Fibroids are growths of the smooth muscle of the uterus.   They can be small  (a few millimeters in diameter),  or very large (up to several inches in diameter),  or somewhere in between.   (Personally the largest uterus that I have seen from fibroids was about the size of an 28 weeks pregnant uterus  and she was not pregnant).    There can be just one fibroid,  or there can be several or many.   Most of the time the fibroids are NOT  cancerous.   They are usually benign.    In a very small percentage of the time,  (less than 1%) a fibroid may cancerous.

If you have fibroids in your uterus,  your doctor may want to monitor the growth  of the fibroid  by either doing an ultrasound (where the fibroids can be measured in millimeters or centimeters), or by doing a pelvic exam  where the size of the uterus is compared to a pregnant uterus.   Then if the pelvic exam is repeated in about 6 months, you doctor can tell whether the uterus has gotten bigger or not.    Not all fibroids require surgery.    The fibroids that cause problems such as,   pain or bleeding, infertility,  pelvic pressure, or urinary symptoms are the ones that need treatment.

Whether or not someone experiences symptoms due to their  fibroids,  depends partly on the location of the fibroids in the uterus.  They can be embedded deep within the muscle of the uterus  (and are called intramural fibroids) and these ones  typically cause a considerable amount of pain,  particularly with the menstrual cycle.      Or they can be right under the lining of the uterus in the inside  (and are called submucosal fibroids), and these ones typically cause bleeding problems–too much, too long,  too  heavy,  with clots.  Fibroids that are located on the outer surface of the uterus are less likely to cause problems when they are small,  but can cause pressure symptoms when they get larger,  as they can press on the bladder or the bowel.   Sometimes the pressure can be exerted in the inner groin area, so that people experience pain that goes down the legs.

Generally speaking,  fibroids respond to the hormones produced by the ovary,   so it is only logical to think that the fibroids would shrink once someone stops having their cycles and the hormone levels decline.  However,  no all fibroids shrink  and so it is important to keep track of the size of the uterus.   And if you should start experiencing a change in your periods–closer than every 21 days,  or longer than 8 days,  then you should contact your doctor.   It is helpful to record your periods in a pocket sized calender in order to be more accurate in evaluating your periods.  Your doctor will want to know what your cycles were like and what has changed about them.  Many people that I know have just do not remember accurately when they had their last menstrual cycle or whether they were even regular or not.   You may need some blood tests to check your thyroid,  for menopause  (depending on your age and other symptoms),  for anemia, and for bleeding disorders.

The treatment for fibroids has expanded over the years so there are many more options for women today than there were years ago.   Treatments range from medical therapy  (some form of hormone manipulation),  to surgical therapy  (outpatient surgeries and inpatient surgeries).    Medical treatments  specifically directed to shrinking the uterus include:

1. Gonadotropin releasing hormone (GnRH)  agonists such as Lupron or Zoladex  to shrink the uterus.   These agents shrink the uterus to about 1/2  the size that it was before treatment, but it is not a permanent effect.  Once the treatment (4-6 months),  is completed the uterus returns to pre-treatment size.
2. Some people have advocated using natural progesterone to balance off the effects of estrogen to see if that will help to shrink the uterus.  I have seen mixed results with this approach;
3. Radiographic uterine artery embolization has also been found to shrink fibroid for people who are done having their children and when the fibroids are symptomatic either with pain or bleeding.  with this particular approach the blood flow to the fibroid  is compromised so that oxygen and nutrients are not delivered to the fibroid.  Subsequently,  the fibroid shrinks.

Surgical therapies include myomectomy  (which means removing the fibroid), and hysterectomy  (which means removing the uterus.)  These are reserved for when other conservative options have failed to control the symptoms.    If someone selects a myomectomy,  this preserves the uterus  (unless there are too many fibroids) ,  so that the person is still able to have children  afterward.   Depending on the size, location, and depth of the fibroid,  a person may have to consider a cesarean section for the delivery of their children should they get pregnant after a myomectomy.  Check out my post on Bleeding Abnormalities and on Robotics to learn more about hysterectomy as a form of treatment.

There are several theories as to what causes prementrual syndrome  (PMS).   One theory involves the function  of the kidney such that there is a change in the ability of the kidney to eliminate the excess water and so this contributes to the water retention.   Another theory  involves  a depletion of certain neurotransmitters   in the brain so that this contributes to the moodiness and irritability and problems with anger management.    The third theory  involves an imbalance between estrogen and progesterone such that there is estrogen dominance and less progesterone production.  This theory actually encompasses what happens with the other 2 because when there is excess estrogen it contributes to water retention and it contributes to changes in metabolism of the neurotransmitters in the brain.   With replacement of the progesterone these  symptoms frequently resolve.  Progesterone has diuretic effects,   anti-depressive/calming effects,  and  then would balance the estrogen.    Natural progesterone,  20 mg in topical form  is easily used on days 12  to 26.   

Now before recommending any form of  “medical therapy”,  I usually counsel my patients to start making a few changes in their life–this is after documenting some sort of cyclicity to the symptoms.  The  first change that I recommend is to avoid processed sugar and the high glycemic index carbohydrates such as white bread,  white rice,  white potatoes, and sugar,  also eliminate artificial sweeteners, flavorings and colors.    Plus it is important to get plenty of rest   (so go to bed a little earlier and get up a little later ).  reduce the  amount  of  caffeine in the diet as well and start a regular exercise program.    These measures help with eliminating and dealing with daily stressors,  which then decreases the severity of the PMS   symptoms.      Now for someone who tries this consistently for several months    and still does not notice any improvement,  then natural progesterone would be the first line of therapy in my opiniion.   If is far safer than starting antidepressants or diuretics which may have potential side effects.  You can get natural progesterone from my web site:   www.womenshealth.myarbonne.com

Now if you happen to be one of those individuals that just has a very heavy period and you decide to go to your doctor about it,  what kinds of options do you have to treat the heavy bleeding?   Part of what might be offered to you will depend upon your age, your smoking status, your prior medical history and medications that you may already be taking.   So let us dive in and discuss what you can do provided that you do NOT smoke or have any underlying bleeding/clotting abnormalities that would contribute to the problem, and for purposes of this discussion  I will assume that you have not yet gone through the menopause.  (The options for treatment are somewhat different if you have already gone through the  “change”).

To begin with,  the options include:

1. some form of hormonal manipulation with synthetic hormones  including oral contraceptives,  (patch)  Ortho Evra,  (ring) Nuvaring,  oral Provera,  DepoPr0vera shot,  or the Mirena IUD;
2. some form of hormonal manipulation using natural hormones such as progesterone , given orally (Prometrium),  vaginally (Crinone),  or topically (there are many companies that make topical progesterone),  I personally have had good success with topical Prolief made by Arbonne International;
3. some form of hormonal manipulation that affects the pituitary gland and suppresses cycles such as Lupron,  Danazol, Zoladex:
4. radio-graphic uterine artery embolization  which reduces blood flow to the uterus and decreases flow;
5. some form of endometrial ablation–such as with Thermachoice,  Novasure, and  Her Option to name a few;
6. and finally,  hysterectomy–which involves removing the uterus.

Now to go into each of these in a little more detail.  The first one involving synthetic hormone manipulation  does work about 95 % of the time to regulate the periods and to reduce bleeding each cycle.  Most individuals also notice a reduction in the amount of pain experienced with  the periods.   However, there are potential side effects and complications possible.   The most common side effects of the contraceptive category are  headaches,  water retention,  moodiness and irritability, weight gain,  nausea, and break-through-bleeding.  The problematic complications are clots in the leg,  heart attack, and stroke–all of which are usually very rare.   However, if you are over  35 and smoke the chances of these complications are significantly higher, and I would NOT recommend the oral contraceptive category, or the patch or the ring.  If you decide with your doctor that you would like to go this route,  I would suggest a trial of at least a 3-6 months  to see if there is an improvement.  Oral Provera,  DepoProvera,   and the Mirena are single agent synthetic progestins  (meaning that the progesterone molecule has been tampered with and adjusted to have several side chains on it),  This changes the actual effect of the hormone at the cell level and is very potent  with side effects:   predominantly headache,  hair loss, acne, weight gain,  moodiness and depression.   In my practice I have seen about 10% to 20% of people on Provera have side effects,   about 40% of people getting the DepoProvera shot have side effects,  and about 2% of people with the Mirena IUD have side effects.  Provera is usually taken orally for 10 to 14 days out of each month,  DepoProvera is given every 3 months and 75% of people will stop getting periods altogether on the shot,  and the Mirena is associated with a lot of irregular bleeding within the first 3 to 6 months after insertion,  but after that the periods get significantly lighter.

The second category of natural hormone manipulation is that this really addresses the real reason why people run into problems with their periods.  Many times it is because there is some element of estrogen  dominance,  and so by adding natural progesterone,  this actually helps the person with balancing out their hormones.   Plus the body has all the receptors to deal with progesterone,   it does not have the receptors to deal with all the synthetic drugs  ( which in fact contribute to the hormone imbalance).   Now of the natural progesterones available,   studies show that topical administration is really the best way to get it into your system.  So topical creams that deliver about 20 to 25 mg per day of use  (on days 12 to 26 of the cycle)   give the person a physiologic dose of the progesterone.  Ther is good absorption of the progesterone in the vaginal forms as well, although this is not as popular because it does tend to be a little messier for the person using it,    as it is usually inserted at night and it can run out of the vagina  the following day.    Oral forms are not absorbed as well from the gastrointestinal tract   and so in order to get some benefit from it,  doses have to be considerably higher than the topical forms  (between 5 to 20 times higher).   This contributes to a higher side effect profile on the oral form–mainly drowsiness and so it does have to be taken before going to bed.  The advantage to the oral and the vaginal route is that most insurance companies cover this as it is a prescription,  and the disadvantage to the topical forms is that most insurance companies do not cover it because people can by it over-the-counter, at health food stores,  or on-line  (like from my web site:   www.womenshealth.myarbonne.com).

The third category of treatment is the gonadotropin releasing hormone agonists  (Lupron, and Zoladex)l:  meaning they suppress the function of the pituitary gland in producing the hormones that signal the ovary to do its job,  so women stop having their periods.  Treatment is usually given for 6 months and causes known side effects of hot flashes, night sweats,  moodiness, irritability,  vaginal dryness and has been associated with contributing to osteoporosis.   In other words, it places people prematurely into a temporary state of menopause.   (I say temporary, because most individuals  will start having their periods again after they get done with this treatment.)   Danazol works a little differently and is a derivative of a male hormone, so additional side effects with this  treatment include hair growth (like on the face and chin), weight gain,  lowering of the voice,  shrinkage of the breasts,  and acne.    This  is not a very popular treatment for the reasons of the side effects–not many women want to get male-type side effects.

Fourthly  radiographic uterine artery embolization has helped women who are candidates for this.  Usually a women has an enlarged uterus with fibroids as the reasons for the excessive bleeding and this is a form of  treatment that addresses the fibroids.   What is done is that an IV (or intravenous line)   is started in the groin area,   then with flouroscopy  the blood flow to the uterine fibroids is identified.  Then a substance that blocks  the blood flow to the fibroid is injected into the artery thus causing the fibroid to shrink.  Eventually  the uterus   shrinks and amount of bleeding decreases.    This is temporary solution, and potentially the blood flow to these fibroids can increase over time and cause them to grow again.   However for some people this is a good temporizing option.

Fifthly,  endometrial ablation is another option, but does depend on the size of the uterus.  It is not as successful a form of treatment for a uterus that is larger than 12 weeks size.   (A non-pregnant uterus is compared in size to a pregnant uterus).  All of the endometrial ablation techniques have similar success rates and can be associated with quite a bit of cramping in the first 24 hours after the procedure.   There is also a watery discharge for a few weeks afterward as well.   About 85% of women will notice a significant reduction in the amount of bleeding that occurs each month.   Of the women that respond, about 1/3 of the women have no period,  about 1/3 have a very light flow, and about 1/3 have a more “normal” period.  About 15- 20% of women may still have heavy bleeding.   There are some potential complications with each one,  and that includes infection, bleeding and uterine perforation.  Thermachoice endometrial ablation involves putting a catheter that has a balloon on the end of it into the uterus.   The balloon is then filled with fluid to reach a pressure of 160 to 180 mm of Hg  (millimeters of mercury, a standard pressure measurement).   Once the appropriate pressure is obtained,  the fluid is then heated up to 87 degrees Centigrade for a total of 8 minutes   (after reaching the goal of 87 degrees.)   Then the catheter and the balloon are removed when the procedure is over.   The Novasure procedure involves putting a triangular wand shaped structure into the uterus, that (when open)  mimics the interior shape pf the uterus.   A negative pressure is applied and the wand has an electrical current run through it which then destroys the superficial endometrial lining.      The cryoablation procedure involves putting a probe up into one side of the uterus and identifying its location by ultrasound and then freezing the lining of the uterus. Then the other side is done , and if needed, the middle.  The last endometrial ablation procedure  involves circulating hot water into the endometrial cavity without being enclosed in anything.  Potentially, the hot water could traumatize other structures as well.

Finally there is a hysterectomy,  which means removing the uterus  (and usually the cervix, but not always).    In this procedure,  the organ that  is the source of the bleeding is removed so periods will stop completely.   This will mean the the woman is also not able to get pregnant and have a child,  so this procedure is not offered unless the women is done having her children or unless cancer is found in the process of figuring out why someone is having a lot of bleeding.  There are 3 major ways of doing a hysterectomy–abdominal,  vaginal, and laparoscopic (either with or without a robot).   Using the robot, the procedure is called a DaVinci Hysterectomy.  All three have potential complications of infection, bleeding, and injury to some other internal structures such as the bowel or the bladder or the ureter,  also there is a chance for developing either clots in the leg or pneumonia postoperatively.   The main advantage to the  laparoscopic approach is that there is less bleeding,  less infection,  less postoperative pain,  shorter hospital stay and also   sooner return to work.

The average period lasts about 4 to 6 days and some people are just lucky to have a  period that only lasts 2-3 days with light flow.   Whereas, others may experience 7-8 days of moderate to heavy flow.    If a person has so much bleeding that they are unable  to leave their home,  then that is a heavy period!   The amount of bleeding for a normal period  also varies from person to person.   On the average,  not more than about 2 ounces  (or about 60 mL)  of blood are lost.   For someone with a heavy cycle,  the amount of blood lost could be significantly more than this.   And once a person has a period that lasts more than 10 days,  this is TOO long;  it is definitely time to talk to your doctor about the periods if this is what is happening.     Conversely,  if your periods are occurring  more frequently than every 21 days  (from the first day of one cycle to the first day of the next cycle),   then this is also more frequent than normal and you should be addressing this with your doctor.   Symptoms that would indicate that you are loosing too much blood each month and could possibly be  anemic (or have low iron),    include feeling fatigued,   dizzy,  lightheaded,  drowsy,  having shortness of breath with minimal activity,  or wanting to chew on ice.

So,  what are the ways to find out if  there is a problem?   Well when you see your doctor, he/she  will want to know the following information:

1. how long has it been going on?
2. are there any other associated symptoms,  such as dry skin, weight loss or gain, hot  flashes, night sweats, pain or cramping besides fatigue, dizziness, or fainting?
3. what was your cycle normally like before the bleeding problems started?
4. are you taking any medications  that may affect your menses?
5. and are  there other pertinent factors related to your prior medical history,  surgical history,  family history  (particularly in relationship to bleeding disorders),  and your current family planning methods, that may have a bearing on the problem?

Of course your doctor will want to examine you–to check for  conditions that can have an effect on your menstrual cycle  such as thyroid conditions,  and enlarged uterus,  pregnancy,  etc.   In addition,  certain blood tests may be ordered.    A pelvic ultrasound may be a helpful test as well.   Now if you end up having all of these tests and there is still not an answer,  then there is a choice between 3 other tests  which may give the answer to the bleeding problems.   The first is an endometrial biopsy,  the second is hysteroscopy, and the third is a D & C  (or dilatation and curettage).      The endometrial biopsy is usually done in the doctor’s office,  the hysteroscopy can be done either in the doctor’s office or as an outpatient procedure,  and the D & C is usually done as an outpatient procedure with some form of anesthesia.   They all have similar risks:   infection,  bleeding, and the potential for uterine perforation (or making a hole in the uterus,  accidentally of course).   The endometrial biopsy involves passing a small narrow, usually plastic, catheter into the uterus through the cervix in order to get a small sample of tissue  that can then be analyzed by the pathologist–this is a medical doctor who specializes in evaluating tissue under the microscope.  This test can cause some cramping (similar to a bad period),  and there may be a little bleeding afterward,  but it is normally done without any form of anesthesia, and takes less than 5 minutes to do.    Any cramping that occurs with the process ends shortly after completing the procedure.   For those individuals who have a low pain tolerance or who have been bleeding so heavily or for a long period of time that it is necessary to stop the bleeding,  then a D & C would be offered.    This can be done with a general anesthetic,  with a spinal anesthetic,  or with local anesthesia  (and perhaps a little sedation).   In this procedure, the cervical opening is stretched a little in order to be able to insert equipment that can scrape off the lining on the inside of the uterus.   Some doctors will combine the hysteroscopy with either the endometrial biopsy or with the  D & C,  in order to actually look inside the uterus to find polyps or irregular areas.   Once the procedure is done,  your doctor will want to discuss the results with you at a later visit as it normally takes several days to get the pathology report back  which hopefully has the answers for you.

Now what are the main problems that contribute to  menstrual or bleeding abnormalities?   One of the most common is related to the thyroid gland–if it is underactive or overactive,  period problems can occur.    Irregular bleeding can also occur in situations where  a person is not ovulating because of polycystic ovary.   In this situation there is a considerable build up of tissue in the uterus which then bleeds for weeks on occasion,  especially after an episode of no periods for  a few months.  The pathology report can show chronic proliferative changes or even hyperplasia  (too much tissue and gland formation),  or endometrial polyps.    These are thought to be due to too much estrogen and not enough  progesterone,  (an estrogen dominant condition).   Another source of irregular bleeding is endometritis,  or a low grade infection in the uterus that causes bleeding to occur between periods.  This bleeding may not be heavy,  or it could simulate the bleeding that one has with the usual cycle.   The endometritis could be acute  (meaning developing over a short period of time)   or chronic  (meaning developing over a long period of time).   Needless to say,  there are also fibroids  (or smooth muscle tumors in the uterus),  and last but not least,  endometrial cancer.  This is not an exhaustive list,  but basically covering the most common problems.

I will cover the treatment options of these various problems in “Bleeding Abnormalities,  Part II”.

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.

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.

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.

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.