Hormone imbalances are some of the most common conditions we see in our office. Hypothyroidism, Hashimoto’s, Pre and Post Menopausal symptoms can be managed effectively and safely with a Functional Medicine Approach.
Dr. Michael Veselak is Certified Functional Medicine Practitioner, allowing him to thoroughly evaluate and properly identify the root cause of the hormonal imbalance. Once the proper testing is performed, the solutions become much clearer and the treatment more effective.
Thyroid
Many patients who suffer from Thyroid disease are told that they have Hypothyroidism and need a thyroid replacement. Most commonly, these patients received this diagnosis because of an elevated TSH level. Unfortunately, the correct testing is rarely done to find out the underlying cause of why the patient has low thyroid function. Many times, women will experience all of the symptoms of Hypothyroid, but when their lab tests show a normal TSH level, they are told everything is fine. However, this is not always the case. In fact, there are many reasons why this can occur. If you want relief from the fatigue, weight gain, anxiety, lack of motivation, joint pain, and the myriad of other symptoms that accompany Thyroid disease, the bottom line remains the same: you must discover the underlying factors affecting the production and utilization of the Thyroid hormones!
Over 20 million Americans are affected by Thyroid Disorders, and more than half are unaware that they have a Thyroid problem because it frequently goes undiagnosed until it gets severe.
The Thyroid is responsible for creating two hormones: T3 and T4. The more biologically active hormone, T3, is a critical component in cellular function; in fact, 80% of T4 is converted to T3 in the peripheral tissues of the body. The T4 hormone acts as a precursor to the more active T3 hormone. Often, one of the main problems in Thyroid disorders is trouble with the T4 to T3 conversion in the tissues. This results in a deficiency of T3, which disrupts the body’s ability to regulate metabolism properly. The Thyroid controls our metabolism “ it is the gas pedal of the body. Thyroid hormones have a direct effect on most organs, including the heart, which beats faster and harder under the influence of increased Thyroid hormones. This is often a major contributing factor to the heart problems that accompany chronic Thyroid problems in many women.
Common Examples of Thyroid Symptoms include:
Hypothyroid (Low Function):
- Chronic Fatigue
- Irritability between meals
- Depression/lack of motivation
- Constipation/Bloating
- Weight gain
- Cold hands/feet
- Morning headaches
- Hair loss
- Dry Skin
Hyperthyroid (High Function):
- Heart Palpitations
- Anxiety
- Diarrhea
- Increased Pulsed Rate
- Insomnia
- Night sweats
- Weight loss
- Nervous/Emotional
- Brain fog
Hashimoto’s
Hashimoto’s Thyroiditis is an autoimmune disorder of the thyroid and can cause both hypothyroid and hyperthyroid symptoms. The treatment of Hashimoto’s must focus on the autoimmune component to inhibit the tissue destruction. Too often it is treated as a hypothyroid issue prescribing medication to discover a few months later all the symptoms return.
Dietary and lifestyle changes along with modulation of the immune system is how you achieve success in the management of Hashimoto’s.
ADRENALS
Adrenal Fatigue is becoming increasingly more common on a daily basis. At least a half a dozen time per week, I consult with a patient that has been diagnosed with Adrenal Fatigue.
The increase in the incidence of Adrenal Fatigue is directly related to all the stressor we have to deal with. These stressors can include emotional, physical, as well as environmental toxicity from chemicals, heavy metals, viruses, bacteria and molds.
The function of the adrenal glands is to release cortisol, to help us deal with theses stressors. In the short term this can be beneficial but in the long term it can create adrenal fatigue and exhaustion.
Symptoms of Adrenal Fatigue
Fatigue in the morning (difficulty getting up)
Difficulty Falling Asleep
Difficult Handling Stress
Excessive Use Of Salt
Increase Use of Caffeine
Anxiety
Depression
Weight Gain
Lightheadedness
Brain Fog
Natural Methods To Help Regulate Cortisol
Dietary Changes to Minimize Inflammation
Supplementation of Adaptogens like Ashwaghanda, licorice root, rhodiola as well as phosphatidylserine and good old Himalayan sea salt.
Mediation
Stress Management
Exercise (not too excessive)
Proper Testing:
The Adrenal Stress Index can measure cortisol levels 4 times during the day. Most commonly the saliva test is run which measures Cortisol at different times of the day, morning, noon, late afternoon and evening. By analyzing the cortisol rhythm, cortisol output and DHEA we can determine what phase of adrenal fatigue the individual is in.
The Dutch Hormone test will analyze cortisol and melatonin levels since there is a inverse relationship between the two. In the morning we should have plenty of cortisol and a little bit of melatonin. This should gradually change during the day so as night time falls our cortisol levels are low and melatonin higher so we can sleep. The Dutch Hormone also analyze hormones as well as organic acids markers.
Four Stages of Adrenal Fatigue
Generally there are 4 stages.
Stage 1: High overall cortisol and spikes determine the first stage at times during the day suspecting a problem.
Stage 2: The second stage of adrenal fatigue is commonly missed since the total cortisol is relatively normal. The cortisol will be low at times during the day but the overall output is within normal range. When we analyze cortisol during the day we should see it high in the morning and it becoming lower at night.
Stage 3: The third stage of adrenal fatigue is when the DHEA levels are low and cortisol is low throughout the day.
Stage 4: Complete Exhaustion
In Office Testing
In our office we will perform some testing on the Adrenals. The first test is we shine a light in the eye causing the pupil to constrict. With the light on the pupil should stay constricted. If the pupil is alternating between dilating and constriction this can be a sign of adrenal fatigue.
The second test is called Ragland’s test. This involves lying down in the supine position for approximately 5 minutes and then takes the blood pressure. Following 5 minutes immediately stand up and take the blood pressure again. Ideally it should raise 5-10 mmHg upon standing. However, if it remains the same or goes down this can be a sign of adrenal fatigue.
Finding The Cause
This is the most important part otherwise the cycle will continue. Is it a H.Pylori infection? Candida? Autoimmue? Emotional or Physical Stress?
We recommend a Functional Medicine Approach to discover the root cause and of course proper testing.
In our office we will perform some testing on the Adrenals. The first test is we shine a light in the eye causing the pupil to constrict. With the light on the pupil should stay constricted. If the pupil is alternating between dilating and constriction this can be a sign of adrenal fatigue.
The second test is called Ragland’s test. This involves lying down in the supine position for approximately 5 minutes and then takes the blood pressure. Following 5 minutes immediately stand up and take the blood pressure again. Ideally it should raise 5-10 mmHg upon standing. However, if it remains the same or goes down this can be a sign of adrenal fatigue.
Following the consultation we will recommend various labs so we can properly identify and address the cause of the adrenal fatigue. I only recommend tests that will actually change our approach to treatment. We also do our best to review the labs you have already had done to make sure there is no overlap.
Tests We Might Recommend
Organic Acids
Dutch Hormone Test
Heavy Metal
Stool Test
Genetic Testing
Alcat
Cyrex
HPA -Axis
It has been our clinical experience that when we find the cause of the chronic stress contributing to the adrenal fatigue and support the Hypothalamus- Pituitary-Adrenal Axis the adrenals begin to function properly and the symptoms improve.
It is also necessary to not only improve digestion, absorption and elimination but also detoxification, mitochondrial and brain health.
Estrogen, Progesterone, Testosterone Balance
Throughout life our needs as well as production for hormones change. This fine balance often times can get disrupted by several factors. A careful analysis of the all the hormones is essential to recommending the proper treatment. Generally, the hormones are checked through the blood. This is a one day snapshot of your hormone levels on that particular day. We have found that during the monthly cycle these can fluctuate where a few days or more out of the month that you can be out of balance causing you some of the symptoms like headaches, fatigue, brain fog, bloating, cramping but the blood tests show they are normal.
We recommend for our patients to get accurately tested with the Dutch Hormone Test. This test will analyze every day of your cycle so we can see exactly your hormone levels on any given day or time of the month.
Other factors that need to be addressed which affects our hormones are
- Blood Sugar
- Stress
- Diet
- Exercise
- Genetics
- Detoxification
Common Conditions:
- Estrogen Dominance
- Testosterone Dominance
- PCOS
- Menopause
- Menstrual Cycle Irregularities
- Headaches/Migraines
Proper Lab Testing:
When managing any thyroid or hormone condition proper lab testing is essential. For long standing improvement we must assess all aspects of Thyroid Hormone production, conversion, transportation and cellular resistance. Furthermore, careful analysis of blood sugar, adrenals, and even genetic vulnerabilities all must be analyzed carefully for optimum results.
Labs We Recommend:
Since every patient is unique in their symptoms we determine what labs are necessary for you to properly manage your Thyroid and begin to feel better.
- Complete Blood Count (CBC)
- Complete Metabolic Panel
- Antibodies Test For Thyroid
- Complete Thyroid Panel
- Dutch Hormone (Female Hormones & Cortisol)
- Adrenal Stress Index
- Cyrex Array 3 (Gluten Sensitivity Panel)
- Cyrex Array 4 (Cross-Reactive Panel)
- Cyrex Array 5 ( Multiple Autoimmune Panel)
- Cyrex Array 10 ( Multiple Autoimmunity Food Panel)
- GI MAP (Stool Sample)
Proper Treatment
Many patients who suffer from Hormonal Imbalances are told that they need a hormone replacement. Most commonly, these patients received this diagnosis because of an elevated TSH level. Unfortunately, the correct testing is rarely done to find out the underlying cause of why the patient has low thyroid function. Many times, women will experience all of the symptoms of Hypothyroid, but when their lab tests show a normal TSH level, they are told everything is fine. However, this is not always the case. In fact, there are many reasons why this can occur. If you want relief from the fatigue, weight gain, anxiety, lack of motivation, joint pain, and the myriad of other symptoms that accompany Thyroid disease, the bottom line remains the same: you must discover the underlying factors affecting the production and utilization of the Thyroid hormones!
Genetics
Many practitioners who claim to treat Thyroid disease direct their treatment at replacing Thyroid hormones. However, to accurately address these symptoms, it is important to evaluate the patient from a metabolic standpoint as well as their underlying genetics. Methylation is crucial to the adequate delivery of the Thyroid hormones to the cells. Dr. Michael Veselak will analyze several genes in the body, including the MTHR, COMT and CYP genes, to optimize the health and function of the body. The way in which methylation affects brain health and neurotransmitters is equally important when addressing a Thyroid patient. It is common for patients with a Hormone Imbalance to experience neurological symptoms because a disruption in hormone function can negatively impact the health of the brain. This results in certain areas of the brain beginning to over-fire. Therefore, it is important to optimize brain function when restoring health to a patient with Hormonal Imbalances.
Examples of Neurologic Symptoms that Develop in Thyroid Patients include:
- Chronic Fatigue
- Light/Sound Sensitivity
- Vertigo/Balance Disorders
- Decreased Libido
- Depression
- Headaches
- Heart Palpitations
- Anxiety
- Increased Sweating
- Insomnia
- Nerve Pain
6 Patterns of Thyroid Dysfunction
Patient Testimonials
Dr. Veselak is a gifted healer, compassionate doctor and wonderful human being. I am so blessed to have been referred to him by my good friend Marylin. After dealing with several issues for so many years Dr V. was able to get to the root of my problems. I was starting to think I was crazy because every test, scan and ultra sound came back negative. I went to various doctors and they all just assumed I was dealing with a thyroid issue. I’m so grateful that instead of assuming or guessing I found a doctor that cares enough to work hard and dive deep into the issue at hand until it is resolved. I feel like my health and my life is back on track. For these reasons I highly recommend Dr Veselak!
Erica D
I was referred to Dr. Veselak from a family member. This was my best experience ever with a doctor. I have experience numerous problems with my health and a regular doctor could never tell me why. For the first time in my life I had straight forward answers and he developed a plan for me to follow. I have never felt so relieved in my life. Finally someone who can help me out. I started following his plan and starting seeing positive results in only a matter of days. I recommend him for everybody! Especially if you are serious about changing your life. So glad I found Dr. Veselak he was such a life savor!
Imani D
