Hormones and Reproductive Health

Hormones and Reproductive Health

Written by Michelle Violi, Pharm.D. – Women’s International Pharmacy


Couple expecting babyWhat would we do without the human reproductive system? True, we might have fewer hormonal ups and downs, but it wouldn’t be long before humans would no longer populate the earth. Let’s take a closer look at how this very important system works in both women and men.

The Female Reproductive System

A woman’s reproductive system is delicate and complex. In order for conception to occur, it is important for a woman’s hormones to be balanced and her organs and tissues healthy. Hormones such as estrogen and progesterone play leading roles; however, there are many other hormones that are important players in the intricate process that is the female reproductive system.

Immediately following menstruation, estrogen levels begin to rise, causing the lining of the uterus to thicken. At ovulation an egg is expelled from the ovary into the fallopian tube where it travels to the uterus. After ovulation occurs, progesterone is produced from the corpus luteum, which forms in the ovary from which the egg was released.

Progesterone causes the uterine lining to become secretory and ready for the egg to implant should fertilization occur. If fertilization occurs, the fertilized egg implants in the uterine lining. The corpus luteum continues to produce progesterone until the placenta takes over its production in the second trimester of pregnancy. If fertilization does not occur, the corpus luteum breaks down, estrogen and progesterone levels fall, menstruation occurs, and the cycle begins anew.

The Male Reproductive System

A man’s reproductive system is no less complex. The primary hormones involved in the functioning of the male reproductive system are follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone.

FSH and LH are produced by the pituitary gland located at the base of the brain. FSH is necessary for sperm production (spermatogenesis), and LH stimulates the production of testosterone, which is necessary to continue the process of spermatogenesis. Testosterone also is important in the development of male characteristics, including muscle mass and strength, fat distribution, bone mass, and sex drive.

Hormonal Effects on Fertility

Infertility issues are very complicated and have many possible causes, including hormone imbalances or deficiencies. The following are just a few ways hormones play a role in fertility.

Hypothyroidism, or low thyroid function, can affect fertility due to menstrual cycles without ovulation, insufficient progesterone levels following ovulation, increased prolactin levels, and sex hormone imbalances. In a study involving 394 infertile women, 23.9% had hypothyroidism. After treatment for hypothyroidism, 76.6% of infertile women conceived within 6 weeks to 1 year.

Luteal phase deficiency (LPD) is a condition of insufficient progesterone exposure to maintain a normal secretory endometrium and allow for normal embryo implantation and growth. Progesterone is used in patients who experience recurrent miscarriages due to LPD. In addition, studies have shown progesterone can reduce the rate of preterm birth in certain individuals.


The human reproductive system is delicate, complex, and affects the overall health of women and men. Hormones serve an important role in maintaining harmony and promoting fertility in this intricate system. Because of this, achieving hormonal balance is a crucial component to supporting reproductive and overall health.

  • Lessey BA, Young SL. Yen & Jaffe’s Reproductive Endocrinology. 7th ed. Amsterdam, The Netherlands: Elsevier; 2014. https://www-clinicalkey-com.ezproxy.library.wisc.edu/#!/content/book/3-s2.0-B978145572758200010X?scrollTo=%23hl0000927 Accessed July 3, 2017
  • https://my.clevelandclinic.org/health/articles/the-male-reproductive-system Accessed July 3, 2017
  • Liedman R, Hansson SR, Howe D, et al. Reproductive hormones in plasma over the menstrual cycle in primary dysmenorrhea compared with healthy subjects. Gynecol Endocrinol. 2008;24:508-513. Accessed April 11, 2017.
  • Hassan SS, Romero R, Vidyadhari D, et al. Vaginal progesterone reduces the rate of preterm birth in women with a sonographic short cervix: a multicenter, randomized, double-blind, placebo-controlled trial. Ultrasound Obstet Gynecol. 2011;38:18-31.
  • Barda G, Ben-Haroush A, Barkat J, et al. Effect of vaginal progesterone, administered to prevent preterm birth, on impedance to blood flow in fetal and uterine circulation. Ultrasound Obstet Gynecol. 2010;36:743-748.
  • Mesen TB, Young SL. Progesterone and the luteal phase. Obstet Gynecol Clin North Am. 2015;42(1):135-151.
  • Verma I, Sood R, Juneja S, et al. Prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility. Int J Appl Basic Med Res. 2012 Jan-Jun; 2(1):17-19.
Hormones and Reproductive Health2017-12-05T12:33:07+00:00

Why Do We Get Hemorrhoids?

Why Do We Get Hemorrhoids?

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


Hemorrhoids are very common. At least we think so. It is difficult to get a handle on the prevalence of hemorrhoids since they can come and go. Many Hemorrhoids bathroomhemorrhoid sufferers will find relief from over the counter and home remedies, but some will be so miserable they will seek help from a health care practitioner. Hemorrhoids tend to be a sensitive subject. People just don’t like to talk about them.

Hemorrhoids Defined

Hemorrhoids can form above and below the rectal sphincter. If you can imagine, hemorrhoids are like varicose veins in the rectum. The veins weaken and swell. If the swollen veins are located above the rectal sphincter, they may cause few problems, but you might see bright red blood in the stools if they happen to bleed. Hemorrhoids above the rectal sphincter may begin to cause pain if the tissue prolapses which means the hemorrhoid falls below the rectal sphincter.

Hemorrhoids can also form outside of the anus below the rectal sphincter. These hemorrhoids tend to cause the most problems with pain and itching. They can also bleed. It is possible the pooling of the blood in the swollen veins may cause a blood clot or thrombus to form. The common name for hemorrhoids, “piles” (from Latin pillae meaning balls), comes from the observation of the small balls these clots form in the swollen veins.

Theories Abound

Why hemorrhoids form is still a mystery. Hemorrhoid formation may be associated with standing or sitting for long periods of time, obesity, and straining while defecating with constipation or diarrhea. Hemorrhoids also often occur during pregnancy. The exact genesis is not clear whether it is the added pressure to the pelvic region by the baby, the changes in hormones which occur during pregnancy, the straining which occurs at delivery, or perhaps a combination of all of these.

Some say that being human and walking on two feet is a risk factor for hemorrhoids; however, this is not a health issue that only occurs in humans. Dogs, cats, horses, cattle, and sheep have all been identified to suffer from hemorrhoids on occasion. Moreover, a rat model for hemorrhoids was easily created by exposing the rat’s anal tissues to an irritating oil.

Along with the cause of hemorrhoids, a number of trends have yet to be explained:

  • There may be a hereditary component in some families
  • Women with hemorrhoids during their first pregnancy often have them again in subsequent pregnancies, but the hemorrhoids then disappear once the baby arrives
  • Hemorrhoids don’t seem to occur in the young or in the elderly

Hemorrhoids and Hormones

How hormones play a role in the formation of hemorrhoids is complicated. For example, constipation is a hallmark symptom of low thyroid function. Connective tissue weakness is also a sign of low thyroid. Is the constipation the direct cause of hemorrhoid formation or is there some innate laxity in the tissue associated with hypothyroidism that causes hemorrhoids to form? Or perhaps a combination of both?

As early as 1942, a theory existed that proposed the high levels of progesterone and estrogens that occur during pregnancy may contribute to the formation of varicosities in the legs and also to hemorrhoids:

  • Increased progesterone was thought to be responsible for decreased tonicity in the vascular walls of the veins
  • Increased estrogens were thought to increase blood volume putting greater stress on venous blood circulation and leading to increased stagnation and pooling of the blood

However, as Dr. de Barros and his colleagues point out in their paper, “Pregnancy and lower limb varicose veins: prevalence and risk factors,” this does not account for the fact that varicosities can occur in one leg and not the other under the same hormonal control.

Confounding Observations

Interestingly, not all studies show the same results with regard to hemorrhoid risk factors. A September 2015 study published in PLOS ONE revealed a lower risk of hemorrhoids with a high fiber diet as have other studies. However, the reduced risk of hemorrhoids was not associated with less constipation, and the number of pregnancies a woman experienced did not affect the risk of hemorrhoids one way or the other. Surprisingly, being sedentary even correlated with a decreased risk of hemorrhoids.

Treatment of Hemorrhoids

Hemorrhoids may come and go without a clearly identified cause or remedy. However, when hemorrhoids and the associated pain become serious, most seek help from a professional. Surgical procedures such as cauterization (burning the hemorrhoids) and ligation (banding or clipping the hemorrhoids) are part of the practitioner’s medical bag to bring relief. As welcome as the relief may be, these procedures do not prevent hemorrhoids from returning and do not address the underlying cause.

Numerous home remedies may also bring some relief:

  • Apple cider vinegar and witch hazel are astringent and may help relieve the swelling
  • Hydrocortisone and even progesterone creams applied to the area may relieve inflammation
  • Whether or not constipation is a cause of hemorrhoid formation, more fiber, more hydration, and any techniques to create softer stools are likely to reduce irritation to the tender tissues
  • Soaking in warm bath water or a sitz bath may ease the pain, and Epsom salts can be added for additional magnesium
  • Cold packs may be used to help reduce inflammation and shrink the hemorrhoids

Joanne May, Doctor of Oriental Medicine, says, “It’s simple.” She feels hemorrhoids are caused by a spleen qi deficiency. In Traditional Chinese Medicine, it is the spleen which governs the muscles and organs, and a deficiency of qi may cause an overall muscle weakness including the muscles lining the veins. Hemorrhoids are thought to be a sagging or prolapse of these muscles. Dr. May recommends using herbs to strengthen or tonify the muscles.

In conclusion

It’s astonishing something as common as hemorrhoids still poses such a mystery to our medical community. Researchers are working diligently to find the answers to our questions about hemorrhoids. Hopefully, these answers will come soon. Hemorrhoid prevention will bring great relief to many.

  • Azeemuddin M, et al. An Improved Experimental Model of Hemorrhoids in Rats: Evaluation of Antihemorrhoidal Activity of an Herbal Formulation. ISRN Pharmacol. Volume 2014 Mar 11;2014:530931. doi: 10.1155/2014/530931. eCollection 2014.
  • De Barros N, et al. Pregnancy and lower limb varicose veins: prevalence and risk factors. J. vasc. bras. [online]. 2010;9(2): 29-35.
  • Peery AF, et al. Risk Factors for Hemorrhoids on Screening Colonoscopy. PLoS One. 2015 Sep 25;10(9):e0139100. doi: 10.1371/journal.pone.0139100. eCollection 2015. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4583402/pdf/pone.0139100.pdf.
  • May, J. Personal conversation: December 23, 2015.\
  • Petersen C. Hypothyroidism: Is 98.6° Really Normal? Women’s International Pharmacy. https://www.womensinternational.com/connections/thyroid-hypothyroidism/.
Why Do We Get Hemorrhoids?2018-04-05T11:28:03+00:00

Eugene Hertoghe and Thyroid Dysfunction

Eugene Hertoghe and Thyroid Dysfunction

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

Dr. Eugene Hertoghe was a Belgian physician who practiced in the early 20th century. He became a renowned thyroid expert in his time, and was so noted for his keen observations that one of the signs of hypothyroidism is named after him. To this day, the “Sign of Hertoghe” is used to describe the disappearance of the outer third of the eyebrows. In April of 1914, Dr. Hertoghe was invited to address the International Surgical Congress at what is now Columbia/NY Presbyterian Hospital.

Dr. Hertoghe’s presentation notes read like a story. The narrative reveals his observations, the conclusions he drew, and the serendipity of finding a research report describing the symptoms of a patient who had had their thyroid removed just as he encountered an unfortunate patient struggling with these same symptoms. He applied all of these findings in treating this individual and found success “feeding” the patient’s thyroid with a thyroid supplement.

Low Thyroid Function in Women
Dr. Hertoghe stated that nine of ten people who suffer with hypothyroidism are women. Thyroid sufficiency is needed for menstruation, pregnancy, lactation, and even the return of the uterus to its usual size after pregnancy.

Let’s start with menstruation. Very heavy menstrual bleeding, or menorrhagia, is a hallmark of thyroid imbalance. Dr. Hertoghe cites two possible mechanisms:

  • The mucous membrane of the uterus is infiltrated by defective uterine muscle cells causing instability.
  • Hypothyroidism creates a sort of hemophilia condition in the blood leading to a higher propensity for bleeding. One can also observe this effect when small scratches on the skin lead to extensive oozing.

Dr. Hertoghe believed women need a more abundant supply of thyroid during menstruation. He even recommended adding thyroid supplementation only during this time for some women. Symptoms often associated with menstruation are also symptoms of low thyroid function:

  • Headaches
  • Muffled tone quality in the voice
  • Physical or mental weariness
  • Back pain
  • Constipation

During pregnancy, the thyroid gland becomes enlarged and produces increased amounts of thyroid hormone. Dr. Hertoghe claimed this additional thyroid hormone is responsible for the arrest of menstruation in pregnancy which protects the fertilized egg. Recurrent miscarriage may be tied into an insufficient amount of thyroid hormone available to stop menses.

The increased levels of thyroid hormone produced during pregnancy may be stored to be called upon later to aid in producing the tremendous energy needed for labor and delivery. Thyroid hormone is also needed to help the heavy walls of the uterus degenerate and oxidize to return to usual, pre-pregnancy size.

Thyroid function plays a vital role in mammary function. Thyroid hormone must be in abundant supply for lactation to occur. In general, women who have had a quick return to pre-pregnancy uterus size also tend to have a good milk supply. Dr. Hertoghe suggested using thyroid supplementation if a woman’s milk supply is scanty and menstruation returns too early.

This article encapsulates just a small amount of the information Dr. Hertoghe presented over 100 years ago. Dr. Hertoghe applied his skills as a medical detective successfully during his career, becoming widely respected for his expertise in thyroid dysfunction. Today, practitioners are encouraged to depend upon blood tests and procedures, rather than relying on their own skills of observation and experience. A young woman of the 21st Century, who has heavy menstrual bleeding or complaints during menses, is likely to be prescribed birth control pills to regulate her cycle rather than being examined for possible low thyroid function. The question that springs to mind is: Are we better off 100 years later?

  • Hertoghe E. Thyroid Deficiency: A lecture presented to the New York Polyclinic School and Hospital. New York, NY: April 1914.
Eugene Hertoghe and Thyroid Dysfunction2018-04-02T16:04:32+00:00

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. https://www.ilads.org/.
  • 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+00:00

Nicotine’s Effects on Thyroid Function

Nicotine’s Effects on Thyroid Function

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

A growing body of data suggests that nicotine can have a detrimental effect on thyroid function. Animal research has established a cellular link between nicotine and thyroid activity. Human research also points to a possible connection between nicotine-induced altered thyroid function and cognitive impairment.

Nicotine may cause underactive or overactive thyroid symptoms in certain individuals. Reproductive-aged women, heavy smokers, and people attempting to quit smoking may be more susceptible to hypothyroidism. People already diagnosed with hyperthyroidism and the general population may more likely develop an increase in overactive thyroid symptoms.

Thyroid hormone levels should be closely monitored in smokers as well as in those attempting to quit so that abnormalities can be addressed. It may be that weight gain and other negative effects associated with smoking cessation can be minimized with thyroid hormone supplementation.

Nicotine’s Effects on Thyroid Function2018-04-04T16:23:50+00:00

Catching Up with Dr. David Brownstein

Catching Up with Dr. David Brownstein

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


Dr. David Brownstein is a family practice physician practicing in the Detroit area. He is the author of 13 books and a highly sought-after speaker. This month, I had the pleasure of hearing him speak at the Association for the Advancement of Restorative Medicine conference in Blaine, Washington.

Desiccated Thyroid and Iodine in Autoimmune Disease

During Dr. Brownstein’s presentation, he focused on the use of desiccated thyroid and iodine in patients with autoimmune thyroid disease. Desiccated thyroid is a porcine-derived thyroid hormone replacement medication containing a full complement of thyroid hormones. He shared that when he was in medical school, he was taught desiccated thyroid and iodine were not to be used in patients with autoimmune thyroid disease. Iodine was even blamed as a cause of the disease! However, when he investigated further on his own, he found practitioners had used desiccated thyroid and iodine with great success over 100 years ago. He now thinks that thyroid autoimmuneity actually arises from a scarcity of iodine in the body.

Two of Dr. Brownstein’s books focus specifically on iodine and thyroid health: Iodine: Why You Need It, Why You Can’t Live Without It and Overcoming Thyroid Disorders. In his books, Dr. Brownstein describes two of the major autoimmune thyroid diseases which involve inflammation of the thyroid gland: Grave’s Disease and Hashimoto’s Thyroiditis. Grave’s Disease is associated with hyperthyroidism (too much thyroid activity) and Hashimoto’s Disease is associated with both hyperthyroidism and hypothyroidism (too little thyroid activity). Dr. Brownstein believes that autoimmune thyroid disease is becoming epidemic, and routinely tests each new patient for thyroid antibodies associated with these diseases. He estimates that as many as 15-20% of the population are now positive for autoimmune thyroid disease.

Are We Getting Enough Iodine?

In the first part of the 20th century, it was discovered that some parts of the country are naturally low in iodine. Iodine was added to salt in an effort to prevent widespread iodine deficiency in the U.S. However, the amount of iodine in iodized salt may fall short in meeting our body’s iodine needs. Dr. Brownstein states the amount of iodine needed by the body is much higher than the Recommended Daily Allowance (RDA). In addition, over the last several decades, our exposure to bromine, chlorine, and fluoride has skyrocketed. Bromine is used as a disinfectant, in fire retardants and as an anti-caking agent in flour. Chlorine is added to our drinking water as a disinfectant. Fluoride has also been added to drinking water to decrease the incidence of tooth decay. Dr. Brownstein describes how these substances compete with iodine in the body and make it difficult for iodine to perform its necessary functions.

What Does Iodine Do in the Body?

Iodine is necessary to form distinct thyroid hormones. It is also needed to create a substance called iodolactone. Iodolactone is a key regulator of cell growth and programmed cell death. This regulator is needed to prevent excessive cell growth (including cancer) in the thyroid gland. Dr. Brownstein proposes thyroid antibodies (substances in the body that can attack the thyroid gland) form when there is damage to the thyroid gland. Iodolactone works with fish oils in a way that can protect the thyroid gland from damage. Iodine also has a number of other important functions in the body unrelated to thyroid.

Thyroid Support and Monitoring

Some patients may need desiccated thyroid in addition to iodine to support their thyroid function. However, the test most practitioners rely on to determine if thyroid hormone supplementation is needed may appear abnormal during the first few months of iodine use and then drop back down to normal levels. This test is called the thyroid stimulating hormone (TSH) test. Dr. Brownstein recommends also testing T3 and T4 levels and thyroid antibodies in addition to taking a patient’s basal body temperature and symptoms into account. Dr. Brownstein further suggests supplementing cofactors like selenium and magnesium, and antioxidants such as vitamin C.

This brief summary of Dr. Brownstein’s presentation and his books just touches the surface of how important iodine and thyroid are to our health. Dr. Brownstein shares a great deal more of his knowledge in his books and I would recommend reading them. The more we can understand about how our bodies work, the better we can direct our efforts to regaining or keeping our health.

Catching Up with Dr. David Brownstein2017-12-14T16:09:35+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

Book Review – The Bulletproof Diet by Dave Asprey

Book Review – The Bulletproof Diet by Dave Asprey

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

In “computerese,” to hack means to devise or modify a computer program, usually skillfully. Dave Asprey challenges us to use the concept of “biohacking” in his 2014 book, The Bulletproof Diet.

Dave Asprey is an early Silicon Valley computer engineer who made millions with Internet hacking. He describes hacking as needing to make complex systems work even when all the pieces of the puzzle are not available. In that respect, he came to understand that the human body is very much like a complex computer program, with some data that is missing or misunderstood. He speculated that it would be possible to use “biohacking” to solve his own health problems.

At the start of his quest, Dave Asprey writes, he was in miserable shape. He weighed 300 pounds and was unable to lose the extra weight, even though he followed various diets and a strenuous exercise program. Other health issues included chronic sinus infections, strep throat, foggy brain and difficulty maintaining focus. He was always tired and overwhelmed with the stress in his life.

Asprey came to look at his body as a complex system. He engaged in what he calls “biohacking,” or “the art of using technology to change the environment inside and outside of your body to take control and make it what you want.” His endpoints of success would be measures such as how he felt, how he performed, the success of his relationships with others, and overall happiness. Just as programmers look to find potential flaws, he took to “troubleshooting” his environment, evaluating what was working and what was not in a scientific manner.

In the end, he concluded that inflammation, toxins, hormones, neurotransmitters, gut bacteria and more play huge roles in the efforts to nourish our bodies and our brains. He asserts that the strongest variable in achieving top performance is—far and away—our diet.

In his “biohacking” journey, Asprey discovered that he had thyroid (Hashimoto’s), adrenal, testosterone and estrogen problems. Realizing that saturated fats and cholesterol are the building blocks for the sex and adrenal hormones, he deviated from the low-fat philosophy being promulgated and started eating butter from the milk of cows who had been raised eating grass. Magic happened as his focus increased, while his weight and inflammatory markers decreased.

Asprey discovered the importance of a molecule called vasoactive intestinal polypeptide (VIP) which, when depleted, disturbs our master glands (pituitary and hypothalamus). This leads to problems with insulin and glucose regulation, causing a craving for sweets. Paying attention to the proper functioning of VIP is one of the cornerstone ideas in The Bulletproof Diet.

Because our medical system prefers to use techniques such as double blind, crossover studies (which tend to limit the variables as much as possible), we are prevented from understanding our human functioning as a system. What usually evolves is something like the conventional treatment for hypothyroidism. Practitioners are taught to test for thyroid stimulating hormone (TSH). If the TSH gets too high because of the effort to stimulate more thyroid hormone production from the thyroid gland, a single thyroid hormone, l-thyroxine (T4), is prescribed. When the TSH level comes down because of the presence of T4, the treatment is considered a success. In truth, for vast numbers of people, the low thyroid symptoms are not relieved. Their practitioners are unable to shift from their linear thinking to a systems analysis, which requires “biohacking” until the other variables are revealed.

It has taken the efforts of an individual who is systems-minded (and who is trained to collect and evaluate data points in a scientific manner) to open our minds to a new approach to optimal health. Practitioners who have embraced using bioidentical hormones in a symphony of hormones have broken away from their linear thinking and learned to “biohack” for their patients. It’s revolutionary and exciting. Dave Asprey presents much more in his book, inviting us all to learn how to “biohack” our way to greater energy, focus and well-being.

  • Asprey D. The Bulletproof Diet: Lose up to a Pound a Day, Reclaim Energy and Focus, Upgrade Your Life. Emmaus, PA: Rodale Books; 2014.
Book Review – The Bulletproof Diet by Dave Asprey2017-12-11T17:42:55+00:00