NTC Module 9: Endocrine 1/13/2017
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MODULE 9MODULE 9EndocrineEndocrine
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MODULE 9 OBJECTIVES
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List the 5 classes of lipid and water soluble hormones and identify the components of each1
State the Big Ideas for Endocrine Health2
Describe how each of the Foundations support the endocrine system3
Describe how a chronic stress response degrades the endocrine system
4
5 Describe two ways in which the administration of HRT or BHRT can exacerbate endocrine problems
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THE BIG IDEAS
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1. Endocrine is a system of complex relationships. Always support the whole as well as the parts.
2. Respect the endocrine individuality of each client.
3. Always address The Foundations first.
Overview:The Endocrine
System
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THE ENDOCRINE SYSTEM
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• The Endocrine system is all about hormones and hormones are all about communication
─ The body creates more than 100 hormones
─ Hormones transfer information and instructions from one set of cells to another
Functions of Hormones
• Help Regulate:
‐Chemical composition & volume of extra cellular fluid
‐Metabolism and energy balance‐Biological clock (circadian rhythms)‐Contractions of smooth and cardiac muscle fibers‐Glandular secretion‐Some immune system activities
• Control growth and development
• Govern operation of reproductive systems
CLASSES OF HORMONES
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Hormones fall into one of five classes:
Lipid Soluble Water Soluble
• Steroid Hormones (derived from cholesterol)
• Thyroid Hormones (iodine atoms + tyrosine)
• Amines (modified amino acids)
• Peptides and Proteins (chains of amino acids)
• Eicosanoids (derived from fatty acids)
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ENDOCRINE GLANDS
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Endocrine glands, as well as other organs/tissues from other systems, produce hormones. Endocrine glands produce hormones that deliver messages from the organ/tissue of
origin, to other parts of the body
• Pineal
• Pituitary
• Thyroid
• Parathyroid
• Thymus
• Adrenals
• Pancreas
• Ovaries/Testes
• Adipose Tissue
Endocrine Glands
pineal gland
testes
OTHER HORMONE‐PRODUCING ORGANS
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Non‐endocrine organs are organs/tissues that produce hormones that deliver messages within
the organ/tissue only:
lungs
skin heart
stomach liver
kidneysmallintestines
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ENDOCRINE RELATIONSHIPS
Follic le
Medulla
Cortex
Pituitary
Corpora Lutea
Placenta
Para-Thyroid
Gonads
Thymus
Liver
Pancreas
Duodenum
Adrenals
Thyroid Pineal
Mammae
Cooperation Antagonism
HORMONES: ORCHESTRATING BALANCE
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The coordinated movement, synthesis, and dispersal of hormones is like an orchestra…all the instruments need to play
together to achieve harmony.
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MINOR PLAYER: PINEAL GLAND
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• The pineal gland is a small gland located in the brain
• The physiological role of the pineal gland is still unclear, though it secretes at least one hormone:
• MELATONIN: An amine hormone that helps set the timing of the body’s biological clock
Follic le
Medulla
Cortex
Pituitary
Corpora Lutea
Placenta
Para-Thyroid
Gonads
Thymus
Liver
Pancreas
Duodenum
Adrenals
Thyroid Pineal
Mammae
Cooperation Antagonism
Adrenals
MAJOR PLAYERS
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Pituitary
Thyroid
Sex Organs
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HYPOTHALAMUS PITUITARY
ENDOCRINE REGULATORY MECHANISM:
THE NEGATIVE FEEDBACK LOOP
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Endocrine Organ
Hypothalamus
Pituitary
Endocrine Gland
Increase Hormone Production
Endocrine Organ
Hypothalamus
Pituitary
Endocrine Gland
Decrease Hormone Production
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THE THYROID
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• The thyroid gland is one of the primary players in the regulation of metabolism
• Two thyroid hormones do most of this work: T4 (inactive) and T3 (active)
• T3 affects virtually every organ of the body by acting as a modulator of cell functions
METABOLISM OF THYROID HORMONE
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TRH
TSH
Target Organs
T3
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ACTIONS OF T4 AND T3
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Thyroid Hormones regulate:
• Oxygen use and basal metabolic rate (BMR)
• Cellular metabolism
• Growth and development
• The activity of the nervous system Thyroid Hormones also:
• Stimulate the synthesis of protein
• Increase the use of glucose for ATP production
• Increase lipolysis (chemical breakdown of fats)
• Enhance cholesterol excretion, reducing blood cholesterol levels
THYROID HEALTH
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• The thyroid is extremely sensitive to stress and toxins:
─ Heavy metals
─ Foreign substances
─ Drugs, such as aspirin
─ Food allergies
─ Endocrine imbalances
• Large amounts of goitrogenic foods can also block the conversion of T4 to T3
Goitrogenic foods
• Cabbage
• Broccoli
• Brussels sprouts
• Rutabaga
• Turnips
• Cauliflower
• Millet
• Kale
• Soy
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THYROID DYSFUNCTION
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Common Thyroid Disorders
• Hypothyroidism (see NAQ symptoms 259‐267)
• Hyperthyroidism (see NAQ symptoms 252‐258)
• Goiters • Nodules • Cysts• Autoimmune Thyroid Disease
Autoimmune Thyroid Disorders*
• Hashimoto’s Thyroiditis: may initially present as hyperthyroid and leads to hypothyroid
• Grave’s Disease: hyperthyroid function presents
*Occur when the immune system mounts an attack against thyroid cells
THYROID DYSFUNCTION CAUTION
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IMPORTANT NOTE:
Though Iodine deficiency is a common cause of hypothyroidism, supplemental use is CONTRAINDICATEDwith autoimmune thyroid disorders. If multiple thyroid symptoms present and client is unaware of autoimmune
disease diagnosis, refer client to Functional Endocrinologist for further evaluation.
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THE ADRENALS
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The Adrenals have three basic hormonal functions:
1 Glucocorticoids regulate blood sugar and inflammation,an important part of the “fight or flight” mechanism
2 Mineralocorticoids regulate mineral balance, particularly sodium and potassium
3 Production of sex hormones
THE SEX GLANDS
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The ovaries produce the female sex hormones, estrogens and progesterone, after puberty and prior to menopause
The testes produce the primary male sex hormone, testosterone
These sex hormones are steroid hormones, meaning they are produced from cholesterol
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Endocrine Issues
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ENDOCRINE DECLINE
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Female Decline
Male Decline
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THE ENDOCRINE CASCADE
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Blood Sugar Imbalances
Adrenals
Pituitary
Thyroid
SexHormones
• Stress
• Toxins
• Poor Diet
• Poor Digestion
• Mineral Deficiencies
• EFA Deficiency
• Dehydration
Endocrine Cascade Offenders
DIAGNOSIS: MENOPAUSE?
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Feminine Forever
Hormones?
Exercise?Diet?
OR
Menopause
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MALE INFERTILITY
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The rise in male infertility is approaching epidemic proportions.
A French research of 1,300 healthy men found sperm counts down by 33% in the last 20 years. The
younger of the men (30 years old) had the poorest counts.
American men were found to have a 60% drop in sperm levels from 1940 to 1990. From 163 to 66 million sperm/ml in sperm density plus a 20%
reduction in seminal volume.
MALE INFERTILITY (CONTINUED)
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• A minimum sperm density is necessary to increase the likelihood of fertilization
• The minimum values are changing:• Was greater than 40 million sperm/ml
• Then 20
• Then 10
• Now 5 million sperm/ml
• Only 1 in 5 millionsperm actually reach the egg
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MALE INFERTILITY (CONTINUED)
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163
66
050
50
100
150
200
1940 1970 1990 2020 2050
Sperm Density in M
illions/ml
STRENGTHEN THE WEAKNESS
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• Zinc therapy improved sperm count in men with low counts (60 mg/day for 6 weeks)
• Nine out of 22 (~41%) previously infertile couples conceived during the course of the study
• It is believed that Zinc plays an important role in contributing to improved sperm motility
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REMOVE THE STRESSORS
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“More and more studies are emerging that support the theory that pesticides (DDT, etc…) and
other chemicals (PCBs, etc…), which are widespread in the environment, imitate hormones (T3, Estrogen) and disrupt sexual
development in the womb (as seen in lab animals).”
Dr. Earl Gray, Environmental Protection Agency
Chief of Developmental Reproduction and Toxicology Research
PREVENTION AND SOLUTIONS
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1 Support the Foundations─ Digestion
─ Blood Sugar
─ Minerals (especially zinc)
2 Strengthen the following
organ systems:─ Liver and kidneys
─ Thyroid
─ Reproductive organs
3 Identify and remove the toxic
burden stressors:─ Read “Our Stolen Future”
by Theo Colborn
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BPH
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Benign Prostatic Hypertrophy affects:─ 90% of men over 80
─ 50‐60% of men ages 40 to 60
─ 10% of men ages 20 to 40
Urinary Tract symptoms:
─ Low stream of urine
─ High frequency of urination
─ Incontinence
─ Impotence
CAUSES OF BPH
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• Testosterone is converted to Di‐hydro testosterone (DHT) by 5 alpha reductase─ DHT is considered to be the toxic form of testosterone
• DHT binds androgen receptors and:─ Stimulates prostate growth
─ Causes acne
─ Causes male pattern baldness
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The Journal of The Maine Medical Association
March 1958
PREVENTION AND SOLUTIONS
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1 Prevent by addressing the Foundations
─ Zinc (may inhibit 5 alpha reductase)
─ Fatty acids (omega 3 reduces risk)
─ Iodine (mobilizes calcium)
2 Saw palmetto
─ Inhibits 5‐AR and DHT binding
─ 92% effective without side effects
3 Glutamic acid, alanine, glycine
4
5
Lycopene
Vitamins C, D, E, and beta carotene
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A NOTE ON PROSTATE CANCER
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Prostate cancer has many of the same signs and symptoms as BPH.
Incidence in 2011:
• 240,890 new cases/year (more than breast cancer)
• 33,720 deaths/year (breast cancer‐39,970)
*American Cancer Society Cancer Facts and Figures 2011
CAUSES OF PROSTATE CANCER
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1 Lifestyle─ Mortality in Black Americans is 2 times higher than whites
─ 2 per 10,000 in China vs. 20 per 10,000 in Chinese Americans
─ 10 per 10,000 in Japan vs. 33 per 10,000 in Japanese Americans
─ Increased in farmers, food manufacturing, cadmium metal workers, and milk drinkers
2 Genetic link─ Clusters in families
─ Gene for protein that suppresses metastasis
3 DHT stimulates induction of prostatic growth
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PREVENTION
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The best way to prevent prostate cancer is to promote good prostate
health
ENDOCRINE SUMMARY
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Follicle
Medulla
Cortex
Pituitary
Corpora Lutea
Placenta
Para-Thyroid
Gonads
Thymus
Liver
Pancreas
Duodenum
Adrenals
Thyroid Pineal
Mammae
Cooperation Antagonism
Excerpt from Harrowers “Endocrinology”
Medulla
Pancreas Cortex
Liver
Adrenals
Duodenum
Para-Thyroid
Pituitary
Gonads
Thyroid
CorporaLutea
Mammae
Placenta
Follicle
Thymus
Immune
Endocrine
The Foundations
• The Endocrine System is a complex system of delicate, interconnected relationships
• ALWAYS treat the whole system for hormone‐related issues, keeping in mind that you may need to provide support for specific organs such as the adrenals
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The Foundations and
Endocrine Health
FIRST LINE OF SUPPORT
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Always address The Foundations first when dealing with hormonal issues
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DIETARY SUPPORT
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Hormones Derived From … Dietary Needs
Steroid Hormones Cholesterol • Good fats
• Unrefined, complex carbs
Thyroid Hormones Iodine Atoms + Tyrosine • Iodine
• Quality proteins
Amine Hormones Modified Amino Acids • Quality proteins
Peptide and Protein Hormones Chains of Amino Acids • Quality proteins
Eicosanoid Hormones Fatty Acids • Good fats (including EFAs)
DIGESTION
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1. Brain
Bolus
3. Stomach
Chyme
4. Small Intestine
Liver/Gallbladder
Pancreas
5. Large Intestine
Remains
Feces
Nutrients
Water/Vitamins
2. Mouth
Salivary Glands
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MINERAL BALANCE
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Every endocrine organ has a mineral on which it is particularly dependent:
Mineral Balance in Endocrine
Thyroid Iodine
Prostate Zinc
Pituitary Manganese
Pancreas Chromium
Gonads Selenium
Adrenals Copper
FATTY ACIDS
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• EFAs and other fats are critical to the entire endocrine system
─ The body cannot make hormones without fats
• Endocrine factories are inside the cells and phospholipids control what goes in and out of the cell
• A healthy cell membrane is also needed for the cellular/hormonal communication to take place
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HYDRATION
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• Hydration supports the efficient transport of hormones throughout the body
• Hydration ensures proper viscosity of the blood and interstitial fluids
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Blood Sugar and
the Endocrine System
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BLOOD SUGAR REGULATION
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Keep in mind that any attempt to normalize hormonal imbalances is futile until blood sugar/adrenal issues are
addressed
A DELICATE BALANCING ACT
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Normal Glucose Level
~100 mg/dL
89.9 mg/dL
~80 mg/dL
Food
Insulin
Between Meals
Glucagon
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PRIMITIVE EMERGENCIES
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Normal Glucose Level
60 mg/dL
89.9 mg/dL
80 mg/dL
40 mg/dL
EMERGENCY
Adrenals fire: adrenaline, noradrenaline, cortisol
PRIMITIVE EMERGENCIES (CONTINUED)
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Normal Glucose Level
60 mg/dL
89.9 mg/dL
80 mg/dL
40 mg/dL
EMERGENCY
Adrenals fireLiver produces and releases more glucose
When the adrenals fire, the body listens
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SO, LET’S DEFINE “STRESS”
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• In today’s world, the primitive emergencies that consistently put our adrenals in a state of
“chronic” stress include:
─ Refined sugars and a high glycemic diet (the major culprit)
─ Coffee and other stimulants
─ Alcohol
─ The morning commute
─ Emotional stress
─ Digestive compromises
─ Nutritional weaknesses
─ Disease/Other Pathologies
BASIC CONCEPT
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Chronic Stress Response
Chronic output of
CORTISOL
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CHRONICALLY HIGH CORTISOL: ITS
IMPACTS
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ElevatedCortisol
Decreased Phase II
ConjugationObesity
Estrogen Dominance
Insulin Resistance
Androgen Dominance
Thyroid Metabolism
Defects
Antigen Overload
Pituitary Imbalance
Decreased Metabolic
Rate
Abnormal Progesterone
Estrogen Ratio
Low T3
Decreased Liver Detox
Increased Cancer Risk
Increased Intestinal
Permeability
Adrenal Exhaustion
Reactive Hypoglycemia
Low Progesterone
Depression
Decreased Immunity
Low DHEA
Decreased Fat
Metabolism
Obesity
Inflammatory Response
Altered EFA Metabolism
Intestinal Dysbiosis
THE LIVER TAKES A HIT
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• The liver is responsible for deactivating hormones that are in excess or are no longer functional
• These hormones have to be broken down, conjugated, and removed from the body
• Elevated cortisol levels decrease the effectiveness of the liver pathways thatperform the conjugation
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THE PANCREAS TAKES A HIT
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• When cortisol levels are elevated, insulin receptors on cells do not respond adequately to insulin
• This puts a strain on the pancreas to secrete more insulin in order to transport glucose into the cells
• This leads to high insulin levels and all the adverse impacts that come along with it
THE ENDOCRINE SYSTEM TAKES A HIT
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A NOTE ON PREGNENOLONE
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• Pregnenolone is considered a “precursor” to the production of the adrenal and sex hormones
• Only the Adrenal Glands can remove and concentrate pregnenolone from the bloodstream
• The Gonads must manufacture their own pregnenolone from cholesterol
ENDOCRINE SYSTEM (CONTINUED)
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Cholesterol Pregnenolone
• This is a catabolic process, requiring extreme use of energy
• Only so much Pregnenolone can be produced by the body
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THE PROLONGED STRESS RESPONSE
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This process is considered a major priority by the body. It is our fight or flight survival response!
Adrenal function is favored over reproduction, metabolic rate and other endocrine function. The adrenal glands
are therefore allowed to “steal” nutrients and hormonal precursors from the rest of the endocrine
system.
CLINICAL PEARL
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The gonads may release pregnenolone to help make more cortisol, depleting
sex hormone reserves
Giving Pregnenolone or Progesterone at this time will fuel
the stress response, further increasing cortisol production
Do not supplement with pregnenolone, progesterone or cortisol until the chronic stress response is abated, and
cortisol production reduced
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INSULIN RESISTANCE
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ElevatedCortisol
Insulin Resistance
Increased Testosterone in
Women
Increased Estrogen in Men
Elevated Blood Pressure and Cholesterol
Poor Mineral Absorption by
Cells
Inflammation Issues
(Excess Insulin Blocks PG1 Pathway)
MENOPAUSAL TRANSITION
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The adrenal glands take over the main production of estrogen from the ovaries
at this time.
Adrenal function MUST be supported at this time. Begin with balancing her blood
sugar handling system.
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THE ENDOCRINE CASCADE
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Blood Sugar Imbalances
Adrenals
Pituitary
Thyroid
SexHormones
• Stress
• Toxins
• Poor Diet
• Poor Digestion
• Mineral Deficiencies
• EFA Deficiency
• Dehydration
Endocrine Cascade Offenders
A Note on
BHRTBio‐Identical Hormone Replacement Therapy
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BHRT
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Be educated so that you may educate your clients
It is absolutely essential that a person be tested properly before beginning any form of BHRT, rather than relying on symptomatic
presentation only. Refer your client to someone capable of ordering and
interpreting these tests.
WHAT IS A BIO‐IDENTICAL HORMONE?
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Bio Identical Hormones are naturally derived substances that have the “identical” biochemical
structure to the hormones found in the body. They come from either wild yam or soybeans.
However, they do require the addition of certain enzymes and activators to convert them into the actual functioning hormone. This happens in a
laboratory. Questions arise regarding their “natural” status because of this process.
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BUT… WHY?
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• Giving hormones will directly squelch the HPT/PT Negative Feedback loop
• Hormonal Resistance: Sx of deficiency in the presence of excess (remember insulin resistance?)
• Progesterone, pregnenolone and DHEA can increase already high cortisol levels in cases of chronic stress
WHY (CONTINUED)
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• Giving testosterone to men (without testing), can increase both DHT and estrogen levels
• Giving estrogen to women in insulin resistance can increase already high testosterone levels
• And of course, giving estrogen inappropriately to women causes estrogen dominance which is at the root of most female cancers, uterine and breast fibroid incidence and ovarian cyst occurrence
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Endocrine Health: Solutions
A NOTE ON GLANDULAR THERAPY
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Glandular therapy, or organotherapy, refers to the use of specific animal preparations to improve physiological function and support the natural
healing process.
Glandular supplements contain the cytoplasm and cytosol extracts of the specific gland used to make the supplement. These extracts act as precursors
for the target organ.
There is also considerable evidence that the nucleic
material in the glandular can enhance immune function.
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HISTORICALLY
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• Natural Healers from almost every culture have used glands therapeutically for thousands of years
• In the 1930’s, glandular therapy in clinical practice was common
• The importance of supplementation with glandulars was emphasized by physicians, such as Frances Pottenger, M.D. and Royal Lee, D.D.S
• Scientific advances of the last 20 years can now answer questions regarding the efficacy of glandular therapy
COMMON QUESTIONS
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Do glandular products survive the digestive tract, and are they absorbed?
Evidence from radioactive tagging shows that proteins, polypeptides, enzymes, etc. are absorbed intact. Approximately 50% of amino acids are absorbed as di‐ and tri‐peptides, many of which are biologically active.
If glandular constituents are absorbed orally, what is the evidence for their specific effects on glands and organs?
Experiments have shown that labeled constituents, such as tissue growth factors, accumulate in the target tissue. Studies have shown that ingested raw glandular concentrates exhibit organ specificity and act on that target organ.
Q.
A.
Q.
A.
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GLANDULAR THERAPY
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“By feeding patients simple proteins that mimic human proteins involved in the diseases, researchers are finding that they can suppress the autoimmune attack, retard the course of the disease and alleviate suffering. Moreover, the treatments seem to be free of side effects.”
October 15, 1993
NEONATAL GLANDULAR PRODUCTS
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Neonatal
Adult
Adrenal function declines with age. Adrenal glands from newborn animals reveal distinct, well‐defined zones for the cortex and medulla.
Adult glands lacked clear boundaries and were more diffuse.
Adult adrenal tissue shows evidence of large amounts of lipofuscin, an indicator of
lifelong exposure to oxidative stress and lipid
peroxidation.
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HORMONE REPLACEMENT?
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Conventional wisdom ascribes the effects of glandulars to the presence of small amounts of hormones, thus the use of glandulars is often viewed as hormone replacement. In fact, the situation is quite different. Glandular products provide a balance of multiple factors to promote growth and maintenance of organs and glands rather than excess (pharmacologic level) of a single hormone or factor.
YOUR STRATEGY
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The Foundations Practitioner Decisions
• 2‐3 months on The Foundations, emphasizing blood sugar regulation:
Ensure good fatty acids are in the diet Ensure minerals are balanced Support the adrenals
• If the client is having discomfort, simultaneously support the specific, weakened organ(s)
• General support for the endocrine system
Re‐evaluate as needed
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ENDOCRINE PROTOCOLS
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• PMS
• Menstrual Cramping
• Heavy/Scanty Menstrual Flow
• Endometriosis
• Female Libido
• Female Infertility
• Morning Sickness
• Lactation, Dried Up
• Postpartum Depression
• To Shrink Uterus After Pregnancy
• Varicose Veins
• Vaginal Tract Dry
• Vaginal Yeast
• Hot Flashes
• Menopausal Support
• Male Libido
• Male Fertility
• Benign Prostate Hypertrophy
• Male Erectile Dysfunction
• Hypothyroid
• Hyperthyroid
• Hashimoto’s Thyroiditis
• Hypoadrenia
• Hyperadrenia
• Diabetes
• Hypoglycemia
MODULE 9 SUMMARY
80
List the 5 classes of lipid and water soluble hormones and identify the components of each1
State the Big Ideas for Endocrine Health2
Describe how each of the Foundations support the endocrine system3
Describe how a chronic stress response degrades the endocrine system
4
5 Describe two ways in which the administration of HRT or BHRT can exacerbate endocrine problems