Are You in the Driver's Seat When it Comes to Your Health?
By Dr. Chad Larson
Now more than ever people are taking charge of their own health because of easy access to the Internet that allows more people to be armed with knowledge about their health. For medical professionals this is both good and bad. It's good in that people feel more empowered than ever about their health, but bad in that access to all of that information can lead to self-diagnosis of their own ailments, which is potentially problematic. That said, taking control of one's own health by working in conjunction with a healthcare provider is the first step to improve a person's overall health.
Here are a few questions to ask yourself and tips to make sure you are in the driver's seat when it comes to your health:
1) Are you getting an unclear diagnosis from your healthcare professional?
If you aren't feeling well and your doctor doesn't know why, no one is in the driver's seat to your health. Due to scheduling demands, most medical professionals have a limited amount of time to spend during a patient's visit. If there isn't a clear way to diagnose your health concern with a blood test or other procedure, sometimes a process of elimination is used as a way to identify what's wrong. With all of this guesswork, it's no wonder patients often feel uncertain and uneasy with their diagnosis. In order to take charge in this situation, I suggest partnering with your healthcare provider to search for what types of tests would assist in pinpointing a clear diagnosis. There are several websites that are patient-friendly and that give consumer information about why a patient may feel unwell. Ask your healthcare provider for some options. Or, depending on your symptoms, start by searching for possible dietary and environmental triggers (often overlooked by your doctor) or use search terms such as "immunology" and "sensitivities."
2) Are you researching your family health history?
Do you know if your mother or father suffered from any autoimmune disorders? Do you know if they were allergic to or had food sensitivities? Write down and keep handy your health history as it pertains to your relatives. According to the American Autoimmune Related Diseases Association, 54 million people have autoimmune diseases, many of which go undiagnosed. If you have a history of autoimmune disease in your family, you are more likely to develop one yourself, according to the national institutes of health. Tracing your family health history is important and highly recommended when you want to be more in control of your health and your risk factors to disease.
3) Are you tracking what you eat?
With genetically modified foods, increased use of pesticides, and glue or gum additives in food, food reactivity is becoming more commonly tied to feelings of overall unhealthiness. Gluten and other foods can have a huge impact on health. Ask your healthcare provider if what you are experiencing is possibly a reaction to what you are eating. This is one easy way to identify the cause of some common health issues such as brain fog, bloating, tiredness and joint pain.
4) Do you follow a successful exercise routine?
Exercise is a great way to get on the road to being a healthier version of yourself. Exercise has a positive effect on many chronic health concerns, including body weight issues. Conversely, remaining overweight or obese can lead to major problems like diabetes, high blood pressure and heart disease. Talk to your healthcare provider about your health and about beginning an exercise routine.
With so much information about health at your fingertips, it is easy to get overwhelmed and frustrated by not knowing why you are feeling unhealthy. Remember that partnering with your healthcare provider and being an advocate for yourself is the first step on the road to wellness. The questions to consider and tips above can help empower you to a healthier and happier lifestyle while putting you in control of one—if not the most—important things in your life – your health.
Dr. Larson, advisor and consultant to Cyrex Laboratories, holds a Doctor of Naturopathic Medicine degree from Southwest College of Naturopathic Medicine and a Doctor of Chiropractic degree from Southern California University of Health Sciences. He is a Certified Clinical Nutritionist and a Certified Strength and Conditioning Specialist. He particularly pursues advanced developments in the fields of endocrinology, orthopedics, sports medicine, and environmentally-induced chronic disease. Cyrex is a clinical immunology laboratory specializing in functional immunology and autoimmunity. Cyrex offers multi-tissue antibody testing for the early detection and monitoring of today's complex autoimmune conditions. Cyrex develops innovative testing arrays through continuous collaboration with leading experts in medical research and clinical practice. Cyrex differs from other labs by offering four pillars of excellence, including antigen purity, optimized antigen concentration, antigen-specific validation and parallel testing technology. Cyrex is based in Phoenix, Arizona and is a CLIA licensed laboratory. For more information please visit joincyrex.com/patients.
By Dr. Chad Larson
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| Dr. Chad Larson |
Here are a few questions to ask yourself and tips to make sure you are in the driver's seat when it comes to your health:
1) Are you getting an unclear diagnosis from your healthcare professional?
If you aren't feeling well and your doctor doesn't know why, no one is in the driver's seat to your health. Due to scheduling demands, most medical professionals have a limited amount of time to spend during a patient's visit. If there isn't a clear way to diagnose your health concern with a blood test or other procedure, sometimes a process of elimination is used as a way to identify what's wrong. With all of this guesswork, it's no wonder patients often feel uncertain and uneasy with their diagnosis. In order to take charge in this situation, I suggest partnering with your healthcare provider to search for what types of tests would assist in pinpointing a clear diagnosis. There are several websites that are patient-friendly and that give consumer information about why a patient may feel unwell. Ask your healthcare provider for some options. Or, depending on your symptoms, start by searching for possible dietary and environmental triggers (often overlooked by your doctor) or use search terms such as "immunology" and "sensitivities."
2) Are you researching your family health history?
Do you know if your mother or father suffered from any autoimmune disorders? Do you know if they were allergic to or had food sensitivities? Write down and keep handy your health history as it pertains to your relatives. According to the American Autoimmune Related Diseases Association, 54 million people have autoimmune diseases, many of which go undiagnosed. If you have a history of autoimmune disease in your family, you are more likely to develop one yourself, according to the national institutes of health. Tracing your family health history is important and highly recommended when you want to be more in control of your health and your risk factors to disease.
3) Are you tracking what you eat?
With genetically modified foods, increased use of pesticides, and glue or gum additives in food, food reactivity is becoming more commonly tied to feelings of overall unhealthiness. Gluten and other foods can have a huge impact on health. Ask your healthcare provider if what you are experiencing is possibly a reaction to what you are eating. This is one easy way to identify the cause of some common health issues such as brain fog, bloating, tiredness and joint pain.
4) Do you follow a successful exercise routine?
Exercise is a great way to get on the road to being a healthier version of yourself. Exercise has a positive effect on many chronic health concerns, including body weight issues. Conversely, remaining overweight or obese can lead to major problems like diabetes, high blood pressure and heart disease. Talk to your healthcare provider about your health and about beginning an exercise routine.
With so much information about health at your fingertips, it is easy to get overwhelmed and frustrated by not knowing why you are feeling unhealthy. Remember that partnering with your healthcare provider and being an advocate for yourself is the first step on the road to wellness. The questions to consider and tips above can help empower you to a healthier and happier lifestyle while putting you in control of one—if not the most—important things in your life – your health.
Dr. Larson, advisor and consultant to Cyrex Laboratories, holds a Doctor of Naturopathic Medicine degree from Southwest College of Naturopathic Medicine and a Doctor of Chiropractic degree from Southern California University of Health Sciences. He is a Certified Clinical Nutritionist and a Certified Strength and Conditioning Specialist. He particularly pursues advanced developments in the fields of endocrinology, orthopedics, sports medicine, and environmentally-induced chronic disease. Cyrex is a clinical immunology laboratory specializing in functional immunology and autoimmunity. Cyrex offers multi-tissue antibody testing for the early detection and monitoring of today's complex autoimmune conditions. Cyrex develops innovative testing arrays through continuous collaboration with leading experts in medical research and clinical practice. Cyrex differs from other labs by offering four pillars of excellence, including antigen purity, optimized antigen concentration, antigen-specific validation and parallel testing technology. Cyrex is based in Phoenix, Arizona and is a CLIA licensed laboratory. For more information please visit joincyrex.com/patients.
News Briefs from the Endocrine Society
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| Journal of Clinical Endodcrinology & Metabolism (JCEM) |
1. Prenatal DDT Exposure Tied to Nearly Four-fold Increase in Breast Cancer RiskFifty year-long study first to directly connect breast cancer risk to in utero chemical exposure
Women who were exposed to higher levels of the pesticide DDT in utero were nearly four times more likely to be diagnosed with breast cancer as adults than women who were exposed to lower levels before birth, according to a new study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM). A more estrogenic form of DDT that is found in commercial DDT, o,p'-DDT, was largely responsible for this finding.
Despite being banned by many countries in the 1970s, DDT remains widespread in the environment and continues to be used in Africa and Asia. Many women who were exposed in utero in the 1960s, when the pesticide was used widely in the United States, are now reaching the age of heightened breast cancer risk.
DDT was among the first recognized endocrine disruptors, according to the introductory guide to endocrine-disrupting chemicals published by the Endocrine Society and IPEN. DDT and related pesticides can mimic and interfere with the function of the hormone estrogen. Past studies have found DDT exposure is linked to birth defects, reduced fertility and increased risk of Type 2 diabetes.
"This 54-year study is the first to provide direct evidence that chemical exposures for pregnant women may have lifelong consequences for their daughters' breast cancer risk," said one of the study's authors, Barbara A. Cohn, PhD, of the Public Health Institute in Berkeley, CA. "Environmental chemicals have long been suspected causes of breast cancer, but until now, there have been few human studies to support this idea."
The case-control study is prospective, having tracked the daughters of women who participated in the Child Health and Development Studies (CHDS) for 54 years beginning in utero. CHDS studied 20,754 pregnancies among women who were members of the Kaiser Foundation Health Plan from1959 through 1967. CHDS participants gave birth to 9,300 daughters during that period.
For the analysis published in JCEM, researchers used state records and a survey of CHDS participants' grown daughters to determine how many were diagnosed with breast cancer by age 52. To determine levels of DDT exposure in utero, the researchers analyzed stored blood samples from CHDS to measure DDT levels in the mothers' blood during pregnancy or in the days immediately after delivery. The researchers measured DDT levels in mothers of 118 women who were diagnosed with breast cancer. The scientists identified 354 daughters who did not develop cancer to use as controls and tested their mothers' blood for comparison.
The researchers found that independent of the mother's history of breast cancer, elevated levels of o,p'-DDT in the mother's blood were associated with a nearly four-fold increase in the daughter's risk of breast cancer. Among the women who were diagnosed with breast cancer, 83 percent had estrogen-receptor positive breast cancer, a form of cancer that may receive signals from the hormone estrogen to promote tumor growth.
Researchers also determined that exposure to higher levels of o,p'-DDT was associated with women being diagnosed with a more advanced stage of cancer. In addition, the scientists found women with greater exposure to o,p'-DDT were more likely to develop HER2-positive breast cancer, where the cancer cells have a gene mutation that produces an excess of a specific protein. Basic research studies where breast cancer cells were exposed to DDT have found the pesticide activated the HER2 protein.
"This study calls for a new emphasis on finding and controlling environmental causes of breast cancer that operate in the womb," Cohn said. "Our findings should prompt additional clinical and laboratory studies that can lead to prevention, early detection and treatment of DDT-associated breast cancer in the many generations of women who were exposed in the womb. We also are continuing to research other chemicals to see which may impact breast cancer risk among our study participants."
Other authors of the study include: Michele La Merrill of the University of California, Davis, in Davis, CA; Nickilou Y. Krigbaum, Lauren Zimmermann and Piera M. Cirillo of the Public Health Institute in Berkeley, CA; and Gregory Yeh and June-Soo Park of the California Department of Toxic Substances Control in Berkeley, CA.
The research was supported with funding from the California Breast Cancer Research Program, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institute of Environmental Health Sciences, the California Public Health Department, the National Cancer Institute's Surveillance, Epidemiology and End Results Program, and the U.S. Centers for Disease Control and Prevention's National Program of Cancer Registries.
The study, "DDT Exposure in Utero and Breast Cancer," will be published online at http://press.endocrine.org/doi/10.1210/jc.2015-1841, ahead of print.
Despite being banned by many countries in the 1970s, DDT remains widespread in the environment and continues to be used in Africa and Asia. Many women who were exposed in utero in the 1960s, when the pesticide was used widely in the United States, are now reaching the age of heightened breast cancer risk.
DDT was among the first recognized endocrine disruptors, according to the introductory guide to endocrine-disrupting chemicals published by the Endocrine Society and IPEN. DDT and related pesticides can mimic and interfere with the function of the hormone estrogen. Past studies have found DDT exposure is linked to birth defects, reduced fertility and increased risk of Type 2 diabetes.
"This 54-year study is the first to provide direct evidence that chemical exposures for pregnant women may have lifelong consequences for their daughters' breast cancer risk," said one of the study's authors, Barbara A. Cohn, PhD, of the Public Health Institute in Berkeley, CA. "Environmental chemicals have long been suspected causes of breast cancer, but until now, there have been few human studies to support this idea."
The case-control study is prospective, having tracked the daughters of women who participated in the Child Health and Development Studies (CHDS) for 54 years beginning in utero. CHDS studied 20,754 pregnancies among women who were members of the Kaiser Foundation Health Plan from1959 through 1967. CHDS participants gave birth to 9,300 daughters during that period.
For the analysis published in JCEM, researchers used state records and a survey of CHDS participants' grown daughters to determine how many were diagnosed with breast cancer by age 52. To determine levels of DDT exposure in utero, the researchers analyzed stored blood samples from CHDS to measure DDT levels in the mothers' blood during pregnancy or in the days immediately after delivery. The researchers measured DDT levels in mothers of 118 women who were diagnosed with breast cancer. The scientists identified 354 daughters who did not develop cancer to use as controls and tested their mothers' blood for comparison.
The researchers found that independent of the mother's history of breast cancer, elevated levels of o,p'-DDT in the mother's blood were associated with a nearly four-fold increase in the daughter's risk of breast cancer. Among the women who were diagnosed with breast cancer, 83 percent had estrogen-receptor positive breast cancer, a form of cancer that may receive signals from the hormone estrogen to promote tumor growth.
Researchers also determined that exposure to higher levels of o,p'-DDT was associated with women being diagnosed with a more advanced stage of cancer. In addition, the scientists found women with greater exposure to o,p'-DDT were more likely to develop HER2-positive breast cancer, where the cancer cells have a gene mutation that produces an excess of a specific protein. Basic research studies where breast cancer cells were exposed to DDT have found the pesticide activated the HER2 protein.
"This study calls for a new emphasis on finding and controlling environmental causes of breast cancer that operate in the womb," Cohn said. "Our findings should prompt additional clinical and laboratory studies that can lead to prevention, early detection and treatment of DDT-associated breast cancer in the many generations of women who were exposed in the womb. We also are continuing to research other chemicals to see which may impact breast cancer risk among our study participants."
Other authors of the study include: Michele La Merrill of the University of California, Davis, in Davis, CA; Nickilou Y. Krigbaum, Lauren Zimmermann and Piera M. Cirillo of the Public Health Institute in Berkeley, CA; and Gregory Yeh and June-Soo Park of the California Department of Toxic Substances Control in Berkeley, CA.
The research was supported with funding from the California Breast Cancer Research Program, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institute of Environmental Health Sciences, the California Public Health Department, the National Cancer Institute's Surveillance, Epidemiology and End Results Program, and the U.S. Centers for Disease Control and Prevention's National Program of Cancer Registries.
The study, "DDT Exposure in Utero and Breast Cancer," will be published online at http://press.endocrine.org/doi/10.1210/jc.2015-1841, ahead of print.
2. Maternal Stress Alters Offspring Gut and Brain through Vaginal Microbiome
Stress may have negative immunologic, nutritional and metabolic effects
Stress may have negative immunologic, nutritional and metabolic effects
Changes in the vaginal microbiome are associated with effects on offspring gut microbiota and on the developing brain, according to a new study published in Endocrinology, a journal of the Endocrine Society.The neonate is exposed to the maternal vaginal microbiota during birth, providing the primary source for normal gut colonization, host immune maturation, and metabolism. These early interactions between the host and microbiota occur during a critical window of neurodevelopment, suggesting early life as an important period of cross talk between the developing gut and brain.
"Mom's stress during pregnancy can impact her offspring's development, including the brain, through changes in the vaginal microbiome that are passed on during vaginal birth," said one of the study's authors, Tracy Bale, PhD, of the University of Pennsylvania. "As the neonate's gut is initially populated by the maternal vaginal microbiome, changes produced by maternal stress can alter this initial microbe population as well as determine many aspects of the host's immune system that are also established during this early period."
In this study, researchers utilized an established mouse model of early maternal stress, which included intervals of exposure to a predator odor, restraint, and novel noise as stressors. Two days after birth, tissue was collected from the moms using vaginal lavages and maternal fecal pellets and offspring distal gut were analyzed. Offspring brains were examined to measure transport of amino acids. Researchers found stress during pregnancy was associated with disruption of maternal vaginal and offspring gut microbiota composition.
These findings demonstrate the important link between the maternal vaginal microbiome in populating her offspring's gut at birth, and the profound effect of maternal stress experience on this microbial population and in early gut and brain development, especially in male offspring.
"These studies have enormous translational potential, as many countries are already administering oral application of vaginal lavages to c-section delivered babies to ensure appropriate microbial exposure occurs," Bale said. "Knowledge of how maternal experiences such as stress during pregnancy can alter the vaginal microbiome is critical in determination of at-risk populations."
Other authors of the study include: Eldin Jašarević, Christopher Howerton and Christopher Howard of the University of Pennsylvania.
The study, "Alterations in the vaginal microbiome by maternal stress are associated with metabolic reprogramming of the offspring gut and brain," will be published online at http://press.endocrine.org/doi/10.1210/en.2015-1177, ahead of print.
"Mom's stress during pregnancy can impact her offspring's development, including the brain, through changes in the vaginal microbiome that are passed on during vaginal birth," said one of the study's authors, Tracy Bale, PhD, of the University of Pennsylvania. "As the neonate's gut is initially populated by the maternal vaginal microbiome, changes produced by maternal stress can alter this initial microbe population as well as determine many aspects of the host's immune system that are also established during this early period."
In this study, researchers utilized an established mouse model of early maternal stress, which included intervals of exposure to a predator odor, restraint, and novel noise as stressors. Two days after birth, tissue was collected from the moms using vaginal lavages and maternal fecal pellets and offspring distal gut were analyzed. Offspring brains were examined to measure transport of amino acids. Researchers found stress during pregnancy was associated with disruption of maternal vaginal and offspring gut microbiota composition.
These findings demonstrate the important link between the maternal vaginal microbiome in populating her offspring's gut at birth, and the profound effect of maternal stress experience on this microbial population and in early gut and brain development, especially in male offspring.
"These studies have enormous translational potential, as many countries are already administering oral application of vaginal lavages to c-section delivered babies to ensure appropriate microbial exposure occurs," Bale said. "Knowledge of how maternal experiences such as stress during pregnancy can alter the vaginal microbiome is critical in determination of at-risk populations."
Other authors of the study include: Eldin Jašarević, Christopher Howerton and Christopher Howard of the University of Pennsylvania.
The study, "Alterations in the vaginal microbiome by maternal stress are associated with metabolic reprogramming of the offspring gut and brain," will be published online at http://press.endocrine.org/doi/10.1210/en.2015-1177, ahead of print.
3. Hormone Fluctuations Disrupt Sleep of Perimenopausal WomenStudy finds sleep interruptions worsen during certain phases of menstrual cycle
Women in the early phases of menopause are more likely to have trouble sleeping during certain points in the menstrual cycle, according to a new study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism.During perimenopause – the earliest stage of the menopausal transition – women may have irregular menstrual cycles due to the body's fluctuating hormone levels. Symptoms such as sleep disturbances and hot flashes typically begin three to five years prior to the onset of menopause, when a woman is in her 40s, according to the Hormone Health Network.
The study examined how hormone fluctuations affected sleep during the luteal and follicular phases of the menstrual cycle. The luteal phase occurs prior to menstruation. The follicular phase refers to the two weeks after menstruation.
"We found that perimenopausal women experience more sleep disturbances prior to menstruation during the luteal phase than they did during the phase after menstruation," said one of the study's authors, Fiona C. Baker, PhD, of the Center for Health Sciences at SRI International in Menlo Park, CA, and the University of the Witwatersrand in Johannesburg, South Africa. "Measures of electrical brain activity found that the hormone progesterone influences sleep, even at this late reproductive stage in perimenopausal women."
The laboratory study examined sleep patterns in 20 perimenopausal women. Eleven of the participants experienced difficulty sleeping at least three times a week for at least a month, beginning with the onset of the menopausal transition.
The women each slept in a sleep laboratory twice – once in the days leading up to the start of the menstrual period and the other time several days after the menstrual period. Researchers used an electroencephalogram (EEG) to assess the women's sleep and brain activity. Each participant also completed a survey regarding their sleep quality in the month prior to the laboratory testing and underwent a blood test to measure changes in hormone levels.
Researchers found women had a lower percentage of deep, or slow-wave, sleep in the days before the onset of their menstrual periods, when their progesterone levels were higher. The women also woke up more often and had more arousals – brief interruptions in sleep lasting 3 to 15 seconds – than they did in the days after their menstrual periods. In contrast, sleep tends to be stable throughout the menstrual cycle in younger women.
"Menstrual cycle variation in hormones is one piece in the overall picture of sleep quality in midlife women," Baker said. "This research can lead to a better understanding of the mechanisms behind sleep disturbances during the approach to menopause and can inform the development of better symptom management strategies."
Other authors of the study include: Massimiliano de Zambotti, Adrian R. Willoughby, Stephanie A. Sassoon and Ian M. Colrain of the Center for Health Sciences at SRI International.
The study, "Menstrual-cycle Related Variation in Physiological Sleep in Women in the Early Menopause Transition," will be published online at http://press.endocrine.org/doi/10.1210/jc.2015-1844, ahead of print.
4. New from the Hormone Health Network: Exercise Anytime, Anywhere
The study examined how hormone fluctuations affected sleep during the luteal and follicular phases of the menstrual cycle. The luteal phase occurs prior to menstruation. The follicular phase refers to the two weeks after menstruation.
"We found that perimenopausal women experience more sleep disturbances prior to menstruation during the luteal phase than they did during the phase after menstruation," said one of the study's authors, Fiona C. Baker, PhD, of the Center for Health Sciences at SRI International in Menlo Park, CA, and the University of the Witwatersrand in Johannesburg, South Africa. "Measures of electrical brain activity found that the hormone progesterone influences sleep, even at this late reproductive stage in perimenopausal women."
The laboratory study examined sleep patterns in 20 perimenopausal women. Eleven of the participants experienced difficulty sleeping at least three times a week for at least a month, beginning with the onset of the menopausal transition.
The women each slept in a sleep laboratory twice – once in the days leading up to the start of the menstrual period and the other time several days after the menstrual period. Researchers used an electroencephalogram (EEG) to assess the women's sleep and brain activity. Each participant also completed a survey regarding their sleep quality in the month prior to the laboratory testing and underwent a blood test to measure changes in hormone levels.
Researchers found women had a lower percentage of deep, or slow-wave, sleep in the days before the onset of their menstrual periods, when their progesterone levels were higher. The women also woke up more often and had more arousals – brief interruptions in sleep lasting 3 to 15 seconds – than they did in the days after their menstrual periods. In contrast, sleep tends to be stable throughout the menstrual cycle in younger women.
"Menstrual cycle variation in hormones is one piece in the overall picture of sleep quality in midlife women," Baker said. "This research can lead to a better understanding of the mechanisms behind sleep disturbances during the approach to menopause and can inform the development of better symptom management strategies."
Other authors of the study include: Massimiliano de Zambotti, Adrian R. Willoughby, Stephanie A. Sassoon and Ian M. Colrain of the Center for Health Sciences at SRI International.
The study, "Menstrual-cycle Related Variation in Physiological Sleep in Women in the Early Menopause Transition," will be published online at http://press.endocrine.org/doi/10.1210/jc.2015-1844, ahead of print.
4. New from the Hormone Health Network: Exercise Anytime, Anywhere
Work out at work! The Hormone Health Network's newest infographic, "Exercises: Anytime, Anywhere" provides examples of simple physical activities that you can do no matter where you are, and how exercise can help those with diabetes. Go online to see the entire Infographics series.
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Founded in 1916, the Endocrine Society is the world's oldest, largest and most active organization devoted to research on hormones and the clinical practice of endocrinology. Today, the Endocrine Society's membership consists of over 18,000 scientists, physicians, educators, nurses and students in 122 countries. Society members represent all basic, applied and clinical interests in endocrinology. The Endocrine Society is based in Washington, DC. To learn more about the Society and the field of endocrinology, visit our site at www.endocrine.org. Follow us on Twitter at https://twitter.com/#!/EndoMedia.
