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Saliva testing

Dr. Rachel Yankama – VoiceAmerica: A Doctor’s Guide To Hormone Balance I (Saliva Testing)

Saliva testing is a common way to assess hormone status, and is actually more accurate than testing hormone in the blood.   It is the preferred way to assess hormone balance according to the World Health Organization.    The reason for testing hormones in saliva is because  hormones are normally bound to a protein in the blood–sex hormone binding globulin– and so is usually dissolved in  the fatty part of the blood or attached to the cells in the blood.  So when the blood is drawn it is then spun down to separate the red cells from the watery part of the blood  (the serum),  and the fatty part gets separated in another layer too.   Any amount the is still in the serum is ready to be filtered by the kidneys and removed in the urine.   Now saliva is a very interesting substance.  You may think that it is watery and so hormones should not be present in it.   However,  saliva is a muco-polysaccharide and therefore hormones that are fat soluble are present in the saliva.   The levels of hormone can vary depending on the time of the day that the saliva is tested and also on the time of the day that someone  is using hormone therapy.   So labs that average out the amount of hormones in the saliva over time (for example, over several samples) are going to give a more accurate assessment of the true hormone level.   Frequently estradiol,  progesterone,  testosterone,  DHEA, and cortisol levels can easily be tested this way.    It certainly makes a lot more sense than to assess hormones in the blood.   What I have found in my own practice is that people need far less hormones than what have been typically given people for treatment of hot flashes and night sweats–all the usual menopausal symptoms.       And, what I have found out is that many people do not even need supplemental estrogen as their bodies are manufacturing enough of it on their own with conversion of hormone precursors  (specifically DHEA)   into estrogen and testosterone.  You can listen to an interview I did with Dr. Mead on saliva testing for hormones at the following link:  http://www.voiceamerica.com/voiceamerica/vepisode.aspx?aid=44075.   If you check the links on the side of the page  this is also listed as “A Doctor’s Guide to Hormone Balance Part I”.

In addition,  saliva testing is now being done to assess how addicted a person who smokes is to nicotine.   Apparently,  the success of quitting can be predicted bases on whether a person is either lightly or heavily dependent on nicotine.     What the saliva test does is assess  2 of the metabolites of nicotine,   to determine how fast someone metabolizes the nicotine.   Someone who metabolizes it more slowly may smoke less and therefore may find quitting easier than someone who metabolizes it faster and therefore smokes more in order to keep his or her nicotine at a certain level.  These individuals may have a harder time quitting  smoking  or may need more than just simple measures to help them quit.

February 27th, 2010 | Category: Saliva Testing | 3 comments

Hormone Balance Part II

Dr. Rachel Yankama – VoiceAmerica: A Doctor’s Guide to Hormone Balance Part II

Did you know  the body makes more than 100 different hormones?   And when some of these hormones get out of balance it causes problems with aging and weight gain.   When these  hormones are in balance,  most of the time the person is able to maintain a healthy weight.   Some of these hormones that play a role in maintaining a healthy weight are:

  1. insulin,
  2. glucagon,
  3. leptin,
  4. thyroid hormones,
  5. human growth hormone
  6. sex hormones (estrogen, progesterone, and testosterone),
  7. cortisol, and
  8. DHEA.

Insulin and glucagon have opposing effects.   Insulin helps get sugar into the cell and contributes to fat storage;  however glucagon  helps to pull the sugar out of storage so the body cn use it for energy.   What can a person do to maximize the effects of glucagon and minimize the effects of insulin?   Well,  one tip is to decrease the amount of processed  foods and sugar in the diet and increase the amount of whole grains,  veggies , fish  (especially salmon, mackerel and sardines)  which are high in omega 3 oils.    When you have a diet that is high in carbohydrates   (particularly with a high glycemic index, the pancreas pours out more  insulin and so the end effect is to store calories and gain weight.    Also adding chromium to the diet helps to normalize blood sugar  and reduces the amount of insulin the pancreas produces.    Brewers yeast  is a good source of chromium,  and adding 1-2 Tablespoons to the diet every day will help.  The other tip to increase your glucagon level is to only have 3 meals per day.   The  frequent meal plan actually contributes to increasing insulin levels which will have the effect of causing weight gain instead.

Now what about leptin?   This hormone plays a role in telling the brain when you are full when you are eating.   If you do not have enough leptin or too much leptin the end effect is to increase appetite.    Diets high in processed foods,  high fructose corn syrup,   transfatty acids cause the body to metabolize calories differently so that you store calories as fat, even if you are trying to reduce calorie intake.

Low thyroid can also contribute to metabolic imbalance,  meaning that calories get used up far more slowly than they should.   Having a poor diet makes this condition worse.   Conversely,  by improving your diet,  you can actually help your thyroid.   It is important to include a natural source of iodine in your diet such as in sea salt,  or kelp,  or other forms of seaweed such as nori and wakame,   and limit the amount of salt that you get in processed foods  (by eliminating the processed foods!)   Also eating plenty of fresh vegetables and fruits helps your body make more of the active form of the thyroid hormone.

Everybody is talking about human growth hormone  (HGH) and how it helps maintain a normal hormone balance and helps people loose weight.    And it truly does help because it helps to build muscle.   As people get older, they tend to make less HGH and so have a higher percentage of body fat than muscle.    There are a lot of companies out there selling  HGH.     Studies have shown that if you eat less frequently  the HGH rises.   Other tips  to increase HGH which don’t cost anything include:

  1. getting sufficient sleep at night;
  2. exercising on a regular basis;
  3. normalizing the blood insulin level (which we have discussed above);
  4. managing stress   (which can be done by  #1` and #2);
  5. and getting your sex hormones in balance.

Ok,  so how do you get your sex hormones in balance?   Women start making significantly less progesterone beginning at around age 35;  whereas men start making less testosterone beginning about age 20.   When women hit menopause they are making essentially  NO progesterone and only a little less estrogen and a little less testosterone. (Women that are underweight will make significantly less estrogen as they go through the “change” and can be deficient in estrogen as well.)  Ways to get the hormones in balance naturally include eliminating sugar,  smoking,  caffeine  and alcohol.   Also increasing exercise improves the hormone balance.    Foods that contribute to a better balance in both men and women  include eggs,  chicken, whole milk,  ground flax seed,  ground chia seed which are high in the omega 3 oils and fiber.   Of course it is better to eat these proteins  from organic sources where hormones and antibiotics are not used.   For example  eggs from free-range chickens have a different cholesterol content than eggs from chickens that are  fed hormones and that do not run around to find their own food.

Cortisol is made by the adrenal gland and is the primary “fight or flight”  hormone.   When a person  is stressed out regularly,  this hormone gets depleted over time.  When it is elevated it contributes to storing calories as fat   particularly around the middle  (meaning the belly).   Ways to reduce stress include yoga,  deep breathing techniques,  tai chi,  meditation and avoiding processed foods.

DHEA  short for  DiHydroEpiAndrostenedione  is one of the  hormones made by the adrenal gland that is really the building block for both estrogen and testosterone.   Diets that are high in trans fats,  coffee, processed foods cause this hormone to be produced in smaller amounts.     Tip:   Avoid these foods.   Add some saturated fats such as coconut oil and palm oil,  in addition to monounsaturated fats such as olive oil,   avocados and nuts.

There is a recurring theme here,  did you notice it?    Avoid processed foods,  sugar,  high fructose corn syrup,   and go organic,  more fresh vegetables and fruits, with higher fiber and whole grains.   Exercise regularly,  get some sunshine which will boost Vitamin  D levels,  and get  enough  sleep every night.

February 25th, 2010 | Category: Hormone Balance | 2 comments

To Breastfeed or Not to Breastfeed?

As you may know there is a constant back and forth emphasis on whether someone should breastfeed or bottle-feed their newborn baby.   Of course,  before formula was “invented”   all mothers breastfed their children,   sometimes up to 2 years or more!   Breast milk is the natural milk  for a baby.   However,  once formulas became popular,  then everyone used formula for their babies–it seemed to be convenient and then everyone else in the family could help with the feeding of the baby.    Now,  studies are coming out indicating that breast milk is still the IDEAL nutritional  food for the baby.   Not only is it   good for the baby–it boosts his or her immune system,  and breastfed babies are thought to be smarter than their formula fed counterparts,   but it is also good for the mother.   Breastfeeding has been shown to reduce heart attack risk by reducing cholesterol plaques  in the blood vessels,  and also reduces the risk for developing metabolic syndrome by helping women loose the weight that they have gained during the pregnancy.   There have also been studies to show that breastfeeding may also lower a woman’s risk for  developing breast cancer, particularly if there is a first-degree relative who had breast cancer.    The risk was decreased by about 59%.

So the question remains,  “To breastfeed or not to breastfeed”.   Well, speaking from an obstetricians point of view,   breast feeding is the way to go—it is natures best option for milk for babies.  Plus it is cheaper—no bottles to heat up in the middle of the night,  no formula to mix up or that smells badly—and always ready and warm.   If  moms could stay home for  6 months to a year after having a baby,  then practically every one who has a baby could breastfeed!    However, you know and I know that moms have to go to back to work about the 6 – 8 week mark,  and so have to wean the baby at that time,  as most jobs are not that flexible to accommodate women so that they can continue to breastfeed even after they return to work.  (Now some women make loads of milk and so can stockpile it in the freezer for the baby for later use,  so the baby will continue to benefit from the breast milk).   Some women just do not make much milk and so that baby has to be  bottle-fed.
There are 7 main advantages to breastfeeding and that is that:
  1. it promotes bonding;
  2. it is a ready made supply;
  3. it is always warm;
  4. it usually suppresses the periods  (but that doesn’t mean a person can’t get pregnant again);
  5. the extra calories burned to make the milk (about 500 cal per day) help with loosing the weight gained during pregnancy;
  6. as the demand for milk increases,  so does the supply; and
  7. colostrum, or the very first milk produced within the first 3 days after the baby is born, is  high in immune factors that protect the baby.
Studies have shown that breastfed babies are healthier than bottle-fed babies,  there are fewer respiratory and gastrointestinal infections  in the first year of life,  there is also a decreased risk for breast cancer in the mother who breast feeds.
There are 9 minor disadvantages to breast feeding and that is that
  1. the mother is the only one who can feed the baby  (unless breast milk is pumped from the breast and stored in advance);
  2. there is no way to know exactly how much the baby eats.   You can only go by wet and dirty diapers, and a measure of the baby’s weight at it’s well checks;
  3. breast milk is affected by the mother’s diet which can affect the flavor or effect on baby.   For example, gas producing foods for the mom, can cause  gas in the baby.  People who breastfeed find out very quickly what bothers the baby;
  4. sometimes breast feeding is painful;
  5. you might not be able to feed the baby in a private place when it gets hungry;
  6. some women don’t loose weight while breast feeding, they gain weight because their appetite has increased a lot;
  7. if you normally have to take certain medications you will need to check with  your doctor if it is safe to take them while breastfeeding;
  8. sometimes your breasts  may leak milk at inopportune times;
  9. hormone levels can be lower while breastfeeding, so intercourse painful for a time due to vaginal dryness.

What are the advantages of bottle-feeding?
  1. Other family member can help feed the baby;
  2. babies sometimes gain weight faster on formula (there is a higher sugar content);
  3. you can begin your birth control sooner  when bottle-feeding.
What are the  disadvantages of the bottle feeding the baby?
  1. The immune system of the baby  is found to be not as good as breastfed babies;
  2. there is a lot of controversy implicating problems with the plastic in the bottles as having an adverse effect  on the health of the baby, particularly in developing ADHD and also affecting hormone balance in the baby;
  3. and there is  more work involved with sterilizing the bottles, heating the milk, etc;
  4. many formulas contribute to gastrointestinal issues with the baby; and
  5. many formulas have an unpleasant odor to them.

Of course,  there is more information in my book,  “A Doctor’s Guide to Pregnancy”  which  is available @ ,  www.borders.com, www.amazon.com, www.barnesandnoble.com, www.dimensions-of-wellness.com.  and www.studentsreview.com.
February 24th, 2010 | Category: Breastfeeding | 3 comments

Acid/Base Balance

Apparently there is a lot of information coming out about the importance  of having a  higher proportion of alkaline foods in the  diet.   The serum in the blood should be slightly alkaline,  and when it is not,  there is a tendency towards poor health.   there is a propensity to develop more  inflammation,  which is thought to be the source of  a lot of medical problems:   diabetes,  cancer,  high blood pressure,    osteoporosis,  chronic fatigue,  to list a few.

How do you know if your body is acidic or alkaline?   There are a couple of ways to tell, and the first way is to test the first morning urine,   the second is to test the saliva,  and the third is to test the blood.   The two easiest are the saliva and the urine.   All you need is the  pH  paper that detects acid or base status and will turn colors depending on the acidity or alkalinity of the fluid being tested.   Water is neutral and should be 7.0 on the  pH scale.   Very acidic is on the lower end of the scale  (towards 1.0),   Very alkaline is on the higher end of the scale  (towards 14.0).    Serum  is usually around 7.35 to 7.45  or slightly alkaline.

So, now what foods are alkaline,  and what foods are acidic?   Well, to put is simply,  the vegetables are predominantly alkaline  with sprouts being very alkaline,   and some fruits such as tomato and avocado,  lemons, limes and grapefruits, fresh coconuts,  sour cherries, and unripe bananas   have an alkalizing effect on the body.    Most fruits because of the natural sugar content can be acidic.   Almost all processed foods,  dairy products,  and high protein foods  (meats) ,   sugar, caffeine,  artificial sweeteners, alcohol,   carbonated beverages are all acid  forming.  If it comes in a can or a box,  it is acidic  and also does not have much in the line of either fiber or nutrients in it.

The following is a partial list of alkaline foods:   ripe peas, asparagus, artichokes,   comfrey,  cabbage,  lettuce,  onions, cauliflower, rutabaga, kohlrabi,  zucchini,  rhubarb, leeks, watercress, spinach,  turnips,  chives, carrots, lemons,  limes,   green beans,   beets,  garlic, tomato, endive, avocado,  radishes, dandelion,  sprouts   (of all kinds),   alfalfa grass,  barley grass, cucumber,   lentils,  lima beans,  soybeans (fresh),   white beans,    soy lecithin,   cumin seeds,   sesame seeds,  fennel seeds, caraway seeds,  almonds,   olive oil,  flax seed oil,  evening primrose oil,   fresh coconut water.

Other foods that are acidic include;   brown rice,  wheat, buckwheat, millet, and spelt,  walnuts,  pumpkin seeds,  sunflower seeds,  macadamia nuts, hazelnuts, flax seeds,  brazil nuts,  sunflower oil, ghee,  coconut milk,  and freshwater fish.

So what does this all mean:   You heard your mother,  “Eat your veggies”,  well that is TRUE.   And as much of what you eat should be fresh and raw.  The more it is cooked and processed,  the less nutrients there are in the food.    And how about fruit juices?   they  are very high in sugar,  low in fiber,  and best to be avoided.     However, it does not mean that you can’t have any acidic foods,  it just means that you need to keep your proportion of  acidic foods to   20 % of your diet or less.    So,  80% of the diet should be alkaline foods.

February 14th, 2010 | Category: Acid/Base Balance | 4 comments

Probiotics

Now what about probiotics?   What are they?   Many companies are now advertising that they are adding probiotics to the food  (cereals,  yogurt,  and other foods).   Why would you want to include them as a supplement or as part of your diet?

Well,  probiotics are essentially the good bacteria  that live  in   your gastrointestinal tract.   These bacteria  help with your digestion and also help to keep you healthy   particularly if the proportion of good bacteria is much higher than the bad bacteria.  Typically the good bacteria should be about 85 % of all the bacteria present and the bad bacteria only 15%.     If that balance changes  for some reason   like  taking antibiotics –which will kill off both the good and the bad bacteria–then a person may experience problems with getting yeast infections or diarrhea,  or problems with digestion.    Probiotics are thought to play a major role in boosting people’s immunity.

Now there are a lot of companies that make probiotics–some which contain only one or two different bacterial subtypes,  and some which contain 10 to 13 different subtypes.   Which probiotic is the best?   (Of course each company that makes the probiotics will claim that their particular formulation is the best).    My general recommendation when you are looking to purchase probiotics,  is to find one that is  stable at room temperature and  one that has the most bacterial subtypes.   There are some that do need to be  refrigerated,  otherwise the total  number of colonies that are said to be present on the label may not actually be present.

February 7th, 2010 | Category: Probiotics | 4 comments