What’s New with Fibroids?

There’s a new drug on the market that is a “selective progesterone receptor modulator”.  What that means is that the drug moderates the effects of progesterone.  I have had a couple of patients on this medication prior to fibroid surgery and for both it does seem to have shrunk their fibroid.  The thinking with fibroids has always been that estrogen was the culprit causing the fibroids to enlarge and in many of the women that I’ve treated for fibroids, that has been the case.  However, in some fibroid patients, that’s not the case as demonstrated by the efficacy of this drug.  For these women, we need more of a progesterone moderating approach.

How can we moderate the effects of progesterone naturally, without drugs?

  1. Ensure a healthy balance of all of the sex hormones so that no one hormone dominates over the others.  That means two main things to me: a) keep insulin levels low by avoiding processed starches and sugars and b) keep the endocrine system working optimally, that includes the ovaries, thyroid, adrenal glands, pituitary and hypothalamus.
  2. Vitamin B6 in it’s active state, pyridoxal-5-phosphate (P5P) modulates the cell’s capacity to respond to steroid hormones.  Although some of the professional lines contain the active P5P, most vitamin supplements don’t contain the active form of B6, relying on the body’s capacity to convert the inactive pyridoxine hydrochloride into the active P5P.  Source: FASEB J. 1994 Mar 1;8(3):343-9.
  3. Scutellaria barbata is a Chinese herb that has been shown to have progesterone moderating and anti-proliferative effects.  Source: Phytother Res. 2008 May;22(5):583-90

Hypothyroid and Autoimmunity

If you’ve been diagnosed with an underactive thyroid, you may also have been tested to determine if your thyroid is underactive because you have a condition called Hashimoto’s disease. Hashimoto’s is an autoimmune thyroid problem where your body is attacking your thyroid and destroying the tissue so that it can’t function normally. Firstly, it’s important to know if this is the type of hypothyroidism that you have. The blood tests for Hashimoto’s include: TSH, free T3, free T4, anti-TPO antibodies, anti-thyroglobulin antibodies and anti-microsomal antibodies.

If these tests are positive for Hashimoto’s, then there are six factors that need to be considered in order to reduce the antibodies and help you feel better, maybe even recovering normal thyroid function.

1. Stress
2. Adrenal gland function
3. Viruses or latent viral infections (such as herpes viruses)
4. Diet
5. Dysbiosis and Leaky gut
6. Toxin accumulation (including heavy metals)

If you have been diagnosed with an underactive thyroid, particularly if there is a family history of hypothyroidism and if you are not feeling significantly better on thyroid medication, you should pursue Hashimoto’s testing and if positive, address the above factors with the assistance of a licensed naturopathic doctor.

Polycystic Ovarian Syndrome Theories

Some of the prevailing theories as to what is going on with women with PCOS include:

1.  A defect in insulin action and secretion that leads to higher blood insulin levels and insulin resistance.
2.  A defect in the nervous and endocrine systems leading to an exaggerated LH (luteinizing hormone) pulse frequency and amplitude
3.  A defect of androgen (male hormone) production that results in enhanced ovarian testosterone, DHEAs and/or androstenedione production
4. An alteration in cortisol metabolism resulting in enhanced adrenal androgen production (Tasoula et al, Clin Endocrinol, 2004)
5. Intrinsic theca (ovarian) cell hypersensitivity to LH stimulation that results from defective inhibition by FSH that may involve inhibin-B signalling. (Hirshfeld-Cytron et al, J Clin Endocrinol Metab, 2009)

In any case, improvement is usually seen through measures that lower insulin such as low glycemic index, low glycemic load diet, stress reduction and daily exercise. Additional support from insulin sensitizing agents like inositol, NAC, zinc, and cinnamon is also helpful.