Holiday Stress and Hormones

Holiday Stress and Hormones

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

Dr. Penny Kendall-Reed spoke at the Integrative Health Symposium conference in October, 2015, highlighting the complexity of how stress affects hormone activity. holiday stress

Research has sought to identify the unique characteristics of hormones for decades.  This is difficult, however, because hormones do not act in a vacuum, but have distinct relationships with each other.

Introducing the Hypothalamus, Pituitary Gland and the Adrenal Glands
One of the more complicated hormone relationships involves the HPA axis. The HPA axis is a set of interactions and signals that exist between the Hypothalamus, the Pituitary gland and the Adrenal glands. This relationship is an indispensable part of our existence.

The hypothalamus is a very tiny area in the brain with an enormous number of functions. Some of these functions include the regulation of body temperature, hunger, attachment behaviors, thirst, fatigue, sleep, and circadian rhythms. The hypothalamus produces a number of hormones which directly stimulate the pituitary gland.

The pituitary gland is also located in the brain and produces hormones that play a role in regulating the thyroid gland, ovaries, testes, and adrenal glands among other things.

The adrenal glands are located above each kidney and produce hormones that help the body control blood sugar, burn protein and fat, react to stressors like a major illness or injury, and regulate blood pressure.

An example of HPA axis activity (i.e., the interaction between these three glands) is as follows: In response to stress, the hypothalamus produces corticotropic releasing hormone (CRH) which signals the pituitary gland to release adrenocorticotropic hormone (ACTH). ACTH then signals the adrenal glands to produce stress hormones cortisol, epinephrine, and norepinephrine to be used by the body to respond to the stressor. Uniquely, women experience more stimulation to the HPA axis under conditions of stress than men do.

The HPA Axis is Self-Regulating
Not only does the HPA axis work to produce hormones to respond to stress, it also regulates itself so the body stops producing stress hormones when they’re no longer needed. When cortisol is released by the adrenal glands into the blood, receptors in both the hypothalamus and the pituitary gland are able to detect this rise in cortisol. The activation of these receptors turns down the production of CRH and ACTH ultimately resulting in a decrease in the production of cortisol. Ideally, the interaction between the hypothalamus, the pituitary gland, and the adrenal glands creates an environment of stability and consistency using these feedback loops.

Sex Hormones
The hypothalamus and the pituitary gland also play a role in regulating the production of sex hormones. The hypothalamus produces gonadotropin releasing hormones (GnRH) which stimulate the pituitary gland to produce luteinizing hormone (LH) and follicle stimulating hormone (FSH) which in turn stimulate the production of estrogens, progesterone, and testosterone by the ovaries and testes. The hypothalamus and the pituitary gland monitor and regulate the ebb and flow of sex hormones with a feedback loop similar to the one used by the HPA axis.

Failure of the HPA Axis Feedback Loop
If the body believes it is under constant stress, the hypothalamus and pituitary gland continue to produce CRH and ACTH to stimulate more and more cortisol production. Eventually, however, the system starts to malfunction. Chronic high cortisol levels damage the production of GnRH from the hypothalamus and, as a double whammy, increase the production of a gonadotropin inhibiting hormone (GnIH), which disturbs the production of sex hormones from the ovaries and testes.

What Happens Next?
Infertility is a significant consequence of the disruption of the delicate hormone symphony. Continued, elevated levels of cortisol are thought to be a prime cause of infertility:

  • Stress may increase the production of prolactin from the pituitary gland which can inhibit ovulation.
  • Cortisol increases inflammation in the uterus which may cause cramping, spasms, and even miscarriage.
  • Increased spasms may cause damage to the egg in the fallopian tube.
  • Disruptions of the HPA axis are thought to be an underlying cause of polycystic ovarian syndrome (PCOS), a condition associated with infertility in young women.

Weight gain is another potential consequence when the HPA axis is disrupted:

  • Ghrelin is a hormone produced in the stomach which contributes to the feeling of hunger. Once food is consumed, ghrelin production is turned off with some help from a neurotransmitter named dopamine. Cortisol can interfere with dopamine activity which may leave one feeling hungry even after eating.
  • Another hormone called leptin, which is produced in fat cells, inhibits food cravings and initiates fat burning. Cortisol can block the release of leptin. Fat deposited in the abdomen has 30% more cortisol receptors than the rest of the body’s fat, so the cortisol blocking effect on leptin release may be further enhanced in individuals with an excess of abdominal fat.
  • Cortisol amps up insulin release in response to grains and fruits possibly leading to increased food cravings.

What Can We Do to Reverse This?
The most obvious step is to take measures to relieve chronic stress. This can include massage, yoga, meditation, deep breathing, exercise and diet. Natural supplements can also be used. Lactium, a peptide isolated from milk may be used to re-sensitize the hypothalamus to cortisol and re-establish the feedback loop. Herbs like magnolia, ashwaganda, schizandra can moderate cortisol production. Theanine from green tea and the amino acid GABA can also mitigate stress reactions. Judicious use of bioidentical hormones may also help break this cycle of dysfunction.

The takeaway point from Dr. Kendall-Reed’s presentation is that high levels of stress and persistent high levels of cortisol affect the very intricate and complicated balance of many hormones. Learning to manage stress with life style, nutrients, hormones and perception may help restore more balanced functioning to many of the body’s systems.

  • Kendall-Reed P. Lecture presented at: Integrative Health Symposium; October 2015.
Holiday Stress and Hormones2018-04-02T15:28:29-05:00

Book Review – The Upside of Stress by Kelly McGonigal

Book Review – The Upside of Stress: Why Stress is Good for You and How to Get Good at It by Kelly McGonigal, PhD

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

Stress is bad, right? It damages our body, causes depression, shortens our lives…the list goes on and on. We say things like, “All this stress is giving me an ulcer!” or, “This stress is killing me!” Your practitioner, if unable to pinpoint the source of your malady, may advise that you reduce your stress level. We have whole industries designed to decrease stress in our lives: yoga classes, meditation courses, massage therapy, breathing exercises, exercise, and life style coaching.

Dr. Kelly McGonigal urges us to rethink the idea that “stress is bad” in her book, The Upside of Stress: Why Stress is Good for You and How to Get Good at It. Dr. McGonigal is a health psychologist who teaches at Stanford’s School of Medicine Health Improvement Center and the Stanford Center for Compassion and Altruism.

A Little History
Dr. Hans Selye, an endocrinologist, found that introducing any sort of unpleasant experience produced a loss of muscle tone, ulcers, immune breakdown, and ultimately death in his lab rats. Having already seen human patients who experienced similar breakdowns in their health, he drew from his observations and his rat experiments to define stress as any demand made on the body. Further, he felt that just about anything that happened to someone in life (good or bad) was toxic.

Dr. McGonigal argues that Dr. Selye’s definition is much too broad. She believes there is a huge difference between the body’s response to near death experiences and electric shocks as the lab rats endured (she calls it The Hunger Games for rats!), and the everyday stresses of living life in the modern world that humans commonly experience.

Fight or Flight
The classic description of the body’s response to stress is “fight or flight.” The body reacts to a stressor by stopping all non-essential processes, like digestion and fertility, and releases a flood of energy and oxygen needed to flee a dangerous situation or to fight for survival. Although this process has served human beings and other animals well throughout millennia in their survival efforts, “fight or flight” may not be always appropriate in modern life. It isn’t very effective to run away from a disagreement with your boss or an argument with your spouse, and it isn’t possible to fight for survival against past due bills or an IRS audit. Dr. McGonigal points out our stress responses have adapted over time and aren’t limited to this one “fight or flight” response. We have developed many more coping strategies.

A More Finely Tuned Stress Response
Dr. McGonigal describes three types of stress responses in addition to “fight or flight,” which all serve to handle stress in such a way that may have a positive effect on the body:

  • Rise to the Challenge: This stress response allows us to focus our attention, heightens our senses, increases motivation and mobilizes our energy. This stress response is of benefit, for example, to an athlete who is about to compete.
  • Connect with Others: This stress response activates the need to protect our tribe and dampens fear and increases courage.
  • Learn and Grow: This stress response helps us integrate experiences and helps the brain learn.

The Main Stress Hormones
The hormones cortisol (also called hydrocortisone) and DHEA produced by the adrenal glands are considered the primary responders to stress. The outpouring of these hormones can affect the body positively rather than negatively. For example:

  • Research has shown that supplementing these stress hormones to enhance the stress response has been beneficial to those with post-traumatic stress disorder (PTSD) and panic attacks.
  • Psychiatrists have begun using these stress hormones before a therapy session and surgeons before surgery to improve outcomes.
  • Experiments designed to measure stress hormone responses find that those with the largest increase in DHEA are the most resilient under stress. DHEA can act as a neuro-steroid and actually help your brain grow stronger after stressful events.

Many More Hormones
While cortisol and DHEA are the main stress hormones, there are a number of other hormones involved in the body’s stress response.

  • Adrenaline (also called epinephrine) pours out of the adrenal glands with cortisol and DHEA, and serves to activate and focus our senses. The pupils of the eyes dilate to let in more light and hearing sharpens. The liver starts to dump fats and sugars into the blood stream to provide more energy for the brain and the muscles.
  • The release of endorphins, testosterone, and dopamine, along with adrenaline, actually provides a feeling of exhilaration that many find enjoyable. This “adrenaline rush” is the feeling thrill seekers are after when they skydive or ride roller-coasters.
  • Oxytocin is produced by the pituitary gland. Oxytocin increases our ability to bond with others and during times of stress, it allows our courage to dampen our fear. Interestingly, heart tissue contains many receptors for oxytocin which allow for regeneration and repair. Many believe that stress will give you a heart attack; however, the outpouring of oxytocin may actually strengthen your heart.

The Mindset
Early in her career, Dr. McGonigal , like many, believed that stress produces negative effects in the body. Then she came across a study that she just couldn’t reconcile with her belief system. This study documented that people who were exposed to stressors had different outcomes dependent upon their mindset about stress. If people believed stress was bad and produced unhealthy effects, it was so. If people believed stress was a part of life and a challenge to meet, they were healthier and even had enhanced life spans when compared to those with low levels of stress.

After this, Dr. McGonigal turned her career around. She no longer teaches fear of stress and stress management. She sums up her change in mindset in the introduction of her book: “The latest science shows that stress can make you smarter, stronger and more successful. It helps you learn and grow. It can even inspire courage and compassion.” She shares the tools to change one’s mindset in her book. Better yet, science shows that mindset is malleable for all of us.

Book Review – The Upside of Stress by Kelly McGonigal2018-05-02T11:18:19-05:00

Lyme Disease Research Update

Lyme Disease Research Update

Written by Carol Petersen, RPh, CNP– Women’s International Pharmacy

What is Lyme Disease?
Lyme disease is a bacterial infection transmitted to humans by infected deer ticks. The bacterium that causes the infection is a spirochete named Borrelia. Initial symptoms include a rash that may look like a bullseye, fever, headache, and fatigue. As the disease progresses, one may experience arthritis, heart problems, and nerve problems. A diagnosis is most often made based on symptoms and history of a deer tick bite. Lyme disease is difficult to diagnose because its symptoms mimic other diseases and lab testing is not definitive. Current treatment most often involves a two to four week course of antibiotics. However, a single round of antibiotics may not eradicate the infection and co-infections with other organisms may arise. Individuals with Lyme disease may find themselves in a situation where the condition becomes chronic and they are in a continuous struggle to restore their health.

International Lyme and Associated Disease Society
The International Lyme and Associated Disease Society (ILADS) is a nonprofit, international, multidisciplinary medical society dedicated to the appropriate diagnosis and treatment of Lyme and associated diseases. They are advocates for helping people with chronic Lyme disease and other associated diseases restore their health. Over 600 people attended the annual ILADS meeting in Fort Lauderdale this year. There were many presentations and among them, there were several linking the symptoms of chronic Lyme infection with hormones and hormone treatment.

Pituitary Gland and Endocrine Dysfunctions in Chronic Lyme/Co-infections, presented by Eugene R. Shippen, MD 
Dr. Eugene Shippen is a family practitioner in Shillington, Pennsylvania. He is also the author of The Testosterone Syndrome and a sought after lecturer on hormone replenishment. Dr. Shippen began his presentation by stating comprehensive hormone testing should be done for all patients with chronic illness. He recommended testing thyroid, adrenal, and sex hormones, as well as pituitary hormones which normally stimulate the production of thyroid, adrenal, and sex hormones. Pituitary hormones including luteinizing hormone, follicle stimulating hormone, growth hormone, and prolactin may be used to evaluate pituitary function. If abnormalities are revealed, the function of the hypothalamus should also be examined.

Prolactin, a pituitary hormone known for stimulating breast milk production, tends to be elevated in chronic illness. Prolactin participates in a multitude of bodily functions and chronically high levels of prolactin can have far reaching effects. Symptoms may include decreased libido and mood, insulin resistance, and weight gain. Low thyroid function may also contribute to high prolactin levels, but a pituitary growth called an adenoma should be ruled out if prolactin levels are especially high. Proper treatment of hypothyroidism may restore prolactin to normal levels.

Impaired cognitive function can be a persistent symptom of Lyme disease and other associated diseases. Dr. Shippen described using a topical gel of selegiline, DHEA, and pregnenolone for cognitive dysfunction arising during chronic illness. Selegiline is a drug that inhibits the breakdown of dopamine in the brain. It is commonly used in the treatment of Parkinson’s disease and has favorable action on neuro-repair. The adrenal hormones, DHEA and pregnenolone, may also have neurosteroid or neuro-enhancing properties. Dr. Shippen presented case studies to illustrate the effectiveness of addressing some of these hormone deficits.

Changes of Thyroid and Adrenal Function in Chronic Infections/Lyme Disease, presented by Usha Honeyman, DC, ND
Dr. Usha Honeyman is a chiropractor and a naturopathic physician who practices in Corvallis, Oregon, and specializes in finding hidden causes to chronic disease and inflammation. She, too, focused on the presence of hormone dysfunction in patients with chronic Lyme disease and other associated diseases.

Patients with chronic Lyme disease and associated diseases tend to have low body temperatures. Normal body temperature is important in patients with chronic infection because white blood cell activity may be impaired under low temperature conditions. Healthy, active white blood cells are vital in helping the body fight infection. Low body temperature is also a symptom often associated with low thyroid function. Lyme disease and associated diseases may affect thyroid function in a number of ways:

  • Cytokines and inflammatory agents, which are often elevated in chronic infection, may affect thyroid function.
  • Corticotropin releasing hormone (CRH) is produced by the hypothalamus and activates cortisol in the body. CRH tends to be elevated in chronic infection. Excess CRH activity may interfere with thyroid function by inhibiting the conversion of the inactive thyroid hormone, T4, to the active form, T3.
  • Infection is a stress activator of the hypothalamus, pituitary, and adrenal glands.
  • The interaction between these three glands regulates many functions in the body, including thyroid.

Final Thoughts
The incidence of Lyme disease is on the rise in the United States. Some practitioners have recommended that anyone who is struggling with any type of chronic health issue be examined for Lyme disease. Hormone disruption is not usually the first thing considered by practitioners when a patient presents with a chronic disease; however, some of the ILADS practitioners are now urging all practitioners to examine the effects of high or low hormone levels and treat accordingly in patients with chronic Lyme disease and other associated diseases. Chronic Lyme disease may contribute to hormone imbalance, or, alternatively, hormone imbalance may be a source of the symptoms exhibited in chronic Lyme disease.

  • International Lyme and Associated Diseases Society.
  • Shippen ER. Pituitary Gland and Endocrine Dysfunctions in Chronic Lyme/Co-infections. Lecture presented at: Annual ILADS meeting; October 2015; Fort Lauderdale, FL.
  • Honeyman U. Changes of Thyroid and Adrenal Function in Chronic Infections/Lyme Disease. Lecture presented at: Annual ILADS meeting; October 2015; Fort Lauderdale, FL.
Lyme Disease Research Update2018-04-02T16:25:10-05:00

Book Review – Adrenaline Dominance by Michael E. Platt, MD

Book Review – Adrenaline Dominance: A Revolutionary Approach to Wellness by Michael E. Platt, MD

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

We know what a surge of adrenaline feels like. It is the hormone that gives us the strength for “fight or flight.” Our hearts beat harder, stronger, faster. Blood is diverted from less important things like digestion to our muscular tissue. Thought processes seem to happen at lightning speed. There are many stories of superhuman feats performed under extraordinary circumstances with surges of adrenaline.

Dr. Michael E. Platt has written his book Adrenaline Dominance because he feels that practitioners and their clients lack understanding of this very important hormone. He finds that knowing how adrenaline functions enables him to successfully guide his patients towards wellness.

Adrenaline is produced by an inner part of the adrenal glands. Dr. Platt explains that there are two reasons for adrenaline to be released: One reason is in response to stress as described above, and the second reason is to ensure that the brain has received enough sugar (glucose). The body uses adrenaline to help create more glucose from protein as well as stimulate the release of glucose stored in the liver. Consequently, as glucose releases, insulin releases. These two hormones are intimately involved with adrenaline.

Dr. Platt organized his book according to “The Good, the Bad and the Ugly,” the classic Clint Eastwood western, to illustrate that adrenaline has both desirable and undesirable effects. He believes that right-brained creative thinkers acquire those qualities from plenty of adrenaline ensuring lots of glucose to the brain. Superb athletes also get their edge from adrenaline. These are “good” mental and physical effects of generous amounts of adrenaline.

It starts to get “bad” when adrenaline output is too generous or our bodies don’t have the ability to moderate the high adrenaline. High adrenaline can be tied into depression, anxiety, irritable bowel syndrome, hypertension, diabetes, obesity, headaches, restless leg syndrome, addictions, and bedwetting. It gets “ugly” when syndromes such as fibromyalgia, interstitial cystitis, road rage, autism, or post-traumatic stress disorder appear.

Progesterone, which is also produced by our adrenal glands, is the natural modifier of excess adrenaline. Dr. Platt recommends progesterone in men and women, as well as children. Along with progesterone, Dr. Platt guides his patients with their food choices. Dr. Platt recognizes the relationship between glucose and insulin and claims the timing and types of foods ingested can make significant changes in the presentation of excess adrenaline.

It is not difficult to imagine the ramifications of adrenaline being out of balance since Dr. John Lee introduced us to the concept of “estrogen dominance.” Many practitioners surprisingly don’t recognize the significance of progesterone in moderating both the effects of estrogens and adrenaline. Thanks to Dr. Platt, we can raise our awareness on an ever enlarging picture about hormone balance. He reveals his evidence and thinking in great detail in his book, which is sure to expand every reader’s thinking about our bodies.

  • Platt ME. Adrenaline Dominance: A Revolutionary Approach to Wellness. Michael E. Platt, MD; 2014.
Book Review – Adrenaline Dominance by Michael E. Platt, MD2018-04-03T16:34:47-05:00

The Lyme Disease Merry-Go-Round

The Lyme Disease Merry-Go-Round: Hormones, the Immune System, and Yeast

Written by Kathy Lynch, PharmD – Women’s International Pharmacy


Patients with chronic Lyme disease have weakened immune systems which may allow intestinal yeast to overgrow. Antibiotics, the mainstay of Lyme disease therapy, destroy the beneficial gut bacteria which keep yeast overgrowth in check. Yeast, in turn, depresses the immune system even further. It also binds up estrogen, making it unavailable to the cells that need it the most. Thus patients with Lyme disease may get sicker and sicker due to a compromised immune system, hormone imbalance, and yeast overgrowth.

A low sugar, low carbohydrate diet can kill off yeast while strengthening the immune system. Acidophilus and other anti-yeast supplements like aged garlic extract can help as well. (See our A Connection with Yeast newsletter.) Practitioners who treat yeast with immunotherapy can be found at the American Academy of Environmental Medicine website.

Marlene Kunold, a German practitioner who specializes in the treatment of Lyme disease, believes that healing may be incomplete until the adrenal and thyroid glands are adequately supported. Researchers have found that the adrenal glands have a positive effect on immunity. And natural killer cells, part of the immune system’s first line of defense, are more active when thyroid function is optimal.

Dr. William Hrushesky believes that estrogen dominance can decrease the activity of natural killer cells and other immune system components. Low estrogen levels can do the same thing. Progesterone can help offset estrogen dominance but may cause yeast overgrowth in susceptible individuals. It is important that patients with Lyme disease have access to medical professionals with knowledge of hormones, the immune system, and yeast.

The Lyme Disease Merry-Go-Round2018-04-05T13:15:46-05:00

Book Review – The Chronic Stress Crisis by William G. Timmins, ND

Book Review – The Chronic Stress Crisis by William G. Timmins, ND

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy


While there are many books about the problems of adrenal exhaustion or adrenal fatigue, very little has been written about that which leads up to it, when the adrenals are on high alert. Dr. William Timmins discusses the full spectrum of adrenal response in The Chronic Stress Crisis.

Dr. Timmins defines chronic stress as stress that is repetitive, ongoing and unremitting; it can be linked to both internal and external sources. He identifies common stressors such as grief, poor sleep, parasites, injury, chemical exposures, too much or too little exercise, and poor food choices. Dr. Timmins makes the case that stress is the number one cause of all illness and disease.

In describing how chronic stress leads to crisis, Dr. Timmins reviews the pioneering work of Dr. Hans Selye, called General Adaptation Syndrome, which identifies three phases of stress response. Dr. Selye characterized the phases by the physical and biological changes that occur in the body in response to stress:

  • During the alarm phase, which is the first reaction to stress, the hormones cortisol (also known as hydrocortisone), adrenaline and noradrenaline rise quickly to provide instant energy.
  • The next phase is the resistance phase, during which the acute sources of stress may have resolved and hormone output has returned to normal, but the ability to handle future stresses may be compromised. Or, there may be constant stressors that keep the body in high alert for long periods of time.
  • The final phase is the exhaustion phase, which happens after repeated stress causes multiple cycles of the resistance phase, and hormone production ultimately fails.

Dr. Timmins expands on these phases, describing five stages of stress response in more detail:

Stage 1 begins when stress first causes a deviation from balance; the body either attempts to return to normal or compensates toward more disorder.

Stage 2 begins when pathophysiology occurs; that is, the body continues to struggle to return to balance but body functions, tissues and organs are starting to compensate.

Stage 3 begins when pathomorphology occurs; in other words, symptoms start to appear but may be subtle, and the body still struggles to return to balance. People may believe that they still feel fine.

Stage 4 begins when symptomatology dysfunction becomes apparent. In this stage, symptoms are apparent and persist, leading people to seek out medical care.

Stage 5 is when the loss of life force occurs (i.e., death), typically as a result of a heart attack or respiratory failure.

Dr. Timmins explains how the build-up to this final stage has actually been going on for years. Chronic stress, which results in abnormally high levels of cortisol, affects the entire body throughout these five stages, causing all body systems to suffer. He calls the hormone changes that occur with chronic stress “the pregnenolone steal” because pregnenolone gets continually diverted to make more cortisol. The interactions among various hormones, and their resulting symptoms, include:

  • Pregnenolone is the first hormone made from cholesterol and is the source material for all other sex and adrenal hormones. During periods of high stress, this redirection of pregnenolone leads to higher than normal levels of cortisol and lower levels of other sex and adrenal hormones.
  • The major impact is that DHEA production declines. Testosterone subsequently becomes deficient leading to decreased libido, depression, muscle weakness, and immune system dysfunctions.
  • Progesterone, which is important for mood and sleep and also balances estrogens, is diminished. The progesterone decline allows the effects of estrogens to dominate, leading to menstrual difficulties, weight gain, insomnia, anxiety, and infertility.
  • Aldosterone, which regulates sodium and potassium levels as well as blood pressure, is reduced leading to symptoms such as drowsiness, absent-mindedness, salt cravings, and frequent urination.

Missing from this book is a discussion of the adrenal hormones, adrenaline, and noradrenaline, which are also released in response to stress. Persistent excesses of these hormones contribute to insomnia, anxiety and irritability, and rapid and irregular heart rates.

Dr. Timmins suggests that removing the sources of stress is the cornerstone to recovering health. Some stressors may be obvious, such as inadequate sleep, traumatic events, or poor diet. Other stressors may not be so apparent and will need the assistance of a medical practitioner to decipher. These can include parasites, viral and bacterial infections, food intolerances, and environmental toxins such as heavy metals and molds.

Dr. Timmins provides a framework for seeking out both obvious and less obvious forms of stress, and identifying steps that could help to remove those stressors. This book provides useful guidance for those people who are trapped in the early high-alert stages, as well as who have reached adrenal exhaustion.

  • Selye H. The Stress of Life. New York, NY: McGraw-Hill; 1984.
  • Timmins WG. The Chronic Stress Crisis: How Stress Is Destroying Your Health and What You Can Do To Stop It. Bloomington, IN: AuthorHouse; 2008.
Book Review – The Chronic Stress Crisis by William G. Timmins, ND2018-04-05T13:09:58-05:00

Uncovering Adrenaline Triggers with the Pulse Test

Uncovering Adrenaline Triggers and the Pulse Test

Written by Kathy Lynch, PharmD – Women’s International Pharmacy

According to Michael Platt, MD, the release of adrenaline contributes significantly to symptoms associated with incontinence. Phil Bate, PhD, a member of the Orthomolecular Medical Society for many years, advocates the use of a simple technique, the pulse test, to detect substances that trigger adrenaline release in the body.

This test, developed in the 1950s by Arthur Coca, MD, provides a reliable and inexpensive method of measuring the adrenaline release caused by allergies and sensitivities to foods and chemicals. When adrenaline is released, the pulse rate goes up. By measuring the pulse rate before and after exposure to particular foods or chemicals, people can determine which substances raise or do not raise adrenaline levels in their bodies. An increase of five beats or more per minute indicates a release of adrenaline. Dr. Bate advises that people not deliberately expose themselves to any known allergen but that they use the test to uncover allergens that they are not currently aware of.

The pulse test helps to uncover hidden adrenaline triggers which may be beneficial in the treatment of incontinence and other disorders. Dr. Coca’s book The Pulse Test explains this test in great detail.

Uncovering Adrenaline Triggers with the Pulse Test2018-04-05T11:08:16-05:00

Treating Cellulite

Treating Cellulite

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

Cellulite is defined as deposits of fat that create a dimpled, orange-peel appearance of the skin. According to Dr. Sharon McQuillan in a webinar prepared for the American Academy of Anti-Aging Medicine, losing weight does not reduce cellulite, but changes in hormone balance, diet, and lifestyle may help to do so.

Approximately 85% of women have some cellulite on their hips, thighs and buttocks. Men do not get cellulite. This gender difference is not simply due to hormones, but also is a result of differences in the structure of the skin and fat cells themselves. Fat cells under the skin are separated by a fibrous tissue called septa. In women, the fat cells and septa are lined up perpendicular to the skin surface. As fat accumulates and the septa become more rigid, the fat bulges around the septa and creates the rippling effect. In men, the septa are in a criss-cross pattern that prevents the bulging effect on the skin surface. Fat cells also tend to be larger in women, further contributing to the bumpy appearance of cellulite.

Women who are insulin-resistant, estrogen-dominant, and eat a high-glycemic diet are prone to cellulite formation. Dr. McQuillan states that hormone balance—especially with regard to insulin, estrogen, and prolactin—may help prevent or treat cellulite. Hormones such as TSH, adrenaline, ACTH, thyroid, glucagon, progesterone, and glucocorticoids help diminish the tendency to form cellulite. In addition to high-glycemic diets, other dietary factors such as protein intake, lack of fiber, and lack of sufficient vitamins and minerals also contribute to the formation of cellulite.

Cellulite is more than a cosmetic issue; it is an inflammatory condition. Because cellulite prevents blood flow to the subcutaneous and deep dermis layer of the skin, areas with cellulite can become sensitive or painful, and even lead to restless leg syndrome.

In The Cellulite Solution, Dr. Howard Murad offers nine strategies for reducing cellulite:

    • Prevent damage to the skin from free radicals. Free radicals can damage the skin and make it more susceptible to cellulite. Raw fruits and vegetables are the best source of antioxidants.
    • Strengthen blood flow. Damage to capillaries is an early component of the development of cellulite. Spider veins are also caused by capillary damage, and often associated with cellulite.
    • Improve the production of connective tissue. Connective tissue includes blood vessels, nerves, tendons, ligaments, and dermis (a layer of the skin). Adequate glucosamine is needed to repair connective tissue.
    • Improve collagen and elastin production. These proteins provide support for the connective tissue. Adequate intake and digestion of protein is needed for the body to make these particular proteins. Supplements of amino acids, which are the building blocks of protein, may help.
    • Attract water to cells. As we age, water that should be inside of cells increasingly tends to seep out and wander between cells and connective tissue. This “wasted water” becomes part of the bloated cellulite fat cells. Essential fatty acids, especially the omega-3 fatty acids found in fish oils, assist in repairing cell walls and help hold water within the cells and connective tissue.
    • Reduce wasted water. As cells and tissues are repaired, there is less water leaving the cells.
    • Repair cell membranes. Supplementing with lecithin or eggs can also help to rebuild cell membranes.
    • Reduce inflammation. The omega-3 fatty acids also reduce inflammation.
    • Promote exfoliation. When old dry skins cells are sloughed off efficiently, new cells now become visible. Washing skin with fruit acids (such as malic acid from apples, glycolic acids from sugarcane, and salicylic acid) helps loosen the old skin cells. Dry skin brushing is another method for removing old cells.

Folk remedies, such as those found at, include recommendations such as applying apple cider vinegar (a fruit acid), moisturizing with coconut oil (to hydrate the skin), and scrubbing the skin with coffee grounds (to exfoliate).

While many people disregard cellulite as an important health issue, it can be considered a sign of more serious underlying health problems. Drs. Murad and McQuillan both concur that addressing issues affecting the skin and fat cells will be a benefit to your total health.

Treating Cellulite2018-04-03T17:48:50-05:00

Book Review – Are You Tired and Wired? by Marcelle Pick, OB/GYN NP

Book Review – Are You Tired and Wired? by Marcelle Pick, OB/GYN NP

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy


Marcelle Pick is a nurse practitioner and cofounder of a medical clinic called Women to Women in Yarmouth, Maine. This pioneering practice provides functional medicine to prevent and treat a variety of health disorders. In her practice and in her book Are You Tired and Wired? Pick weaves the physical aspects of health disorders together with the emotional ties that often accompany them.

The primary focus of the book is a comprehensive review of “adrenal dysfunction.” However, Pick doesn’t just define the problem medically. Because she holds a bachelor’s degree in psychology, she is also able to outline a program that readers can use for emotional self-help or to seek out a practitioner to coach them in solving their problems.

We are all familiar with the adrenal “fight or flight” response. In the presence of perceived danger, the adrenal glands pump out extra hormones that enable us to deal with the challenge. However, Pick contends that we have reached a point in human evolution where, for some of us, the stress of challenges does not stop. This unremitting outpouring of adrenal hormones has consequences to both our physical and emotional health. Researchers are now attempting to measure the consequences of these changes, and gauge how these measurements can predict our long-term health and even our lifespan, referred to as “allostatic load” or “allostatic overload.” Pick identifies three dysfunctional types associated with adrenal dysfunction:

  • The Racehorse is in a constant state of stress and may even be an “adrenaline junkie,” feeling speedy all day long. The constant high cortisol levels lead to weight gain and obesity, even without feeling hungry or eating very much. The high cortisol also tends to wreak havoc with sex hormones, leading to PMS or perimenopausal symptoms and a lack of sexual interest. The high adrenaline may also cause problems with digestion, blood pressure, anxiety and tension. The Racehorse may be emotionally programmed that she is not good enough and therefore refuses to let up even while feeling exhausted.
  • The Workhorse has trouble getting up in the morning and is fueled throughout the day by copious amounts of caffeine and carbohydrates. By nighttime, the adrenals are so revved up and producing stress hormones that sleep is nearly impossible. But, even revved up, adrenal hormone production is already failing. The Workhorse puts herself in service to others ahead of taking the time to look after herself.
  • The Flatliner is totally exhausted and has trouble completing even daily chores. She struggles with low blood pressure and low blood sugar. She craves salt and sugar. She is worn out, and doesn’t even want to leave the house. Any small issue can be an unbearable stress. She tends to have problems with weak thyroid function, autoimmune diseases, and insulin resistance.

Marcelle Pick presents a detailed program designed for each of these types of adrenal dysfunction. She begins with diet and even addresses the timing of meals.  She discusses suggested nutrients and herbal support. She identifies toxin loads and ways to avoid them, including resources for alternative cleaning and healthcare products.

However, perhaps more importantly, a good third of the book is dedicated to helping people reprogram the emotional overload they carry. Pick explains that we carry many events from our childhood, and throughout our lifetime, that keep us on stress alert. She describes a patient who had a father who became loud and boisterous whenever he became drunk, sometimes hitting her while in that condition. Now, as an adult, she is married to a very kind and loving man, who sometimes raises his voice and become boisterous. This emotional trigger causes her body to react by going into high alert, even though there is no longer anything to fear.

Pick offers many techniques to help break this type of emotional programming. She also points out that we have a choice about how we perceive and react to events. A particular set of circumstances can become a very stressful situation or, with a change in our interpretation, we can learn to have no reaction at all.

Pick emphasizes the importance of this awareness because high cortisol levels produced by stress can have a profound impact on the quality of life, even shortening our lives. In simple terms, she educates us about how critical the adrenals are to our daily lives, such as:

  • At a cellular level, the enzyme telomerase protects cells that are dividing from becoming shorter and from aging. With allostatic overload, the immune cells that produce telomerase become weakened and therefore do not produce the enzyme as well.
  • With adrenal dysfunction, thyroid and growth hormone (both of which affect our metabolism, mood, and energy) are also impaired.
  • The adrenals take up the slack of declining ovarian function during perimenopause. When adrenals function is inadequate, menopausal symptoms become more severe.
  • When cortisol is high, aldosterone production is impaired, leading to low blood pressure, fatigue, muscle weakness, and a craving for salt.

Marcelle Pick believes that because the medical profession has been taught only to diagnose the extremes of too much or too little adrenal function rather than recognize it as a range of dysfunction, many people struggle with the kinds of symptoms described here. Her book offers clear explanations for typical causes of the variety of symptoms presented by adrenal dysfunction. Reading this book and absorbing some of its valuable insight may be an important first step for those who feel “tired and wired” all the time.

  • Pick M. Are You Tired and Wired? Your Proven 30-Day Program for Overcoming Adrenal Fatigue and Feeling Fantastic. 2nd Ed. Carlsbad, CA: Hay House; 2012.
Book Review – Are You Tired and Wired? by Marcelle Pick, OB/GYN NP2017-12-14T12:23:11-05:00