Our lives are all about the balance and integration of our many parts. The yin and yang, the building up (anabolic) and breaking down (catabolic), sympathetic and parasympathetic nervous systems are to name a couple. When we lose the balance in our bodies, it causes disease. When we experience a of combination of symptoms like fatigue, joint pain, muscle pain, headache, abdominal bloating and pain, it tells us that many systems in our body are out of balance. We need to find and treat the main imbalances and our body will start to rebalance itself and heal. Now more than ever in this age of specialization, we need our health care providers to look at our bodies and health as a whole and how each part affects the other.
A lovely quote from Jeff Bland PhD, the father of Functional Medicine, “Functional Medicine is the science of creating health. Disease goes away as a side effect”.
The highest balance/integration is the balance between the mind (emotional), body (physical), and spirit. Within the body, the neurological, endocrine, and immune systems must be balanced. Any disruption in any system causes the others to malfunction. Within the endocrine system three of the major systems, the thyroid, adrenal, and sex hormones must be balanced. Failure to do this is why some people do not feel quite right on sex hormone replacement alone. For instance, elevated levels of cortisol from the adrenal glands causes a change in the binding of the sex hormones and the amount of free hormones like estrogen available to perform their functions.
Hypothyroidism is a good example of the effects of different organs on another. Treating hypothyroidism is not just a matter of testing and TSH and finding it to be elevated and then giving the patient medication to fix it. It is necessary to ask the question ”why did this occur? ”. Then to find the root cause(s), begin the proper treatment(s) and balancing our bodies allowing them to heal. It is necessary to have the proper nutrients such as iron, iodine, tyrosine, zinc, selenium, vitamin E, B2, B3, B6, C and D to make thyroid hormones. So we must eat a healthy, nutrient dense diet, but that is not enough. We must digest and breakdown and absorb those foods-the proteins, fats and carbohydrates. So we can have the nutrients from those foods available to us to use in the many cellular reactions in our bodies and in this case to make thyroid hormone.
Here are examples of the gut-thyroid balances/interregulation. Medicines like the protein pump inhibitors, Prilosec, can interfere with the absorption of vital nutrients that can lead to disease states like hypothyroidism and osteoporosis. Surgeries like removal of the gallbladder, and stomach surgeries for weight loss and also alter the ability for digestion and absorption of our food. Celiac disease, an autoimmune disease, causes damage to the intestinal lining and problems with digestive enzyme production, absorption of foods. This damage to the lining gives loose connections between the cells (leaky gut) and allows foods to pass from the gut into the blood stream and body. This causes the body to react to these ‘foreign invaders’ and produce antibodies leading to autoimmune diseases like Hashimoto’s thyroiditis.
Hypothyroidism is known to cause elevation in the cortisol levels. It is felt to do this as it is causing metabolic stress on the cells. And elevated cortisol levels suppresses TSH and low cortisol levels cause a high TSH. This is an example of the thyroid axis and adrenal axis interplay.
Cholesterol metabolism is another example of complex interplays. High cholesterol
Is not a statin deficiency. It comes from a variety of causes. It can come from genetic, inflammation, hypothyroidism, insulin resistance, the foods we eat and stress. Just because our genes say we have inherited a particular genetic sequence, does not mean that we are doomed. Another of my favorite quotes by Dr. Bland is “Genetic expression=Our genes get messages from our interactions with the environment and with how we choose to behave. They translate those messages into cellular instructions. These instructions are then what control our health and disease patterns. Genetic inheritance is not fate. Your lifetime health was not predetermined at your conception. On the contrary you have the opportunity-and the power-to shape your own pattern of health and longevity. It’s what personalized health management is all about”.
Insulin resistance can come from high cortisol levels, problems with carbohydrate metabolism from excessive intake, and stress increases cortisol levels. Insulin resistance can cause high cholesterol levels. It is all really interrelated and interdependent. So when you get that high cholesterol level back, you can see why just putting you on a statin isn’t the answer. One of the reasons that statins have been shown to work in the studies is that they do decrease the inflammation which is one of the causes of high cholesterol. In Functional/Integrative Medicine, we have other ways to treat the inflammation. First we need to find the source. We need to look at the whole picture and decide on a treatment plan. We access genetic risk and then how our environment affects this causing those genes to express or not. Are we eating a diet that is balanced and giving us the proper nutrients? Are we eating too many carbohydrates and the wrong kind of fats?
Do we have in place a daily lifestyle plan that we use to modulate the stresses in our lives? Are we exercising and not excessively? Have we evaluated our thyroid and adrenal (cortisol and adrenaline) function? Have we identified any inflammation that could be causing the problem? So all these factors need to be taken into consideration when treating high cholesterol to treat it appropriately.
Another important interplay is between cholesterol and sex hormones and cortisol. Cortisol is the ‘mother’ substrate necessary for the production of adequate sex hormones like progesterone, estrogens, DHEA, testosterone, and cortisol. If we don’t
have enough cholesterol, we can’t make these hormones and have deficiency states. Driving cholesterol down too far with statin drugs becomes a problem for our hormone production and we become symptomatic. So the hot flashes, fatigue, insomnia symptoms that a woman is presenting with can be coming also from this very low cholesterol.
We all know that stress is necessary for our health and too much either of the right kind which gives us high cortisols initially or the wrong kind damages our bodies. Elevated levels are a tear me down situation, not a build up the body.
Too much exercise contributes to this problem also.
We need to balance our lives with proper foods, exercise, stress management, and attitudes. Be happy, generous, and most of all be yourself.
I am happy to help you on your journey to optimal health, happiness and well -being.
Dr. Susan Beaven, MD is a board certified Family Medicine physician and one of 215 internationally certified in Functional Medicine by the Institute of Functional Medicine. She is a Diplomate of the Academy of Integrative Health & Medicine. Her extensive training, qualifications and experience in allopathic Medicine and Functional/Integrative Medicine allow her to provide patients with exceptional care.
Dr. Beaven works at Hermann Wellness on 6387 Central Avenue, St Petersburg, FL.
Call 727-278-4992 for an appointment for a comprehensive evaluation and plan.