Transcript File - Michael Greer, MD

Michael E. Greer, M.D.
Holistic, Homeopathic, Herbal &
Natural Solutions for Health
Webinar Sampler
Trekking Series
12-hour Seminar
737 Olive Way, Suite 1804, Seattle, WA 98101
www.michaelgreermd.com
[email protected]
About Dr. Greer
• OB-GYN by training
• Board certified in 1984
• Alternative medicine in my
practice since 1996
• Combining the best of
integrative medicine for optimal
patient wellness
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Webinar Contents
• Trekking the Hormone Jungle
• Adrenal Fatigue: Etiology, Diagnosis & Nutritional
Solutions
• Detoxifying in a Toxic World
• Diabetes: Overview & Treatment Options
• Estrogen Dominance & Its Role in Cortisol, Weight
Management & Hypothyroidism
• Testing for Wellness: How to Test & Interpret Results
for Maximum Wellness
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Understanding how
all the hormones
influence each other
to attain hormone
balance
Parotid Gland Initiates the Hormones
Ghrelin & Leptin
• GHRELIN: The “I am Hungry” hormone
released in the stomach and intestine
• LEPTIN: The “I am Full” hormone that
helps control fat storage and appetite
– Fat cells produce and secrete leptin
Ghrelin and leptin work together as a
regulatory arm in the feedback
communication of hunger
Ghrelin
Leptin
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Leptin & Heart Disease
• Obesity and cardiovascular disease are
closely related
– Leptin, an adipocyte-produced hormone, is associated
with increased cardiovascular risk
– Increased plasma levels of leptin are measurable in the
plasma of obese individuals
• An Italian study associating Leptin & CV disease
found a close relationship between Leptin and CRP
– Provides support to the view that this adipokine, besides
being involved in the pathobiology of obesity, might play
an active role inflammation and atherothrombosis
Dr Rosa S, Cirillo P et al, J Vasc Res, Jun 2009;46(6):609-619
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Function of Leptin
• Produced by fat cells, leptin signals the
hypothalamus that we have consumed enough
calories and can stop eating
– Suppresses appetite
• Increases triglyceride breakdown in adipocytes
• As excess glucose accumulates in the blood (pre
diabetes segue), the glucose is converted by glycerol3-phosphate dehydrogenase (an enzyme) into
triglycerides for storage into adipocytes
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Leptin Resistance
• As we age, our cells become leptin resistant
– Similar to insulin resistance
– C-reactive protein (CRP) – the most accurate
marker of systemic inflammation - binds leptin
and prevents it from crossing the blood-brain
barrier to signal satiety
• Proof that systemic inflammation and
detoxification failure plays a very powerful
role in weight regulation
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CRP & IL-6 Predict Death
• Elevated CRP, IL-6 (and other inflammatory
cytokines) indicate significantly greater risks of
contracting or dying from many diseases
– Heart attack, stroke, Alzheimer’s disease, etc.
• In a study of a group from the Women’s Health
Study, several risk factors predicted Type II diabetes
– Baseline levels of CRP and IL-6 were significantly higher
among those who later developed diabetes
– Supports a possible role for inflammation in
diabetogenesis
Prandhan et all, JAMA, July 18, 2001
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The Extra-cellular Matrix
• Fat cells store toxic waste. Estrogen is made
from fat cells. Fat breakdown is inflammatory!
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Detoxification & Drainage
• Toxic waste is deposited into the cellular
matrix for disposal
– Must be diluted by the addition of water to
prepare them for elimination
– Explains why we have to urinate the first thing in
the morning (or during the night)
• Fat cells STORE TOXIC WASTE
– Protect the rest of the body from involvement in
detoxification until the time is right
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Cardiac-CRP and Cancer
• “Elevated levels of Cardiac-CRP in cancer-free
individuals are associated with increased risk
of cancer of any type ... (and) with early death
after a diagnosis of cancer.”
• Regular monitoring of Cardiac-CRP is an
important component of a health
maintenance program
Circulation.2008 Nov 25;118(22):2243-51
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Chronic Toxins and Inflammation
Exposure
Systemic Effects
Signs & Symptoms
Disorders
• Nervous system
• Endocrine system
(hormones)
• Immune system
• Sensitivity to
chemicals, odors,
medications, etc.
• Chronic fatigue
• Depression, anxiety,
mood swings
• Cognitive
dysfunction
• Recurrent headaches
• Muscle aches and
weakness
• Infertility
• Recurrent infections
• Autoimmune
disease
• Reproductive
disorders
• Chronic dermatitis
• Neurodegenerative
disorders
• Autism
• Obesity
– Allergies
– Autoimmune
– Chronic infections
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CRP and Dementia Risk
• Appears to correlate with nutrition-related
diseases
– Cardiovascular, metabolic, obesity, etc.
• In fact, patients who are obese at middle age
are almost twice as likely to develop dementia
later in life (check CRP!)
• Elevated cholesterol and serum cardiac
homocysteine levels also appear to be
independent risk factors for cognitive decline
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Other Hormones Involved
in Appetite Regulation
• INSULIN - Increases ghrelin (thus hunger), cortisol,
norepinephrine
• CORTISOL - Increases insulin, decreases thyroid
function by blocking T4 to T3 conversion
– Active mechanism = liver produces 3-4X more TBG (thyroid
binding globulin) a SHBG (sex hormone binding globulin) to
decrease thyroid function
• SEROTONIN - Increases leptin (thus a “full” sensation,
decreasing hunger)
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Testosterone
Androstenedione
Estradiol-17 (E2)
Estrone (E1)
Estriol (E3)
Cortisol
Upregulates E1
& High Estrogen
Upregulates
Cortisol
High Estrogen Increases
T4-Binding Globulin (TBG) 2-3X
Lower Thyroid Hormone Activity
Suppresses Metabolism
Lower Metabolism
Leads to Weight Gain
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10 Essentials to Keep the Weight Off
and Decrease Inflammation
1.
2.
3.
4.
Improve Digestion
Minimize Cortisol
Lower Insulin Level
Eliminate Excess
Estrogen
5. Treat Sub-clinical
Hypothyroidism
6. Support the Adrenal
Glands
7. Eat Healthy and
in Moderation
8. Exercise
9. Kill the Inflammation
10. Sleep
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Essential Fatty Acids Initiate
the Hormone Sequence
• Fish Oil – Principally Omega-3
– The most highly unsaturated fatty acid, easily
oxidized in light, air, heat
• Flax Oil – Principally Omega-6
– Converts to Omega-3
Essential fatty acids: linolenic,
arachidonic, omega-3s
and derivatives, etc.`
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Systemic support:
Comparing Omega-6 & Omega-3
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Misc Benefits Of Omega-3
• Possibly reducing the risk of many other
medical conditions
– Painful periods
– Diabetic kidney damage
– Obesity
– Skin conditions
– Some cancers
– Crohn's disease
– May improve pulmonary function
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Anti-Inflammatory Products

• SP Cataplex F (3-9 tabs/day, 3-6 perles/day)
– Flax seed with 0.8 mg B6
– Tabs contain 95mcg iodine
– Perles contain no iodine
• SP Linum B6 (3-6 perles/day)
– Flax seed oil (630 mg) and B6
• SP Black Currant Seed Oil 320 mg (3-6p/day)
– Omega-6 GLA -47mg
• SP Wheat Germ Oil 385 mg /Fortified
• Cataplex E 50 IU (3-6 p/day)
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Anti-Inflammatory Products
• SP Chlorophyll Complex perles™
– Vit A 335 IU (3-9 p/day)
• SP Calamari Omega-3 Liquid
– DHA 800mg/EPA 400mg SP (1 tsp/day)
• SP Tuna Omega-3
– DHA 300mg/EPA 60 mg with Tuna Oil 1,200 mg
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E1, E2 & E3
• The three most widely known estrogens:
– Estrone (E1)
– Estradiol (E2)
– Estriol (E3)
• Estradiol and estrone interconvert freely, and
both may be metabolized to 2-hydroxylated,
16-hydroxylated, or other forms
– These hydroxylation steps take place in various
tissues, including breast, kidney, and liver
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Estrone vs. Estradiol
• An imbalance occurs between the types of
estrogens
– Although estradiol levels decline, estrone levels
decline much more slowly, resulting in more
estrone than estradiol
• Although both hormones are strong enough
to cause concern about the development of
breast cancer, the ratio of the hydroxyestrones
becomes a more significant factor
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Estrogen Differences
• Some hydroxyestrones (4-hydroxy- and 16alpha-hydroxyestrone) may promote cancer,
while 2-hydroxyestrone seems to prevent it
• Estrone is less desirable because it is cancerpromoting and tends to be naturally present
in higher quantities relative to the other two
estrogens during menopause
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Indole-3-carbinol (I3C)
• I3C is one of several potent compounds found
in cruciferous vegetables such as broccoli,
cauliflower, and Brussels sprouts
• I3C functions by modulation of hormones and
the activation of genes
• Dosage should be based on weight
– 179 lbs: 200 mg
– 80-239 lbs: 300 mg
– Over 239 lbs: 400 mg
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Cruciferous Complete
• Contains Kale (300 mg), Brussels sprouts
(300mg)
• Essential to modulate E-2 flow for Estrogen
metabolities
• E-2 is anti cancer
• E-2 is anti-inflammatory
Common Symptoms of
Excess Estrogen
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Water retention
Breast swelling & tenderness
Craving for sweets
Fibrocystic breasts
Uterine fibroids
Nervousness/anxiety/irritability
Heavy, irregular menses
Fatigue
Weight gain
Mood swings
Low thyroid symptoms
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Thyroid & Dieting
• Thyroid levels fluctuate in response to caloric
intake, exterior temperature, etc.
– During starvation (diet) the body naturally lowers
thyroid hormone
– Lower metabolism results in more estrogen and
fat storage
• Estrogen and thyroid hormone have opposite
effects
– Estrogen causes calories to be turned into fat
– Thyroid hormone initiates fat conversion to energy
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Thyroid Hormone Exists
in 2 Major Forms
T4 + T3
Think of T4 as firewood and T3 as fire
T4  T3
Tri-iodothyronine (T3) is 8 times more
biologically active than T4
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Wellness Testing
for Adrenal Fatigue
©2011, Michael Greer, MD. May not be reproduced without permission.
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Adrenal Rhythm & Its Importance
• The human adrenal gland does not secrete its
steroid hormones at a constant level
throughout the day
• The hormones are
released in a cycle
– Highest value in
the morning
– Lowest at night
• 24-hour cycle: circadian rhythm
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Thyroid Function
• Intracellular cortisol controls thyroid
hormone production
• Hypothyroid symptoms such as fatigue and
low body temperature may be due to an
adrenal maladaptation
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Constant Stimulation
• Constant cortisol stimulation allows adrenal
(cortisol) stimulation for emergencies
• Followed by tolerance
• Followed by depletion of adrenal gland
hormones when over stimulated
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Adrenal Fatigue Symptoms
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•
•
•
•
•
Fatigue
Chronic illness
Decreased sex drive
Panic attacks
Mild depression
PMS
•
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•
•
•
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Stubborn belly fat
Absentmindedness
Irritability
Unclear thinking
Asthma
Hair loss and more
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Defining Stress
• Much of the investigation into the effects of stress
was carried out by Hans Selye
• Developed a theory called the General Adaptation
Syndrome (GAS)
– Hypothesized that stress is a major cause of disease
• Believed that chronic stress causes long term
chemical changes within the body and the body’s
ability to copy with stress is an exhaustible resource
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Cortisol: Clinical Manifestations
Target Tissue
GC Excess or
Hypersensitivity
GC Deficiency or
Resistance
CNS
Insomnia, anxiety
Depression, fatigue,
malaise, defective
cognition
Liver
↑ gluconeogenesis and
lipogenesis
Hypoglycemia
Fat
↑ visceral fat, metabolic
syndrome
Weight loss
Cardiovascular
Hypertension
Hypotension
Bone
Osteoporosis, stunted
growth
Immunity/inflammation
Immune suppression,
vulnerability to infection
and tumors
Chrousos GP, Kino T. Stress 2007; 10(2): 213-219
↑ inflammation,
autoimmunity and allergy
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Stress and the Thyroid
By conservative
estimates, 50% of the
individuals diagnosed
with hypothyroidism
also have adrenal
fatigue or depletion
Rothfield GL, Romaine DS. Thyroid Balance, Adams Media, Avon, 2003, p.97.
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Stress and Immunity
• One of the key discoveries of the research by
Selye was stress-induced immune suppression
• GCs impact T-cells more than B-cells
– Thus cell-mediated immunity is more disrupted
than antibody-mediated immunity
– Results in less protection against pathogens
Bornstein SR, Rutkowski H. Endocrine Res 2002; 28(4): 719-728
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Stress and Immunity
• There is a transient
immune stimulation in
response to stress
regardless of cause
• It is chronic stress that
causes the issues
described and the
increased risk of
infections
Sapolsky, RM. Why Zebras Don’t Get Ulcers, 3rd Ed, Henry Holt and Co, New York, 2005, p. 155
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Stress and Autoimmunity
• With chronic stress
the immune system is
being constantly
ramped up
• Over time this is
associated with an
increased risk of
autoimmune diseases
Sapolsky, RM. Why Zebras Don’t Get Ulcers, 3rd Ed, Henry Holt and Co, New York, 2005, p. 155
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How Adaptogens Work
• Exact mode of action of adaptogens is unclear
and many possibilities have been put forward
• Possible that different adaptogenic herbs may
have different modes of action
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On/Off
• Adaptogens have the ability to influence the
‘switch on’ and ‘switch off’ systems
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Herbs With Adaptogenic Activity
• Chinese/Korean ginseng (Panax ginseng) (1/2
tsp 1-2x/day)
• Astragalus (Astragalus membranaceus) 1-2 day
(tab or liquid)
• Siberian ginseng (Eleutherococcus senticosus)
(tab or liquid 1-2x/day)
• Withania (Withania somnifera) (tab or liquid 12x/day)
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Withania Complex
•
•
•
•
Skullcap Herb 4:1 extract (117.5 mg)
Licorice Root 7:1 extract (107.15mg)
Withania (Ashwaganda)root 10:1 extract (95mg)
Korean Ginseng root 5:1 extract (20 mg)
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Foods That Hurt the Adrenals
• Coffee and black tea (including decaf) - elevate
cortisol
• Juice - high glycemic index – incites insulin
• Sugar - high glycemic index – incites insulin
• Alcoholic beverages - stuns the liver
• Deep-fried foods - saturated fats
• Rancid oils, seed and nuts - increase need for
antioxidants for the free radicals
• Soda, including diet soda - elevates insulin, cortisol
• Processed meats and cheeses – sulfites, which impair
detox by the liver
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This Webinar is a Sampler Only
Attend the Seminar for immediately
applicable information
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Michael E. Greer, M.D.
Holistic, Homeopathic & Herbal
Solutions for Health
2721 First Avenue, Suite 408, Seattle, WA 98121
Tele: (206) 343-5985 Fax: (206) 343 2356
www.michaelgreermd.com
[email protected]
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