The Great Outdoors: The Natural Anti-Depressant

Exercise, as we all know, has many benefits – and it is recognized to have a positive effect on our mind and our moods.  It is now a recognized way to improve the symptoms Multi-Generation Family Enjoying Walk In Beautiful Countrysideof depression.  The best evidence comes from a review by a team of UK researchers, published in the “Cochrane Database of Systematic Reviews” that looked at 37 studies that compared exercise with a placebo, medication or psychological counselling.

Across this research, more than 2,000 people with depression found exercise to be as effective as antidepressants and psychological therapies for reducing the symptoms of depression.  Researchers noted, however, that there needs to be more detailed research looking at what types of exercise are most helpful for depression, as well as the number and duration of sessions that would help the most.

No matter which way you look at it, exercise is beneficial for the mind as well as the body – as it boosts hormones like endorphins and serotonin….so take a break and take a walk.  Your body and your brain will thank you.  It may turn out that exercise in the fresh air will be better than taking tablets!

Until next time…

Dr. Gatis

The Fifth and Last Force of Illness: Oxidative Stress (or “Rusting”)

We are all rusting.  In this sense, we are all like apples – going brown with age (think “age Oxidative Stressspots”).   The process of oxidizing is a necessary component of burning fuel to make energy, but the by-products of this process are highly reactive oxygen molecules known as “free radicals” – which can damage the tissues unless there is enough “anti-oxidation” happening to counteract free radical production.   This state of imbalance is called Oxidative Stress, or the unchecked effects of oxygen on the body.

Research has shown that virtually all illnesses have an increased level of oxidative stress in common.

Heart disease, cancer, osteoarthritis, rheumatoid arthritis, diabetes and neurological problems like alzheimers’s, parkinson’s and multiple sclerosis are some common diseases that appear to be triggered by oxidative stress.  The related symptoms include fatigue, weakness, muscle and joint pain, headaches, itchiness, digestion problems, anxiety and depression – to mention only a few.

VitaminsThe source of oxidative stress can be both internal and external.  Internally, we may have nutritional deficiencies of the “antioxidants” – like Zinc, C, Selenium, and E.  How we live our lives also contributes to this imbalance as smoking, alcohol, excessive exercise, pharmacologic drugs and overeating contribute to oxidative stress.  Blood sugar imbalance leads to oxidative stress, and so does being overweight.  External sources include exposure to pollution, pesticides, petrochemicals and heavy metals.

Tests for Oxidative Stress include measuring lipid peroxides, superoxide dismutase, glutathione peroxidase, catalase and/or glutathione in the blood.  Certain free radical markers like catechol and 2,3 – dihydroxybenzoate can be measured in the urine.  Blood levels of the antioxidant nutrients A, D, E, CoEnzyme Q10 and beta-carotene can be measured in the blood as well.

We are all at risk for Oxidative Stress – since the majority of us do not get enough antioxidant-containing through our food.  I believe that supplementation of these nutrients is often a necessary first step – if the individual already has signs of oxidative stress.  This being said, there are no supplements that can take the place of optimizing your diet.  Choose to eat high nutrient-to-calorie ratio foods rather than eating meals or snacks which are high in calories but low in antioxidants.  Eliminate anything “white” or processed from your diet i.e. white sugar, white flour, white bread, white rice and white pasta.  Dramatically increase the colourful vegetables and fruits in your diet which contain antioxidants like lycopene, lutein and proanthocyandins.  “You are what you eat” is an appropriate phrase.  As Mr. Spock might say….”Eat Right, Live Long and Prosper”!

Until next time…..

Force Of Illness #4: Impaired Detoxification

Detoxification is a normal function of the body.  It is the first step in the process of removing foreign, potentially toxic compounds from the body regardless of whether they are environmental or the natural products of cellular metabolism.  All cells have detoxification mechanisms and all cells detoxify all the time.  Detoxification, or the process of making a toxic substance “non-toxic” or “water-soluble”, must occur first before the harmful substance can be eliminated from the body – through the urine, feces, sweat, breath or bile.  The process of Detoxification utilizes the P450 enzymes and has two phases.   Both of these phases have unique nutritional requirements.  Some of the common problems that have been related to poor detoxification are Chronic Fatigue Syndrome, pain, chronic hormonal problems, fibroids, heavy menstrual bleeding,  Breast Concept of Detox Diets  The New Diet FadCancer, Parkinson’s and Alzheimer’s Disease.

Many people mistakenly believe that they are “detoxing” when they are doing a “cleanse” – a “liver cleanse”, for example.  In actuality, they are supporting elimination rather than detoxification.  The liver, kidneys, colon, lungs, skin and lymphatics are all organs of elimination.  They remove detoxified substances i.e., substances converted to water-soluble, from the body.  This can be useful, of course, and often necessary – but when you are talking about detoxification, you are talking about the cellular or micro processes rather than the macro system processes.  A “cleanse” or elimination support is most effective when any nutritional deficiencies relating to the P450 enzymes and other enzymes relating to detoxification have been corrected first.  The nutrients needed for optimum detoxification include vitamin A, B6, B12 and Folic Acid; the sulfur-containing amino acids found in kale, bok choy, garlic, onions, kale, cauliflower, cabbage broccoli and Brussels sprouts, and minerals such as zinc, magnesium, selenium, manganese and copper.

In addition, reactions to certain drugs are far more common than most people realize – and are the result of compromised or inefficient detoxification mechanisms.  Reye’s Syndrome (a potentially-lethal disorder), for example, occurs in someone with impaired aspirin detoxification if they take the drug when they have a virus.  In the future, it is my prediction that a “detoxification test” will have to be taken before certain classes of drugs are prescribed.  There is a special test that exists now – where patients are given small amount of aspirin, acetaminophen and coffee.  After 12 hours, the urine, blood and saliva are checked to see if the drugs were normally detoxified.   In the future, it is my prediction that a “detoxification test” will have to be completed before certain drugs are administered.

Until next time…..

Force of Illness #3: Inflammation & Disease

The “Third Force of Illness” is Inflammation.  The inflammatory process is a natural body reaction to injury, infections, allergens, toxins, pollution, pesticides, food additives, drugs, cosmetics, chemicals, free radicals and oxidative stress.  The five associated signs that the process of inflammation is occurring are redness, swelling, heat, pain and loss of function.  The first three signs are the ones most often associated with inflammation – and we have all experienced it.  It is usually local and self-limited.  The body runs into trouble, however, when inflammation is excessive, chronic or systemic.

As strange as it sounds, the most common externally-generated cause of inflammation isBlue cold gel pack to kill the pain what happens in the digestive tract.  Even though we consider the “gut” is inside, it is actually “outside” us.  If we turned ourselves inside-out, the gut would be on the outside (like the skin).  The gastrointestinal tract is one of our primary defenses against invaders.   In many ways, it is an extension of the skin and similarly protective.  When the gut is inflamed, the inflammation process occurs in other areas of the body – like the covering of the bones and the walls of the arteries.  Any arthritis or arteriosclerosis has at its roots this inflammatory process.  As an interesting side-note, researchers are finding  that certain micro-organisms exist in the wall of diseased arteries.  We may find that cardiovascular disease may be linked to the presence of one or more of these organisms triggering the inflammatory response – just like Helicobacter pylori has been linked to the development of stomach ulcers.

In other words, gut function – especially an “inflamed” gut – affects other systems directly.  The digestive tract is a major regulator of the immune system.  Even though the source of the inflammation may be different, the end result is the same i.e., inflammation activates the immune system systemically.  Whether it starts in your pinky finger or your molar, inflammation puts your immune system on alert.  Reducing inflammation in the gut can, and does, have a modulating effect on the majority of disease processes that have an immune system component.

By far, the most common internally-triggered factors for chronic inflammation are free High resolution 3D human for anatomy,medicine and healthradicals and oxidative stress – which can be caused by anything that depletes the body of “antioxidants” e.g., overeating, obesity, chronic infections, toxins, and so on.  Please understand that free radicals are one of the naturally-occurring by-products of cellular metabolism.  Free radicals are kept from damaging tissue by “antioxidants” which neutralize them.   The problem results from an imbalance between free radical production and free radical neutralization.  Unadulterated colourful vegetables and fruits are perhaps the best way to get your daily dose of antioxidants e.g., vitamins A,D,E, K, C.  There are also certain supplements, like N.A.C., that increase other important antioxidants like glutathione.

Virtually all of us are antioxidant deficient, with inflamed digestive tracts and low-grade chronic inflammation.   This not only puts a heavy burden on the body, but it is my contention that it takes its toll on the Brain/Mind as well.  Much of the anxiety and depression experienced by our young people (which I consider epidemic) is directly related to poor diet and digestion.  An inflamed gut, most definitely can lead to an inflamed mind – and drugs are not the solution.  Mind what you eat, and eat for your mind.  Say “no” to your latte and say “hello” to you morning antioxidant smoothie!

Until next time……

Dr. Gatis

Testing For Malnutrition and Impaired Metabolism (“Sludge” and “Burnout”)

There are many ways to test for the first and second force of Illness (called malnutrition, orMale thyroid anatomy what we have called the “sludge” factor and impaired metabolism or “burnout”).  When we take in food, and digest and assimilate it, only the waste or unusable portion should be eliminated in the stool.   If meat fibers or fats are showing up in the feces, then you are not fully breaking down and absorbing the protein and fats in your food. Your Naturopathic or Medical Doctor may order a comprehensive digestive stool analysis to determine if this is the case.  Levels of the essential fatty acids and amino acids can also be measured in the blood also.  Individual vitamins like B12 and vitamin D can be individually measured as can homocysteine – a major methylation and cardiovascular health marker.

Mitochondrial function can be indirectly tested by a urine organic acid profile – a relatively new and non-invasive way to indirectly measure certain factors related to metabolic function i.e.,  fatty acid and carbohydrate metabolism markers (B1, B2, B3, Carnitine, Lipoic Acid, CoQ10), Energy production markers (B complex, Amino Acids, Mg), B-complex vitamin markers (B1, B2,B3, B5, B6, Biotin), Methylation Cofactor markers (B12, Folate), Neurotransmitter Metabolism markers (Tyrosine, Tryptophan, B6, antioxidants) and Detoxification markers (Arg, NAC, Met, Mg, antioxidants).

Mitochondrial function can also be affected by pollutants, heavy metals, and so on.  Many of the environmental contaminants can now be tested for in blood or urine.

One of the most important factors to test for is insulin resistance (IR).  As I mnaturopathy 3entioned in the previous blog, IR is linked to obesity, arteriosclerosis, stroke, high blood pressure and diabetes Make sure that your M.D. or N.D. orders HbA1c and serum insulin in addition to fasting serum glucose.  Optimum levels of HbA1c and Insulin are below 5.5% and less than 40 (fasting) respectively in addition to a fasting blood sugar less than 6.0.  In routine blood work, a lipid panel is done (total cholesterol, LDL, HDL, triglycerides).  If the triglyceride-to-HDL ratio is greater than 4.3, this suggests a high probability of insulin resistance.  The waist-to-hip ratio is an easy way to determine you tendency to IR.  Divide your waist measurement at the belly button level by the hip measurement.  For women, any value over 0.8 is associated with IR and, in men, any value over 0.9.

Thyroid dysfunction is becoming somewhat of an epidemic.  In my opinion, everyone should have a full thyroid panel done early in their life to provide an individual’s “normal” levels.  Optimal levels of TSH, or thyroid stimulating hormone, should be between 1 and 2.  Please be aware that the “normal” range is up to 4 – but the normal and “optimum” functional ranges are different.  Free T3 should be measured as well as free T4 – because T3 is the more active thyroid hormone form.  T3 is formed from T4.  There are many factors that affect this conversion – including stress and female/male hormones.

In the next blog, we will consider the Third Force of Illness called “Inflammation” or “Heat”.

Until then…..

Dr. Gatis

The Second Force of Illness: Impaired Metabolism or Burnout

The First Force of Illness is inadequate digestion and absorption of foods (or “sludging” – as we mentioned in the previous blog) and endothelial dysfunction.  The Second Force of Illness is “burnout” due to impaired metabolic/cellular processes creating an overall lack of energy.  How many of you suffer from being “tired”.    Metabolism is the term used to describe the creation of usable energy from food – and fatigue is an indicator that you may have an impaired metabolic ability to generate this “food energy”. The main factors in impaired metabolism are:  insulin resistance, mitochondrial dysfunction and thyroid dysfunction.

A major player in “burnout” is glucose regulation and control.  There is a saying that you chargercan have “too much of a good thing” – and this applies to carbohydrates – especially glucose and sugars.  Insulin, secreted by the pancreas in response to carbohydrates in the blood, regulates the uptake of glucose into the cells.  In the current North American diet, insulin secretion is virtually constant due to the almost continual intake of sugar and carbohydrates.  The only thing the body can do is to continue to secrete insulin in the attempt to lower the blood sugar level.  The cells can only take in a certain amount of glucose at a time, so the cells, under the stress of too much insulin, will do the logical thing – change the receptors for insulin making them inactive.  The scientific term for this is Insulin Resistance.

When a cell is unresponsive to insulin, our cells become unable to get energy from the food we eat – despite the fact that we have eaten enough – and our insulin blood levels become chronically elevated.   We become tired and hungry.   The cells are crying out for energy and we crave the quickest energy source (sugar) – which only compounds the problem when we eat them.   For our ancestors, food availability was always in question, so the body adapted by being able to store away the energy that we didn’t immediately need in the moment for use later – as fat tissue.  In today’s society, however, food (especially carbohydrates) is plentiful for most of us, so the “rainy day” never comes – but we still eat as if it could.  This is the crux of our obesity epidemic.  .  High insulin levels in the blood and Insulin Resistance have not only been linked to obesity, but also to arteriosclerosis and heart disease, stroke, high blood pressure and diabetes.

Mitochondrial Dysfunction is the second major part of burnout. Mitochondria are the energy producers of the cell.  They do this by taking sugar, fatty acids or amino acids from your food and, in the presence of oxygen, burn them to create energy.  Mitochondrial dysfunction is caused by a number of factors.  Overproduction of free radicals (also known as “reactive oxygen species” or RburnoutOS) can cause mitochondrial damage.  This is why you take antioxidants like vitamin A and E.  Poisoning from heavy metals, petroleum products, pesticides and trans fats also contribute.  At the cellular level, we find mitochondrial damage or dysfunction occurring in almost every type of major illness e.g., heart disease, stroke, diabetes and cancer.

The third major factor in impaired metabolism is thyroid dysfunction.  The thyroid is like the gas pedal in your car and determines your rate of speed.  Too little thyroid hormone and your metabolism slows.  Too much and your metabolism “red-lines”.  A low-functioning thyroid – especially in women – is becoming the norm.  Symptoms of hypothyroid include:  being cold all the time, weight gain, constipation, oily skin, coarse hair, increased cholesterol and depression.  There are many possible causes which include allergic reactions (wheat allergy/celiac disease has a well-known association with autoimmune thyroid disease), toxins, infections, hormonal disturbances and low selenium or iodine levels.

In the next blog, we will explore the ways you can test for “sludge” and “burnout”.  Until then……

Dr. Gatis

Are You Suffering From Sludge?

In a previous blog, I mentioned the book “Ultraprevention” by Dr. Mark Hyman, M.D.   According to Dr. Hyman, there are Five Forces of Illness.  The First of these Forces is what he calls the “sludge” factor.  Sludge (from a process I like to call “sludging”) is a term that means the result of abnormal or incomplete digestion and absorption of food.  Many of us are deluded into thinking that eating “right” i.e., eating lean meats, fruits, vegetables and cereals while avoiding fatty foods,  means that we don’t have to consider the possibility that we are malnourished.  This is unfortunately untrue.   Diet is important, of course, but how your body processes food is as important as the food itself.

Digestion, the breakdown of food into its components is complicated and involves severalHuman internal organs key players – the most important being hydrochloric acid from the stomach, pancreatic enzymes and bile from the liver/gallbladder.  If all of these digestive factors are working well, then there should be no fats, carbohydrates or proteins in the fecal material.  If there is, then either the digestion or absorption process has gone wrong.  Many individuals, for example, say that they eat well – but have digestive problems like chronic diarrhea, constipation or abdominal pain that is unrelated to an overt pathology.

It is now known that there is a process, called endothelial dysfunction, which occurs in the lining of the stomach and digestive tract, the lining of the arteries, the lining of the bones, the skin and the blood-brain barrier .  The same factors that cause inflammation in the gut can also cause inflammation in these other areas.   When a patient presents with symptoms on the skin (like psoriasis or eczema), autoimmune reactions or demonstrated arterial disease, the first thing that an ND suspects is a problem with digestion or absorption leading to a state of malnutrition.  Malnutrition in this sense is the chronic lack of certain essential nutrients that are either not being supplied in the diet or less-then-optimally absorbed that are necessary for the optimum functioning of the system in question.

70% of our immune system is located in the gut because swallowing “germs” is one of their major entrance routes into the body.   Any protein that is not recognized as yours is considered a potential invader and attacked.  The last thing that you want is your body to react against a food component.

Incomplete digestion is the major contributor for the digestion of food sensitivities.  Food How Do You Feel Question 3d Wordssensitivities occur when a food (especially protein) is not digested fully.   These incomplete breakdown particles can enter the circulation and create an antibody response because they are seen by the body as a foreign protein.

One of the reasons food sensitivities develop is a lack of hydrochloric acid (or HCL) production by the stomach or enzymes by the pancreas.    HCL is necessary for the breakdown of proteins into single amino acids.  Single amino acids don’t trigger an immune response where tripeptides (three amino acids bound together) can.   HCL is also necessary for mineral absorption.  This is why individuals that are taking a drug like Tecta for overacid conditions on a daily basis will eventually suffer from osteopenia or soft bones – due to the reduction in mineral absorption.   It has also been related, I believe, to creating low thyroid conditions – probably for the same reason.

In summary, chronic health conditions are usually related to problems with “sludging” or abnormal digestion and absorption of foods.  This “sludge” interferes with the cell’s ability to optimally function and is one of the first signs of the beginning of illness.

In the next blog, we will talk about Force 2:  Impaired Metabolism or Burnout.

Until then……

Dr. Gatis

Testosterone Is Important To Heart Health: How to Raise It Naturally

In the last blog, I mentioned that my “patient” (myself) was experiencing uncharacteristic fatigue and lack of motivation.  The regular blood tests showed a normally-functioning thyroid, no anemia and blood sugar regulation within normal parameters.  The cholesterol level was slightly high but not significantly changed over the last few years.  The total testosterone was within the “normal” range, but the free or “active” testosterone was in the very low part of the range. Remember what I said about testosterone and heart disease?  The free or “active” form of Testosterone helps to protect a man’s heart and arteries.  Dr. Edward Lichten, M.D. in his “Textbook of Bio-Identical Hormones” states that “scientifically, vitamin D, human growth hormone, thyroxine (T4), and triiodothyronine (T3), DHEA, and testosterone in men and estradiol in women have strong cardio-protective or therapeutic applications”.

Man running in a gym on a treadmill concept for exercising, fitnWhat can a 58-year-old male do to increase his testosterone? Exercise – especially resistance training – tends to increase the testosterone level and the HDL.  Reducing fat mass increasing lean muscle mass also reduces the tendency of the body to convert testosterone to estrogen and decreases insulin resistance.  It is important for a man’s reproductive health that his body have the correct levels of Zinc, Vitamin E, and certain amino acids (like L-Citrulline and L-Arginine) vitamin C, B vitamins, and magnesium.  Certain herbs are reputed to raise the free testosterone level – in particular, Tribulus terrestris and Eurycoma longifolia.  Taking the natural precursors to testosterone production may increase levels e.g., DHEA, if it is available.  Reducing stress is very important because high levels of cortisol (produced when stressed) suppresses DHEA.   In general, I prefer patients to raise their testosterone levels through natural stimulation – rather than immediate testosterone replacement – if at all possible.  Read on as I make testosterone stimulation very personal….

In my case, Blood Spot testing (done by finger prick and is a combination of arterial and venous blood) had previously been done in 2012 and was repeated on the same day as the regular blood tests last month.  In 2012, the only parameter that was slightly below normal was the Testosterone level.  The current test showed a further 30% drop in testosterone and a 56.5% reduction in DHEAS values.  The current results show that there are four cardiovascular parameters that are now abnormal:  the triglycerides are elevated (20% more than 2012); the HDL or good cholesterol has decreased by 40%; the VLDL (the very bad LDL cholesterol) is elevated as is the insulin level.  In addition, the Vitamin D level is also severely low – which is surprising because I routinely take 2000 IU per day.

In a nutshell, it is my contention that most, if not all, of these cardiovascular-related changes are due to a less-than-optimal testosterone and vitamin D level .  Unless I take appropriate action, I will become insulin-resistant (Type 2 diabetic) and the mechanisms of arteriosclerosis will continue to increase.  Rather than immediately going for Bio-identical testosterone replacement, I will attempt to raise the testosterone level through exercise, stress reduction, weight reduction, nutrient supplementation and so on over the next few months and will report back to you when the tests are repeated in January 2015.

Until next time…..

Dr. Gatis

Blood Tests and the Naturopath

A 58-year-old male Naturopathic Doctor (myself) presented at my clinic complaining of unexplained low energy, feeling uncharacteristically emotional with a decreased of motivation to do any physical or mental beyond that required for his job. Power naps during the day did return some energy but at the end of the day he has little left to do anything other than watch television. The diagnosis could be anything from depression, to low thyroid, so blood work was requested (14 vials to be exact) In addition, a blood spot test was completed – a relatively new way to measure to measure hormones like testosterone.

The preliminary results of the blood tests have returned. Iron metabolism (Ferritin, Hemoglobin, Serum Iron and Iron Saturation) were normal. Thyroid parameters were normal – although the Free T4 was at the lower end of the range. No thyroid antibodies and the ANA was negative (which reduces the possibility of autoimmunity). In other words, low thyroid and anemia were ruled out. The Fasting Blood Glucose was normal as was the HBA1c. His waist-to-hip ratio, however, is 1.0 (and should be less than 0.9) and a previous blood insulin reading was at the top of the range, so he may have some Insulin Resistance.

The most revealing parameters have to do with cholesterol, heart and hormones. Total Cholesterol was 5.32 (which Man with conceptual spiritual body artis slightly above the upper range of normal). His total cholesterol had been around 5.4 for 20 years. Cholesterol usually is released by the liver when the body has a need to make more testosterone or when there is a low thyroid state (Both conditions are on the rise in aging males). When the cholesterol is high there is also a suspicion that plaque may be forming on the arteries. Of the blood parameters tested, the HDL was low (1.03 versus the optimal 1.5 or more) and the Apolipoprotein B was 1.13 (any value above 0.8 is associated with an increased risk of heart disease). The Total testosterone, although in the normal range was in the lower third and the Free Testosterone was so low that it was almost out of range. Testosterone in males is heart protective and anti-plaque as estrogen is in women.

From the first round of blood work, the working diagnosis is Low Testosterone – especially low Free Testosterone (some of the symptoms include fatigue, tiredness, depression and lack of motivation).
The first line of defense is to attempt to increase the testosterone naturally. In this case, moderate exercise – both interval training and strength training was prescribed which will increase the testosterone and the HDL and reduce the insulin resistance. To protect the heart by decreasing the Apo B and increasing the HDL, Niacin, Pantethine (B5), Resveratrol and Green Tea were also prescribed.

The answer to the question from the last blog is Homocysteine. Homocysteine is an indirect measure of methylation. “More than any other single test, homocysteine correctly identifies the risk of such conditions as heart attack, stroke, and dementia years before the onset of any symptoms.” (Dr. Hyman, M.D.)

In the next blog, we will track the progress of the patient, discuss the results of the blood spot analysis (if available) and investigate certain herbs that are reputed to raise testosterone naturally.

Until then…

Dr. Gatis

How Does A Naturopath Think?

I have enjoyed relatively good health over my life – with a few minor/major blips along the way.  As an aging male Naturopathic Doctor, I am acutely aware of the fact that – although I have taken care of my body and mind reasonably well over the years – my level of health has not yet achieved optimization.  In short, like the rest of you, life gets in the way.  I have decided, therefore, to use this blog as an instructional tool (how a naturopath thinks) over the next few months by using my own situation as a reference point rather than case studies.  In other words, I will assess myself as if I was one of my clients – including any naturopathypossible blood work and/or functional tests that are available – and, based on the findings, will put myself on a treatment regimen and monitor the results.

I am currently reading a book (one of many) by Dr. Mark Hyman, M.D. called “Ultraprevention”.   He is a brilliant man and far more Naturopathic Doctor than Medical Doctor, in my opinion.  I say this because he has come to the conclusion that the human body is complicated and health is a process.  There is no “magic bullet to shoot down all your health issues”.  There are “forces” that lead us down the path to illness.  When we are aware of these forces and make them personal i.e., understand that one size does not fit all when it comes to our own health, we can truly be more in control of our own well being rather than at the whim of “illness”.  These (naturopathic) factors as summarized by Dr. Hyman are:  1) Malnutrition/Mal-digestion (sludge),  2) Impaired metabolism (burnout),  3)  Inflammation (heat),  (4) Impaired detoxification (waste);  Oxidative stress (rust).  Over the next few months, we will explore these topics in more depth.

Until then, there is one crucial test (according to Dr. Hyman) that will provide you with personally with the inside track on the possibility of preventing diseases like heart attack stroke, dementia, and some forms of cancer.  This test is:

  1. Cholesterol
  2. Blood sugar
  3. Vitamin E
  4. Homocysteine

See the answer in the next blog.

Dr. Gatis

Optimizing Progesterone and Estrogen – Especially After Menopause

pretty senior woman relaxing on a couchIn the last blog, I mentioned the importance of progesterone to a woman’s health – especially after menopause.  The biggest question for a woman to ask is…How do I know which of my hormones are low and by how much?  Venous blood values after menopause are virtually useless when talking about monitoring estrogen and progesterone levels because they do not accurately represent the amount of hormone active in the target tissues.  The current way to measure the “functional” hormone level is by saliva or urine test.  Both are non-invasive and simple to do.  In general, saliva testing measures the “free” or “active” forms of the tested hormones at the tissue level directly, while urine testing measures the excretory metabolites of the hormones (from which the hormone levels are extrapolated).  I usually use the urine testing at least once during hormonal therapy – as it is important for the physician to monitor the ratio of certain estrogen metabolites for the patient’s protection.  I believe that it is important for every woman over 30 to have urine metabolite testing done at least once every five years to assess her tendency to certain cancers – whether or not she is considering natural hormonal therapy options or hormone replacement outright.


Taking hormones or substances that affect hormones must always be taken in the context of general health and the functioning of other glands in the body that affect the reproductive hormones.  Adrenal function and thyroid function should always be evaluated before any therapy is prescribed.  I usually suggest that a four-point cortisol saliva evaluation be completed at the same time as the saliva female hormones – as this determines the adrenal/stress response of the person.  As we have stated before, over-or-under functioning adrenal glands influence the production and/or the action of the female hormones.  In other words, chronic stress can affect a woman’s hormonal balance.  The saliva hormone evaluation is usually used before any therapy is prescribed.  I also recommend a thorough naturopathic workup to evaluate the current state of the body and the organ functioning– especially if the woman is considering Bio-identical Hormone Replacement Therapy (BHRT) –


When the saliva results are known the first line of defense is to attempt to stimulate the natural production of hormones if at all possible.  There are many herbal and homeopathic combinations, for example, that claim to “balance” female hormones, and many of them do reduce or alleviate troublesome symptoms like hot flashes and so on.  It is important, in my mind, to do a follow-up saliva test or urine test to make sure that the tissue levels of the estrogen, progesterone and testosterone are now within normal levels.  If not, the woman may be still be at higher risk for heart disease, and will not get the full benefits and protection that the right amounts of estrogen, progesterone and testosterone can give for the brain, heart and nervous system.  Many of the symptoms and signs of aging are related to, or made worse, by hormonal decline.  Therefore, optimizing your hormonal function as you age just makes sense – as long as you do it safely and under the supervision of your health care professional.

Until next time….

Dr. Gatis

How to Maintain the Benefits of Having a Period When You No Longer Have One ~ Part One

It is now time to talk about a woman’s hormones and the effect on her body as she gets older. Having a period is nature’s way of keeping you young. The optimum amount of estrogen and progesterone during the various phases of the monthly cycle have definite effects on a woman’s health and longevity.
The first half of a woman’s cycle is dominated by estrogen and the second half by Portrait of mature woman sitting in countrysideprogesterone. In this blog we will concentrate on progesterone.

A woman really begins to show her age when her periods become irregular and eventually stop. Why is this? In the middle of her cycle when the egg is released, the part that is left, the corpus luteum, becomes a progesterone factory. Progesterone gets the uterus ready for a possible implantation if fertilization occurs. When a woman ceases to have her period the most immediate change is progesterone deficiency. Even though some progesterone continues to be produced by the adrenal glands after menopause, in many ways you could think of it as “no period, no progesterone”.

What about estrogen? It has been shown that a woman’s estrogen does decrease at menopause to about 50% of that she would have produced at age 30. Estrogen is also of major importance, of course, but the big change to my mind is the initial progesterone drop – which immediately changes the optimal progesterone to estrogen ratio and often produces symptoms like hot flashes and other deficiency symptoms. In fact, it is known that a woman has a higher risk for breast cancer if she has a low progesterone to estrogen ratio. In addition, a low P/E ratio can create abnormal bleeding during peri- and post-menopause and an increased risk of uterine cancer.

So let’s talk about natural progesterone (progesterone with the same biochemical structure that your body produces) versus “progestins” which are synthetic progesterones (and do NOT have the same biochemical structure that your body produces). Natural Progesterone works on many tissues other than the uterus. There are receptors for progesterone in the bone, brain and blood vessel walls, for example. Natural Progesterone balances estrogen, has a natural calming effect, helps sleep, increases metabolic rate, increases scalp hair, lowers cholesterol, lowers high blood pressure, is a natural diuretic, normalizes and improves libido, is a natural anti-depressant and anti-inflammatory.
Therefore, symptoms of progesterone deficiency include: anxiety, decreased HDL levels, decreased libido, depression, insomnia, pain and inflammation, insomnia and osteoporosis.

To be fair, synthetic progesterone or “progestins” do have some positive effects that they share with Natural progesterone. Both build bone, help thyroid function, protects against endometrial cancer and normalize zinc and copper levels. This is where the similarity ends, however. Here is partial list of the side-effects of progestins that natural progesterone does NOT have: increased appetite, increased LDL (bad cholesterol), decreased HDL (good cholesterol), insomnia, irritability, weight gain, breast tenderness, decreased energy, decreased sexual interest, fluid retention and hair loss. In addition, progestins stop the protective effects estrogen has on the heart. Dr. Stephen Sinatra, a cardiologist, states in his book “Heart Sense for Women” states “I have found that synthetic progestins can lead to serious side effects in my patients, including shortness of breath, fatigue, chest pain and high blood pressure.

Progesterone is extremely important to a peri and post-menopausal woman. Her life may depend on maintaining optimal levels of progesterone as well as estrogen. In the next blog we will talk about how we may accomplish this. Until next time…..

Dr. Gatis

How to Naturally Increase A Man’s Testosterone Level

In the last blog, I talked about what testosterone does to maintain a man’s health (in addition to maintaining erections). Most men would probably choose to die doing the horizontal mambo – but would in their 80’s and not in their 50’s. Testosterone levels are extremely important to males. How then can we optimize these levels? To my mind, it is always better to attempt to raise levels naturally rather than initiate hormone replacement as the first therapy option – and testosterone levels fluctuate according to diet and lifestyle


Seven to Eight hours of sleep per night is extremely important to optimize testosterone
levels. A lack of sleep affects many important hormones and chemicals in your body including melatonin. Melatonin, in addition to helping you fall asleep is an extremely strong antioxidant and some researchers claim that melatonin production is somehow linked to testosterone production.


Men who are overweight convert testosterone into estrogen in their fat cells due to an enzyme called aromatase. In other words, having abdominal fat lowers a man’s testosterone and increases estrogen. Losing the extra weight can bring the testosterone back up because the fat-cell conversion of testosterone to estrogen is reduced and the normal ratio of testosterone to estrogen is restored.


Testosterone reacts to your body’s needs. When a man is physically active, the brain sends out the signal to increase testosterone in order to build muscles and bones. Take time to move your body. Walk, run, skate. Do Tai Chi. Remember the old adage “Use it, or lose it”. This is true whether you are using a regular muscle or the “love muscle”. Interestingly, only short intense exercise has been shown to boost testosterone while aerobics and prolonged moderate exercise do not raise testosterone levels.


When a man is “stressed” the hormone cortisol is produced. Chronic elevations of cortisol affect a man’s ability to create adequate levels of testosterone. Learn to relax from the brain on down. Spend an hour-a-day on an activity that isn’t work or exercise related. Learn meditation or self-hypnosis techniques.


Many medications affect testosterone level. Discuss the drugs you are taking with your doctor or pharmacist to rule out drugs as the cause of your symptoms or low testosterone.

I value your feedback and would like to know the topics that are pertinent to you.

In Health,
Dr. Gatis

Testosterone Is Not Just For Sex

funkyicon_maleHormone Optimization Therapy is important to every man, and at every age past puberty.  It might surprise you to know that the average man in his thirties these days has less measurable testosterone than his grandfather did at the same age – which probably explains why many thirty-year-olds are still living at home!  My theory is that these lowered testosterone levels (and the availability of online pornography) are killing the desire for young males to go out and start families of their own.  In other words, “the population-level declines are greater in magnitude than the cross-sectional declines in testosterone typically associated with age.” (J. Clin. Endocrinol. Metab 2006, Oct 24)

What do optimal levels of testosterone do for a man?  If we take sexual desire and erections out of the equation for a moment, an adequate level of testosterone contributes to brain, bone, muscle and heart health – and reduces overall mortality rates.  A 2007 study had been following 800 men over the age of fifty for 18 years.  The group of men with values in the lower 1/3 testosterone level had a 33% increased rate of death from all causes than those men whose values were in the upper 1/3 testosterone level.  Another way to say this is… a higher level of testosterone that a man has as he ages reduces his risk of dying.  High free testosterone levels correlate with improved cognitive function and memory, and reduce the risk for Alzheimer’s disease.  Lower testosterone levels are associated with coronary artery disease and atherosclerosis.  Testosterone improves exercise-induced angina as it dilates coronary arteries.  High cholesterol has been associated with low testosterone and testosterone therapy has been shown to lower total cholesterol.  Testosterone therapy builds muscle mass in elderly men and increases bone strength.  These are just a few examples in current literature of the benefits of having enough testosterone.

The following is a list of symptoms indicating that a man may be low in testosterone:  decreased muscle mass and strength;  decreased sex drive;  reduced frequency and firmness of erections;  reduced ejaculate volume;  hot flushes;  excessive emotions/sensitivity to difficulty;  unnecessary worry anxiety, fear;  depression;  loss of self-confidence;  joint pains;  persistent fatigue that increases with activity; dry eyes;  reduced muscle tone;  depressed attitude;  nervous, irritable;  poor concentration and memory;  pale skin/anemia;  increased fat in breasts, abdomen and hips;  metabolic syndrome.  If you have any of these symptoms/signs on a continuing basis, please mention them to your primary health care provider and ask for testing to rule out testosterone deficiency. If, after the testing is done, your provider says that you are in the “normal” range, please ask him or her where in the normal range do your values fall?  If you are in the lower 1/3 of the range you are at risk (re-read paragraph number two above) and should consider or hormone optimization therapy.  In the next blog, I will talk about the ways to optimize testosterone levels – both naturally and by replacement.

~ Dr. Gatis