nemu bacaan menarik yang ditulis oleh sesedokter yg berkecimpung di kesehatan wanita
mod aris numpang save di marih ya..
Treatment for 4 types of PCOS, treat the cause
I invite you to think differently about polycystic ovarian syndrome.
PCOS is not one thing. It is not one disease.
PCOS is a set of symptoms. The key primary symptom is failure to ovulate regularly. Failure to ovulate is why you are deficient in estradiol and progesterone. It’s why you have high testosterone, and why you develop secondary
PCOS symptoms like hair loss, acne, and infertility.
You cannot treat PCOS until you first ask: “WHY — in your particular case — do you not ovulate?”
I say “in your particular case” because your reason may be different than someone else’s reason. That’s why there are so many different natural treatments, and that’s why only some of them will work for you.
Tip: Don’t be too quick to accept a PCOS diagnosis. Proper diagnosis requires a blood test that shows high testosterone or other male hormones like androstenedione or DHEA. Never accept a diagnosis that was made by ultrasound alone. Please read The Surprising Truth About PCOS. 4 Types of PCOS 1) Insulin-Resistant PCOS This is the classic type of PCOS, and by far the most common. High insulin and leptin impede ovulation and stimulate the ovaries to make testosterone. Insulin resistance is caused by sugar, obesity, smoking, trans fat, and environmental toxins. Is this you? You have been told that you are borderline diabetic, or you had an abnormal glucose tolerance test. You probably have elevated insulin, and you may also have elevated LH (luteinizing hormone). You are probably overweight, although you may be normal weight. Normal-weight insulin-resistance can occur in the years following dieting or eating disorder.
Treatment ideas: You need to quit sugar and/or lose weight. Please also consider intermittent fasting, which works well to improve insulin sensitivity. Best supplements for insulin resistance are magnesium, lipoic acid, inositol, and berberine. The Pill is not a treatment for this type (or any type) of PCOS because it impairs insulin sensitivity. Improvement for Type 1 PCOS is slow and gradual over 6-9 months. Please see my Insulin Resistance post. 2) Pill-Induced PCOS or Post-Pill PCOS The birth control Pill suppresses ovulation. For most women that is a temporary effect, and ovulation will usually resume fairly soon after the Pill is stopped. But for some women, ovulation-suppression can persist for months or even years. During that time, it is not unusual to be given the diagnosis of
PCOS. Some experts deny the existence of Pill-induced
PCOS, but it is very real. It is the second most common type of
PCOS that I see in clinic. I have spoken to many other clinicians who are seeing the same thing. We desperately need more research into it.
Is this you? You had regular periods before starting the Pill, although you may have had acne. You probably now have elevated LH on blood test, although you may have normal LH, and high-normal prolactin.
Treatment ideas:
If your LH is elevated, the best herbal treatment is Peony & Licorice combination (see my book for more information). If your prolactin is high-normal, then the best herbal treatment is Vitex (also called chaste tree or chaste berry). Do not use Vitex if your LH is elevated. Vitex stimulates LH so it will make things worse. Indeed, many of my PCOS patients report feeling worse on Vitex. See my Vitex post.
Both Peony and Vitex work on your pituitary-ovarian axis, and they are powerful herbs. I recommend you do not use them too soon or for too long. Do not take them if you are a teenager, or if you have just come of the Pill. Give yourself at least 3-4 months off the Pill. Peony and Vitex should not be used for more than 10 months in a row. They should not need to be used that way. If they are the right herbs, they will work fairly quickly (within 3-4 months). And then, your periods should stay regular after you stop the herbs. You should not take licorice if you have high blood pressure. Please seek professional advice.
3) Inflammatory PCOS Inflammation—or chronic immune activation—results from by stress, environmental toxins, intestinal permeability and inflammatory foods like gluten or A1 casein. Inflammation is a problem for
PCOS because it impedes ovulation, disrupts hormone receptors, and stimulates adrenal androgens such DHEA and androstenedione.
Is this you? You have other symptoms of immune-dysfunction such as recurring infections, headaches, joint pain or skin conditions. Your blood test shows inflammatory bio-markers such as vitamin D deficiency, abnormal blood count, elevated C-RP, thyroid antibodies, or gluten antibodies. You may have elevated DHEA or androstenedione, and a positive urine test for intestinal permeability.
Treatment ideas.
Reduce stress and exposure to environmental toxins like pesticides and plastics. Eliminate inflammatory foods such as wheat, dairy, and sugar. Treat intestinal permeability with zinc, berberine, and probiotics. Supplement magnesium because it is anti-inflammatory and normalises adrenal hormones (HPA axis). Improvement is slow and gradual over 6-9 months. 4) Hidden-Cause PCOS
This is the ‘simpler-than-you-think’ type of
PCOS. Fairly often (at least once per week) I encounter a
PCOS patient who does not meet any of the criteria for the first 3 types of
PCOS. These are my favourite cases, because it usually means that there is one simple thing that is blocking ovulation. Once that single thing is addressed, this type of
PCOS resolves very quickly, usually within 3-4 months.
Common hidden-causes of PCOS include:
– Soy, because it is anti-estrogen and can block ovulation in some women.
– Thyroid disease, because your ovaries need T3 thyroid hormone.
– Vegetarian diet, because it causes zinc deficiency, and your ovaries need zinc.
– Iodine deficiency, because your ovaries needs iodine. Please be careful with iodine supplementation. Read more at my iodine post.
– Artificial sweeteners, because they impair insulin and leptin signalling.
– Too little starch in your diet, because your hormonal system needs Gentle Carbs. Is this you? You do not exactly fit the criteria for the first 3 types of
PCOS. You have tried a number of natural
PCOS treatments and nothing seems to work. Look deeper.
diagnosis
Know when it’s time to let go of your
PCOS Diagnosis. In most cases,
PCOS is not a permanent condition. With the right diagnosis and the right treatment,
PCOS can become a thing of the past.
I am the first to acknowledge that there is some overlap between these 4 types. For example, inflammation is a major cause of both insulin-resistance and thyroid disease (Types 1, 3, and 4). My intention was not to over-simplify, but rather to alert you to some treatment ideas that you have not yet considered.
For more detail about the types of
PCOS, please see my book Period Repair Manual. I provide a visual flow-chart of the 4
PCOS types.
Yours in Health,
Lara
(larabriden.com)
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numpang save dimarih ya mod aris..
9 Things to Know About Female Hair Loss
January 27, 2015 by Lara Briden
Female Hair LossThis post is long overdue. It’s a follow-up to my 2013 Hair Loss post, which is one of the most popular posts on my blog. A big thank you to everyone who commented there and shared your hair loss stories.
As I’m sure you understand, there is no one treatment that will work for everyone. To find your hair loss solution, you’ll have to do a bit of detective work.
Here is what you need to know.
Blame your birth control (
i'm not using birth control, so this caused i ignored)
Hormonal birth control is a common cause of female hair loss. The problem is androgenic (male-like) progestins such as levonorgestrel, which shrink (miniaturize) your hair follicles. It’s a slow process. You may be on the Pill for many months—even years—before you start to notice hair loss. Your doctor’s solution is to switch you to a pill with a different progestin such as drospirenone, but those progestins have their own problems. They cause depression and blood clots, and they also prevent ovulation, which is the very thing you need for healthy hair.
For more information about androgenic birth control, please read my latest post: 4 Causes of Androgen Excess.
You need estrogen and progesterone, so you need to ovulate (
i still in confuse about this)
As I explain in my book Period Repair Manual, your hair loves estrogen and progesterone. The only way to make those hormones is to ovulate. The only way to ovulate is to stop the pill.
I have not the smallest doubt that stopping the pill is the best strategy for your hair in the long-term. However, it might temporarily worsen your hair in the short-term as your hair follicles withdraw from synthetic estrogen. Pill-withdrawal hair loss should improve after a few months, as long as you start to ovulate. If you don’t start to ovulate, then you need to find a way to do so. For treatment ideas, please see my post Ode to Ovulation.
You have to wait three months
Your hair roots (hair follicles) are time capsules. Your hair today is the result of something that happened months ago. It’s all to do with your hair’s telogen (resting) phase, which lasts two to six months. The telogen phase is like a waiting room. Once a hormonal problem has caused your hair to enter the telogen phase, it will fall out two to six months later. There is nothing you can do to stop it. Likewise, once you correct your hormone balance, you will still have to endure the loss of all the hairs queued up in their telogen phase. Even with the best treatment, you will have to wait two to six months to see improvement.
Be patient. Stick with a treatment for at least six months before trying something different.
You may need to lower androgens (
i don't check this yet)
Androgens are hormones such as testosterone, androstenedione, and DHT. It’s normal to make some androgens. You need them for mood, libido, and bone health. If you make too many androgens, they will cause the kind of hair loss that occurs all over your head, but is worse at your temples.
Ask your doctor test your androgens. If they’re high, it probably means that you have a condition called polycystic ovarian syndrome (
PCOS). For more information, please see my posts: Causes of Androgen Excess in Women and Treatment for 4 Types of
PCOS.
You may need to curb inflammation
What if you have the androgen pattern of hair loss (temples), but you don’t actually have high androgens on blood test? This is called androgenic or androgenetic alopecia. It simply means that your hair follicles are “overly sensitive” to androgens for some reason. That “some reason” is probably the Pill (discussed above), but it could also be chronic inflammation. Inflammation hyper-sensitizes your hair follicles to a normal amount of androgen.
Reduce inflammation by avoiding food sensitivities such as wheat and/or dairy, and by correcting intestinal permeability. You may need to treat your thyroid
Your hair follicles are exquisitely sensitive to thyroid hormone—either too much or too little. Do not go any further with your treatment plan until you have ruled out thyroid disease. Ask your doctor to test for “thyroid antibodies”, which are the marker for autoimmune thyroid disease, which is the most common type of thyroid disease. See my Thyroid post for treatment ideas, and stay tuned for more posts (maybe a book?) about thyroid.
Don’t go too low carb (
a little bit missunderstanding, but i thought it's mean i still can eat rice, yeeay)
Yes, please cut out sugar and wheat, but think very carefully before you cut out other starches. As I explain in my Gentle Carb post (and my book), starches such as rice and potato are good for most women. Starches support your hormonal system including your thyroid, adrenal, and female hormones. Without adequate starch, your hypothalamus will think you’re starving, and may decide to stop your periods—thereby reducing your beneficial estrogen and progesterone.
Probably take zinc (
i should take this advice,
![Dandan](https://ibuhamil.com/images/smilies/monyet/dandan.gif)
)
Your hair seriously loves zinc. Zinc works at every part of your hair loss story. It reduces inflammation, promotes ovulation, and reduces androgens. Zinc also directly stimulates hair growth.
The birth control pill depletes you of zinc, so that’s another reason to get off it. Best food sources of zinc are red meat, pumpkin seeds, and oysters. You might also want to supplement. I recommend 25 mg per day after food.
Ask your doctor to test your iron
Whatever your cause of hair loss (Pill,
PCOS, thyroid), being iron deficient makes it worse. That’s because your hair follicles require a lot of iron (because they grow fast).
Ask your doctor to order a test called “iron studies”. Your ferritin (iron stores) should be at least 50 ng/ML. If it’s lower than that, then take 25 mg of a gentle iron such as iron bisglycinate.
Yours in Health,
Lara
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How Soy Affects Hormones
I’ve never been a huge fan of soy. I don’t like soybean oil because it contains mostly omega 6 fatty acids, which promote inflammation. I don’t like processed soy protein because it impairs nutrient absorption. I don’t like how much pesticide is sprayed on soybeans.
Inflammation, impaired nutrient absorption, pesticides. That’s why industrially processed soy is bad for hormones.
But what about whole bean, organic, and fermented soy? Does it affect hormones? Yes, but possibly not in the way you think. Is Soy an Estrogen?
Soy contains phytoestrogens or “plant-estrogens”, which sounds a bit scary at first. Who wants to ingest a foreign estrogen? But in reality, we ingest a lot of foreign estrogens (also called xenoestrogens).
⇒Xenoestrogens are not estrogen. They’re chemicals that are molecularly similar to estrogen, so they interact with estrogen receptors and with the pituitary-ovarian feedback loop.
We take in a frighteningly large array of man-made xenoestrogens such as pesticides, plastics, and ethinylestradiol (the synthetic estrogen in the birth control pill). T
hose xenoestrogens are the most potent and concerning xenoestrogens because they cause hormonal problems such as PCOS, endometriosis, infertility, and breast cancer.
Phytoestrogens, on the other hand, are more benign. They’re naturally present in many different foods including flaxseeds, lentils, oats, peanuts, cashews, garlic, cabbage, fennel, apples, coffee, beer, and even dairy and meat. It’s pretty safe to say that at least some level of phytoestrogens has long been part of our traditional diet. We’re adapted to them, and phytoestrogens appear to play a beneficial role in regulating and metabolizing estrogen.
In women, phytoestrogens protect and buffer estrogen receptors from estradiol (our strongest estrogen). They also promote the healthy detoxification of estrogen. So when estrogen is high (as in menstruating women), phytoestrogens have a net anti-estrogen effect. They make periods lighter and reduce high-estrogen symptoms such as PMS and heavy periods [1]. They also seem to be protective against breast cancer in large population studies [2].
Soy’s anti-estrogen effect is so strong that it can stop periods and impair fertility. Period suppression the biggest negative effect from soy that I see in my hormone clinic, and that’s why I listed soy as one of the “hidden causes of polycystic ovarian syndrome” in my 4 Types of
PCOS post.
⇒What about men, children, and post-menopausal women? When estrogen is low, phytoestrogens have a net pro-estrogen effect. That’s probably okay at low dose, but men and children should avoid too much soy. Post-menopausal women may benefit from phytoestrogen’s pro-estrogen effect. The jury is still out.
Thyroid
Thyroid suppression is second biggest negative hormonal effect from soy. Soy’s isoflavones inactivate thyroid peroxidase, which is the enzyme that makes thyroid hormone [3]. Thyroid suppression is less likely to be a problem if you have sufficient iodine in your diet.
Bottom Line: Should You Eat Soy? There is really no need to eat a lot of soy because there are so many other more nutrient-dense foods to enjoy (such as meat and vegetables).
But you need not fear small amounts of whole-bean soy such as tofu and soy sauce. You might even benefit from them if you suffer from PMS or heavy periods. You will certainly benefit from small amounts of traditionally fermented soy such as tempeh, miso, tamari (good soy sauce), and natto because they are a great source of vitamin K2. You should strictly avoid industrially processed soybean oil, flour, and protein powder.
What are your thoughts about soy? I’d love to hear from you.
Yours in Health,