope you see why after reading this article.

So that you can relate, I will give you a scenario that might help you understand the link of anxiety, panic attacks, and depression to hormone imbalance. 

53 year old Sue suffered from anxiety and panic attacks and had been prescribed Valium, Effexor, and Wellbutrin throughout the years by her primary care doctor. This "mix" of medicines was causing side effects so she stopped taking them. (Thankfully not immediately which is never a good thing to do if you are taking antidepressants).  A couple of years ago she went through menopause and started noticing that the anxiety attacks were precipitating hot flashes.  Sue tested her hormones and it was obvious that her estrogen and progesterone was low.  Her symptoms were promptly relieved with bio-identical hormone therapy.  It wasn't enough just to do that though, Sue needed some vitamin and mineral guidance and was started on B12 and magnesium supplements along with some other menopause busting naturals to provide restoration and balance in the whole.  Six weeks later she was sleeping better, her anxiety was virtually non-existent, and she reported better clarity of mind.  Oh, and her night sweats and hot flashes had resolved as well.  Sue was a new woman!

A study published in 2005 Menopause reported that anxiety is STRONGLY associated with menopausal hot flashes, and usually precedes the hot flash episode.  Numerous articles summarize the medical literature showing that low estrogen and progesterone levels cause anxiety and depression in humans. 

How does estrogen help?  What is the mechanism?
Estrogen receptors have been found in the brain, and estrogen increases the expression of an enzyme called tryptophan hydroxylase-2.  This enzyme converts tryptophan to SEROTONIN, an important neurotransmitter which has an anti-anxiety and calming effect in the brain.  It also helps with mood stabilization and is the magic neurotransmitter that is restored through most prescription anti-depressants.  Long story short, the serotonin can often be reestablished in the brain by using bio-identical hormones and natural supplements instead of heading directly into the medical chart with a diagnosis of depression and anxiety.  Estrogen makes things happen in the brain. 

How does progesterone help?  Progesterone helps to stimulate the GABA receptor in the brain.  It's a calming neurotransmitter and is always under suspicion by me when a person says they don't sleep well and they are anxious all the time.  Progesterone also converts to estrogen which can provide an additional benefit in restoring states of estrogen deficiency. 

Each person I meet is at a different stage in their life, they have different concerns and symptoms, and often need different approaches to their care.  Whether it's a young woman struggling with horrible PMS, a "40 something" woman struggling with depression, or a post-menopausal woman struggling with anxiety, the approach is the same.  They each need to have their hormones evaluated. 

The testing is simple and affordable, can be done from your own home, and is strongly recommended if you can relate to any part of this post.  I love helping people in this area of medicine, in case you haven't noticed.(smile)  I also love helping myself, because hey, I'm an aging woman just like everyone else and I practice what I preach.  I'm fielding calls from all over the U.S. these days which is exciting to see.  Hormones are getting a lot of attention and I think we are turning the corner in the traditional healthcare model.  Hopefully when you go in to discuss this with your personal physician, you will get the attention you deserve on this topic.   A pat answer of "oh, you're just getting older" or "oh, everything is normal" should never be accepted when you know there is something more significant going on inside your body. 

Please don't hesitate to call me or my staff if you want more information on how to test your hormones  and how to get treated.


To your good health,
Dr. Sonja

Is It All In Your Head?

Read these health concerns and if you notice anything that affects you personally, read on.  If not, then have a great day and archive this BLOG in your records for later or pass it along to a struggling friend.   The mind truly is a beautiful thing, WHEN it operates properly.  You'll see what I mean.

Do you suffer from?
Poor sleep, Fatigue, Anxiety, Low Mood, Attention Difficulties, Restless Leg Syndrome, Excess Energy, Cravings, Intestinal Complaints, Poor Cognitive Function, Weight Management Difficulties, Excess Stress, Headaches, or Immune Issues.   Then let me tell you, the answer to your health concerns truly could be ALL IN YOUR HEAD!!


One of the greatest areas of interest in my studies throughout the years has been the neurological and psychological aspects of health and wellness and their connection to each other.  Depression, Schizophrenia, Parkinsons, Bipolar Disorder, Attention Deficit, and other neurotransmitter mediated disorders are fascinating to me.  And not only "diagnosis" driven interests, but also just the everyday things that people struggle with (like those listed above).  The mapping of the brain, the production or lack of neurotransmitters, and the influence of cofactors (vitamins/enzymes/genetics) ALL play in to the connection of your mind to your body.  So much that I have been absolutely determined to find a way to truly test what people have been expressing to me in my office all of these years.  Read on and you'll understand why. 

See where you fit in terms of how YOUR brain is wired.  There are 4 major neurotransmitters that make us who we are. Literally! 

1. Acetylcholine (brain speed) People: This defines about 17% of the worlds population.  You are more likely adept at working with your senses and viewing the world in sensory terms.  You are creative, a quick thinker, have great intuition, and often sociable and charismatic.

2.  Dopamine (brain power) People:  Also 17% of the worlds population.  You tend to be confident, extremely rational, enjoy facts and figures more than emotions and feelings, and have a very driven personality. 

3.  GABA (brain rhythm) People: Almost 50% of the worlds population, thank goodness.  (smile) You are most likely a very stable person, very traditional, a team player, very dependable, and calm most of the time.

4.  Serotonin (brain mood and synchrony) People: 17% of people who really know how to enjoy themselves.  You know how to live in the moment, are very receptive to stimuli, you are in touch with your mind and body, and often described as cheerful and the "life of the party".

Poor self care, demanding lifestyles, and poor eating habits, stress, hormones, and traumatic life events can short circuit your system causing you to say, I wish I could just get back to "myself".  In the traditional healthcare model, it seems that physicians and practitioners are forced to shoot in the dark in terms of identifying what the brain needs to reset. Well, there's good news for those that have STRUGGLED (maybe for years) with no significant improvement.  Why are you not sleeping?  Why are you anxious?  Why can't your child pay attention?  Why is your stomach always nervous and upset?    I can provide and at-home testing kit that is non-invasive and specific for brain chemistry and neurotransmitters that cause these problems listed above.  And look at this simple chart and the impact of neurotransmitters on the brain and body.

Neurotransmitter testing can be done from the convenience of your own home, is covered by many healthcare insurance plans, but is also affordable for those without insurance.  It's a WIN/WIN/WIN.  When I discovered this technology, I immediately educated myself and signed up as a healthcare provider to be able to offer this to those wanting to know the true reason for their problems.  I have seen men and women struggle to sleep for months, and years, which ages them so rapidly and affects EVERY aspect of their life.  Although anti-depressants, sedatives, and natural products may help as a band-aid treatment for the short term, it makes sense to me, and hopefully to you, that testing the problem neurotransmitter is the better way to know how to approach things.  This is also why prescribers are excited about this too.  It will help them to know what specific therapy regimen to offer their patients in helping the brain and the body to reset.

These are some of the neurotransmitters that can be tested using your "At-Home" Kit.
Serotonin, Taurine, GABA, Glutamate, Histamine, PEA, Norepinephrine, Epinephrine, Histamine, Glycine, Melatonin (saliva), and Dopamine. 

Did you know that certain vitamins are required for neurotransmitters to be synthesized in the brain? It's true.  There are key vitamins that are critical in getting the problem neurotransmitter back to it's normal level.   Without the vitamin co-factor, the process of brain restoration will be hindered.  Quite simply, fixing one part without the other, is not going to produce the best results.  I know the metabolic cascades and schematics and can suggest certain supplements and nutritionals to compliment the missing parts to restore wholeness to the brains chemistry. 

This is an exciting BLOG post because it will help so many in the process to feeling better.  If you would like more information on getting neurotransmitter testing, please give me a call.

This changes EVERYthing!

To your good health,
Dr. Sonja

Are You Hungry or Thirsty? Mixed Signals

The only reason some people eat is because their satisfaction centers are begging for attention all the time.  But sometimes, the appetite centers want something to quench thirst, NOT to fill the stomach.  Hunger signals can be caused by hormones in the gut especially when ghrelin outslugs leptin and you feel hungrier than a bear on a bug-only diet.  BTW, that's not good for the bear or anyone hunting in the woods at that moment.  In this case, it's great to develop and have at your disposal (no pun intended), a list of emergency foods to satisfy your senses.  V8 juice, a handful of nuts, pieces of low sugar fruit, cut up vegetables, or a protein shake can combat the bear binges when they strike. 

Another great way to counteract your hormonal reaction to food is to make sure that your satiety "signal" isn't just a thirst sensor.  To find out and just as a good practice for weight loss and maintenance, it's good to drink water before you ever put food into your mouth.  People who do this tend to eat less and find the satisfaction they need without overloading their stomach unnecessarily.  Sugar drinks, for thirst, aren't the answer nor are artificially sweetened "diet" drinks loaded with chemicals that are actually now being linked to endocrine disorders and diseases.  One thing that causes blood sugar to spike is, uh, SUGAR-not eaten with any other substances like fat or protein around it.  If you are going to eat a small amount of sugar, you should always be sure NOT to eat that candy bar or cookie dough by itself. Have a handful of nuts to slow your stomach from emptying as quickly which will keep sugar levels from creating such a significant spike in your blood.

Strategies:
Eat foods with fiber, healthy fats, whole-grain carbs and protein, as well as fruits and vegetables.  (Be careful, some fruits have a lot of sugar)
Eat a little healthy fat before your meal (handful of nuts-6 walnut halves, 12 almonds, 20 peanuts) and pause for 25 minutes to allow the hunger signal to get from your brain to your stomach. 
Eat anti-inflammatory foods such as green tea, omega 3's (fish, canola oil, flax seeds, walnuts), coffee, vegetables and fruit, to help counteract the effects of obesity.
Drink a glass or two of water before you eat.
Certain supplements and vitamins have been shown to aid in waist-management.  Check out my blog titled Fables on Labels for key weight busters.

The 6 pounds in 6 weeks challenge is off to a great start.  The weigh in's this morning are showing tremendous loss in those that are engaged in this initiative.  Hey, and did you see the TV news highlighting this program?  Very cool! Yeah!!! 

Reminder: We will be weighing anyone in the program who wants to track their week 2 progress this week.  Get here!!

To your good health,
Dr. Sonja

Sticker Shock?

The label on a food product should be read as closely as if you were buying a new car and looking for all of the options.  Or, in the case of weight loss, you're probably looking for something without some of the options.   Here's a few things to watch for to make sure your body runs at peak performance .

Don't eat anything that has these things as one of the top 5 ingredients:

1) Simple Sugars
2) Any grain but 100% whole grains including those buzz terms enriched, bleached, or refined.  These are often indicators that the nutrients have been stripped.
3)  Syrup: Those four letter words High Fructose Corn Syrup can be found in a lot of things
4) "Artificial" Sweeteners.  Poison I tell you.  You can do your homework for yourself, but I feel very strongly that these sweeteners are a bad idea.   I wrote a blog on Splenda and you can check it out in the BLOG archives.

Putting these things into your body is like dunking a cell phone into a glass of water.  It will cause all of your systems to short circuit and send confusing messages about energy levels to other parts of your body.  When typical and slightly overweight people eat sugar, they store 5 percent as "readily available" energy for use later.  They metabolize about 60%.  But, heres the kicker, they tend to store 35% as FAT that can be converted to energy later if there's a situation of restriction of food or water.

Stay Tuned!  More tips are coming to help you lose those 6 pounds in 6 weeks.

To your good health,
Dr. Sonja 

Weight Loss and Hormones-Suzanne Somers Weighs In

Why Bioidentical Hormones Are Best

When I hit my 40s, I had three years of frustrating, unexplained weight gain that no one seemed to understand. “It can’t be menopause,” I thought, “I’m only 40! But it sure seems like my thighs are growing.” Come to think of it, once I hit my 40s I wasn’t very interested in sex either. When did that happen? I had always loved it!What did happen when I hit 40? A one-two punch: The changing toxic planet took its toll along with my declining hormones — a lethal combination if you are trying to stay thin. Declines in levels of hormones start early now, often in the mid- to late 30s, with some lucky people making it to their 40s intact. But eventually we all get there. Did I make that connection? No! I suffered through another ten years before I understood; and during three of those years life would be a living hell due to dramatic symptoms of declining hormones. My life now is much different: I’m at a healthy, happy weight. I enjoy a robust sex life. I sleep eight hours nightly. And while I avoid chemicals in my home and eat organic food, none of this good feeling would be possible without natural bioidentical hormone replacement therapy (BHRT).
Why bioidenticals? All methods of hormone replacement aren’t created equal — and the most conventional treatments may put you at greater risk for serious health issues down the line. Bioidenticals, which are crafted in the lab from material derived from yam or soy to be as identical as possible to the hormones your own body produces, are often considered the gold standard of treatment explains why it’s the gold standard. Here’s why:

• Synthetic hormone replacement treatment (standard in the US) may be linked to a cancer risk. Studies showed that women who had received estrogen replacement in the form of Premarin, an estrogen that’s derived from a pregnant horse’s urine (and that is not identical to the estrogen a female body produces), had an increased risk of breast cancer., the study participants were given doses of Premarin, an estrogen that’s derived from a pregnant horse’s urine — and that is not identical to the estrogen a female body produces. Bioidentical estrogen has not been shown to have the same risks as the horse-derived estrogens.
• Bioidentical hormones can promote weight loss. While standard hormone replacement treatment may actually cause you to gain weight, especially around your abdomen, using bioidenticals may actually help you lose weight.

Dr. Sonja's two cents:

I've seen many patients throughout the years lose weight by just getting their hormones reset.  You can read personal blogs on my page of some of the success stories for yourself. 

We customize Bio-identical Hormone Replacement Therapies all day, everyday.    After reading this blog and Suzanne's information, you might consider getting your hormones checked if you are nearing the "40 year" dash and have had some weight creeping up on you with no change in your activity level or eating habits.  Getting things evaluated from the inside-out can help you manage the battle of the bulge for the long haul.  It's better to address a few pounds rather than waiting for the problem to go away on it's own.  I promise you, it won't.  Hormone imbalance and weight gain is an issue for both men and women. 

Enjoy your day!

To your good health,
Dr. Sonja
 

Secrets of Thin People

In honor of our community wide weight loss initiative, I will be posting some tips and tricks to help you lose weight in a healthy and positive way.  I'm a very practical person by nature,  so I often try to share my experiences and advice in ways that you can digest too. (no pun intended on the topic of weight loss)  Smile!!

It's been a FANTASTIC kick-off this morning with people signing up to get started.  And maybe I should explain that to start the FREE program, we simply need to get you on the scale to record your beginning weight THIS WEEK.  We are also calculating your BMI to determine your level of obesity.  Both weight and BMI are equally important markers in the weight loss realm.  I also wrote a blog on calculating your BMR and posted it again today so you can determine a calorie intake target.  BMR, what's that? That's your Basal Metabolic Rate, or simply, the rate at which you burn calories without doing much of anything different from your normal routine.  If you cut your calorie intake regularly from your BMR, you will lose weight. These calculators are also available online through various websites if you want to simply google the search terms and key in your values.

Today, I'll give you the secrets of those that are effortlessly thin.  Practice these common behaviors to get the scale moving in the right direction for yourself. 

Here we go..... TOP 10 Secrets of Thin People!!

1.  They don't diet.  Repeat!!  They DON'T diet!  Simply reassess what you eat.  Go on an EDIT and not a DIET.  Reduce the bad stuff and add the good stuff. You know this, but applying it is the key.

2.  They keep track of their weight.  Get on the scale regularly to keep a handle on your progress. 2 pounds is easier to catch than 10. 


3.  They exercise regularly.  5 days a week x 30 minutes.  Get up off that thing!!

4.  They don't solve problems with food.  Pay attention all stress eaters.  Food is not medicine and it's not a good coping mechanism. 

5.  They stop eating when they're full.  You don't have to clean your plate, contrary to what your mother taught you growing up.  Sorry Mom!

6.  They allow themselves treats.  If you lose two pounds in a week, have the hersheys kiss or scoop of sherbert.  But don't have the triple large, chocolate fudge, brownie batter, oreo yabadaba doo with a cherry on top.  Control the rewards, but do incorporate them. 

7. They don't surround themselves with temptation.  Go home and do a pantry inspection.  What you have in stock is what you'll eat.  And by all means don't bring it to your office for everyone else to indulge in.  This is a group initiative and we're all in this together.  No sabatoge!

8.  They eat breakfast.  Now this is one of those that I think needs some explanation.  For some breakfast is 7am, and for others like me, it's around 10 am.  Do start off your day with a good start of protein and fruit.  It will keep you going longer.

9.  They move, stand, and fidget more.  Now I love this one because it gives allowance for my personality and behaviors.  I'm a toe tapper, finger tapper, and on high gear most of the time.  I don't sit in one place very long.  If fact, research shows us that people who are lean tend to sit for 2 hours less each day than their overweight friends.  If you are a desk junkie, again, get up off that thing!! 

10.  They don't skip meals.  Here's what happens if you skip meals.  You do great at the beginning of the day and then supper time comes and you eat everything in your path.  Then, because you've denied the hunger pangs for so long, the appetite intensifies and continues throughout the evening hours.  That's a really bad time to overload your stomach.  Eat little meals throughout the day to keep the furnace burning.  I tend to always have a piece of healthy food near me at all times, just in case. 

This is a great thing GOING DOWN in our community.  And I feel so compelled by this initiative that I opened it up to all of our social media followers.  If you want to join and share your starting weight, I'm more than happy to record your progress each week and coach you to success.  We are so happy to partner with you in helping you to look better, live better, and feel better. 

To your good health,
Dr. Sonja

Men, Give High Priority to Low Testosterone Levels

Men, (or woman reading this blog for your man), I couldn't help but share some of the most recent information we have in the medical community related to low testosterone levels in men and the long term impact of not treating this growing problem.  I say growing problem because experts agree that low testosterone production, which characteristically occurs after age 65, IS NOW OCCURRING in men in their late 40s and early 50s.  I've asked a few colleagues why they think that is the case, and stress, poor diet, and unhealthy lifestyles seem to be the usual response. 

So, what are the signs and symptoms of low testosterone?  Sexual and reproductive dysfunction, mood and concentration impairment, low energy and fatigue, irritability, and sleep disturbances are a few of the major complaints you will hear from a man that needs his testosterone checked.  Left unchecked and untreated, studies now tell us that diabetes, high cholesterol, increased weight gain, and loss of muscle mass and bone density can all occur in men ignoring the signs of low testosterone for the long haul. 

One expert, Martin M. Miner MD, points out one reason that serum testosterone is the best marker of a man's health is because of it's bi-diretional relationship to glucose intolerance, increased weight circumference, high blood pressure, and low HDL cholesterol and that testosterone deficiency could be due to stress, depression, sleep deprivation, and sleep apnea. A recent article I read stated emphatically that EVERY diabetic male is also Testosterone deficient.  In 2006, a study demonstrated that men with low levels of T in the morning versus men with normal T levels, were at a significantly higher risk of all-cause mortality over the next 8 years.  Many other studies have also validated this finding. 

What about prostate cancer risk?  Again the experts and the literature support that there is NO evidence that testosterone causes a prostate cancer flair. The prostate gland takes in a certain amount of Testosterone, and after that it doesn't need or use any more.  Those with active or prior prostate cancers should discuss things carefully with their physician, but I can verify that we have former prostate cancers patients in our care that are doing great with testosterone therapy.  The marker that is most important with Testosterone therapy is Hematocrit.  Patients with a hematocrit >50% should have discussions with their physician about risk versus benefit before starting Testosterone therapy and, if started, it should be monitored regularly. 

What is the best way to take Testosterone therapy?  In my opinion testosterone gels are the best.  Why?  First, because they are simple to apply and use and they don't require you to give yourself a shot.  But secondly, and more importantly, because they don't seem to cause the elevated hematocrit that can sometimes happen with other administration methods.  Hematocrit can be elevated with pellet and injection therapies but has not been a problem with the gels. 

Testosterone replacement is a life changer! Here's a few study supported reasons why. 

~Subjects with low testosterone were more than twice as likely to have Obstructive Sleep Apnea as those with normal production.

~After following 130 men on T therapy for nearly 5 years, weight loss, reduction in Body Mass Index, and reduction in waist circumference were all realized.  Their glucose, cholesterol, blood pressures, and triglycerides also showed significant improvement dropping from 56% to 30% in metabolic syndrome markers.  WOW!!! 

~ 155 men with the lowest testosterone at study start appeared to experience the greatest numeric improvement in sexual dysfunction with testosterone therapy. 

~Testosterone levels are linked to regulation of mood. There was a study specifically designed to assess depression scales amongst men with low testosterone.  At the end of the study with 17% having severe depression at the study start, only 2% had this same problem at the end of 12 months on testosterone therapy.  Mens health experts now suggest that testosterone levels be evaluated for men experiencing depression and alterations in mood.

So how do I get my Testosterone level checked? Call you doctor and plan a laboratory evaluation.  Or more simply, call our office (417-231-4544) and ask for a testing kit to be shipped to your home.   When your levels come back, I will call you and provide a written assessment of a treatment plan for you individually.  And remember, when natural supplements and lifestyle changes can be the answer, that's what I suggest EVERY time.

I think the evidence weighs in heavily that testosterone evaluation should be a HIGH priority on a mens health evaluation.  I suggest that any male over the age of 45 get his testosterone checked, and especially, if any of these problems noted in this blog are of personal concern.  Remember issues of blood pressure, sexual dysfunction, poor moor, decreased stamina, high cholesterol, and high blood sugar all point in the direction of low testosterone.  Don't let this KEY assessment be missed in your personal evaluation with your provider. This is all good advice to prevent future disease and to improve quality of life.

We have more and more men coming to us these days because they simply feel better, live better, and look better when this problem is discovered and treated appropriately. 


To your good health,
Dr. Sonja