Book Review – The End of Alzheimer’s

Book Review – The End of Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline by Dale E. Bredesen, MD.

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

older couple taking a walkAlzheimer’s disease is a grim disease that causes both the mind and body to deteriorate. In 1906, Dr. Aloysius Alzheimer identified plaques in the brain autopsy of a patient who had suffered from dementia, and in doing so he discovered what is generally thought to cause the symptoms of the disease that bears his name. These plaques, made from a protein called amyloid-beta, are thought to interfere with the functioning of our brains.

Since Dr. Alzheimer’s discovery over a century ago, the focus has not been in pinpointing the cause of Alzheimer’s disease, but rather in finding an effective treatment for the related symptoms. Theoretically, if we can find a drug that will stop the formation or contribute to the removal of plaques in the brain, we will be able to prevent or reverse the development of the symptoms associated with Alzheimer’s disease. We have been using this line of thinking to develop drugs since the 1980s, without success.

Dr. Dale Bredesen has turned this thinking upside down. His book, The End of Alzheimer’s, poses the questions: What if the amyloid proteins are there to protect the brain rather than disrupt the brain? Is it only when plaque formation is excessive that it interferes with nervous tissue signaling?

A Leaky Roof

Dr. Bredesen uses the metaphor of a leaky roof for Alzheimer’s disease. The roof has approximately 36 “holes,” though a few more may yet be identified. These holes signify the number of contributors he and his team have identified as playing a role in the development of dementia and Alzheimer’s disease.

The size of the holes—that is, the probability of developing Alzheimer’s disease–depends on the impact of genetics and the environment. Because each hole is a different size (depending on genetics and other factors) for each person, not every single hole needs to be patched; however, if you only patch one hole in the roof, you will still have a leaky roof. Our pharmaceutical model only has touched on one pathway—trying to stop the formation of plaques—and overlooked other possible causes, which is why our attempts at treating Alzheimer’s disease have failed.

What Causes Amyloid Production?

Among the 36 “holes” that contribute to developing Alzheimer’s disease, there are three major categories. These categories contain conditions that can be grouped together. The three major categories are inflammation, deficiencies in hormones or nutrients, and exposure to stress or environmental toxins. All of these conditions force the body to defend the brain by producing amyloid plaques, thus leading to Alzheimer’s disease.

Inflammation is the first category that may increase amyloid production. While inflammation is often related to infection, it may be caused by other things such as food or food sensitivities. Dr. Bredesen uses the example of ingesting trans-fats or sugar, substances that are known to be inflammatory.

The second category includes hormones and nutrient deficiencies and imbalances that interfere with neuronal repair in the brain. For example, vitamin D deficiency may be a critical trigger for amyloid production. See below for a more detailed description of this category.

The third category includes exposure to significant stress, poisoning with heavy metals and mold toxins, or other environmental or chemical exposures. Even the stress of menopause may instigate the disease. Because this category tends to present psychological symptoms (such as depression), which mask the symptoms of Alzheimer’s disease, these contributors can be easily missed.

Alzheimer’s Disease By the Numbers

The Alzheimer’s Association has gathered these statistics about this increasingly-prevalent disease:

  • An estimated one in ten of people over the age of 65 is affected.
  • Two-thirds of those diagnosed are women.
  • It is the sixth leading cause of death in the United States.
  • Life expectancy after diagnosis is 4 to 8 years.
  • The cost of care for Alzheimer’s disease and other dementias in the United States is estimated at $277 billion for 2018 alone.
  • One-third of seniors die with Alzheimer’s disease or another form of dementia.
  • 7 million Americans are living with dementia as of 2018.
  • In the United States, every 65 seconds a patient is diagnosed with Alzheimer’s disease.

Hormones Are a Key

As mentioned above, some of Dr. Bredesen’s findings show that the key to preventing or recovering from Alzheimer’s disease may be restoring depleted hormone levels. Of the 36 and more contributors identified, several involve hormonal imbalance. Dr. Bredesen states, “Reaching optimal hormone levels is one of the most effective and most critical parts of ReCODE (reversing cognitive decline protocol).” Based on his observations, Dr. Bredesen recommends optimizing:

  • Insulin secretion and signaling
  • Estradiol
  • Progesterone
  • The ratio of progesterone to estradiol
  • Free T3 (the active thyroid hormone liothyronine)
  • Free T4 (the thyroid hormone thyroxine which is the precursor to T3)
  • Thyroid stimulating hormone (TSH), made by the pituitary gland to stimulate the thyroid gland to produce T3 and T4
  • Pregnenolone
  • Testosterone
  • Cortisol
  • Dehydroepiandrosterone (DHEA)

Dr. Bredesen takes great care to explain the development of his ideas and the work in his laboratory. With decades of research behind him, he presents a theory addressing everything we do know about Alzheimer’s disease, and as a researcher and physician, he has been able to practically apply this theory to successfully treat patients.

Connection with Insulin

Another contributor to inflammation—and by extension, developing Alzheimer’s disease—is insulin resistance. Insulin resistance, metabolic syndrome, and diabetes all involve abnormally high levels of insulin. Some even call Alzheimer’s disease “Type 3 diabetes” because of the problems high insulin levels cause the brain. Dr. Bredesen explains that the enzyme, insulin degrading enzyme (IDE), helps us break down excessive insulin. This same enzyme can break down amyloid. If we follow a lifestyle and eating program that constantly elevates insulin, IDE may not be available in amounts needed to break down and help stop amyloid overproduction.

Sex, Adrenal, and Thyroid Hormones

A common factor of aging is the depletion of adrenal hormones (although cortisol is sometimes high), sex hormones, and thyroid hormones. The loss of hormones parallels an increased risk of Alzheimer’s disease as we age.

For each of the markers that Dr. Bredesen has identified, he also describes how to test or evaluate hormone levels, and presents what he believes are the optimal parameters. Replenishing these depleted hormones may help patients prevent or recover from Alzheimer’s disease. To restore proper hormone function, bioidentical rather than synthetic hormone replacement must be used, as bioidentical hormones are equivalent in structure to the hormones our own bodies make.

Diagnosing Alzheimer's Disease

Alzheimer’s disease used to be diagnosed only after the patient had died. An autopsy would reveal the presence of amyloid plaques, explaining the decline in the patient’s health and eventual death. Now we have testing that can identify the presence of plaques during the patient’s own lifetime. These include scans of the retina, brain scans, and checking the cerebral spinal fluid. A genetic test for Apolipoprotein (APO)E also shows potential to predict susceptibility to this disease.

Mending the Holes in the Roof

Alzheimer’s disease does not follow the “one disease, one treatment” model our current medical system relies upon. Each patient should be evaluated for their individual needs. Successfully treating Alzheimer’s must involve a personalized, complex therapy program, but the reward—giving patients the ability to reclaim their brains and their lives—makes the effort more than worthwhile. The End of Alzheimer’s presents an opportunity to forestall and correct the onslaught of this devastating disease. Thanks to his groundbreaking work, dedication to making this information available, and training practitioners to use his guidelines, Dr. Bredesen demonstrates that patients with Alzheimer’s disease do have treatment options.

© 2018 Women’s International Pharmacy

Edited by Michelle Violi, PharmD; Women’s International Pharmacy

For any questions about this article, please e-mail

Carol Petersen at carol@womensinternational.com

Book Review – The End of Alzheimer’s2018-10-08T10:45:16+00:00

Progesterone for Mental Health

Progesterone for Mental Health

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

The Diagnostic and Statistical Manual of Mental Disorders (DSM) outlines the symptoms of schizophrenia and bipolar disorders to include scattered thinking, memory problems, confusion, behavioral changes, depression, anxiety disorders, unstable emotions, uncontrollable anger, low motivation, and changes in appetite. Many psychiatrists rely on the DSM’s description of symptoms as a way to diagnose mental disorders. They attempt to describe and categorize aberrant behaviors before applying an assortment of treatments that may include antipsychotic drugs, behavior modifications, counseling, or institutionalization. Often, the goals of treatment are to return patients to society, but may not include a “cure.”

Recent studies suggest hormones–specifically, progesterone—may offer some solutions not found in standard treatments. According to Doris King, each of the DSM’s symptoms for schizophrenia and bipolar disorder can be traced back to a deficiency of progesterone. In her book, Curing Bipolar Disorder and Schizophrenia, King claims that she was able to turn around her diagnoses of both these disorders.[i] She bases many of her arguments on writings by the late Dr. John Lee, which stress the importance of maintaining normal progesterone levels.

Could Progesterone Be the Key?

Dr. Lee recommended supplementing progesterone in doses that reflect the amount of hormone the body should normally produce.[ii] However, King maintains that people who have a long history of progesterone depletion—as in the case of patients with schizophrenia or bipolar disorder—need much more progesterone, stating simply, “When you have bipolar disorder or schizophrenia, your brain doesn’t have the progesterone it needs to function properly.” She introduces the idea of a loading dose, using progesterone in doses 3-4 times higher than Dr. Lee’s recommendation, until the body’s deficit is restored. During King’s recovery from bipolar disorder she used high doses of progesterone for four months.

Niacin and Schizophrenia

Another progesterone-related angle to schizophrenia is through treatment with niacin. Niacin aids in the synthesis of the sex hormones estrogen, testosterone, and progesterone. Dr. Abram Hoffer spent his career successfully treating patients with schizophrenia with high doses of niacin, a B vitamin.[iii] Niacin taken in high doses may normalize adrenaline metabolism. Dr. Hoffer identified an oxidized metabolite of adrenaline, which he named adrenalchrome, as being responsible for the hallucinogenic effects present in schizophrenia.

Progesterone and Adrenaline Imbalance

In his book, Adrenaline Dominance, Dr. Michael Platt writes that the medical field often ignores the effects of excessive production of adrenaline by the adrenal glands.[iv] Adrenaline is part of our “fight or flight” response, which may make us shaky, hyperactive, superhumanly strong, and intensely aware. A problem occurs when adrenaline is consistently overproduced, leading to symptoms associated with ADHD, anger, depression, PTSD, bipolar disease, addictions, and more. According to Dr. Platt, progesterone, produced in both the adrenal glands and sex organs, is the natural balancing hormone for excess adrenaline.

Nerve Damage Research and Other Breakthroughs

The myelin sheath wraps itself around nervous system tissue as a protective shield. If the myelin sheath is damaged, nerve conductivity is lost. Led by Natalya Uranova, Russian scientists have published research linking damaged myelin sheaths to both schizophrenia and bipolar disorder.[v] They examined the nervous system tissue of deceased patients who had these disorders, identifying myelin damage in these patients. In another study, Michael Schumaker et al. concluded that progesterone can be independently produced by myelin tissue and can be used in myelin repair strategies.[vi]

Conclusion

Mental health has become a large focus of today’s healthcare, as researchers strive to identify the genetic and environmental influences on mental health. While sex hormones have long been associated with changes in mood—such as anxiety and depression found in PMS or menopause—we can now turn our attention to the hormonal influences on other psychiatric disorders such as schizophrenia, bipolar disorders, and more. As research continues, progesterone may emerge as a key factor in developing treatments to recover and optimize mental health.

Additional Resources:

For more information on mental health and hormones visit our Mental Health Resources page.

Progesterone for Mental Health2018-04-09T13:58:51+00:00

Hormones on Our Minds and Nerves

Hormones on Our Minds and Nerves

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

George Orwell’s novel 1984 predicted a society with language controls and “double speak.” It astonishes me how accurate these predictions have been in the field of medicine, as evidenced by the fact that various medical establishments meet regularly to decide how their members ought to think about issues such as hormones.

Some say that, without sufficient evidence to the contrary, all estrogens are alike and all progesterone/progestins are alike. Even basic science courses, going back decades, teach that very small differences in shape and size between molecules can have significant differences in their effects on the body. Recently, the KEEPS study opened the door to the idea that perhaps all estrogens are NOT alike. (See KEEPS Study for more info.)

One of the most enduring (and preposterous) pronouncements has been that women without a uterus do not need progesterone. The idea is that the hormone progesterone has a single function, which is to slough off accumulated tissue in the uterus and in doing so, preventing uterine cancer, and that it has no other effects on the body. In a perverse way, this pronouncement has saved numerous women from the effects of progestins (altered progesterone molecules) such as medroxyprogesterone, which was linked in the Women’s Health Initiative Study with an increase in breast cancer risk.

This type of limited thinking perseveres, potentially leading to serious deficits in medical care. Over 40 years ago, Dr. Katharina Dalton wrote that women without a uterus most likely had surgery to remove their uterus because of a long-standing deficit of progesterone, and actually needed much more progesterone than women reaching a natural menopause.

One area of research that is currently opening minds to the potential of hormones focuses on “neurosteroids,” which are hormones produced by nerve cells in the brain, spinal cord and peripheral nervous system, independently of hormone production elsewhere in the body. In essence, this research indicates that the “sex” hormones we commonly identify as being produced by the ovaries, testes, and adrenal glands (such as the estrogens, progesterone and its derivatives, DHEA, testosterone, pregnenolone, and others) are so important to neural function that they are also independently produced by neural tissue.

The neural tissue responds to the hormones circulating in the blood stream and to the neurosteroids (i.e., the hormones produced locally by the nerves themselves). The local neurosteroid production allows for higher concentrations of hormones when and where they are needed, and these concentrations can be 20 to 50 times the level circulating in the blood stream. Different areas of the brain, or different nerve cells, may produce or concentrate different hormones. Some hormones may also trigger opposing activities, depending on their concentrations.

The interplay of neurosteroids is extremely complicated, and the science is just getting started. What is equally exciting is that our minds are being opened to the possibilities that the so-called “sex” hormones might now also prove useful for treating neurodegenerative diseases!

Steroidal hormones are believed to help heal damaged neural tissue. For example, in the disease ALS (amyotrophic lateral sclerosis), it has been hypothesized that motor neurons may be affected by a deficiency of receptors for testosterone. Estrogens can make it worse by causing neuronal excitement. Progesterone may help repair the neurons by repairing the myelin sheath that protects them. Notably, patients with ALS typically have low progesterone levels.

With Alzheimer’s disease, changes occur in brain cells that can be linked to hormone levels, according to Dr. Ray Peat. Of prime importance is the ability of the mitochondria (i.e., the part of a cell responsible for energy production) to use oxygen. The enzyme needed for oxygen uptake is dependent upon sufficient thyroid hormones, and antagonized by the presence of estrogen, iron and toxins. A low progesterone level, relative to estrogen, results in increased levels of LH and FSH (pituitary hormones associated with menopause, when elevated). Both LH and FSH are themselves very inflammatory, and may be balanced by DHEA and testosterone, and even more so by progesterone.

Dr. Dalton found that progesterone helped women eliminate premenstrual epileptic seizures. Neurosteroid scientists have demonstrated the effectiveness of both progesterone and its metabolite allopregnanolone in preventing convulsions.

As this research continues, we may discover that vision and hearing could be improved by ensuring the healthy functioning of the nerves involved. Cognition, memory, and mood may be improved with a healthy nervous system. Mental diseases, such as schizophrenia, may be curtailed with neurosteroid hormones. And we may find that one of the brightest neurosteroid stars, progesterone, is not just for the uterus.

  • Dalton K. Once a Month: Understanding and Treating PMS. Hunter House Inc.; Alameda, CA; 1999.
  • Peat R. Demystifying Dementia, Protective Progesterone. Ray Peat’s Newsletter, Jan 2013.
  • King SR. Neurosteroids and the Nervous System. SpringerBriefs in Neuroscience; Springer Science+Business Media; New York, NY; 2013.
  • Baulieu E, Schumacher M. Progesterone as a neuroactive neurosteroid with special reference to the effect of progesterone on myelination. Steroids; 65 (2000) 605-612.
  • Schumacher M, et al. Novel Perspectives for Progesterone in Hormone Replacement Therapy with Special Reference to the Nervous System. Endocrine Reviews; 28 (4) 387-439; 2007.
Hormones on Our Minds and Nerves2017-12-14T12:54:27+00:00

Hormones and Traumatic Brain Injury

Hormones and Traumatic Brain Injury

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

 

Traumatic brain injury (TBI) is an area that has received little clinical attention—until now.

Medical researchers are now studying the impact of acute injury on the pituitary and the hypothalamus, two important hormone-producing glands in the middle of our brains.

The staggering number of soldiers returning from the wars in Afghanistan and Iraq with head injuries caused by improvised explosive devices prompted medical researchers and practitioners to review the literature for anything that would help these veterans recover. A 2010 update to a literature review in Future Neurology notes that there are literally hundreds of studies regarding the “neuroprotective” effects of progesterone and its metabolites, with most of these studies being published in the last few years. In particular, two clinical trials demonstrated the effectiveness of using progesterone to successfully treat patients with moderate-to-severe head injury, resulting in sparing the lives of about 50% of those treated. This revelation provided a ray of hope for both practitioners and veterans.

The picture gets much bigger when you factor in the many others suffering from lingering brain injuries. Each year, approximately two million Americans suffer from some sort of brain injury, ranging from mild (such as concussions) to severe, due to childhood head injuries, car accidents, sports, and even childbirth. A sudden impact to the head from external forces, or even sudden acceleration or forceful rotation, can cause an acute TBI with effects lasting anywhere from a few hours to becoming a life-long condition.

Medical researchers are now studying the impact of acute injury on the pituitary and the hypothalamus, two important hormone-producing glands in the middle of our brains. What they are finding is that long after a brain injury, and even when brain scans show no physical distortions after healing has occurred, the hypothalamus and pituitary may never fully recover. The consequences of this can be far-reaching because the hypothalamus and pituitary glands are master glands that signal the proper production of thyroid, adrenal, and sex hormones.

The resulting hormone imbalances cause a number of psychological, physiological, and physical symptoms. Some of these are depression, angry outbursts, anxiety, mood swings, memory loss, inability to concentrate, learning difficulties, insomnia, increased risk for heart attack and stroke, high blood pressure, diabetes, loss of libido, menstrual irregularities, premature menopause, obesity, loss of lean body mass, muscular weakness, and more. Practitioners working with an aging population will easily recognize these symptoms as those that mirror declining levels of TSH and thyroid hormones, DHEA and corticosteroids from the adrenal glands, and estrogens and testosterone from the ovaries and testes. These symptoms are also beginning to be recognized as associated with TBI, as well.

Dr. Mark Gordon of the Millennium Health Center in Los Angeles was among the first to make a connection between the symptoms of TBI and pituitary dysfunction, and to incorporate that discovery into his clinical practice. According to an article in the January 2012 Life Extension magazine, Dr. Gordon employs a comprehensive laboratory test panel that covers all pituitary-related hormones when treating patients with brain injury. For direct testing of pituitary hormones, he looks at growth hormone (HGH), luteinizing hormone (LH), thyroid stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), follicle stimulating hormone (FSH), and insulin-like growth factor (IGF-1) levels. He also orders tests for the secondary hormones (i.e., those produced from the thyroid, adrenal, ovary, and testes glands) including T3 and T4, cortisol, testosterone, and estrogens.

Dr. Gordon and others believe that growth hormone is particularly important because it is also neuroprotective, meaning that it enhances the survival of damaged nerve cells and even promotes the creation of new nerve tissue. Declining growth hormone has been associated with cognitive decline and memory loss, symptoms which may persist after a brain trauma.

An interesting study published in the Journal of Neurotrauma tracked cortisol, progesterone, testosterone, estradiol, and pituitary FSH and LH in men and women who had suffered traumatic injuries in car accidents, taking measurements each day after the accident. The authors noted that FSH and LH declined steadily, as did progesterone, and that these results indicated damage to the pituitary gland, which could continue chronically. They suggested that progesterone treatment might be appropriate in both men and women, but cautioned that such treatment would also affect other hormones. They also noticed that a rise in estradiol in men and a rise in testosterone in women after the trauma seemed to predict a poor outcome. In another study mentioned in the literature review update in Future Neurology, the authors reported finding that combining progesterone and vitamin D provided better outcomes, because progesterone was not as neuroprotective when a vitamin D deficiency existed.

We are fortunate to have access to hormones that can fill in these deficits and perhaps significantly improve the quality of life for the millions of people suffering from traumatic brain injuries. Unfortunately, we are sometimes hindered by the gap in time before the information gathered by research is put into practice for patients. If you have had a past head injury, it is very important to make your practitioner aware of it, especially if you suffer from any of the symptoms mentioned. In addition, requesting broader hormone lab tests may provide some answers.

Hormones and Traumatic Brain Injury2017-12-14T14:48:42+00:00

Is There a Connection Between Thyroid Dysfunction and Mental Illness?

Is There a Connection Between Thyroid Dysfunction and Mental Illness?

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

 

Endocrine glands, and the hormones they secrete, significantly affect the central nervous system (CNS). Thyroid hormones in particular are crucial to the formation and function of the CNS. The inactive thyroid hormone T4 is secreted by the thyroid gland and transported across the blood-brain barrier, where it is converted into T3, the active thyroid hormone. Adequate thyroid hormone levels are necessary to support both the neurons, which are the structural and functional units of the nervous system, and the glia cells, which connect and support the brain and spinal cord.

Suboptimal thyroid function can lead to mental disorders like anxiety, depression, bipolar disorder, and schizophrenia. Hypothyroidism may contribute to apathy, low energy, impaired memory, and problems with attention span. Hyperthyroidism may also result in mood swings, impatience, irritability, and mental decline in the elderly.

To make matters worse, medications used to treat mental disorders can adversely affect thyroid function. A comprehensive review of the medical literature concluded that some medications used to treat bipolar disorder, schizophrenia, and depression are associated with thyroid function abnormalities. These include lithium, phenothiazines, and tricyclic antidepressants. Patients using these classes of medications should be monitored for thyroid dysfunction. Patients receiving other types of mental illness drug therapies may also need to be monitored.

Additional Resources:

For more resources from Women’s International Pharmacy, see our Mental Health Resources page.

  • Noda M. Possible role of glial cells in the relationship between thyroid dysfunction and mental disorder. Front Cellular Neurosci. 2015 June; 9(194).
  • Bou KR, Richa S. Thyroid adverse effects of psychotropic drugs: a review. Clin Neuropharmacol. 2011 Nov-Dec; 34(6): 248-55.
Is There a Connection Between Thyroid Dysfunction and Mental Illness?2018-04-04T15:16:07+00:00

Book Review – Female Brain Gone Insane

Book Review – Female Brain Gone Insane by Mia Lundin, NP, RN

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

How many women have felt like her world was falling apart at some stage in her life? Assailed by symptoms such as anxiety, depression, sleep disturbances, irritability, weeping, brain fog, and loss of focus and concentration, she seeks help from her trusted medical practitioner. Traditional medicine offers her symptomatic relief with pharmaceutical chemicals such as anti-depressants, anti-anxiety agents, and sleep aids. Side effects from these medications sometimes lead to the addition of more medications. When this option fails, the medical practitioner, at a loss, may tell her, “It’s all in your head.” This roller coaster of symptoms can make any woman think she is going insane.

This happened to Mia Lundin, NP, author of Female Brain Gone Insane, after she gave birth to her second child. Although resistant, she did turn to antidepressants for a time. Prior to using antidepressants, she noticed an injection of progesterone dramatically relieved her symptoms for a few days. Ultimately, her curiosity about hormones, sparked by the benefit she experienced with progesterone, led her to a 20-year clinical practice using bioidentical sex, adrenal, and thyroid hormones along with amino acids to help with neurotransmitter production in the brain.

Neurotransmitters are made in the body from amino acids obtained by digesting proteins in the diet. Neurotransmitter balance is a key component of brain function. There are over 50 known neurotransmitters, but those we understand the best are serotonin, GABA, norepinephrine (or noradrenaline), and dopamine. The first two have calming effects and the second two are excitatory. Neurotransmitters do not operate alone, but are greatly influenced by sex, thyroid, and adrenal hormones.

A woman’s hormone levels may be especially affected at certain times during her life. Hormone fluctuations may occur cyclically before a woman’s period, after childbirth, and during perimenopause. Low hormone levels are common during perimenopause, menopause, and surgical menopause. These hormone level changes may produce changes to the hormone-brain chemistry balance.

Estrogen affects serotonin activity in a number of ways. Estrogen makes tryptophan, an amino acid precursor to serotonin, more available in the brain to make serotonin. Estrogen also supports serotonin levels by enhancing the removal of the enzyme, monoamine oxidase (MAO), that breaks down serotonin in the brain. Additionally, estrogen sensitizes serotonin receptors and fluctuating estrogen levels may impair the production of serotonin. Loss of the calming effect of serotonin may trigger symptoms of agitation, sensitivity, and uneasiness.

Adrenal cortisol may become depleted when the body is under continuous stress. When this happens, estrogen and progesterone can become unbalanced. GABA levels may be affected because progesterone stimulates GABA production. Serotonin stores may also become depleted.

On the other hand, if adrenaline and cortisol are high, as during a response to acute stress, and estrogen is out of balance with progesterone, thyroid activity may be inhibited. Low thyroid function can contribute to low serotonin levels and low serotonin levels can contribute to low thyroid function.

In Female Brain Gone Insane, Lundin does much more than describe how the disruption of hormones affects brain chemistry. She supplies lists of symptoms to help identify hormone deficiencies and excesses, provides suggestions on hormone testing and how to have it done, and she suggests ways to approach medical practitioners to find assistance with hormone use. She provides questionnaires and charts for those who want to help themselves. In short, she provides the framework for an entire lifestyle makeover. Women who feel that their world has fallen apart can find guidance back to themselves in this book.

This book is an excellent primer for those who want to learn more about bioidentical hormone therapies. Further, it is so well-referenced that practitioners who want to start learning about identifying and helping their patients with hormone-brain chemistry imbalances will find what they need here.

Book Review – Female Brain Gone Insane2018-06-14T10:49:33+00:00

A New Treatment Program to Improve Memory Loss

A New Treatment Program to Improve Memory Loss

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

In spite of hundreds of clinical trials over the past ten years, Alzheimer’s disease (AD) has no effective treatment. AD affects 5.4 million Americans, predominately females. It is estimated that women have a greater chance of developing AD than breast cancer.

Research supports the theory that an imbalance in brain nerve cell signals causes this disorder. Specific signals make nerve connections to cement memories while others allow irrelevant memories to be lost. This signaling system becomes imbalanced so that new memory connections are inhibited while more information is forgotten. Reversible metabolic processes may be involved in the early stages of AD.

Dr. Bredeson and his colleagues at UCLA believe that a comprehensive, personalized approach is the best way to treat memory loss. They have developed a program that optimizes diet (no simple carbohydrates, gluten, or processed foods), utilizes meditation and yoga, and emphasizes the importance of sleep, hormones, good oral health, and exercise. Patients may use supplements as well as medium chain triglycerides like coconut oil or Axona.

The researchers believe that free T3 and T4, estradiol, testosterone, progesterone, pregnenolone, and cortisol need to be optimized. Nine out of ten patients in this pilot program had cognitive improvement.

Additional Resources:

For more resources from Women’s International Pharmacy, see our Mental Health Resources page.

A New Treatment Program to Improve Memory Loss2018-04-04T15:44:16+00:00

A Tribute to Dr. Katharina Dalton

A Tribute to Dr. Katharina Dalton

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

 

Even though they’re not really funny, PMS jokes abound in today’s society. It’s very likely that most of us toss around the acronym of PMS (for premenstrual syndrome) without giving a thought as to where or how it originated.

In 1994, there was a movie titled Tom and Viv about the relationship of the American poet T.S. Eliot and his wife, Vivienne Haight-Wood Eliot, whom he married in 1915. Upon their marriage, he became the custodian not only of her money, but also of her physical being. Vivienne suffered terribly each month from what we now would recognize as PMS. After unsuccessfully trying to help her, T.S. Eliot had his wife committed to an asylum where she spent the remainder of her days. He never saw her again after she was committed. This movie reflected the thinking at that time. Women who suffered from hormone disturbances were thought to have mental rather than physical problems.

Dr. Katharina Dalton made a huge contribution to our understanding of hormone disturbances, and she is also the one who named the syndrome PMS. She identified and successfully treated many problems that were uniquely female. As we explore the mysteries and benefits of hormone therapies today, we are standing on the shoulders of her achievements, which include a tremendous amount of observation and study.

On her death at the age of 87 on September 17, 2004, Dr. Dalton’s life and work were reviewed by many major newspapers in Great Britain, where she practiced, and in the United States, where she also made a huge impact by identifying physical reasons for issues that had previously been dismissed as hysterical or only a figment of the mind. The concept of a women’s health movement may very well have started with her work.

At age 32, Dr. Dalton was still a medical student and pregnant when she wondered why she was suddenly free of the severe headaches she had experienced monthly. She took her observations to Dr. Raymond Greene, an endocrinologist, and speculated that progesterone, which is abundant during pregnancy and also should be abundant during the luteal phase (the second half of the menstrual cycle), might be the key. She and Dr. Greene first published their clinical experiences and theory in British medical journals in 1958, and proposed the term premenstrual syndrome. By then, Dr. Dalton had successfully treated premenstrual asthma, epilepsy, and migraine headaches with progesterone.

Progesterone, which has an effect throughout the body, is produced in the adrenal glands in addition to the progesterone produced by the ovaries. Dr. Dalton used progesterone that was equivalent in structure to the hormone found naturally in the human body. She was adamant that other synthetic derivatives of progesterone could not be used, contrary to what her medical colleagues believed.

Throughout her career, Dr. Dalton carefully examined her patients, collected data, posed theories, and tested her ideas. She developed a system of charting to help monitor the large number of symptoms that could present with PMS. An adaptation of the Symptoms Chart is available for download from our website.

One of Dr. Dalton’s observations was that some of the symptoms of PMS (including edema, hypertension, and albumin in the urine) seemed to also occur as early signs of toxemia in pregnancy. She began trials of intervention with progesterone, in collaboration with a maternity hospital. The hospital records showed an average incidence of toxemia to be 9%. After the first patients who were treated delivered babies in 1955, the incidence dropped to a low of 1.0%. Each patient was given a test dose of progesterone when early symptoms occurred, and then treated continually if symptoms resolved, while moderating the doses according to symptom relief.

Men, women, and children all have progesterone receptors in operation throughout their lifetime. Dr. Dalton focused her attention on progesterone receptors and, because only natural progesterone fits the receptors, she felt this was the only appropriate hormone to use. She also understood that, if there was too much adrenalin being produced, progesterone would not be able to be picked up by the receptors. Similarly, if women were experiencing swings of low blood sugar, progesterone would also not activate the receptor.

Dr. Dalton used very generous doses of progesterone to treat women; often a 400 mg suppository would be the minimum dose. Tests to measure levels of progesterone in the body using various means were immaterial, in her opinion, because the only meaningful test would be at the receptor sites. Successful treatment would be verified by a positive response to supplementation.

Dr. Dalton observed that progesterone has a very positive effect on hair growth in women. After delivery of a baby, many women experience significant hair loss because of the sudden drop in progesterone. When progesterone is supplemented for those women, the hair regrows luxuriantly.

Progesterone has also proven to be effective for brain trauma because of its protective effect on the myelin sheath, which covers nerve tissue. Additionally, progesterone can reduce swelling in the brain and has even been used by neurosurgeons prior to surgery.

Dr. Dalton also claimed that there was no unsafe dose of progesterone. In high enough doses, started before ovulation, progesterone could be used as a safe contraceptive. It was also safe to use with breast cancer, even concurrent with breast cancer treatments.

Prior to menopause, Dr. Dalton noticed that progesterone would typically start to become deficient for at least two years. During this time, women would develop symptoms that were similar to those she identified as PMS, which we now identify as symptoms of perimenopause.

She also identified the onslaught of symptoms some women experience after childbirth as having a pattern similar to PMS. She advocated for using large doses of progesterone immediately after childbirth, especially in those women with a history of PMS, to cushion them from the effects of the huge drop in progesterone that occurs at delivery.

Unlike current conventional thinking, Dr. Dalton claimed that women who have had a hysterectomy need more than the amount of progesterone needed by a woman who has undergone a natural menopause. The reasons behind most hysterectomies are consistent with a long-term progesterone deficiency; thus, so much more progesterone is needed to relieve symptoms afterwards. Ignoring the considerable research on progesterone receptors throughout the body, many practitioners today still believe that women with a hysterectomy do not need any progesterone because they maintain that it is only the uterus that benefits from progesterone and, because the uterus has been removed, progesterone no longer has any function.

As an active advocate in the justice system, Dr. Dalton also published a book titled Premenstrual Syndrome Goes to Court. She studied women serving time in prison and found that a large majority of the violent crimes committed (such as manslaughter, baby battering, and assault) occurred during the luteal phase in women who had a history of PMS symptoms. As part of her study, Dr. Dalton devised a menstrual chart indicating symptoms and their cyclical occurrence, helping the women establish the cyclical and hormone dependent nature of the symptoms. She appeared in court in about 50 trials in defense of women suffering from PMS and claiming a state of diminished responsibility if their criminal actions occurred during the luteal phase of their cycle.

She tried to find an independent marker for PMS and studied sex hormone binding globulin (SHBG). In the groups studied, she found that SHBG, which would bind estrogens and testosterone tightly, was low in the women suffering with PMS. She theorized that low SHBG translated into more free estrogens, which then created inadequate progesterone activity. This premise, unfortunately, was not verified by other scientists.

Dr. Dalton practiced the true scientific method. She made her observations based on the evidence she found, devised a theory that tested the observations she made, and tested her theory. She even applied her theory to situations beyond PMS, recognizing the implications of a host of different symptoms, to further an understanding of the importance of progesterone, as illustrated by her observations of patients with post-partum depression and toxemia during pregnancy.

Today, faced with the numerous symptoms that present with PMS, scientists only look at one issue at a time. Instead of turning to progesterone, which is indeed the golden key for progesterone receptors (as Dr. Dalton has shown), we treat PMS piecemeal with diuretics for edema, with narcotics and anti-inflammatories for pain, with anti-epileptics for seizures, and with antidepressants, anxiolytics, and antipsychotics for mood disorders.

Some say it takes 50 years for a new idea to take hold in our collective minds and, since we are now more than 50 years from her first publication, the time is now ripe for acceptance of Dr. Katharina Dalton’s work with progesterone. Pointing to the current widespread use of bioidentical hormone therapies in women’s health today as proof, perhaps her ideas have at last garnered a place in our consciousness.

  • Gilbert B. Tom & Viv. Oxford, Oxfordshire, England, UK; Miramax Films; 1994.
  • Oliver M. Katharina Dalton, 87; First Doctor to Define, Treat PMS [obituary]. Los Angeles Times. September 28, 2004.
  • Dalton K, Holton W. Depression after Childbirth: How to Recognise, Treat, and Prevent Postnatal Depression (4th Edition). Oxford, United Kingdom: Oxford University Press; 2001.
  • Allen LV Jr, et al. Interview: Katharina Dalton, MD: Progesterone and Related Topics. Int J Pharm Compd. 1999 Sep/Oct:332-9.
  • Dalton K, Holton W. Once a Month: Understanding and Treating PMS (6th Edition). Alameda, CA: Hunter House Publishers; 1999.
  • Dalton K. Premenstrual Syndrome Goes to Court. Droitwich, UK: Peter Andrew Publishing Co Ltd; 1990.
  • Dalton K. Should Premenstrual Syndrome be a Legal Defense? In: Ginsburg BE, Carter BF, eds. Premenstrual Syndrome: Ethical and Legal Implications in a Biomedical Perspective. Boston, MA: Springer-Verlag US; 1987:287-300.
  • Dalton ME. Sex hormone-binding globulin concentrations in women with severe premenstrual syndrome. Postgrad Med J. 1981 Sep;57(671):560-1.
  • Dalton K. Toxaemia of Pregnancy Treated with Progesterone during the Symptomatic Stage. Br Med J. 1957 Aug 17;2(5041):378-81.
A Tribute to Dr. Katharina Dalton2018-04-03T11:13:16+00:00

Is Vitamin B12 Safe to Use in the Presence of Mercury Fillings?

Is Vitamin B12 Safe to Use in the Presence of Mercury Fillings?

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

 

Methylcobalamin (meB12), along with folate and vitamin B6, is often used in Sweden to treat symptoms of chronic mercury poisoning as well as diabetes, fibromyalgia and multiple sclerosis. Some practitioners prefer meB12 as it is the only form of B12 present in the brain.

Concerns have been raised about the safety of using meB12 in the presence of mercury. The fear is that meB12 will react with inorganic mercury fillings to create methyl mercury, which they speculate is more toxic than inorganic mercury, and thus should be avoided in individuals with mercury fillings.

Dr. Christopher Shade, PhD, president of Quicksilver Scientific, LLC, disagrees. While some people do seem to have neurological reactions to meB12, he suggests that those reactions are related to disturbances in methylation and/or to neuro-inflammatory conditions rather than the mercury. He feels there is growing evidence that inorganic mercury is more toxic to cells than methyl mercury.

MeB12 may actually assist in detoxifying inorganic mercury in the body. Related research is ongoing and we will be keeping a close eye on the results.

  • Shade CW, President Quicksilver Scientific, LLC, personal correspondence, February 14, 2014.
  • Ahlrot-Westerlund B. Vitamin B12 Levels and Mercury – A Link with Multiple Sclerosis and Other Disorders. https://www.whale.to/w/b12.html: February 18, 2014. 10(2):117-124.
Is Vitamin B12 Safe to Use in the Presence of Mercury Fillings?2018-04-03T17:29:54+00:00

Pediatric Vitamin B12 Deficiencies

Pediatric Vitamin B12 Deficiencies

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

 

According to Sally M. Pacholok in the February 2014 issue of Pharmacy Times, vitamin B12 deficiencies often go undiagnosed in infants.

What is even worse is that some of the symptoms of this deficiency so closely resemble those of autism that the child is misdiagnosed, when a simple replenishment program could reverse the symptoms. These symptoms include developmental delay, flaccid muscles, tremor, seizures, reduced IQ, and mental retardation. MRI scans will actually reveal brain atrophy.

Sadly, although medical professionals now pay close attention to folic acid levels for pregnant women, many don’t realize that vitamin B12 deficiencies are also involved in neural tube defects, preeclampsia, and miscarriage. Prenatal vitamins do not contain enough vitamin B12 to restore a depleted mother’s levels.

Ms. Pacholok urges that women intending to get pregnant, or who are nursing, be screened for vitamin B12 deficiency. She also suggests that infants who are colicky, or apathetic and slow to develop, also be screened. In these cases, restoring depleted B12 can make a great deal of difference.

Pediatric Vitamin B12 Deficiencies2018-04-03T17:30:29+00:00