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adrenal

Weight Gain During Menopause–The Hard Truth

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It is almost a mantra for women to complain of weight gain during menopause. But are we putting the cart before the horse? Could our view be all wrong?

Before I say anything else, let me just remind everyone of that famous saying…

“Don’t shoot the messenger”

Everyone has heard a 50-something women complain about weight gain associated with menopause.  But is this just an old wives’ tale, or does menopause truly lead to weight gain in some (if not most) women?

First, let’s drop a bombshell that rarely gets discussed.

Menopause may not be related to a woman’s ovaries and their production of estrogen (specifically E2 or estradiol).

I would say that this information has the potential to blow apart the hormone replacement industry, but the news is a little late since the Women’s Health Initiative already did this when the trial was stopped early in 2002 because the data was suggesting that HRT was killing women faster then it was saving them (Wwow!  What a unique story in mainstream medicine!).

 So if it’s not the ovaries, what is it?

The adrenal glands are two small glands located just above the kidneys and, while small, have a massive role to play in our health.  In women, they are responsible for a large chunk of her circulating hormones throughout her life, NOT just post menopausally.

This means that, in a healthy functioning woman with her adrenal glands doing what they are supposed to be doing, even in the peri and post menopausal times there can be circulating levels of some hormones near to that in her youth.

Current research suggests that the adrenal glands may be critical for a healthy menopausal transition and NOT the ovaries (although the ovaries may play a role in triggering the adrenals to pick up the slack).

So why is this a problem?  Because in today’s stressed out society, our adrenals glands are beat up.  During stress, the adrenals glands do a great job of keeping up.  However, driven to work harder over the course of decades leaves them barely able to keep up with demands.

Imagine that your adrenal glands have been overworked for 30 years because you are a stress monster and spend an extra 20 minutes every morning worried about what you are going to wear before you even begin to face the trials and tribulations of the day.  They’re wiped out.

Along comes the early stages of menopause and the trigger goes out from the ovaries for the adrenal glands to pick up the slack.  Ain’t going to happen.  And you’re left with a menopausal transition rife with problems, hot flashes, bone loss and the rapid development of prediabetes.

NOT because of menopause, but because of the 30 years of abuse you’re done prior to that.  Menopause is just when it all comes crashing down.

Luckily, if you have a provider wizened enough to recognize the problem, there are solutions for adrenal problems.  Controlling stress on the front end through exercise, yoga and meditation are important.  In addition there are natural adrenal support supplements that can work very well at helping the adrenals recover from abuse.

One thing is for sure–they do not recover on their own.  They’re going to need supplemental help.

So what does all this have to do with this particular article?

Researchers looked at weight gain and menopause through the lens of the chicken and the egg.  Does weight gain precede menopause, or does weight gain happen before menopause, potentially even triggering the transition?

As I mentioned before, I’m just the messenger.

According to this study, the weight gain preceded the change in hormone levels.

If the weight gain is from menopause, this is the easier answer.  It suggests that there is little women can do; that the process is near inevitable (except for 20 years ago–then they would’ve recommended hormone replacement therapy to keep you in a horse-urine induced youth).

As with much else, the responsibility lies within us.  The good news is that means that we can make choices to improve our health and ease the transition into the postmenopausal period.

What did you find that helped with your own experience of menopause?

COFFEE MODIFIES GI HORMONE EXCRETION AND GLUCOSE TOLERANCE – (10-15-03)

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Coffee acutely modifies GI hormone secretion and glucose tolerance: glycemic effects of chlorogenic acid and caffeine. For me, coffee falls into the “everything in moderation” category (incidently, broccoli and other veggies from the brassica family are not in the moderation category–overindulge). What I do have a problem with is coffee drinkers who cannot function until their fifth gallon of coffee–these people usually have adrenal insufficiency that they are trying to override with super-physiologic doses of caffeine. For everyone else, coffee has shown to have benefits from their polyphenols.

AJCN — Abstracts: Johnston et al. 78 (4): 728

Read entire article here

 

DO YOU HAVE LOW TESTOSTERONE?

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The understanding is that mainstream medical research takes about 20 years to make it into clinical practice, specialists included (unless it’s blockbuster drug research, in which case it seems to make it to doctors’ offices overnight…).  That means that current research I comment on won’t be used appropriately for at least another 2 decades.  While I consider this completely inappropriate because, as a physician, it is my responsibility to my patients to stay current to some degree, it is a reality.

However, there is an occasional glimpse of the sun through the clouds when mainstream medical practioners try to apply functional medicine concepts in limited aspects.  Probiotics are a key one–106 years in the medical literature and some docs are starting to recommend Florastor in limited situations.  Unfortunately, Florastor can work great to lower the risk of antibiotic associated diarrhea, but is not considered a probiotic to restore normal flora in the gut.  So, great idea for mainstream medicine, but inappropriate application.

Strangely, I see the same thing with checking testosterone levels.  I’ve seen more and more of this over the years, and some clinics even hang their hats on the idea of testosterone checking and supplementation (usually as pellets implanted under the skin of the glut region).  But it seems so out of context with the rest of the bloodwork checked that I just scratch my head in wonder.

Why?  Several reasons.  First, checking testosterone in the blood is not my favorite method.  Salivary testing is much easier and checks the levels of unbound, active hormone in the body, which blood testing does NOT do (it checks the protein bound, inactive levels). 

Next, if the levels are low, their is never a question as to why they are low; it’s just replacement with creams, pills, injections or pellets.  Which–by the way, can really screw up the way your body works.  It would not be the first time I’ve seen a male patient with low testosterone pushed into sterility from exogenous testosterone use.

In functional medicine, we would ask WHY are the levels low and address that aspect of the issue.  Many times, it can be an adrenal issue.  A chunk of a male’s circulating testosterone is actually derived from the adrenal gland (on the range of 5%) and we need to evaluate and support adrenal function via supplementation, exercise and stress mangement. 

Toxicity from the environment can contribute greatly.  The principal agent are the phthalates, which are well known to produce a feminizing effect on the male.  So avoid things with that “new car” or “new shower curtain” smell as much as possible.

http://www.sciencedirect.com/science/article/pii/S0002934311002749

PROTECT YOUR HEART THROUGH YOUR ADRENALS

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Mainstream medicine today has become more and more specialized (I’ve heard it said that the more specialized we become, the less we know about more and more…).  Unfortunately, no one discussed this arbitrary division of human physiology with the human body.  Every single system in the body is interconnected in hundreds of ways with every other organ system.  Ask your cardiologist what advice he or she can give you about protecting your adrenals or ask your endocrinologist how to protect your heart and they will happily refer you out to someone else.

This article is a perfect example of how the systems interact.  A normal cortisol response from the adrenal gland produces higher levels of cortisol in the morning and it gradually tapers off at night so you can sleep.  High stress levels and poor nutrition will alter this pattern.  Let this go on long enough and you may burn out the adrenal glands (they can only do so much to keep up with poor choices), flattening out this cortisol response.

As a side note, this study used saliva samples to determine cortisol levels, which is the only reasonable method to check most hormones.  Mainstream medicine will typically run a single blood test for cortisol, which gives no indication as to the pattern of cortisol production.

In patients who had this flattening out response they had an 87% increased risk of dying of cardiovascular causes.  Given how bad stress is for us, this should come as no surprise, and the actual mechanism is likely multifactorial.  The bottom line is that there is no question that stress affects our body’s function and this will ultimately lead to death.  Harsh, but true.  And, given today’s healthcare system, you can trust that it will be a long and painful deterioration of health before the end.

http://jcem.endojournals.org/cgi/content/abstract/96/5/1478