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Archive for November, 2009

My practice is fortunate enough to be in a holistic wellness center that has wonderful practioners of all types.  Because of this I am able to offer unique packages to my clients at reduced rates.  Currently I am running a great special on first time clients with an intial consult for 1.5 hrs and a 30 minute massage (by a professional massage therapist) following our appointment!! This package is $130!  Ongoing massages from any of the therapists will be discounted if you are a client of mine.  So take advantage of this opportunity.

There are a variety of ways to relieve stress, depression, and anxiety. Traditionally talk therapy is extremely helpful, but along with other modalities the recovery rate is much higher.  I believe in treating the body as a whole instead of parts which is why I practice at a center that offers all these options.  If you are interested give me a call or email at 650-224-1796 or amoreena@gmail.com.

Happy Thanksgiving!

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You may be surprised to know how prevalent polycystic ovaries are among young women. This information from the PCOS Health review was interesting to me so I thought I would pass it along. I think it is important to know the difference between PCO and PCOS.

A report in the September issue of the Gynecological Endocrinology medical journal  said about 4 of every 5 normal, healthy women have polycystic ovaries. However, as women get older, the rate of polycystic ovaries decreases.

We were surprised that polycystic ovaries are so common. However, polycystic ovaries is not the same thing as polycystic ovary syndrome.

In the case of polycystic ovaries, the ovaries are larger than normal, and there are a series of undeveloped follicles that appear in clumps, somewhat like a bunch of grapes. Polycystic ovaries are not especially troublesome and may not even affect your fertility.

However, when the cysts cause a hormonal imbalance, a pattern of symptoms may develop. This pattern of symptoms is called a syndrome. These symptoms are the difference between polycystic ovary syndrome and polycystic ovaries.

So you can have polycystic ovaries without having PCOS. However, nearly all women with PCOS will have polycystic ovaries.

The good news is that you can deal with both problems with the same approach: improved diet and lifestyle.

PCOS Health Review

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Thyroid has a lot to do with our fertility and ovulation.  I have posted some information here regarding the variety of thyroid conditions.  This is a standard test that should be done to rule out this possibility, however there is a thyroid antibody test that is rarely done.  I myself am someone who has been affected by this condition. It has taken me almost 3 years and 2 miscarriages to figure this out.  I just happen to ask about getting my thyroid antibody test done and it came back positive.  So do your research and ask for all the tests, you never know!  This is the last place I suspected to find the answers.

Hyperthyroidism – or having an overactive thyroid gland – can pose special concerns during pregnancy. When the body delivers too much thyroid hormone, both the mother and the baby can suffer. Miscarriages, premature births, and intrauterine growth retardation can occur when the disorder goes undiagnosed or untreated. Pregnant women with hyperthyroidism can also develop high blood pressure, and are at greater risk of heart conditions.

While a thyroid condition can sometimes complicate the process of getting – or staying – pregnant, the good news is that when your disease is properly managed, most of you with thyroid conditions — whether hypothyroid or hyperthyroid — can have a safe, uneventful pregnancy and delivery. Taking your medications, keeping your thyroid levels — including TSH and T4 — under control, getting regular care with a specialist familiar with treating pregnant thyroid patients, and taking charge of your own health appears to be key to a successful outcome.

In some cases, pregnancy can actually lessen the symptoms of thyroid disease, and you may be one of the many women who enjoy a nine-month respite from some of the undesirable effects of thyroid conditions.

If I could urge women with thyroid disease who are contemplating pregnancy to do one thing, it would be to become educated about how thyroid dysfunction can affect fertility and pregnancy – and what to do about it. Read all you can, ask questions, and urge your doctors to perform the necessary blood tests to keep your levels in check.

Will my thyroid disease hamper my ability to get pregnant?

Sometimes – but certainly not always – thyroid disease can affect your fertility. According to Dr. Sheldon Rubenfeld, a practicing thyroidologist, and Founding Chairman of the Thyroid Society for Education and Research, fairly common problems caused by thyroid dysfunction are anovulation (no ovulation, or release of an egg) and menstrual irregularities. With no egg to fertilize, conception is impossible.

Thyroid dysfunction can halt ovulation by upsetting the balance of the body’s natural reproductive hormones. One way to tell if you’re ovulating is to test the level of a pituitary hormone called LH (or luteinizing hormone) by using an ovulation predictor kit. LH stimulates the ovaries to release an egg. The kit will show you if you have that surge in LH that indicates ovulation. If there is too much or too little thyroid hormone, ovulation might not occur. Remember…even though you may be menstruating regularly, you may not be ovulating – and may never know that fact until after years of infertility.

In addition, some women experience a short luteal phase. The luteal phase is the timeframe between ovulation and onset of menstruation. The luteal phase needs to be of sufficient duration — a normal luteal phase is approximately 13 to 15 days — to nurture a fertilized egg. A shortened luteal phase can cause what appears to be infertility, but is in fact failure to sustain a fertilized egg, with loss of the very early pregnancy at around the same time as menstruation would typically begin.

Dr. Rubenfeld said that “the mechanisms by which thyroid problems interfere with fertility are often unknown, but there is no question that other aspects of thyroid function affect fertility.” For example, Dr. Rubenfeld said that hypothyroidism can cause an increase in prolactin, the hormone produced by the pituitary gland that induces and maintains the production of breast milk in a post-partum woman. Excess prolactin has a negative effect on fertility – sometimes preventing ovulation, or sometimes causing irregular or absent monthly cycles.

The increase in prolactin may be caused by an elevation of a hormone from the hypothalamus called TRH (or thyrotropin releasing hormone) that stimulates the pituitary gland to send out both prolactin and TSH.

Some women with hypothyroidism also have polycystic ovaries, or cysts on the ovaries, which hamper ovulation and can cause fertility problems as well.

This all sounds pretty grim. Should I even bother trying? What can I do to maximize my chances of getting pregnant?

Yes, you should bother trying – there are many, many success stories (I happen to be one of them, as it only took a few months to get pregnant with my daughter). You shouldn’t go into this thinking it’s going to be a long, arduous process. But attempting pregnancy with a thyroid condition may require a little preparation.

First of all, talk to your doctor about when you should attempt conception. Many doctors think TSH levels of 3, 4, or even 5 may acceptable to try to get pregnant. But research suggests otherwise. In 1994, a study in the Journal of Clinical Endocrinology and Metabolism looked at pregnant women with thyroid antibodies and TSH in the normal range. The study found that women with autoimmune thyroid disease had TSH values significantly higher, though still normal, in the first trimester than in women with healthy pregnancies used as controls.

The higher TSH level of the women with autoimmune thyroid disease? 1.6.

The normal TSH level for the control group of pregnant woman without autoimmune thyroid disease? 0.9. A TSH of .9 is a far cry from the so-called “normal” TSH levels of 3 or 4 or 5 that some doctors feel are no impediment whatsoever to getting — or staying — pregnant.

My endocrinologist at the time I was trying to get pregnant believed very firmly that most women with a thyroid problem should be maintained at a TSH level of between 1 and 2 in order to help them get pregnant — and maintain the pregnancy.

Second, ascertain whether you’re ovulating. An excellent, empowering book is Toni Wechsler’s Taking Charge of Your Fertility.. You can learn how to use basal temperature and other fertility signs to chart your monthly hormonal cycle. You can also use an over-the-counter ovulation predictor kits, available for around $10 at the drugstore, to confirm ovulation. Or the more expensive ovulation predictor electronic devices can also be used.

What if I can’t get pregnant, but my thyroid tests “normal?” Or what if I test positive for “antibodies?”

Some women who have fertility problems actually have underlying autoimmune thyroid problems, but they and their doctors are not aware. If you or someone you know is having difficulty getting pregnant, or is suffering recurrent miscarriage, thyroid antibodies should be tested.

Many doctors do not appear to know about this link between antibodies and infertility, yet it is published in conventional research journals. The respected journal Obstetrics & Gynecology reported that the presence of antithyroid antibodies increases the risk of miscarriage. And according to U.S. research reported in the Journal of Clinical Endocrinology and Metabolism, that risk of miscarriage can be twice as high for women who have antithyroid antibodies.

Researchers have also demonstrated that antithyroid antibodies can cause greater difficulty conceiving after in vitro fertilization, regardless of whether or not there are clinical symptoms of hypothyroidism. The researchers had greater success in achieving successful pregnancies when they gave low doses of heparin (an anti blood clotting agent) and aspirin and/or intravenous immunoglobulin G (IVIG) to women who had antithyroid antibodies.

Thyroid INFO by Mary Shomon

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Our first support group for women going through infertility issues is starting November 21 from 12-1pm.  That is a Saturday and this group will meet bi-weekly for 6 sessions.  My goal is for this group to be a safe supportive environment for you to be able to express yourself as well as learn mindfulness tools to help cope through your journey.  Women in all phases of the infertility process are welcome, whether you are doing natural, IUI, IVF, or deciding what is next we would love for you to join us.  We are meeting at the Integrative Women’s Health Center in Oakland, 3300 Webster Street. If you would like more information please email or call me, 650-224-1796 amoreena@gmail.com.

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