Michael E. Greer, M.D.Holistic, Homeopathic, Herbal & Natural Solutions for Health

Webinar Sampler Trekking Series 12-hour Seminar

737 Olive Way, Suite 1804, Seattle, WA 98101www.michaelgreermd.com michaelgreermd@comcast.net

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About Dr. Greer

• OB-GYN by training• Board certified in 1984• Alternative medicine in my

practice since 1996• Combining the best of

integrative medicine for optimal patient wellness

Webinar Contents

• Trekking the Hormone Jungle • Adrenal Fatigue: Etiology, Diagnosis & Nutritional

Solutions • Detoxifying in a Toxic World • Diabetes: Overview & Treatment Options • Estrogen Dominance & Its Role in Cortisol, Weight

Management & Hypothyroidism• Testing for Wellness: How to Test & Interpret Results

for Maximum Wellness

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Understanding how all the hormones influence each other to attain hormone balance

Parotid Gland Initiates the Hormones Ghrelin & Leptin

• GHRELIN: The “I am Hungry” hormone released in the stomach and intestine

• LEPTIN: The “I am Full” hormone that helps control fat storage and appetite– Fat cells produce and secrete leptin

Ghrelin and leptin work together as a regulatory arm in the feedback

communication of hunger

Ghrelin

Leptin

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Leptin & Heart Disease

• Obesity and cardiovascular disease are closely related– Leptin, an adipocyte-produced hormone, is associated

with increased cardiovascular risk– Increased plasma levels of leptin are measurable in the

plasma of obese individuals• An Italian study associating Leptin & CV disease

found a close relationship between Leptin and CRP– Provides support to the view that this adipokine, besides

being involved in the pathobiology of obesity, might play an active role inflammation and atherothrombosis

Dr Rosa S, Cirillo P et al, J Vasc Res, Jun 2009;46(6):609-619 6

Function of Leptin

• Produced by fat cells, leptin signals the hypothalamus that we have consumed enough calories and can stop eating– Suppresses appetite

• Increases triglyceride breakdown in adipocytes • As excess glucose accumulates in the blood (pre

diabetes segue), the glucose is converted by glycerol-3-phosphate dehydrogenase (an enzyme) into triglycerides for storage into adipocytes

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Leptin Resistance

• As we age, our cells become leptin resistant– Similar to insulin resistance– C-reactive protein (CRP) – the most accurate

marker of systemic inflammation - binds leptin and prevents it from crossing the blood-brain barrier to signal satiety

• Proof that systemic inflammation and detoxification failure plays a very powerful role in weight regulation

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CRP & IL-6 Predict Death

• Elevated CRP, IL-6 (and other inflammatory cytokines) indicate significantly greater risks of contracting or dying from many diseases– Heart attack, stroke, Alzheimer’s disease, etc.

• In a study of a group from the Women’s Health Study, several risk factors predicted Type II diabetes– Baseline levels of CRP and IL-6 were significantly higher

among those who later developed diabetes– Supports a possible role for inflammation in

diabetogenesis

Prandhan et all, JAMA, July 18, 2001 9

The Extra-cellular Matrix• Fat cells store toxic waste. Estrogen is made

from fat cells. Fat breakdown is inflammatory!

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Detoxification & Drainage

• Toxic waste is deposited into the cellular matrix for disposal– Must be diluted by the addition of water to

prepare them for elimination– Explains why we have to urinate the first thing in

the morning (or during the night)• Fat cells STORE TOXIC WASTE

– Protect the rest of the body from involvement in detoxification until the time is right

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Cardiac-CRP and Cancer

• “Elevated levels of Cardiac-CRP in cancer-free individuals are associated with increased risk of cancer of any type ... (and) with early death after a diagnosis of cancer.”

• Regular monitoring of Cardiac-CRP is an important component of a health maintenance program

Circulation.2008 Nov 25;118(22):2243-51 12

Chronic Toxins and Inflammation Exposure

Systemic Effects• Nervous system• Endocrine system

(hormones)• Immune system

– Allergies– Autoimmune– Chronic infections

Signs & Symptoms• Sensitivity to

chemicals, odors, medications, etc.

• Chronic fatigue• Depression, anxiety,

mood swings• Cognitive

dysfunction• Recurrent headaches• Muscle aches and

weakness• Infertility• Recurrent infections

Disorders• Autoimmune

disease• Reproductive

disorders• Chronic dermatitis• Neurodegenerative

disorders• Autism• Obesity

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CRP and Dementia Risk

• Appears to correlate with nutrition-related diseases – Cardiovascular, metabolic, obesity, etc.

• In fact, patients who are obese at middle age are almost twice as likely to develop dementia later in life (check CRP!)

• Elevated cholesterol and serum cardiac homocysteine levels also appear to be independent risk factors for cognitive decline

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Other Hormones Involved in Appetite Regulation

• INSULIN - Increases ghrelin (thus hunger), cortisol, norepinephrine

• CORTISOL - Increases insulin, decreases thyroid function by blocking T4 to T3 conversion – Active mechanism = liver produces 3-4X more TBG (thyroid

binding globulin) a SHBG (sex hormone binding globulin) to decrease thyroid function

• SEROTONIN - Increases leptin (thus a “full” sensation, decreasing hunger)

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Androstenedione

Cortisol Upregulates E1

& High EstrogenUpregulates

Cortisol

Testosterone

High Estrogen IncreasesT4-Binding Globulin (TBG) 2-3X

Estrone (E1)Estradiol-17 (E2)

Estriol (E3)

Lower Metabolism Leads to Weight Gain

Lower Thyroid Hormone Activity Suppresses Metabolism

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10 Essentials to Keep the Weight Off and Decrease Inflammation

1. Improve Digestion2. Minimize Cortisol3. Lower Insulin Level4. Eliminate Excess

Estrogen5. Treat Sub-clinical

Hypothyroidism

6. Support the Adrenal Glands

7. Eat Healthy and in Moderation

8. Exercise9. Kill the Inflammation10. Sleep

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Essential Fatty Acids Initiate the Hormone Sequence

• Fish Oil – Principally Omega-3 – The most highly unsaturated fatty acid, easily

oxidized in light, air, heat • Flax Oil – Principally Omega-6

– Converts to Omega-3

Essential fatty acids: linolenic, arachidonic, omega-3s

and derivatives, etc.`

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Systemic support: Comparing Omega-6 & Omega-3

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Misc Benefits Of Omega-3

• Possibly reducing the risk of many other medical conditions – Painful periods– Diabetic kidney damage– Obesity – Skin conditions– Some cancers – Crohn's disease– May improve pulmonary function

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Anti-Inflammatory Products• SP Cataplex F (3-9 tabs/day, 3-6 perles/day)

– Flax seed with 0.8 mg B6 – Tabs contain 95mcg iodine– Perles contain no iodine

• SP Linum B6 (3-6 perles/day)– Flax seed oil (630 mg) and B6

• SP Black Currant Seed Oil 320 mg (3-6p/day)– Omega-6 GLA -47mg

• SP Wheat Germ Oil 385 mg /Fortified • Cataplex E 50 IU (3-6 p/day)

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Anti-Inflammatory Products• SP Chlorophyll Complex perles™

– Vit A 335 IU (3-9 p/day)

• SP Calamari Omega-3 Liquid – DHA 800mg/EPA 400mg SP (1 tsp/day)

• SP Tuna Omega-3 – DHA 300mg/EPA 60 mg with Tuna Oil 1,200 mg

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E1, E2 & E3

• The three most widely known estrogens:– Estrone (E1)– Estradiol (E2)– Estriol (E3)

• Estradiol and estrone interconvert freely, and both may be metabolized to 2-hydroxylated, 16-hydroxylated, or other forms– These hydroxylation steps take place in various

tissues, including breast, kidney, and liver

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Estrone vs. Estradiol

• An imbalance occurs between the types of estrogens– Although estradiol levels decline, estrone levels

decline much more slowly, resulting in more estrone than estradiol

• Although both hormones are strong enough to cause concern about the development of breast cancer, the ratio of the hydroxyestrones becomes a more significant factor

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Estrogen Differences

• Some hydroxyestrones (4-hydroxy- and 16-alpha-hydroxyestrone) may promote cancer, while 2-hydroxyestrone seems to prevent it

• Estrone is less desirable because it is cancer-promoting and tends to be naturally present in higher quantities relative to the other two estrogens during menopause

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Indole-3-carbinol (I3C)

• I3C is one of several potent compounds found in cruciferous vegetables such as broccoli, cauliflower, and Brussels sprouts

• I3C functions by modulation of hormones and the activation of genes

• Dosage should be based on weight – 179 lbs: 200 mg– 80-239 lbs: 300 mg– Over 239 lbs: 400 mg

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Cruciferous Complete

• Contains Kale (300 mg), Brussels sprouts (300mg)

• Essential to modulate E-2 flow for Estrogen metabolities

• E-2 is anti cancer• E-2 is anti-inflammatory

Common Symptoms of Excess Estrogen

• Water retention• Breast swelling & tenderness• Craving for sweets• Fibrocystic breasts• Uterine fibroids• Nervousness/anxiety/irritability • Heavy, irregular menses• Fatigue• Weight gain• Mood swings• Low thyroid symptoms

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Thyroid & Dieting• Thyroid levels fluctuate in response to caloric

intake, exterior temperature, etc. – During starvation (diet) the body naturally lowers

thyroid hormone– Lower metabolism results in more estrogen and

fat storage• Estrogen and thyroid hormone have opposite

effects– Estrogen causes calories to be turned into fat– Thyroid hormone initiates fat conversion to energy

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T4 + T3

Think of T4 as firewood and T3 as fire

T4 T3

Tri-iodothyronine (T3) is 8 times more biologically active than T4

Thyroid Hormone Exists in 2 Major Forms

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Wellness Testing for Adrenal Fatigue

©2011, Michael Greer, MD. May not be reproduced without permission.

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Adrenal Rhythm & Its Importance

• The human adrenal gland does not secrete its steroid hormones at a constant level throughout the day

• The hormones are released in a cycle– Highest value in

the morning– Lowest at night

• 24-hour cycle: circadian rhythm

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Thyroid Function

• Intracellular cortisol controls thyroid hormone production

• Hypothyroid symptoms such as fatigue and low body temperature may be due to an adrenal maladaptation

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Constant Stimulation

• Constant cortisol stimulation allows adrenal (cortisol) stimulation for emergencies

• Followed by tolerance• Followed by depletion of adrenal gland

hormones when over stimulated

Adrenal Fatigue Symptoms• Fatigue• Chronic illness• Decreased sex drive• Panic attacks• Mild depression• PMS

• Stubborn belly fat• Absentmindedness• Irritability• Unclear thinking• Asthma• Hair loss and more

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Defining Stress

• Much of the investigation into the effects of stress was carried out by Hans Selye

• Developed a theory called the General Adaptation Syndrome (GAS) – Hypothesized that stress is a major cause of disease

• Believed that chronic stress causes long term chemical changes within the body and the body’s ability to copy with stress is an exhaustible resource

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Cortisol: Clinical ManifestationsTarget Tissue GC Excess or

HypersensitivityGC Deficiency or Resistance

CNS Insomnia, anxiety Depression, fatigue, malaise, defective cognition

Liver ↑ gluconeogenesis and lipogenesis

Hypoglycemia

Fat ↑ visceral fat, metabolic syndrome

Weight loss

Cardiovascular Hypertension Hypotension

Bone Osteoporosis, stunted growth

Immunity/inflammation Immune suppression, vulnerability to infection and tumors

↑ inflammation, autoimmunity and allergy

Chrousos GP, Kino T. Stress 2007; 10(2): 213-219

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By conservative estimates, 50% of the individuals diagnosed with hypothyroidismalso have adrenalfatigue or depletion

Stress and the Thyroid

Rothfield GL, Romaine DS. Thyroid Balance, Adams Media, Avon, 2003, p.97.

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Stress and Immunity

• One of the key discoveries of the research by Selye was stress-induced immune suppression

• GCs impact T-cells more than B-cells– Thus cell-mediated immunity is more disrupted

than antibody-mediated immunity– Results in less protection against pathogens

Bornstein SR, Rutkowski H. Endocrine Res 2002; 28(4): 719-728

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• There is a transient immune stimulation in response to stress regardless of cause

• It is chronic stress that causes the issues described and the increased risk of infections

Sapolsky, RM. Why Zebras Don’t Get Ulcers, 3rd Ed, Henry Holt and Co, New York, 2005, p. 155

Stress and Immunity

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Stress and Autoimmunity

• With chronic stress the immune system is being constantly ramped up

• Over time this is associated with an increased risk of autoimmune diseases

Sapolsky, RM. Why Zebras Don’t Get Ulcers, 3rd Ed, Henry Holt and Co, New York, 2005, p. 155

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How Adaptogens Work

• Exact mode of action of adaptogens is unclear and many possibilities have been put forward

• Possible that different adaptogenic herbs may have different modes of action

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On/Off

• Adaptogens have the ability to influence the ‘switch on’ and ‘switch off’ systems

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Herbs With Adaptogenic Activity

• Chinese/Korean ginseng (Panax ginseng) (1/2 tsp 1-2x/day)

• Astragalus (Astragalus membranaceus) 1-2 day (tab or liquid)

• Siberian ginseng (Eleutherococcus senticosus) (tab or liquid 1-2x/day)

• Withania (Withania somnifera) (tab or liquid 1-2x/day)

Withania Complex

• Skullcap Herb 4:1 extract (117.5 mg)

• Licorice Root 7:1 extract (107.15mg)

• Withania (Ashwaganda)root 10:1 extract (95mg)

• Korean Ginseng root 5:1 extract (20 mg)

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Foods That Hurt the Adrenals

• Coffee and black tea (including decaf) - elevate cortisol

• Juice - high glycemic index – incites insulin• Sugar - high glycemic index – incites insulin• Alcoholic beverages - stuns the liver• Deep-fried foods - saturated fats• Rancid oils, seed and nuts - increase need for

antioxidants for the free radicals• Soda, including diet soda - elevates insulin, cortisol • Processed meats and cheeses – sulfites, which impair

detox by the liver

This Webinar is a Sampler Only

Attend the Seminar for immediately applicable information

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Michael E. Greer, M.D.Holistic, Homeopathic & Herbal Solutions for Health

2721 First Avenue, Suite 408, Seattle, WA 98121Tele: (206) 343-5985 Fax: (206) 343 2356

www.michaelgreermd.commichaelgreermd@comcast.net