Tag Archives: hormones

Health Matters: The Big Test

8 Apr

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Also titled “When the odds are not in your favor”
Also titled “That’s a lot of red”

It’s been a while since I talked about my health. In all honesty there wasn’t a ton going on: just a lot of testing. And my schedule running my own magazine, while working full-time and caring for my family leave little time at the end of the day. At any rate, the big test is surely worth making time to write. About a month ago I had blood drawn for this fancy test by Health Diagnostic Laboratory.

The test looks at tons of stuff: lipids, inflammation, genetics, hormones, sterols, insulin resistance, and so on and so forth.

A. lot.

And I knew going into it the answers would not be good. As I said, the genetic odds are not in my favor. So here it goes (sorry this is going to be a long one):

I knew I had high cholesterol. Since starting with my doctor last year we’ve been steadily working toward the real answer behind my cholesterol problems. My total cholesterol is 265. Anything above 240 is high risk. My LDL is 196 (above 130 is high risk). A bright note is that my HDL is 63 (optimal is more than 50), but Doc said she wants it much higher. Here’s a good primer on heart health for more information.

Some notes from the test:
My markedly elevated LDL is suggestive of familial hypercholesterolemia or another related genetic disease, familial defective Apo B100. We’re going to run further tests on this.

Tests like these can even tell you the size of your cholesterol. There’s small/dense stuff and there’s large/bouncy stuff. The large stuff is less harmful. My small dense LDL cholsterol and ApoB are increased, consistent with the presence of small dense LDL particles. Studies have shown that elevated small dense LDL particle concentration is associated with increased risk for coronary heart disease even in the presence of optimal LDL cholesterol values. Small LDL particles may be observed in association with metabolic syndrome and prediabetes (note my insulin resistance below). Statin drugs effectively reduce the number of LDL particles, but do not generally influence the size distribution of the LDL particles. Niacin, omega-3 fatty acids, a low carb diet, fibric acids, and combo therapy (statin + niacin) have been shown to increase LDL particle size.

My LDL particle concentration is also increased, which is a risk for coronary heart disease, even in the presence of optimal LDL cholesterol values. Exercise and weight loss also increase LDL particle size.

My Apo B:Apo A-I ratio was increased. Large case studies have demonstrated that this ratio is superior for predicting risk for myocardial infarction. Decreasing the ratio can be achieved by lowering Apo B and or increasing Apo A-I. Statins reduce Apo B as do fibrates and Niacin. Combo therapy is particularly effective, especially when small dense LDL particles are present. Apo A-I concentration may be increased by exercise or omega-3 fatty acids. Niacin, fibric acids, and combo therapy are also effective.

C-reactive protein and fibrinogen are in the intermediate range. These are acute phase reactants associated with an increased risk for ischemic cardiovascular events. We’ll retest and if they’re still elevated, lifestyle changes will help: including weight reduction, regular exercise, a diet rich in soy protein, viscous fiber, and almonds, can help. Statins, fibrates, niacin, aspirin, and omega-3 fatty acids also help. Fibrinogen levels have been found to be associated with subsequent myocardial infarction and stroke. If your levels are in the upper tertile have a relative risk of future cardiovascular disease 2.3 times higher.

LP-PLA2 was increased, which is an inflammatory risk marker produced by macrophages and is a marker of vascular specific inflammation. Lp-PLA2 circulates in the plasma primarily bound to LDL particles. They are associated with increased risk for cardiovascular disease and events, endothelial dysfunction and peripheral arterial disease. Again, statins, fibric acids, omega-3 fatty acids and niacin help.

My fasting insulin level was elevated, which reflects hyperinsulinemia, an atherosclerosis risk. The combination of my elevated fasting insulin, apolipoprotein B (Apo B), and small LDL size identifies a very high-risk group for the development of ischemic heart disease. I like Doc’s explanation of insulin. Insulin is the key to the door. The door is the cell receptor. If the key is not recognized, the pancreas calls for backup (more keys) and eventually a resistance is built, in which case, among other things, the brain will even start sending out sugar cravings. It’s a wonderful combination (sarcasm) that makes a lot of sense to the way I’ve always felt. I’m taking Metformin to help my doors recognize the keys.

I have an increased free fatty acid concentration, associated with the metabolic syndrome and increased risk for the development of Type 2 diabetes. Basically my body isn’t turning fat into fuel. It’s storing it. With my lifelong struggle to shed fat, this makes a lot of sense.

My ApoE genotype is 3/4. Everyone has ApoE, but it comes in different values: 2/2, 2/3, 2/4, 3/3 (most common), 3/4 and 4/4. It’s our body’s instruction manual. In general, patients with the E4 allele respond less favorably to high-dose statins and may respond better to dietary change or combination drug therapy as a means to lower lipid levels. My 3/4 means my body won’t clear bad cholesterol. Decreasing fat intake as well as supplementing with omega-3 fatty acids are beneficial. This genotype may be th emost in need of supplemental omega-3 fatty acids. Along with an insulin resistance, a low carb or Mediterranean diet may be appropriate. I talk to a dietician in a week. Here’s an interesting article about the possible correlation between ApoE-4 and Alzheimer Disease.

I also have the normal or wild-type genotype for the MTHFR C677T (C/C) polymorphism. I’m also homozygous for the MTHFR A1298C (C/C), which results in significantly reduced activity of MTHFR, potentially leading to diminished production of L-methylfolate, the active form of folate. I guess only 7-12% of people get it. Doc calls these “Mother effers” … which sounds … awesome? Reduced levels of A1298C lead to decreased production of neurotransmitters, reduced conversion of homocysteine to methionine, and reduced s-adenosylmethionine (SAMe) concentrations. CNS neurochemical deficiency, along with buildup of homocysteine and decreased availability of methyl groups from SAMe, may increase risk for cardiovascular disease. It may also predispose me to certain psychiatric disorders and/or memory and attention deficits. I am supplementing with active L-methylfolate in combo with B12.

My total HDL particle concentration is in the intermediate range, an increase for cardiovascular disease. HDL particle concentration can be increased by exercise or omega-3 fatty acids. Statins, ezetimibe, fibric acids, metformin, and combo therapy have increased HDL particle concentration. Niacin increases HDL-P size.

Myeloperoxidase (MPO) is a marker of inflammation and oxidative processes, which may lead to atherosclerotic plaque vulnerability and left ventricular remodeling. In healthy individuals, elevated MP are associated with a 2-fold increased risk for major adverse cardiovascular events. The difference between Lp-PLA2 and MPO is their location relative to the arterial wall and their function. MPO is on the outside of the vessel wall and is a leukocyte derived enzyme that catalyzes the formation of oxidants and results in the formation of oxidized LDL. Lp-PLA2 is produced by macrophages and circulates in association with LDL particles. Inside the vessel wall, Lp-PLA2 on oxidized LDL specifically cleaves oxidized phospholipids to produce bioactive intermediates that upregulate inflammation. Lp-PLA2 is indicative of vulnerable plaque When both MPO and LP-PLA2 are elevated, it creates a situation where oxidized phospholipids are formed, which can subsequently be cleaved to bioactive products, which upregulate and maintain the inflammatory pathway.

In summary, a lot of my problems would normally be treated with statins, but because of my genotype, my body doesn’t really like statins. This fact makes me more thankful than ever to be with Dr. Alexander at New You Health Studio. To say she understands alternative medicine is an understatement. I have total faith in her and I’m so thankful to finally have a doctor who spends time with me, figures me out, and helps me be well.

Here’s a list of the large amount of meds I’m now. Incidentally, I had to get an app to manage when I take everything. Mango Health is a great app!

8 a.m.
Drink Metagenics UltraMeal 360 Plus, which contains the active MTHfolate my body needs because of the “mother effer” gene
Fish Oil
Armour Thyroid
L-Carnitine

10:30
Cholesterzyme

Noon
Super B Complex
L-Carnitine

3:30
Cholesterzyme

6:00
L-Carnitine

10:00
Niacin ER
Co Q-10
Vitamin E 400 Mixed
Metformin

I had a bad reaction to the Metformin at first, but I’m seeing this is pretty normal and moving it to bedtime instead of dinner time helped. None of this is cheap. I said I was going to live to a ripe old age but have no money left. Doc laughed at that and denied the idea. The cost of organic foods has been great, but with my diet limitations, we don’t buy as much other stuff. The cost of medical expenses is great, but hopefully it will save me money later in life. The cost of supplements and prescriptions is great, but I am happy knowing exactly what I’m putting in my body.

The good news from the test was that my hormones and thyroid are doing much better. These are the first things we tackled and I’m so happy they’re in check again. My antibodies when I first started, you may remember were in the 800s. They have steadily declined with not eating gluten to 500s, then 300s, now 200s. I broke down and had one of my mom’s homemade cinnamon rolls at Christmas, so that’s probably why it hadn’t dropped farther. My omega-3 levels are also good. 🙂

Anyway, there it is! I know some people were waiting for an update, and I’m sorry it’s a long one. Hopefully this will be the longest. 🙂

Cheers to your health!

Health Matters: Dosing Modifications

18 Oct

It has been a month since my last doctor’s appointment. I’ve been so busy with life that I’m just now updating. A month ago I still wasn’t feeling great. I’ve made a lot of changes with supplements and getting off synthetic prescription drugs. Repairing 10 years of damage to my system is not a quick process and I didn’t expect it to be.

As always, Dr. Alexander spent all the time I needed going over my concerns, digging deep into how I was feeling and explaining my recent test results so I understood them.

Here is what we discussed:

Thyroid: I do have Hashimoto’s Thyroiditis. (Incidentally, there was a great article on MSN today about modern wheat’s connection to Hashimoto’s.) We decided to increase my Iodoral 2% to 4-5 drops per day and continue Armour med at the 1.5 dose (up from 1). Nutritionally, she said the best for me is to start trying to cut out wheat and corn as well as any processed foods (processed contains the bromine that is blocking iodine). My TSH level was an insane 15.9 in July, but is now at 1.32 (less than 2 is good). My T4 and T3 are continuing to improve as well.

Adrenal: A new item we discussed this time was Adrenal Fatigue. Because I was still so tired and lacking energy, Dr. Alexander thought this might be what’s going on. She said I wasn’t fatigued yet, but she was concerned I was headed there. I started adrenal support that contains Ashwaganda, which also helps the thyroid. We’ll check the progress in labs in a month. We also discussed the importance of meditation and getting away from work when I can. This is hard for me because I work two jobs: one for a national magazine and one publishing my own magazine. I am having to make conscious efforts to disconnect with work and connect with myself and my family. Stress is the biggest cause of adrenal fatigue. This makes so much sense to me.

Hormones: Hormonally I have been feeling up and down. While I was on birth control, as I have discussed before, I had no libido, and I’m only 32 years old. I lived the first 10 years of my marriage being crippled by a rocky physical relationship with my husband. It was the single biggest struggle in my marriage. And while the kinks are still being worked out hormonally, I am happy to report I feel somewhat normal again in that department. As much as I know of “normal” anyway. I am continuing on a progesterone supplement nightly on days 14-25 of my cycle.

Vitamin D deficiency: My vitamin D level was 65 at my last labs, which is a huge improvement from the 31 it was in May. We will continue to replace to goal of around 80.

I’m still very hopeful we will get all of this figured out. Dr. Alexander said I wasn’t making this easy. 😉 But it’s still so wonderful to know someone is on my side and committed to digging into these problems with me.

I’ll be back next week with an update on how my organic produce delivery is going. (Spoiler: We love it!)

Here’s to our health friends.

Health Matters: First Appointment

31 Jul

First of all, since my last post sharing my back story on starting this new natural health quest, I’ve received a lot of new followers and I want to say welcome and how excited I am that people are into figuring out this whole health thing along with me. It’s fascinating and overwhelming and empowering all at the same time. And although I will share what my doctor has told me in my case, please do the research for yourself and get a professional opinion before doing anything.

So, on to my first official appointment with Osteopathic Dr. Alexander…
After an initial consultation that lasted about 45 minutes (it’s usually about 30 minutes, but you know me and all my issues now…) I was sold. Dr. Alexander’s knowledge and compassion won me over, despite the fact that insurance does not cover this form of treatment, which of course I find ridiculous.

The particular program I am under involved a $500 payment for the first month and subsequent $150 payments for every month I continue to need guidance and testing.

It was a hard pill to swallow at first, but I tell you that the first in-depth consultation I had with Dr. Alexander was worth the $500 alone. It lasted two hours. I’ve never spent so much time talking to a doctor. We got so into the discussion that we went after closing time and not one person complained about having to stay and draw my labs and set up my next appointment.

I never feel like a burden here and I never have to wait.

Dr. Shelley talked to me all about my history, asked me a ton of questions about what I’m experiencing currently and patiently answered all of my questions. The experience was nothing less than eye opening. Dr. Alexander would say things like, “We’ve known birth control is terrible for our bodies for a long time…” and my eyes would bug out and I would shake my head and think to myself, “We” know no such thing! (Here’s more on that.) I was shocked and amazed at all the things I didn’t know. Because no one ever told me. No doctor ever shared with me the side effects of all the drugs I was on. I could have looked them up myself, sure, but I assumed there was nothing I could do because I had to be on these meds and there was no alternative. I was just a good little girl who took her pills and didn’t ask questions for something like nine years. All the while not feeling like myself and becoming less and less connected with who I am, mind, body and soul.

Here is a breakdown on what came out of our first meeting:
1. Dyslipidemia (cholesterol problems): I am on a statin, which depletes CoQ10 in our bodies, so I am now on a 100mg/day CoQ10 supplement. According to WebMD, CoQ10 is “used by cells to produce energy our bodies need for cell growth and maintenance. It also functions as an antioxidant, which protects the body from damage caused by harmful molecules. Coenzymes help enzymes work to digest food and perform other body processes, and they help protect the heart and skeletal muscles.” So yeah, we kinda need it.

I learned that cholesterol is the father of all of our sex and adrenal hormones (it looks something like this) and statins inhibit the body from making appropriate levels. My main hormones were checked in labs to follow up next time. A more thorough panel of my cholesterol was also checked. The goal is to get me off the statin and on a more natural way to treat cholesterol.

2. Hypothyroid: When I stopped taking birth control (and also when I was pregnant) my thyroid level changed and my regular doctor decreased my dose synthetic thyroid supplement. When they drew my blood last May, my antibodies were also high, which they did not tell me. When I brought a copy of my labs (which I had to ask for because they were never sent to me) to my new doctor, she immediately noticed the connection between my thyroid and my high antibodies and suggested the idea that I may have Hashimoto’s Thyroiditis. (Here’s more on that). It is very common in women of childbearing years and the most common form of hypothyroidism. She checked a more in depth panel of my thyroid in labs and started me on a more natural thyroid supplement called Armour. It is bio identical instead of synthetic. I also ordered Lugol’s Iodine Solution at 2% from Amazon. Iodine is essential in thyroid function.  

3. Irregular periods: This is probably due to a hormonal imbalance. Hormones are being checked in the lab.

4. Vitamin D deficiency: A Vitamin D deficiency was noticed in my labs that were drawn in May. Dr. Alexander says we are all essentially low in Vitamin D and she wants the level at around 80. She called in a prescription strength supplement for me at 50,000IUs a week.

5. Healthy Aging:  Dr. Alexander asked me to start taking fish oil twice a day with meals. She said, the higher the dose the better the health where fish oil is concerned. She also suggested using sea salt because it is a wonderful safe source of minerals, including iodine. (More on that here). Because my body has been depleted of vitamins due to oral contraceptives, she asked me to take a B Complex vitamin daily.

So basically, it was a great, long conversation on what she suspects is going on with my body (without seeing new, more in-depth labs) and how it all works together. I left feeling very hopeful and much more knowledgeable and equipped to research more things on my own instead of feeling so lost and alone.

I had my second visit with my lab results on Monday and I’ll write about that later this week. Here’s to our health!