UC Berkeley News reports

Exposure to flame retardants linked to changes in thyroid hormones

By Sarah Yang, Media Relations | 21 June 2010

BERKELEY — Pregnant women with higher blood levels of a common flame retardant had altered thyroid hormone levels, a result that could have implications for fetal health, according to a new study led by researchers at the University of California, Berkeley.

A new study shows that PBDE flame retardants alter thyroid function in pregnant women.

“This is the first study with a sufficient sample size to evaluate the association between PBDE flame retardants and thyroid function in pregnant women,” said the study’s lead author, Jonathan Chevrier, a UC Berkeley researcher in epidemiology and in environmental health sciences. “Normal maternal thyroid hormone levels are essential for normal fetal growth and brain development, so our findings could have significant public health implications. These results suggest that a closer examination between PBDEs and these outcomes is needed.”

PBDEs, or polybrominated diphenyl ethers, are a class of organobromine compounds found in common household items such as carpets, textiles, foam furnishings, electronics and plastics. U.S. fire safety standards implemented in the 1970s led to increased use of PBDEs, which can leach out into the environment and accumulate in human fat cells.

Studies suggest that PBDEs can be found in the blood of up to 97 percent of U.S. residents, and at levels 20 times higher than those of people in Europe. Because of California’s flammability laws, residents in this state have some of the highest exposures to PBDEs in the world.

“Despite the prevalence of these flame retardants, there are few studies that have examined their impact on human health,” said the study’s principal investigator, Brenda Eskenazi, UC Berkeley professor of epidemiology and of maternal and child health. “Our results suggest that exposure to PBDE flame retardants may have unanticipated human health risks.”

The new study, to be published June 21 in the journal Environmental Health Perspectives, is the second study to come out this year from Eskenazi’s research group linking PBDEs to human health effects. Eskenazi was the principal investigator on the earlier study that found that women with higher exposures to flame retardants took longer to get pregnant.

In the new study, the researchers analyzed blood samples from 270 women taken around the end of their second trimester of pregnancy. The women in the study were part of a larger longitudinal study from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) that examines environmental exposures and reproductive health.

The researchers measured concentrations of 10 PBDE chemicals, two types of thyroxine (T4) and thyroid-stimulating hormone (TSH). They controlled for such factors as maternal smoking, alcohol and drug use, and exposure to lead and pesticides.

Analysis focused on the five PBDE chemicals that were detected most frequently and are components of a mixture called pentaBDE. The researchers found that a 10-fold increase in each of the PBDE chemicals was associated with decreases in TSH ranging from 10.9 percent to 18.7 percent. When the five PBDEs were analyzed together, a tenfold increase was linked to a 16.8 percent decrease in TSH.

The study did not find a statistically significant effect of PBDE concentrations on levels of T4. With one exception, all the women in the study with low TSH levels had normal free T4 levels, which corresponds to the definition of subclinical hyperthyroidism. The study found that odds of subclinical hyperthyroidism were increased 1.9 times for each tenfold increase in PBDE concentrations.

“Low TSH and normal T4 levels are an indication of subclinical hyperthyroidism, which is often the first step leading toward clinical hyperthyroidism,” said Chevrier. “Though the health effect of subclinical hyperthyroidism during pregnancy is not well understood, maternal clinical hyperthyroidism is linked to altered fetal neurodevelopment, increased risk of miscarriage, premature birth and intrauterine growth retardation.”Exactly how flame retardants influence TSH levels is unclear, the researchers said, but animal studies have shown that certain PBDEs can mimic thyroid hormones.

In addition to the commercial mixture pentaBDE, octaBDE and decaBDE have been developed for use as commercial flame retardants. PentaBDE and octaBDE have both been banned for use by the Stockholm Convention on Persistent Organic Pollutants, the European Union and eight U.S. states, including California, but they are still present in products made before 2004.

The production of decaBDE by major manufacturers is scheduled to be phased out in the United States by 2013. However, pentaBDE and decaBDE are being replaced by new brominated and chlorinated compounds whose impact on human health is not yet clear, the researchers noted.

Other co-authors of the study are Kim Harley and Asa Bradman, associate directors at the Center for Children’s Environmental Health Research at UC Berkeley’s School of Public Health; Myriam Gharbi, a doctoral student at the Pasteur Institute in France; and Andreas Sjödin, chief of the Combustion Products and Persistent Pollutants Laboratory at the Centers for Disease Control and Prevention.

The U.S. Environmental Protection Agency, the National Institute for Environmental Health Sciences and the University of California Institute for Mexico and the United States provided support for this research.

The following article was prepared by Randine Lewis, Ph.D., founder of The Fertile Soul and the CEFP community, for purposes of helping patients to understand how Chinese Medicine interprets AMH markers as “potential” indicators for fertility.  Susan Fox is a member of the CEFP community, an international group of practitioners dedicated to treating fertility challenge using principles of The Fertile Soul method.

AMH – What Does It Really Mean?  Markers of Ovarian Reserve Viewed Through the Lens of Chinese Medicine   By Randine Lewis, Ph.D., L.Ac.

“Ovarian reserve” testing can be intimidating and daunting. The results often feel like a fertility death sentence. When viewed through the eyes of Chinese medicine, however, these laboratory markers of ovarian potential can actually make diagnostic sense, and help determine the best natural therapeutic course for you.  It will be helpful to understand a little reproductive physiology first.

Brain Hormones:

The pituitary gland, which sits behind your eyebrows, emits FSH (follicle stimulating hormone) in response to messages translated by the hypothalamus, which secretes Gonadotropic releasing hormone (GnRH) in response to the hormone levels in your blood, and your emotional response to your environment. This hormonal command post, like all of the hormones in your body, responds to internal chemical messages conveyed through the blood, and emotional interpretations of your external environment.

These external and internal messages determine how the pituitary hormones interact with and are able to communicate with your ovaries, and how the ovarian output communicates back to the hypothalamus and pituitary gland.

Ovarian Hormones:  Activin and Inhibin B are protein complexes within the ovarian follicule. Activin enhances FSH secretion, cellular proliferation and plays a role in menstrual regulation. Inhibin B, on the other hand, down regulates and inhibits GnRH from the hypothalamus, and FSH secretion from the pituitary gland.

When the system is in sync, the hypothalamus secretes GnRH to trigger the pituitary gland to release small amounts of FSH during the last few days of the previous menstrual cycle, which rise until the beginning of the next follicular phase. FSH recruits Graafian (or antral) follicles, which have been growing within the ovary for the better part of a year. Around three months before these follicles are ovulated, they enter the tonic growth phase, where protein synthesis occurs. Follicles that have interacted optimally with the internal environment have the potential to become dominant follicles, primed by FSH. They then secrete estrogen, and express LH receptors, which allow the chosen dominant follicle to mature and become capable of ovulation.

Higher levels of Inhibin B indicate that the ovarian follicle is doing its job of putting out adequate estradiol. Inhibin B provides negative feedback to the hypothalamus and pituitary gland to let them know to turn down the GnRH and FSH, as output is sufficient.

The High FSH Craze  Within the last ten to 15 years, reproductive medicine has been making quite a fuss over high FSH levels. Chinese medicine doesn’t focus so much on the unqualified meaning of laboratory values like Western medicine does; we view lab results energetically according to what is behind them, rather than providing meaning to the absolute numerical value.

The body energetically views the ovaries as “essence”, an elemental potential, like the primordial follicles within them. Follicles are only potential until they begin to interact with their internal environment, which is responding to cues coming from our interpretation of our external environment. All of this is subject to change, when we change our internal environment, and our response to our external environment. FSH, on the other hand, is viewed as “heat”, which activates the potential of the ovaries’ essence in the form of eggs, and resulting blood levels of estradiol (or yin). When the essence is adequate, it doesn’t require much heat to ignite the ovaries. When the essence is weak (due to stress, lack of restoration, follicular malnourishment, and the demands of life), it takes more heat to induce the necessary ovarian response, indicative of present ovarian health.

To put it simply and in energetic terms, those who have high FSH and low estradiol levels generally have too much heat, in relation to the underlying essence capable of responding to FSH stimulation. Although optimal FSH values are seen as <10, The Fertile Soul Method ® has helped women whose FSH values are well over 100 conceive naturally. First, however, we have had to energetically reduce their heat, and maximize their essence, which allows the FSH to activate healthy follicles.

Although Western medicine views the reproductive system as an ever-deteriorating disease process waiting for intervention, Chinese medicine employs a different lens. We view the body/mind/spirit as an ever adaptive system, which, when given appropriate environmental cues, has a miraculous ability to manifest its highest potential.

The Low AMH Frenzy  As if high FSH values, and low estradiol/inhibin-b levels weren’t enough to convince you of your need for drastic intervention and donor eggs, the newest craze in ovarian reserve testing is a hormone known as Anti-Mullerian Hormone or AMH.

Again, some reproductive physiology will be helpful to make sense of this hormone.  During embryonic development, male testes produce AMH, to inhibit the expression of Mullerian ducts, which become female sexual organs. In the presence of AMH, the primordial urogenital ridge bears Wolfian expressions of prostate, testes and vas deferens, rather than the female Mullerian expressions of fallopian tubes, uterus and vagina. We could look at Anti-Mullerian Hormone as a “holding back” hormone. After birth, AMH becomes expressed by females, within the granulosa cells of the ovary, where it inhibits the responsiveness of growing follicles to FSH. Since human beings aren’t made to raise litters, the body’s internal wisdom does not allow the recruitment of all of the primordial follicles, as only one dominant follicle is chosen for ovulation during each menstrual cycle. If FSH is viewed has heat, and estradiol is viewed as yin, AMH is viewed as the “essence potential”, or the ability to hold back the ovarian essence from interacting with the pituitary gland’s igniting fire. The greater the body’s ability to hold back ovarian essence, the easier it is for the FSH igniting potential to activate a response in the form of a healthy egg and its resulting estradiol levels. Therefore, higher AMH values are indicative of a greater abundance of interactive follicles. The range of AMH values run between 0-6 ug/L. The closer you are to 6, the greater the force behind the dam. Once again, The Fertile Soul Method ® has helped women whose AMH values were zero conceive naturally. How does this work?

Putting It All Together  We are endowed with a primordial pool of follicles during fetal development. At birth they measure near one million; by the time we enter menarche, they number about 500,000, and by the time we approach the perimenopausal years we have around ten thousand. These primordial follicles do not undergo any change or deterioration until they begin to circulate within the ovaries’ response to its internal environment, which is an inner result of how we relate to our external environment.

The hypothalamus interprets our emotional response to our environment (via neurochemicals), and translates it into hormonal messages in the form of GnRH or Gonadotropin Inhibitory Hormone. These chemicals then trigger the appropriate response from the pituitary gland, whose hormones signal the gonads to release their germ cells and hormones. The resulting blood laboratory values are a manifestation, not a cause. These circulating hormone levels feed back to the hypothalamus, along with our emotional response, to regulate its ongoing release of brain hormones. Because of this adaptive feedback system, supplying external hormones will not improve the function of the ovaries; only suppress their release. In order to improve the functioning of any part of this system, the entire system must be addressed.

Tiny follicles leave their primordial pool (again, not changed since before birth), and enter into the growing pool of follicles, where the dominant follicles are activated by FSH fire from the pituitary gland. The number of circulating follicles depends upon many factors – blood flow to the ovaries (which can be enhanced), nutritional and hormonal fuel to the ovaries (which can be enhanced), our emotional response to our environment (which can be enhanced), our ability to restore and access the follicles to allow them to enter into a healthy internal environment (which can be enhanced.) The number of follicles in the growing pool determines the levels of AMH. Only the chosen dominant follicle will mature in response to the pituitary gland’s release of luteinizing hormone during ovulation. LH can be viewed as the energetic trigger, causing the entire cascade to produce the potential for release, fertilization, implantation and continued growth.

An early antral follicle releases estradiol in the form of yin. If the endocrine system provides messages that this system is conducive to new life, the ovaries perceive a great internal potential to produce more follicles. They will respond with more yin, access more essence, and the entire cascade will dance into full expression. AMH values will rise. FSH values will tend to lower, as very little flame is necessary to keep the fire going. More follicles will produce greater levels of inhibin B. The body will select a dominant follicle; LH will mature its residing egg, and allow the release of a healthy potential.

Keeping The Fire Burning  A simple analogy – FSH is the flame. The uterus is the oven. LH is the opening of the flue. The ovaries are the wood; Estradiol measures the available wood for burning, inhibin B could be seen as the damper that keeps the fire from burning out of control, and AMH could be seen as the lighter fluid. If we are trying to ignite the spark of life and keep it going, we need to ensure all of our provisions are adequate. Assisted reproductive technology gives you one tool – more fire. However, if we need a drier oven, if we need to gather more wood, soak it in more fluid, or reduce the wind that is keeping the spark from igniting, more fire is not the only answer. In fact, sometimes more fire actually keeps the materials from being able to burn on their own. A flame-thrower is not the best way to tender the gently burning fire of life. Some ways you can improve your capacity on your own:

Reduce stress Perform reproductive and femoral massage

Take anti-oxidants Eat organic, natural fruits and vegetables

Get adequate rest Practice internal deep breathing techniques

Acupuncture Keep yourself in supportive environments

Chinese Herbal therapy

The Fertile Soul Method ® is proven to maximize your reproductive potential. Most of our patients are 40 or over; most have high FSH, low AMH, other hormonal abnormalities, or have been diagnosed with poor ovarian reserve, poor egg quality, endometriosis, or recurrent miscarriages. Most have not found their answers solely within Western reproductive medicine. Most have been able to rectify their internal energetic imbalances through our program, and produce new life.

Dr. Randine Lewis is the founder of The Fertile Soul, the president of the Continuing Excellence in Fertility Professionals, the author of The Infertility Cure, and The Way of the Fertile Soul. Find out more about Dr. Lewis’ work at www.thefertilesoul.com, and about The Fertile Soul’s network of professional fertility acupuncturists at www.thefertilesoulcefp.org.

Copyright 2010 The Fertile Soul

Acupuncture in Pregnancy, Childbirth, Postpartum

Susan Fox, L.Ac., M.S., FABORM, CEFP

Recently I was asked to give a talk on when and why to consider acupuncture during pregnancy, childbirth & postpartum.  I prepared the following summary as a guide.  I hope you find this useful for yourselves, your loved ones and your clients.  You should consider acupuncture during the

First Trimester: (1 – 12 weeks)

With the rapid growth of fetus and hormonal changes occurring, some symptoms that can be treated with acupuncture include:

· Morning Sickness – mother’s Qi is disturbed by growing fetus

· Bleeding – always use complementary medicine in conjunction with Ob/Gyn care for issues such as this

· Urinary tract infections

· Fatigue

· Anxiety

Second Trimester: (13 – 28 weeks)

Baby’s organs are maturing, bones are hardening, respiratory passages are developing. Estrogen/progesterone production cause decrease in smooth muscle tone, including stomach and cardiac sphincter.  Symptoms that may arise that can be treated with acupuncture include:

· Heartburn

· Digestive irregularities – constipation

· Varicose veins and hemorrhoids

· Lower back and sciatica pain

Third Trimester: (29-40 weeks)

Baby is gaining weight at 1 oz (28 g)/day. It’s nerve cells increase, lungs and immune system mature, digestive tract develops, bones lengthen and harden, growth spurts in brain. Mother needs approx 200 extra calories/day and protein need is very high. Mother’s blood volume has increased by approximately 40%.  Symptoms that arise in the third trimester that can be addressed with acupuncture and Chinese medicine include:

· Anemia

· Insomnia

· Muscle cramps (usually legs).  You’ll always want to work with your Ob/Gyn or vascular specialist to rule out Deep Vein Thrombosis

· Edema

· Breech presentation – acupuncture can help turn a breech presentation duirng the period  32 -35 weeks using moxabustion.  The exceptions to this include twins, hypertension, or bleeding

Labor

· Acupuncure induction, with or without electrostimulation, is very effective in inducing labor

Fourth Trimester: Postnatal period

· Depression and emotional problems, frequently caused by hormonal fluctuations, can be addressed with acupuncture.  Depending upon severity of symptoms, you may want to combine acupuncture and prescription medication as recommended by your Pediatrician

· Lactation problems – insufficient milk production and/or mastitis are common issues easily addressed by acupuncture.

· “Mother roasting” – Keeping mother’s abdomen warm with moxa or hot stone therapy helps with the healing process that is crucial to a postpartum mother.  Pregnancy and childbirth are greatly depleting to mother’s Qi, and this tonification process helps mom return to her vital health quickly.

· Caesarean section postnatal care - acupuncture around a caesarean scar can help bring blood flow to the area of injury and hasten the healing process

I am delighted to announce that I and my brilliant business partner, Anne Cabrinha, have passed the Board Certification exam and are now Fellows of the American Board of Oriental Reproductive Medicine (FABORM)!   ABORM certification demonstrates that we have proven competency of the complex nature of treating all areas of reproductive medicine, including infertility, menstrual issues, menopause, male factor, etc.  Patients and medical professionals can be assured that FABORM practitioners can assess medical conditions, interpret them through the perspective of the principles of Traditional Chinese Medicine, and prescribe acupuncture and herbal medicines accordingly.

To quote Anne during our hours of study and to second her opinion, “Preparing for this exam has caused me to fall in love with our medicine all over again!”  In deepening my knowledge of TCM’s approach to infertility, I have come to see the advantages of our body of medicine, insofar as it supports not only the physical, but also the emotional and spiritual journey that our patients are undertaking.

We look forward to helping you achieve optimum health and get your Balance Restored!

AN OUNCE OF PREVENTION…
Susan Fox, L.Ac., M.S.O.M.

Due to the daily deluge of media attention to the outbreak of H1N1 virus, commonly referred to as swine flu, fear and questions as to what we can do to prevent contracting or reduce the symptoms of influenza permeate our conversations.  Seems we’ve been down this road before….I prepared the following article nearly 4 years ago during the bird flu scare, with suggestions for building immunity in the model of Traditional Chinese Medicine and conventional wisdom, as well as things to consider for intervention should we find ourselves with the signs and symptoms of the flu.

First, let’s not forget our common sense approach to prevention.  Wash your hands, avoid touching your nose, mouth, and eyes. Cover your mouth when coughing or sneezing to prevent transmission of viruses.  Also, get plenty of rest.  Get to bed by 11pm and try to get 8 hours of sleep each night.

For prevention, Acupuncture stimulation has been shown to have an effect on bolstering the immune system responses, including increasing IgA levels (an immunoglobulin involved in strengthening immunity) and by activating white blood cells and antibodies. Acupuncture points also have specific actions to reduce fever and chills, relieve nasal congestion and other symptoms associated with a cold and flu presentation.  My favorite prescription is referred to as an “acupuncture tune-up”, as it addresses all of the organ systems associated with immunity.  If you feel in need of a tune-up, make your appointment today.

Herbal remedies have a complementary role in boosting the body’s defense systems. Many herbal formulas used to both prevent and treat a cold and/or flu incorporate Astragalus Membranceus, which has been shown to contain medicinally-active compounds that stimulate the immune system. Named “huang qi” in Chinese medicine, it is described in ancient texts as having the ability to create a barrier as strong as jade against invasion of wind.  Modern medicine now refers to these as airborne viruses.  It is fascinating to note how a body of medicine that was developed through clinical observation thousands of years ago is now demonstrating its theories to be supported by modern scientific investigation.  I have several formula that include huang qi in the office.  Depending upon your specific constitution and presentation, I will determine the best for you.
Mushrooms, specifically reishi (ganoderma), maitake (grifola), shiitake (lentinus), polyporus, and tremella.contains high percentages of polysaccharides, which activate white blood cells and stimulate complements and antibodies.  My favorite formula, called Ten Mushroom formula by EcoNeugenics, is available at the office.

Vitamin D is essential for a prevention program.   Adults need 5,000 IU when midday sun exposure is not possible, infants need 1,000 IU, and older children need 2,000 IU.

Vitamin C at 2-4 grams per day prevents inflammation and maintains the body’s vigilance against infection.

Vitamin A is essential to immune function and mucous membrane integrity.   I recommend taking it in the form of beta-carotene or in consumption of whole foods..  The recommended daily amount (RDA) of vitamin A is 1,000-2,000 IU for children, depending on their age (1,000 at one year of age, 2,000 by age nine).   One egg contains 300 IU, one cup of whole milk or whole milk yogurt contains about 225-250 IU of vitamin A. One tablespoon of butter contains 350 IU of A.

Zinc has potent immune protective effects. Take 25 mg zinc per day, but if you continue zinc for an extended period of time you will also need to take copper to prevent a deficiency (10:1 ratio of copper to zinc). Get a supplement that contains both.

For intervention, Traditional Chinese medicine consider infectious disease as wen bing (warm disease) and treat it with heat-clearing herbs. Many of these herbs are confirmed to have remarkable antibiotic effects, including antibacterial and antiviral.   We have these formula at the ready should you find yourself symptomatic.

In addition, homeopathic remedies containing Influenzinum, a specific preventive for the flu, as well as support if you are exposed to the flu.   I have a supply at the office in drops or spray.   If you have been diagnosed with H1N1, we can supplement your influenzinum remedy with the nosode (i.e., remedy created from some element of the disease itself, such as a discharge or diseased tissue) H5N1, bird flu.  This is the closest element that matches the H1N1 virus that is currently available

If you would like to schedule an appointment for consultation or treatment, you can go online to our website, www.balancerestored.com.  In the left navigation, click on the icon “Make an Appointment”, then click on my name, and you will be connected to my web-based patient calendar.  Please be advised that first-time use requires registration and then reservation.

Let’s keep our minds, bodies and spirits at ease – let’s keep our Balance Restored.  To stay informed on local updates, you can access additional information at www.marinflu.org.  But first, take a breath, and remember: this is a flu.  We’ve experienced the flu each year; with proper precaution, and without panic, we will be fine.