CCH Health Review
Ideas & Strategies to Improve Your Health
July 2006
Hormones and Migraines
More and more women come to see me with concerns about headaches; particularly migraines. Most of these women have been worked up by neurologists and have tried numerous prescription drugs that are either ineffective or cause unacceptable side effects.
Nancy, age 46, described years of migraine occurrences that started shortly after menarche. The timing was a big clue for me. Although she experienced the headaches in a random and frequent pattern, she ALWAYS had one the day before her menstrual flow each month. After trying several medications, including the birth control pill which actually caused an increase in the headaches, she consulted me.
Fluctuations in hormones affect the dilation and constriction of our blood vessels. Treatment focusing on balancing hormonal fluctuations typically eradicates this type of migraine. Nancy had a multitude of other hormonal symptoms in her premenstrual phase. Her appetite, especially for sweets increased. She became constipated and more fatigued. Her temper quickened and she felt agitated and foggy headed for the week prior to the onset of her menstrual flow. Her menstrual cycle was regular, but she consistently had a very heavy flow lasting 7 days. She had been slightly anemic in the past and used an iron supplement reluctantly as it caused constipation.
She had excellent blood test results that her PCP had ordered. I ordered additional tests including DHEA sulfate, Pregnenolone, and RBC Magnesium.
Nancy had tried Feverfew in the past. Many of my patients have reported no help from Feverfew, yet I was not convinced that the failure was actually due to Feverfew not working but more likely from a poor quality Feverfew product. While waiting for the lab results to come back, I started Nancy on Vital Nutrients Feverfew 0.7% 120 mg, one capsule two times daily between meals. When she returned for her follow up visit three weeks later, Nancy reported a 50% reduction in migraine occurrence and a slight decrease in the severity of pain. As I expected, her Pregnenolone was below detectable limits and her RBC magnesium was in the low normal range. DHEA was normal.
Although already encouraged with just the addition of Feverfew, Nancy started Pregnenolone 10 mg- 1 capsule before breakfast, Triple Mag- 1 capsule at dinner, PMS Support- 1 capsule 2 times daily starting 10 days after the start of her menses continuing until the menstrual flow started, OsteoNutrients -3 at bedtime and MultiNutrients with Iron and Iodine- 2 capsules two times daily with food. At her two month follow up, Nancy reported only having 1 mild headache since her last visit. Her energy was improving and her menstrual flow at her last cycle was 5 days in duration and considerably less heavy.
I have seen Nancy for over 3 years since her initial visit and she has had only a few headaches in that time period. We have reduced both the Pregnenolone and PMS Support as her laboratory values have improved and she has not used Feverfew in almost a year.
I could write dozens of cases similar to this with equally good results. I have also found that women with sleep disturbance who suffer from chronic migraines benefit greatly from the addition of Melatonin (I start with 3mg each night between 8-9 p.m., regardless of bedtime) to the above regimen. For further information see: Toglia, JU Melatonin: a significant contributor to the pathogenesis of migraine in Med Hypothesis 2001 Oct; 57 (4):432-4.
Pedicures and Heart Disease
A study in the American Journal of Epidemiology in June 2005 (162(2):157-16found that low chromium levels are associated with an increase risk for myocardial infarction. The researchers actually measured chromium in toenail clippings because they found that it better assessed long term chromium intake over a blood test. Findings indicate that among 1,400 men, those who suffered a heart attack had chromium levels about 15% lower than those who did not. In addition, those with higher levels of chromium had fewer heart attacks
Toxic Metals and Inflammation
Karina is a 61 year old woman who came to my office after being diagnosed with polymyalgia rheumatica. She appeared healthy and fit and expressed confusion about the diagnosis and upset about her treatment plan from the rheumatologist. Karina had been on 10-20mg of Prednisone daily for almost 1 1/2 years. Her pain was tolerable on that dose but without it and even at a reduced dose, she described incapacitating pain throughout her joints.
She described a very active and healthy lifestyle leading up to the sudden onset of painful joints. She had never taken any medications and had never been hospitalized. She exercised regularly and ate a healthy whole foods diet her entire life. She was eager to get off the Prednisone and to find an explanation for her illness.
Karina had seen several specialists, including a Lyme disease specialist. We reviewed pages of labs results and radiographic studies. Without a clear direction, I asked her to keep a diet journal for me and fill out other dietary questionnaires. I started her on Vital Nutrients Ultra Pure High Potency Fish Oil at 1 teaspoon three times daily with food and ordered the only test I did not initially see had been done: a serum level of 25-OH Vit D.
Two weeks passed and Karina returned to go over her lab result. Her Vit D level was significantly below normal and I advised her to start Vital Nutrients Vitamin D3 2,000iu/cap -1 capsule daily with food. She had kept up with her fish oil, yet reported only a slight decrease in pain and stiffness, but said her skin was softer and her occasional afternoon headache had not occurred since she started the fish oil.
While reviewing her diet information, I noticed she had eaten tuna fish every day that she recorded her diet. I asked her about her fish intake in general. Karina stated that she loved fish and had eaten it 5-7 days a week for most of her life. Without hesitation, I discussed with her the concept of heavy metal toxicity and the idea of taking a DMSA challenge and testing her urine for toxic elements (Doctor’s Data (800) 323- 2784 or www.doctorsdata.com).
Karina’s urine test results showed the highest levels of mercury and arsenic that I had seen. Using the standard protocol, she underwent two rounds of DMSA therapy before we evaluated her levels again. Although her pain symptoms had only reduced about 50% after the 2 rounds of DMSA, she had been able to also wean entirely off her Prednisone. When the repeat test showed about a 60% reduction in the levels of Arsenic and Mercury, we discussed repeating another round of DMSA treatment and did so. Currently, Karina has been off her Prednisone for 4 months and completed her DMSA treatment 6 weeks ago. She is virtually pain free and has started exercising again. She is happy to get the benefit of essential fatty acids from the Fish Oil she is taking without worrying about the potential heavy metal hazards of eating fish and admits she is so overjoyed by her comfort. Her energy has returned and she is happy to eat fish once a year, on her birthday, if she feels the need.
Niacinamide for Anxiety
Barbara is a 44-year-old physician’s assistant who came to me with concerns over increasing anxiety, restlessness and sleep disturbance. Her intense schedule at her medical practice certainly contributed to irregular hours and disrupted patterns of sleep as she worked in a very busy obstetrical practice. Her on-call schedule varied week to week and she was juggling this schedule with her home routine with a husband and two teenage children.
Barbara was using Ambien several nights weekly to sleep and used Xanax during the day as frequently. She was often teary and felt overly reactive to minor inconveniences and was explosive at times. Her increasing use of Xanax concerned her as she felt it offered only minimal help and she knew it was interfering with her mental focus, which she needed for her important work.
Barbara’s story is a complex one and I do not mean to minimize the work she did with dietary changes, the addition of a good supplement program, and starting an exercise regimen. All these things helped a great deal, but her reliance on Ambien and Xanax went unchanged.
I had heard some interesting reports from my practice partners about the use of Niacinamide for anxiety and proposed to Barbara that we add Vital Nutrients Niacinamide 750mg 2 times daily to her current regimen. Last week, she came to the office for a follow up visit just 6 weeks after starting the Niacinamide.
I immediately knew there was a significant change in her. Even as I approached the waiting room, her smile and bright face encouraged me. She barely made it into my office before she rambled on about her success with Niacinamide. Not only was she sleeping well, but also her daily demeanor was calmer, and she felt clear headed and focused. She also had completely weaned herself off Ambien and Xanax and had been prescription free for over a month. She emphatically stated that she had not felt so well in “many years”. Niacinamide is an under appreciated nutrient. This form of vitamin B3 is literally required in hundreds of enzymatic reactions in the body and is thought to be an endogenous ligand for the benzodiazepine-GABA receptor complex.
More Good News for Green Tea
Researchers from the University of Minnesota performed a meta-analysis of 13 studies and concluded that the consumption of green tea does lower the risk of breast cancer. It was also determined that the women who had the highest intake of green tea had the biggest reduction in the risk of developing breast cancer compared to the women with the lowest intake. I generally recommend 2-4 capsules daily of Vital Nutrients Green Tea Extract for my patients with breast cancer, with a history of breast cancer, and as part of a prevention strategy as well. Citation: Green tea, black tea and breast cancer risk: a meta-analysis of epidemiological studies. Carcinogenesis. 2006 Jul;27(7):1310-5. Epub 2005 Nov 25.
