Hormones, Probiotics, and the Human Microbiome

Hormones, Probiotics, and the Human Microbiome

Adapted from the Connections eBook Probiotic Potential

Written by Carol Petersen RPh, CNP 
Reviewed and Updated by Michelle Violi PharmD 
Published by Women’s International Pharmacy

The microbiome organ is a collection of microbes or single-celled microorganisms—called microflora—that live on and in the body. The human body contains 100 trillion cells, and 90% of them are not even our own—nearly all of these are bacteria; the rest are yeasts and parasites. These microbes are incredibly diverse in size, shape, col­or and growth rates, and may include as many as 1,000 different species.

Among our body’s microbes you will find:

  • The “good” – Probiotics like Lactobacillus, a strain of bacteria commonly found in yogurts with active cultures.
  • The “bad” – Bacteria that usually result in serious illness, such as Salmonella.
  • The “risky” – Several bacterial species that are beneficial when they are in the right place and quantity, but may lead to health issues if their numbers are unbalanced or if they are located in the wrong part of the body. For example, species of Klebsiella make vitamins B12 and K when they’re in the small intestine, but may cause pneumonia when they’re inside the lungs.

The microbiome begins developing at birth and changes throughout our lifetime. Environment plays a larger role in determining microbiome makeup and health than genetics, which explains why members of the same household may have similar conditions even without being genetically related.

Microbial imbalance in our gut can affect other systems in our body, including our hormonal system. The digestive system plays an important role in the proper disposal of es­trogens from the body. When the flora in the intestines is disturbed, estrogen that should be excreted may instead be recycled into the bloodstream, creating hormone imbalance.

The development and changing of the microbiome over time may coincide with other physical changes. Many major life changes such as puberty, pregnancy, and menopause that affect the microbiome also affect hormone balance: University of Utah’s webpage Your Changing Microbiome provides just a few examples, saying: “puberty affects skin microbes by causing changes in skin oils. And pregnancy brings on changes in the vaginal microbiome: species start to grow that will colonize and benefit the baby as it’s born.”

Optimizing Microbiome Health to Maintain Hormone Balance

A probiotic—literally, “for life” in Greek—is defined as “a preparation or a product containing a sufficient number of live microorganisms to alter the flora of the host and bring about beneficial health effects.” In short, probiotics are “friendly” bacteria (and sometimes fungi) that we import into our system to hold more dangerous mi­crobes in check. A growing number of scientific studies have found that probiotics may aid both digestive and immune system health.

Yogurt, aged cheese, and many other cultured and fermented foods make up this category of “superfoods.” Probiotic foods or supplements are generally safe and widely available. Most people find them both tasty and easy to digest.

In general, probiotics promote healthy diges­tion. Microbes in the intestines make short-chain fatty acids (needed for GI tract health), antioxi­dants, amino acids, and vitamin K. Nutrients in fermented foods absorb more readily than nutrients in unfermented foods. Fer­mented foods use agents such as yeast, bacterium, molds, or enzymes to break down a substance into simpler substances; examples include converting milk to yogurt or cheese, fermenting soy to make miso, and fer­menting cabbage to make kimchi or sauerkraut.

Getting a beneficial effect for individ­ual health need depends on various factors, including:

  • The strain of probiotics selected and how the body can use it
  • The numbers of live probiotics in the pur­chased product, and whether they are stored and taken properly

Safety, Storage, and Use of Probiotics

Probiotics are safe for the majority of people, except for those at high risk for infections of all types (such as those with HIV/AIDS or cancer), or those taking immune-suppressive steroids. It is always advisable to check with your prac­titioner before taking any new supplements, as probiotics do have the potential to interact with some medications. Moreover, your practitioner can help you select the probiotic that is best suited to treating your particular condition, notes Dr. Kelly Dowhower Karpa in the book Bacteria for Breakfast: “You may have to search for the right probiotic, the appropriate number of microorganisms, or the necessary combination of probiotics until you find the right mix to successfully fill the bacterial niche missing in your gastrointestinal tract.”

Whether taken by pill (as a supplement) or by plate (in food), either form of probiotics can be effective as long as proper procedures of storage and ingestion are followed. Although it might seem that pill supplements would be required for the lactose-intolerant, that is not neces­sarily the case. Probiotics have been shown to help break down lactose, reducing symptoms of the illness and allowing sufferers to reintroduce dairy into their diet—at least in the form of yogurt and other fermented products.

Any form of probiotic should be purchased with care to ensure you are receiving the promised strain and quantity of live bacteria (or, in some cases, fungi), and that it has been properly stored. Foods containing live cultures must be kept refrigerated, and storage dates must be strictly followed. In Acidophilus and Your Health, author Frank Murray includes this advice when purchasing yogurts:

  • Always purchase yogurt with “live, active cultures,” including Lactobacillus acidophilus
  • Avoid frozen yogurt or pudding-style yogurts, which have stabilizing chemicals and artificial sweeteners added


Probiotics play an integral part in many of the body’s functions, including:

  • Microbiome health
  • Proper digestion
  • Hormone balance
  • Strengthening the immune system
  • Prevention of allergy development

When trying to incorporate dietary or supplemental probiotics into your lifestyle, recommendations from your healthcare practi­tioner may help guide you to reliable products from proven manufacturers. Finding the right probiotic for your individual needs may help optimize microbiome health—and, by extension, hormone balance and overall wellness.

Read the complete Connections e-Book:

Probiotic Potential

Using “Friendly” Bacteria to Promote Healthy Digestion, Strengthen Immunity, and More

  • Karpa KD. Bacteria For Breakfast: Probiotics for Good Health. Trafford Publishing; Victoria, BC, Cana­da; 2003.
  • Murray F. Acidophilus and Your Health. Keats Publishing Inc.; New Canaan, CT; 1998.
  • Petersen C, Violi M. Probiotic Potential. Women’s International Pharmacy. https://www.womensinternational.com/portfolio-items/probiotics/. Reviewed and updated August 2019.
Hormones, Probiotics, and the Human Microbiome2019-08-23T12:19:11-05:00

Can Vitamin D Keep the Doctor Away?

Can Vitamin D Keep the Doctor Away?

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


Vitamin DVitamin D is well-known for its role in the regulation of calcium balance and bone health. Within the last ten years, an enormous amount of research has focused on additional benefits. Observational studies report that low vitamin D levels may increase the risk of TB, HIV, Hepatitis C, respiratory tract, and other infections.

The vast majority of human cells have vitamin D receptors. It is particularly essential for optimal immune system function. Vitamin D stimulates cells that fight against bacterial, fungal, and viral infections while creating an inhospitable environment for microbial growth.

Not only does vitamin D support a healthy immune system, it helps control an overactive immune response by suppressing cells that cause excessive inflammation. If you suffer from multiple infections or inflammatory symptoms, checking your vitamin D level might be just what the doctor ordered.

Can Vitamin D Keep the Doctor Away?2018-04-03T17:26:22-05:00

Vitamin K2 – A Missing Link in the Western Diet?

Vitamin K2 – A Missing Link in the Western Diet?

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

In 1925 an enterprising dentist, Dr. Weston Price, and his wife began traveling the world and documenting their observations of healthy, remote populations. They observed significant changes in tooth arrangement and mouth and facial structure when people of various cultures strayed from their traditional diet and adopted the Western diet. Traditional diets varied greatly, but all consisted of animal protein and fat in the form of fish, fowl, land animals, eggs, milk and milk products, reptiles, and/or insects. The Western diet introduced processed foods, sugar, and grains. Narrowed mouths, crowded teeth, thin faces, and smaller arches appeared in children whose parents adopted the Western diet. Dr. Price suspected that something specific was missing from the Western diet. He called this mysterious factor Activator X. He demonstrated that Activator X was prevalent in the meat and milk products of animals that grazed on green grasses. He even showed that these facial and dental abnormalities could be reversed in the next generation if Activator X was replaced in the diet. Finally, in 2006, Dr. Price’s Activator X was identified to be vitamin K2.

Confusion With the K’s
There are a number of types of vitamin K, but only two natural forms: vitamin K1 and vitamin K2. Vitamin K1 is present in leafy, green vegetables and is most identified with blood clotting. The drug, Coumadin, works to prevent blood from clotting by inhibiting the action of vitamin K1. The effects of excessive Coumadin may be reversed by administering vitamin K1.

Vitamin K2 exists in a number of distinct active forms. The two most commonly seen are designated as MK-4 and MK-7. MK-4 is present in the organs, milk, eggs and cheese of grass-fed animals. MK-7 is most abundant in a bacterial ferment of soy beans called natto. It is also present in lesser amounts in other fermented foods. Vitamin K2 does not appear to share Vitamin K1’s association with blood clotting.

A Calcium Paradox
Nutritional biochemistry is complicated. In order to learn how various vitamins and minerals work in the body, we often look at the function of one single nutrient at a time. However, when we do this, we fail to understand how nutrients work together. For example, we know that bones need calcium, but supplementing with calcium alone is unlikely to strengthen one’s bones. We need to consider how a number of nutrients work together to contribute to bone health. Each of the fat soluble vitamins, A, D, E, and K, works together synergistically. Vitamin D facilitates calcium absorption into the blood stream. Vitamin K2 converts vitamin D into its active form and also activates the hormone osteocalcin to direct the calcium to the bone. A deficiency of any one of these vitamins may cause malfunctions in the body. Specifically, a deficiency of vitamin K2 may cause calcium to be stored in other tissues rather than being directed to the bone. If calcium settles in the arteries, it can lead to atherosclerosis. Calcium may also cause problems by settling in the joints and in soft tissues like the breasts.

The French Paradox Solved?
Many find it surprising that the French eat a lot of cholesterol and saturated fat and have low rates of death from coronary heart disease (CHD). Some think it’s an ingredient in red wine that keeps them healthy. Perhaps these saturated fats laden with vitamin K2 are the protective factor.

Vitamin K2 in All Parts of the Body

  • Heart Disease: One of the most powerful tools against calcification of the blood vessels is a vitamin K2 activated protein.
  • Osteoporosis: Vitamin K2 activated osteocalcin directs calcium to the bones.
  • Diabetes and Metabolic Syndrome: Vitamin K2 improves insulin sensitivity thus potentially stalling progression to metabolic syndrome and diabetes.
  • Wrinkles and Tissue Laxity: May be due to a vitamin K2 deficiency causing misplaced calcium in the skin and tissues.
  • Varicose Veins: May be due to a vitamin K2 deficiency causing calcium to deposit in the veins.
  • Arthritis: Joint damage may reflect a vitamin K2 deficiency.
  • Dental Health: Vitamin K2 may be useful in treating and preventing dental cavities.
  • Pregnancy: Adequate vitamin K2 promotes the healthy development of fetal teeth and facial structure. Also, labor may be easier when vitamin K2 levels are adequate.
  • Cancer: Vitamin K2 promotes cell differentiation and may protect against metastasis.
  • Nervous System: Vitamin K2 plays a role in nervous system protection, myelin development, and signal transduction.

Vitamin K2 and Hormones
Vitamin K2 has an important relationship with estrogen and bone health. Estrogen and bone density both decline during menopause and postmenopausal women are often markedly deficient in vitamin K2. Bone health may be improved in postmenopausal women by restoring adequate vitamin K2 levels as vitamin K2 acts in the bone loss pathway in a number of areas specific to the loss caused by low estrogen levels. Vitamin K2 also plays a role in estrogen metabolism itself. Additionally, testosterone levels and sperm production may be improved by osteocalcin, the hormone activated by vitamin K2.

It is remarkable that it took decades from Dr. Weston Price’s careful observations and characterization of Activator X to finally identify vitamin K2 and a number of its myriad functions. We are still not sure of the appropriate supplement dose to use or the amount of vitamin K2 rich foods to eat. Tests are being devised to help evaluate our vitamin K2 status. In the near future, we will be able to measure vitamin K2 levels as readily as we test for vitamin D now. Research has only scratched the surface of the potential of this fascinating vitamin!

Vitamin K2 – A Missing Link in the Western Diet?2018-04-05T11:10:21-05:00

Diabetes and Osteoperosis

Diabetes and Osteoporosis: Is Vitamin D the Missing Link?

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


Studies suggest that osteoporosis and bone fractures are a significant and under-reported complication of Diabetes Mellitus (DM). An increase in osteopenia and bone fracture risk, coupled with a decrease in bone mineral density (BMD), is well documented in diabetics with little or no insulin production (Type I).

This same risk in diabetics with insulin resistance (Type II) is more uncertain. Even though Type II diabetics have a higher BMD than the non-diabetic population, both Type II and Type I diabetics have an increased risk of experiencing an osteoporosis-related fracture.

There may be more than just low BMD involved. Cytokines are substances made in immune system cells that have negative effects in both diabetes and osteoporosis. Vitamin D is known to be beneficial to the immune system as well as helpful in maintaining bone health.

Scientists have recently theorized that vitamin D may be beneficial in preventing Type I and Type II diabetes. Epidemiological studies have demonstrated that high doses of vitamin D are associated with a decreased risk of Type I diabetes when cod liver oil is given to babies or mothers in their third trimester.

Multiple studies suggest that vitamin D has a positive effect on pancreatic cells as well as on insulin production, secretion, and sensitivity. Higher blood levels of vitamin D3 are associated with a lower risk of metabolic syndrome in Type II diabetics. Poor blood sugar control has been observed during the winter months when vitamin D from the sun is less available.

Wouldn’t it be wonderful if vitamin D could help build strong bones while combating diabetes at the same time? Further research is warranted.

  • Leidig-Bruckner G, et al. Prevalence and Determinants of Osteoporosis in Patients with Type I and Type 2 Diabetes Mellitus. BMC Endocr Disord 2014;14(33):1-13.
  • Chau DL, Edelman SV. Osteoporosis and Diabetes. Clinical Diabetes. 2002;20(3):153-157.
  •  Brown SA, Sharpless JL. Osteoporosis: An Under-appreciated Complication of Diabetes. Clinical Diabetes. 2004;22(1):10-20.
  • Harinarayan CV. Vitamin D and Diabetes Mellitus. Hormones. 2014;13(2):163-181.
  • National Institutes of Health. What People with Diabetes Need to Know About Osteoporosis. https://www.niams.nih.gov.
Diabetes and Osteoperosis2017-12-13T12:42:53-05:00

Mitochondrial Dysfunction & Hypothyroidism

Mitochondrial Dysfunction and Hypothyroidism

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


Mitochondria are biological structures that produce energy within cells. They act much like engines that produce energy within cars. Fuel (food) combines with oxygen, which combines with one or more catalysts (vitamins) within each cell to ignite energy production.

Lack of cell energy has been associated with conditions such as autism, chronic fatigue, diabetes, fibromyalgia, heart disease, hypothyroidism, multiple sclerosis and obesity. Drugs, environmental toxins and insulin resistance may trigger mitochondrial dysfunction, while thyroid hormones are known to enhance energy production in skeletal muscle cells.

Energy production is compromised in people with hypothyroidism. One study found evidence that elevated TSH (an indicator of low thyroid function) resulted in decreased energy production in 34 obese adolescents compared to 32 lean adolescents. Another study found mitochondrial dysfunction in blood cells obtained from persons with subclinical hypothyroidism (elevated TSH, normal T4 and minimal to no physical symptoms). The ratio of T4 to T3 thyroid hormones in these subjects was low when compared with normal subjects.

Vitamins, particularly thiamine (B1), minerals and other nutrients, like Coenzyme Q 10 and L-Carnitine, are also helpful for maintaining healthy energy-producing cells.


  • Marrs C. Why Fatigue Matters in Thyroid Disease. Hormones Matterhttps://www.hormonesmatter.com/fatigue-matters-thyroid-disease/: November 7, 2013.
  • Bloomquist L. Could Autism Be Linked to Mitochondrial Dysfunction? Hormones Matterhttps://www.hormonesmatter.com/autism-linked-mitochondrial-dysfunction-mri-shows-lactate-doublets/: April 14, 2014.
  • Crunkhorn S, Patti ME. Links Between Thyroid Hormone Action, Oxidative Metabolism, and Diabetes Risk? Thyroid. 2008 Feb;18(2):227-37. doi: 10.1089/thy.2007.0249.
  • Kvetny J, et al. Subclinical Hypothyroidism Affects Mitochondrial Function. Horm Metab Res. 2010 May;42(5):324-7. doi: 10.1055/s-0030-1248261. Epub 2010 Feb 22.
  • Wilms L, et al. Evidence of Mitochondrial Dysfunction in Obese Adolescents. Acta Paediatr. 2010 Jun;99(6):906-11. doi: 10.1111/j.1651-2227.2009.01635.x. Epub 2009 Dec 15.
Mitochondrial Dysfunction & Hypothyroidism2017-10-19T16:56:51-05:00

What Does Tinnitus Have To Do With Hormones?

What Does Tinnitus Have To Do With Hormones?

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


Tinnitus, commonly known as “ringing in the ears,” is prevalent among the elderly and in women. The severity can vary from a mild annoyance to significantly disturbing.

Tinnitus may also be associated with deafness and dizziness. Most will experience a temporary tinnitus when exposed to loud sounds. Loud sounds can also induce a chronic tinnitus.

The “ringing in the ears” can actually be heard as a variety of sounds such as ringing (the word tinnitus comes from the Latin word for “ringing”), buzzing, whooshing, swishing or clicking. These sounds create a background of noise when there is no sound actually present. In his book Musicophilia, Oliver Sachs even reports cases of tinnitus of a musical nature. The American Tinnitus Association website has recordings of the various sounds of tinnitus.

The onset of tinnitus in women seems to be particularly related to periods of hormone variability. It can be triggered by PMS, perimenopause, menopause and pregnancy. Menopausal symptoms such as sweating, hot flashes and mood changes may correlate with tinnitus.

Tinnitus can also be caused by some prescription medications, including antidepressants, aspirin and quinine, some antibiotics, benzodiazepines, anticonvulsants, some chemotherapy and certain diuretics. Sometimes conventional hormone treatments have brought on tinnitus. A review posted at eHealthMe.com compiled the details on side effects from 69,299 Premarin users, of whom 0.5% have reported tinnitus as a side effect. The incidence increases dramatically with the number of years on Premarin, and no one reported a recovery. While the search for a pharmacologic solution for tinnitus has been on for decades, there have not been any successful candidates thus far.

However, while presenting at the Royal Society of Medicine on May 8, 1985, Dr. Albert Gray successfully treated 7 of 14 patients with an injection of thyroxine (T4) solution through the tympanic membrane of the ear. Tinnitus has been identified as a symptom of both hypo- and hyperthyroidism. This observation should trigger more investigation into the thyroid status of a sufferer.

Tinnitus treatments involving the injection of other drugs (particularly the synthetic analogs to hydrocortisone) through the tympanic membrane have been attempted, also without success. Otologists had reasoned that this procedure would allow a larger concentration of the drug to reach the inner ear, and that the localized treatment would be more likely to have an effect.

Research in the last decade has increased our awareness of hormones acting on the central and peripheral nerves. Low estradiol, for instance, may be responsible for confusion in the transmitting of sound signals from the ear to the brain, possibly resulting in tinnitus.

In 2012, researchers from Nigeria reported on the correlation of vitamins C and B12 and melatonin by examining those levels in a group of elderly people, some with and some without tinnitus. They found no significant correlation with vitamin C levels, but found significantly lower levels of B12 and melatonin in those people with tinnitus.

Treatment options now offered include counseling, cognitive behavioral therapy, auditory stimulation, and neuro feedback. Efforts to mask the noise, such as using white sound or hearing aids, are also sometimes used. Drug therapies are not effective at treating tinnitus but may be offered to treat anxiety, depression or sleep deprivation, which may accompany it.

An evaluation of nutrition (particularly with regard to the B complex vitamins), stress levels, exposure to loud noise and hormone balance may be avenues to explore for tinnitus relief.

What Does Tinnitus Have To Do With Hormones?2018-04-05T11:22:18-05:00

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?2018-04-03T17:29:54-05:00

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 Deficiencies2018-04-03T17:30:29-05:00

Book Review – Hashimoto’s Thyroiditis by Izabella Wentz, PharmD, FASCP

Book Review – Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause by Izabella Wentz, PharmD, FASCP

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

Hashimoto’s Thyroiditis, which is considered an autoimmune disease, is the leading cause of hypothyroidism. However, the very simplistic approach taken by the current medical ideology is to use only one form of relatively inactive thyroid, T4 (thyroxine), for treatment, and to rely on a problematic single test, TSH (thyroid stimulating hormone), to guide treatment. This approach falls extremely short of providing adequate treatment to those who suffer the consequences of Hashimoto’s disease.

Izabella Wentz has put together a remarkable book that documents her own journey, in part, and shares the information and resources that she gained along the way. In Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause she details her approach to finding the real reasons this disease develops and then identifies steps to remove the causes and/or rebuild the body’s own resources.

The amount of information in this book is astonishing. Wentz uses readable language to explain complicated issues such as the development of “autoimmunity” and what it means with regard to immune system function, inflammation, allergies, and infection.

One particularly interesting and eye-opening section discusses a common laboratory test called alkaline phosphatase. This test is included on standard liver function tests; elevations can indicate liver dysfunction or an infection. Alkaline phosphatase is an enzyme that removes a phosphate group from a number of different molecules. This enzyme can help control infection by essentially neutralizing bacteria.

Most practitioners only pay attention to elevated levels, and do not consider the implications of low levels. However, in her quest for her own wellness, Wentz obtained copies of her lab results and noticed low levels of alkaline phosphatase, wondering what that might signify. Not being content with being told that everything was “fine,” she dug into the research and found that low levels of alkaline phosphatase were associated with bone reabsorption and malnutrition, especially deficiencies of B6, B12, folic acid, vitamin C, and zinc.

Wentz also noted that people with celiac disease have diminished alkaline phosphatase activity in their intestinal mucosa, which can be an indicator of the amount of damage caused by gluten. Levels of alkaline phosphatase normalize with a gluten-free diet, along with improvement to the intestinal mucosa.

Low alkaline phosphatase is also associated with hypothyroidism and with Hashimoto’s disease. Restoring thyroid hormones can increase alkaline phosphatase levels. Thus, having discovered that a low level of alkaline phosphatase was indeed significant in her case, Wentz realized that the health of her gastrointestinal tract was a significant underpinning of Hashimoto’s disease, which led to more tangible information that was helpful in her recovery.

Wentz compiled lists of “dos and don’ts” to help restore this enzyme and to help improve overall health. For example, excessive use of sodas and artificial sweeteners will diminish alkaline phosphatase. She brings together lots of valuable resources that anyone hoping to restore or simply improve their health can access. This book is well-referenced and is a gem for people looking to dig in and improve their ability to recover from the devastation of Hashimoto’s thyroiditis.

  • Wentz I, Nowosadzka M. Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause. White River Junction, VT: Wentz LLC, Chelsea Green Publishing; 2013.
Book Review – Hashimoto’s Thyroiditis by Izabella Wentz, PharmD, FASCP2017-12-12T12:29:56-05:00

Foot Fat Pad Atrophy

Foot Fat Pad Atrophy

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


Here’s another one to add to the number of signs and symptoms of declining hormones: Is the heel or bottom of your foot causing you pain? Are you finding yourself seeking relief in the Dr. Scholl’s section of the pharmacy? It could be due to foot fat pad atrophy.

The foot fat pads are the tissue that protects your foot on the ball of the foot and at the bottom of the heel. Atrophy means shrinking or disappearing. The foot pad tissue under the foot does decline with age. Menopause and surgical menopause increase the rate of decline. Obvious mechanical issues, such as being overweight, can also have a negative impact and hasten the loss of the plumpness of this tissue.

If plantar fasciitis (painful inflammation of the bottom of the foot) has been an issue, your practitioner may have used one or more injections of “cortisone” to relieve pain. Unfortunately, this “cortisone” is not the same as the cortisone hormone the body produces; it is actually a synthetic analog that can lead to even more atrophy of the foot pads.

In addition, as Dr. Sergey Dzugan points out in The Magic of Cholesterol Numbers, cholesterol levels elevate when the body senses a deficiency of the sex and adrenal hormones, which are normally produced from cholesterol. So statin users beware! When taking statins, not only do cholesterol levels fall, but the ability to make hormones drops even further. Statin drug use may be a source of foot pain from accelerated foot fat pad atrophy.

If you are experiencing foot pain, have your practitioner check for hormone deficiencies, including vitamin D (which is also made from cholesterol). These deficiencies may be the underlying cause of your foot pain.

Foot Fat Pad Atrophy2017-12-14T15:16:50-05:00