Archive for June, 2010

The Estrogen/Thyroid Connection

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Having a Functional Endocrinology based practice I often focus on disorders pertaining to sexual function so I want to describe to you a rather obscure tidbit pertaining to estrogen and its relationship to thyroid function. Low thyroid function is something that I talk a lot about because it affects a great many people whether they know it or not. Indeed the thyroid gland is very misunderstood and is certainly mistreated through the mainstream approach. But the thyroid gland itself aside, this article is focused on how thyroid hormone activity (not thyroid hormone production) can be hindered due to imbalances in the sex hormone estrogen.

When looking at thyroid hormones, or any hormones really, it is important to differentiate between the protein bound and free forms of the hormone. When a hormone is created by a gland it is immediately bound up with a carrier protein who’s job it is to get that hormone to where it needs to go without being destroyed or lost along the way. Once the hormone is where it needs to be that carrier protein is removed and the hormone is “free” to do its job. That is why these hormones are called “free fraction” or “free hormones.”

In the case of thyroid hormones there is a specific carrier protein called Thyroid Binding Globulin. It just so happens that when there are elevated levels of estrogen the amount of Thyroid Binding Globulin in the blood also goes up. This increased number of binding proteins hold onto more of the thyroid hormone which works to hinder them from doing their job. Remember, protein bound hormones can’t bind to their receptor. They just float around in the blood. So if you were to do a basic thyroid screen you would usually be looking for the protein bound form (generally due to the lower cost of the test) and everything might look fine. The thyroid is producing plenty of hormone and the paperwork all looks great. But why then is this woman still having trouble losing weight, losing her hair, struggling with low energy, and not pooping very often? These are all low thyroid symptoms which exist even though the actual hormone levels are normal. “Go home, there is nothing wrong with you.” Right? Hmmm….

The reason that these symptoms persist is because the elevated estrogen induces a low thyroid state by stopping the free form of the hormone from binding to the receptor. For all intensive purposes this person is low thyroid. The unfortunate part is that the average blood work up won’t account for the interplay between estrogen and thyroid Binding Globulin.

A careful history looking for high estrogen conditions like breast cancer, breast cysts, endometriosis, uterine fibroids, or hormone replacement therapy for example should all come into play when considering complaints of low thyroid function. This is thinking outside the box of mainstream medicine. These cases are missed all the time which is unfortunate. It is also of course a great idea to have a look at estrogen levels and there is even a test for Thyroid Binding Globulin. These are tests that I can order if your primary physician is unable or unwilling to order them for you. Be prepared for such a response.

This is just another example of how hormone imbalance can have a negative affect on sexual function and health in general. Let’s face it… Someone who is experiencing low thyroid symptoms for any reason is generally low energy. And I think that we all know how great sex can be when one or more of the people involved is, “too tired!” Let’s be proactive here. Healthy sexual function can translate into great overall health and lend itself to a positive outlook on life. It is as natural as breathing, sleeping, and pooping! And when it comes to thyroid health all of the above can be involved. The solution may be as simple as just looking for the right thing.

 

Mini Monks in Nepal

Mini MonksWhen I signed up to work with Mindful Medicine Worldwide I was able to request my location so I chose to work in Chapagaon, a rural location just outside of Kathmandu. The clinic is on the grounds of a Buddhist teaching monastery. A teaching monastery is where boys age 5 to 18 come to live to learn to be Buddhist monks. That’s right, there are lots of mini monks here, running around in burgundy and yellow robes.

One of the perks of being in this clinic is getting to treat the mini monks, whether it be rubbing Neem oil on their heads or dressing their many cuts and scrapes. (What the hell is Neem oil ? Why, it’s a wonderful Ayurvedic antimicrobial, antifungal, skin healing plant oil that has a gnarly funk to it.)

In my head, before I came here, I had thought how peaceful it would be to be next to a Buddhist monastery. I had pictured rolling green hills and monks chanting in unison at dusk. Monks in training are actually quite noisy; they’re learning to play horns, they chant out of tune and tempo. Every morning at 9:30 and evening at 7:30 they come into the clinic using the little English they know, “hellloo, hello, helloo?” I massage the Neem onto their shaved, fungus-infected heads, not bothering to wash my hands in between. A few of them roll back their ears to show crusty spots where I apply a Chinese herbal balm to it. Another shows me the chunk of skin missing on the bottom of his foot and points to the Calendula. Read the rest of this entry »

 

Teaching Massage in Nepal

Nepal clinic

This is my second blog on being in Nepal as a volunteer for Mindful Medicine. (See my earlier blog for more details on how I ended up in Nepal.)

What I like about Mindful Medicine is that they want their work to be sustainable, to make a lasting difference. Instead of just bringing acupuncturists in for 2 to 4 month periods to treat, they have them teach as well. The Vajra Varahi clinic-paid interpreters have been learning basic acupuncture treatments so that they can help the acupuncturists that come here as well as treat in their absence.

Since I am a body worker and only halfway through my training as an acupuncturist I came to work here in a slightly different capacity. I was able to bring a massage table that was donated from Earthlight to do the work (30 pounds, by the way!). My job here is to teach the staff the basics of massage and anatomy so that they can continue to help the local population. A lot of people here have low-back, neck, and shoulder pain, often accompanied with arthritis. See the picture below (enough said).

Nepal bushels

nepal_women

I’ve started teaching. The students are Satyamohan, Sonya, and Prajwal who are all 25 years old and Ramita who is 33 and the only one with a child. They all have other jobs in the clinic, such as interpreting and reception work. I designed my classes based on my 6 years of experience, what Jessica and Grainne of Mindful Medicine had talked to me about, and what I went over with the clinic director when I got here. The students are picking it up fast and I’m actually envious of the way they get to learn massage, with one-on-one attention and none of the bullshit classes I had to take to satisfy state requirements. I’m working really hard to make sure that they can apply what I am teaching them once I am gone. Read the rest of this entry »