So many of you women with PCOS also have problems with your thyroids…I decided it was time for all of us to learn more about the issue. I asked Dr. John O'Dea to participate in our professional training, and he is going to talk about the topic.
John O'Dea, MD, was born in the south of Ireland. He was raised and educated in Dublin, where he received his undergraduate and medical education at the National University of Ireland. Upon graduation from medical school, he moved to the US. He served his internship and residency in Internal Medicine at St. Luke's Hospital in Cleveland, Ohio. He then went on to receive full training in Endocrinology and Metabolism through a NIH fellowship at Case Western Reserve University. Following the completion of this two-year endocrine fellowship, which involved both clinical and research experience, he moved to the Los Angeles area, where he is in private practice.
I met Dr. O'Dea through a client, who shared that after visiting many, many physicians, he was the one who finally helped her get back into balance. After meeting with him personally, I was excited to know someone was out there who could help the women of inCYST.
The webinar will be broadcast live on Friday, May 19, 2010, at 6 pm Eastern Daylight Time. If you cannot attend, we will be recording the presentation and that recording will be available for sale as well.
You may participate in this activity only, or if you register for the complete inCYST Professional PCOS Training, this lecture is included in the package. Early registration discounts are available for both options.
Most of us assume that every calorie we eat goes directly to being metabolized by muscle and fat. Did you know that over half of the calories you burn are used to maintain your body temperature? When you severely restrict your calories, your body temperature drops. If you know anyone who is super lean, or anorexic, they are often wearing more clothing than others with regard to the ambient temperature, which illustrates this fact.
If you've been on a restrictive diet, and you are afraid to increase your calories, for fear you're going to gain weight, try this:
Take your body temperature. If it is less than 98.6 degrees, chances are, the main change you will see if you increase your calories, is an increase in your body temperature. It's usually best to increase your calories in 100 calorie increments at a time, and sit there for a week to evaluate the effect. If your weight stays stable or drops, but your temperature increases, your problem with weight may be that you're eating too little food. Try adding 100 calories a week until you get to 98.6 degrees and see where you land.
The only condition where this experiment may not work, is if you have a thyroid that is not working the way it should, as the thyroid directly affects your metabolism.
It's a very common sense tool to look at what you're doing vs. what you may need to be doing.
We had a great chat with Dr. Gretchen this morning! We covered everything from how she does her work, what counseling can do for a woman with PCOS, to her love for her local farmer's market.
If you have ever thought about getting counseling to deal with the stress that your diagnosis has placed on your daily plate, please check in and listen to what Dr. Gretchen has to say!
Gretchen's practice is located in West Los Angeles. You can learn more about her at http://www.drhousemd.com/. She can be contacted directly at 310.625.6083, or gkubacky@yahoo.com.
As I mentioned in the first part of this series, vitex has its strongest effect on four hormones: estrogen, progesteron, luteinizing hormone (LH), and the one this post is dedicated to, prolactin.
Prolactin is primarily associated with lactation. It is also important for sexual arousal, sensing orgasms, and libido. So it's safe to say, you have to have good prolactin metabolism in order to successfully conceive and carry a pregnancy through to nursing!
One of the most important, and often overlooked, influences on prolactin function, is medication. I am most familiar with psychotropic medications because of my specialty, and I believe, with the very high incidence of anxiety, depression, and sleep disorders in women with PCOS, it is incredibly important to use these medications with discretion in order to not interfere with fertility, or successful PCOS management in women who are not in pursuit of conception.
Before considering any supplement, make a list of all the medications you've ever been prescribed and show them to a registered pharmacist. Ask them if any of those medications have any potential for disrupting prolactin function. And if you come up with a"yes" for any of them, ask for a list of alternatives that you and your prescribing physician can use to adjust your treatment plan.
When prolactin is out of balance, funny things can happen. You can produce milk when you're not supposed to (I once had a male client who started to lactate, and it turned out to be a symptom of a pituitary tumor.)
You might not be able to produce milk when you want to. Many, many, many women with PCOS find, much to their dismay, that they get pregnant, and cannot feed their babies. I am shocked at how many medical colleagues with PCOS write me to share that until they heard us mention this at inCYST…they never knew it could be a problem. And they themselves could not nurse their babies!!!
This lack of awareness and the incredible importance of healthy prolactin function to the overall health of mother and baby, is precisely why, our first outreach outside of dietitians, with inCYST, has been with lactation consultants. They understand this physiology best, and they are the most likely to pick up on problems as soon as they become apparent.
Bottom line, PCOS is not just about infertility. It is about successful reproduction, which includes being able to successfully create the next generation of healthy people.
But I digress. Back to prolactin.
Prolactin is controlled by the hypothalamus, the part of the brain we at inCYST are obsessed with learning and teaching about. The hypothalamus also regulates estrogen, progesterone, testosterone, cortisol, thyroid, and growth hormone. You can see why it's your BFF as a woman with PCOS. If you have problems with one of those, you likely have problems with more than one.
Most medical treatments address each of those hormone imbalances as if they are separate, requiring a separate medical treatment…better yet…a separate medication. So by the time you've made the specialist rounds, you've been given a birth control pill, an antidepressant, a sleep medication, a lipid lowering medication (since some of these hormones are made of cholesterol, when they're out of balance…cholesterol will be, too).
We like to think we start where the problem starts. Giving the hypothalamus what it needs to work efficiently. And the number one chemical you can focus on, which should help all of these functions, which I call our"Recipe for a Happy Hypothalamus (SM)"…is DHA, one of the fish oils.
1. DHA makes it harder for the hypothalamus to feel stress. Stress is a very selfish thing. It steals energy away from other things your body might need it for. With enough DHA in the system, the hypothalamus can put its energy into healing the functions that are NOT related to stress, mainly reproduction, sleep, and mood.
2. DHA increases dopamine receptor density. Prolactin is dopamine-controlled, meaning the more receptors there are to communicate with the dopamine that is there, the less prolactin your body needs to make.
An interesting aside--dopamine imbalance is common in people who crave and/or binge on sugar. So if you've got cravings AND your prolactin levels are not right…you just might be DHA-deficient.
I have one more post coming on chaste tree berry that will summarize important findings and recommendations.
But, with regards to prolactin, what I will say is that two very important things you can, and should, do, to move yourself back into balance, are:
1. Make sure your medications are not the source of the problem, and 2. Make sure your food choices are promoting healthy dopamine function.
Even if you DO decide to try an herbal formula, it is much more likely to work for you, if you provide it with an environment that allows it to do what it does best.
Important Lab Tests for PCOS Many women who have PCOS have not had the correct blood work done or don't know what blood tests to ask to have done.I would like to post some important labs used to diagnose and monitor PCOS 1. Total testosterone (elevated levels are > 50ng/dl 2. Free testosterone 3. Luteinizing Hormone (LH) (plays a role in ovulation and egg development) 4. Follicle Stimulating Hormone (FSH) (responsible for egg release from the ovaries) 5. LH/FSH ratio (results should be under 2) 6. DHEA-sulfate (this test tells how much androgens or"male hormones" your body is producing) DHEA sulfate converts into testosterone. 7. Prolactin 8. Thyroid Stimulating Hormone (TSH) this test will help to rule out hypo or hyperthyroidism (slow vs fast metabolism issues) 9. Liver Function tests (LFT's). Important since medications pass through the liver, to check for possible damages. Checking every 3-6 months is recommended. 10. Fasting Lipid Profile: Total Cholesterol (<>45 mg/dl is ideal)Low Density Lipoproteins (LDL) (<130 mg/dl is ideal)Triglycerides (fat in blood) (<150 mg/dl is ideal) 11. Fasting Insulin (results should be <10) difficult to do, it needs to be frozen when brought to the lab and tested before it reaches a certain temperature, expensive but would be very beneficial in determining and monitoring insulin resistance. 12. Fasting blood chemistry panel (includes glucose, electolytes and sometimes renal labs) 13. Fasting glucose to insulin ratio (used to diagnose and monitor insulin resistance, ratio under 4.5 usually indicated insulin resistance)
Ellen Reiss Goldfarb, RD 11500 W. Olympic Blvd, Suite 400 Los Angeles, CA 310-408-1770 info@ellenreissgoldfarb.com
I am on my way over to Los Angeles to work with Dr. John O'Dea on the webinar presentation he is doing for us. I'm super excited, because he loves PCOS, he loves to talk about hormones, and you all are always asking questions about the thyroid I wish I could better answer!
We'll be broadcasting live at 3 pm Wednesday May 19 (Pacific time) from his office. If you can't be there live, the recording will be available to purchase until December 31 of this year…simply click on this link. This is the same link to click to register live. Someone this busy with his practice is being extra generous by making time for us. If your thyroid is something you have questions about, it's worth making time to get answers from a great source.
