Podcast 16 – Bad Birth Control
Transcription
Dr. Chad: This is Dr. Chad Edwards and you are listening to Podcast 16 of Against the Grain Podcast.
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Marshall: Welcome to Against the Grain Podcast with Dr. Chad Edwards where he challenges the status quo when it comes to medicine. We get into hot topics in the medical field with real stories from real patients to help you on your way to a healthy lifestyle. Get ready because we’re about to go Against the Grain.
Dr. Chad: Welcome back, everyone. This is Dr. Chad Edwards. We are without Bryan Wilks today and I got to say I’m a little bit lonely. However, we do have our special guest back today, and it is the one and only Courtney. Courtney, welcome back. Tulsa Prolotherapy
Courtney: Thank you. Thank you for having me.
Dr. Chad: It’s always a pleasure to have you here. What you bring to the table is just amazing, and your topics are always without question-
Courtney: Fun?
Dr. Chad: – some of the most interesting, and fun, and educational.
Courtney: Beautiful.
Dr. Chad: I tell you what, I am ready to rock and roll on this topic today. Are you?
Courtney: I am so ready. It’s a passion of mine, it’s one of those hot topics for me.
Dr. Chad: Yes, I mean it’s a hot topic for a lot of people. The funny thing is I went to a conference a couple few years ago and it was led by an OB-GYN, functional medicine OB-GYN, and he had this slide in his presentation that said, “This is gynaecology in three bullet points.” And the sad thing is he was right on. Tulsa Prolotherapy
The first bullet point was “If you have menstrual irregularities, female problems really of any kind and you’re less the age of 40, we put you on birth control pills. If you’re over the age of 40, we put you on hormone replacement therapy. If those don’t work, we just cut that stuff out.” Those were his three points. Tulsa Prolotherapy
Courtney: Right. And leave you with nothing, right?
Dr. Chad: Exactly.
Courtney: Isn’t it great?
Dr. Chad: Yes, it’s amazing.
Courtney: It’s amazing, yes.
Dr. Chad: So tell us what we’re talking about today.
Courtney: Bad birth control.
Dr. Chad: That sounds like a movie.
Courtney: Doesn’t it? Dun, dun, dun.
Courtney: No, but getting to why to not use birth control, we’re really getting to a point where a lot of times in medicine, we’re using birth control as symptom management instead of what it was really intended for, actual birth control. And we’re doing a disservice to people. Tulsa Prolotherapy
Dr. Chad: I 100% agree with that. So, what– Tell me how does this whole thing get started.
Courtney: As far as birth control medicine?
Dr. Chad: Yes. I mean and the hormones and the stuff in a little pill.
Courtney: I looked all this up. In 1956, the FDA approved oral contraceptives for menstrual disorders and started using it for regular periods and PMS type symptoms. And prior to that, it had really been used as a method of just simply birth control. And since then, we’ve seen a major movement of throwing everybody on birth control even at a young age, teenagers. I mean I’ve even seen 12, 13-year-olds get put on birth control because they have “heavy periods”. And now, we’re looking at a statistic that 99% of American women have used birth control at some point or another. Tulsa Prolotherapy
And it may not sound bad until you really understand what happens five, 10 years down the line of being on the birth control and really never getting to the root issue of the symptoms beyond just the birth, wanting to not have babies and be able to have sex.
Dr. Chad: So we’re talking about oral contraceptive pills, so this is “the pill”.
Courtney: The pill.
Dr. Chad: So you got a 14, 15, 16, 17-year-old girl wants to be sexually active regardless of what we think about appropriate and inappropriate, whatever. And she doesn’t want to get pregnant, so she’s going to go to her doctor, plan parenthood, something like that. And high chance, they’re going to give her one of these.
Courtney: Absolutely.
Dr. Chad: Is that right?
Courtney: Absolutely.
Dr. Chad: So what’s the problem with that?
Courtney: Well, just a ton of side effects of those. We’re seeing there’s some research out now that we’ll really get into during this podcast about a decrease in fertility, cancer risks. There’s a lot that goes into birth control. And in all reality, there are other good options for birth control and we really could do a whole separate podcast on just that, what’s good birth control for birth control reasons. But really what we’re after is those patients that are getting put on birth control just for their symptoms, not for prevention of pregnancy.
Dr. Chad: Yes. In fact, I had a patient today that she’s in her 40s and she said as we’re going through all of this, she clearly has a hormone-related issue.
She’s been to Cleveland Clinic, she’s been to endocrinologists, neurologists, OB-GYNs, couldn’t get anyone to put her on progesterone, put her on any hormones. And she’s like, “There’s something wrong.” Of course, they do the standard thing. They get the blood work. “Well, you’re not in menopause.” Her FSH and LH were normal. They checked her thyroid and say, “Well, your TSH is normal.” You know that you can reference our previous podcast on TSH and normal labs and why all that stuff matters. When they sent her to Cleveland Clinic, they said, “They’re only going to let you see a neurologist. The OB-GYNs are not going to see you because there’s ‘nothing wrong with your hormones.”
And she ended up seeing a naturopath here locally in Tulsa, or in the vicinity. No, this naturopath was actually in Texas and she never saw him, he just heard her symptoms. I guess she talked to him, emailed something, and he was like, “You know what, I’m going to put you on reverse osmosis water,” I guess just clean water, “And I’m going to go ahead and put you on over-the-counter progesterone cream.” And she did that and within a week, she was dramatically better. Dramatically.
Courtney: We see this all the time going round and round with OB-GYNs and all of providers. I’ve seen pediatricians putting their teenage patients on birth control. And the patients saying, “I’m not sexually active. I just have heavy periods. I’m irritable, I have migraines,” or “I have headaches,” or whatever it is, “around my cycle.”
And instead of really just trying to address, okay, there could be some vitamin deficiencies, there could be hormone-related deficiencies, but, okay, where does all of that come from? Why are we having these deficiencies? I mean they just pick off the list, they have three or four that they kind of tend to lean to, and just put them on that. And a lot of times, it may help their periods to be somewhat better, but I have a lot of patients that come in and they’re no better or they’re worse. Or, “Okay, my periods are better, but now I’m 25, I’m 30, I’m married, and I have zero sex drive.” And so I’ve seen huge spectrums of it’s a problem.
Dr. Chad: No, question. And that patient that I mentioned just a second ago, as I got to talking with her, she said, “You know, I’ve never had normal periods.” In fact, her words, “I was on birth control when I first started having periods because I felt horrible and had these heavy periods and all that stuff.” And now she’s in her 40s, no longer on birth control pills, her issues have never been addressed, ever.
Courtney: You’re starting from scratch.
Dr. Chad: But, yes, they were “controlled”. It’s kind of like with anti-depressants when a lot of anti-depressants don’t fix the problem, they just make you not feel so bad about feeling bad.
Courtney: It’s band-aid.
Dr. Chad: Yes. Covering it up.
Courtney: Yes, exactly.
Dr. Chad: In the military, we did the tactical combat casualty care. And prior to that, I’ve been in the military for a long time.
And before that, tourniquets were the last thing. And with TCCC and what we did in Iraq and Afghanistan and things like that, when our guys get injured and they’ve got what we call compressible wounds, compressible blood loss, we’d put a tourniquet on it. So it was this dramatic shift. And so when we started making this shift to tourniquets, we said that the old methods, the Vietnam era of methods of you just put these big bandages on there and put pressure on them, all they did was keep blood from hitting the floor. They don’t stop the bleeding; it just keeps it from hitting the floor so we all feel better about that.
So in effect, that’s kind of what we’re doing with these whole use birth control pills to cover this stuff up. So what’s in a birth control pill?
Courtney: Some of them actually have some level of progesterone in them, but most of them are synthetic progestin and synthetic or equine estrogens. And if you look at the literature on this, major increased risk for cancer or blood clots, heart disease, all of these things down the line when you look at this. And what I’m interested in is, okay, really here, are these people that are younger coming through for these symptoms is, ust they have low progesterone, why is that? And really, handling it from that perspective, versus just slapping on a birth control pill.
Dr. Chad: So when you say equine estrogens, that maybe lost on some people. Tell us about that.
Courtney: Horse urine.
[laughter]
Dr. Chad: We got to love that. So the standard, for those of you that don’t know the first commercially available estrogen was called Premarin which stands for “Pregnant Marriage Urine,” Pre-ma-rin. So it was horse urine where we derived those hormones, and the thing is a lot of those estrogens are not bioidentical to human estrogen, correct?
Courtney: Exactly. The molecular structure is different. And that’s when you really get into problems of your body doesn’t know what to do with that, and so you end up converting to estrone, which is the cancer-causing estrogen.
We see that rise at a patient the other day, was on her 60s. She was still on birth control, she was menopausal, and Premarin together, got a saliva test, her estrone levels were through the roof. And no one was interested in taking her off. She just came for a second opinion. And she had no idea what she was really doing to herself, what the risk was. She was just simply trying not to have hot flashes. Unbelievable.
Dr. Chad: Yes. And I don’t know. We may be going over this, but I hope I’m not jumping the gun. If I do, just put your hand up and say, “Stop. Stop right there.” I haven’t looked through all of our timeline here. Do you talk about oral estrogen versus topical estrogen in here?
Courtney: I’m not addressing that one today. I think that that’s a huge, huge topic, though. Huge topic.
Dr. Chad: It is a huge topic. And I’ll just touch on it and we’ll probably have a podcast on this. There are studies on oral estrogen versus topical estrogen. And I say growing up, when I was in my residency and things like that, that’s what I mean by growing up, I was told that a woman over the age of 35 that smokes should never be on –
Courtney: Oral estrogen.
Dr. Chad: Exactly. Because your risk of blood clots goes up and the estro trial, I think it was published in circulation, but I don’t remember. And we’ll reference that in the future. We’ll talk specifically about estrogen, oral estrogen, and blood clots. But topical estrogens don’t do that. They don’t increase your risk of blood clots, which I think is very interesting. So I just wanted to touch on that. It’s a little teaser for the future on something to talk about.
So, these birth control pills, they can have some nasty effects, right?
Courtney: That’s absolutely right. If you look through– Going through increased risk of spasm of coronary arteries, there are some literature on breast cell replication and growth due to stimulation of estrogen receptors by the progestins in the birth control. And you name it. I’ve seen drop in DHEA, which is your precursor to estrogen and testosterone. Being on oral birth control synthetic hormones, it actually gives a rise of your sex hormone-binding globulin.
Dr. Chad: Right. I see that all the time.
Courtney: So, that rises, and it does exactly what it sounds like. That hormone will bind up your testosterone and give you no free testosterone. And all the time, we see these women that are low sex drive and all these issues that we touched on even in Podcast 15, and it’s all due to just the fact they’re taking these synthetic hormones orally. And there’s some literature out there on a 50% decrease in fertility for those women who have been on oral birth control pills for greater than 10 years. And that is staggering to me.
And what is so scary is that we’re putting these young women on birth control for their symptom management of low progesterone which we need to touch on those symptoms so the patients recognize that, and the difference with what we need to do here. But, we’re putting these young women on the synthetic hormone and not giving them any information about that. And they’re young, they’re not recognizing. And their parents are just like, “I don’t want them to have bad cramps and all of this stuff.” So, we’re just masking all of those symptoms. And no one’s telling these people that, “Essentially, this teenager is going to most likely have a difficult time getting pregnant if we start this now.” No one’s talking about it.
Dr. Chad: So what you’re saying is that the birth controls work so well that they continue –
Courtney: It’s permanent.
Dr. Chad: – to work after you start taking them?
Courtney: Exactly.
[laughs]
Courtney: It’s so scary. It’s so scary.
Dr. Chad: Yes, that is scary. The idea is that you want to have birth control, good effective birth control when you need it, and then when you don’t need it anymore you want to stop it and be able to conceive. And then if you wanted to go back on it again, then you could. So what you’re saying is that those things continue to work even after you stop and you may have trouble getting pregnant?
Courtney: Exactly.
Dr. Chad: Half the time?
Courtney: Half the time. Which is big, it’s huge. If you look at fertility clinics, it’s an industry. And we could do a whole dough on that as well, but it’s an industry and it’s a big issue. A lot of people have a hard time getting pregnant and it never feels that when they come into my office and we talk about those issues, there almost always have been people that started birth control at young age.
Dr. Chad: It’s amazing.
Courtney: It is.
Dr. Chad: It’s amazing. So, you touched on side effects associated with these progestins, which is a fake progesterone, is structurally different than progesterone that’s normally in our body. So tell me about some of those side effects.
Courtney: The number one thing that we all probably see is weight gain. I think that’s probably a pretty common thing to come to the office of people associating timeline of significant weight gain with the start of a contraceptive.
Dr. Chad: But that’s not really that big a deal, is it? These young girls that start having problems with their parents –
Courtney: They’re playing devil’s advocate?
Dr. Chad: – they never really care if they’re gaining weight, right?
Courtney: Right, right. No one cares about that.
Dr. Chad: That’s not a big deal.
Courtney: Increased appetite, water retention, irritability, there’s been a lot that’s showing that there’s increased depression on these, headaches, low energy, and I think it comes back to the fact that we’re lowering our free testosterone levels by being on birth control. Bloating, breast tenderness, decreased sex drive with the right terestrone, acne, hair loss, nausea, difficulty sleeping, and it actually interferes with the body’s own production of progesterone. So, you’re not only covering up what you think are your symptoms, but you’re also now creating a further problem with hormone issues, with your own natural production.
Dr. Chad: Yes. So one of the things that I see, we obviously get a lot of lab testing and we’ll do the blood work, and we’re checking our hormone levels. And I had a patient the other day, 21 years old, and got her labs. Now, she should be in the prime of her fertility and all of those kinds of things. And when I looked at her labs, it’s very obvious who’s on birth control pills, right?
Courtney: Absolutely.
Dr. Chad: When you look at those labs. Her FSH and LH were completely suppressed which is actually how they work. You’re giving these estrogens, these synthetic estrogens which will suppress FSH and LH.
And for those of you that don’t know, FSH is follicle-stimulating hormone and LH is luteinizing hormone. And both of those function in the ovary for the maturation of this egg and causing that follicle to grow and to actually produce the egg so that it can be fertilized. And so when you suppress those, because we have this process called negative feedback, so when we give these high levels of estrogens, higher levels of estrogens, we’re suppressing FSH and LH so that those follicles never develop, right?
Courtney: Right.
Dr. Chad: And that’s basically how they work. We’re just giving this high dosage of stuff to kind of shut that stuff down. So also, she’s not making estradiol. So her estradiol, which is the prominent –
Courtney: Right. And that’s where some of those symptoms come from.
Dr. Chad: Right. Exactly, so hers were non-detectable. Her FSH and LH were non-detectable; her sex hormone-binding globulin was very high. And the other thing, you mentioned that sex hormone-binding globulin carries these hormones, all of these hormones are steroid hormones, they’re actually derived from cholesterol, so it’s one of the benefits of cholesterol. And cholesterol and water, it’s like oil and water, they don’t mix, so it has to catch a ride, so that sex hormone-binding globulin carries it around. So when you have more of that stuff, your total levels can look normal, right? But, you don’t have enough free because the free stuff is what can actually get into the cell.
Courtney: And that’s where you’re catching that in the saliva test, that free hormone level. That’s why I almost always start with a saliva test with women. You can really just tell more about what’s going on.
Dr. Chad: No question, no question. Much more consistent with their symptoms. So I don’t dismiss the serum testing, but boy, I sure don’t hang my hat on it.
Courtney: Definitely not. Let’s talk about symptoms of low progesterone.
Dr. Chad: Let’s do it.
Courtney: All right. Low progesterone, you’ve got estrogen hormones, there’s three of them, progesterone, and testosterone. But, symptoms of low progesterone is usually what women are getting started on birth control for other than actual pregnancy reasons. Anxiety, depression, irritability, mood swings, difficulty sleeping, pain or inflammation, excessive periods heavy or lengthy, migraine headaches right before the cycle, and sometimes weight gain if there’s an estrogen dominance. Meaning just that there’s more estrogen in the system than the progesterone. There’s not an equal ratio there.
Dr. Chad: Right, right. So basically, a lot of what you’re describing is premenstrual syndrome.
Courtney: Exactly, exactly.
Dr. Chad: What you’re saying is that this is actually a progesterone deficiency?
Courtney: Right. In the history of mankind, we’ve never had a deficiency of oral contraceptives.
Dr. Chad: [laughs]
Courtney: It’s amazing.
Dr. Chad: That’s why I love you, Courtney.
Courtney: [laughs]
Dr. Chad: Because there is yet a medical problem of really any kind that’s a deficiency of medication.
Courtney: So true.
Dr. Chad: Sometimes they have benefits and those kinds of things.
Courtney: Absolutely, but really not in this case.
Dr. Chad: If it’s okay, I would like to tell a quick little brief story-
Marshall: It’s story time.
Dr. Chad: – before we pay the bills. And then we’re going to go on with the next bullet, is that cool with you?
Courtney: Sounds good. Absolutely.
Dr. Chad: So I had this patient. And one of the things that you do different and that we do different in Revolution is we spend a little bit of time trying to talk to our patients. Sir William Osler, one of my favorite physicians of all time in the early 1900s said, “Listen to your patient because they’re telling you the diagnosis.” So if we actually take time to listen, then we’ll get much more information. If I remember the statistic correctly, the average physician spends five minutes listening to a patient, or less than five minutes listening to a patient.
Courtney: I would say it’s less than, absolutely. Especially in today’s times.
Dr. Chad: Right. So, I had a patient come in, she was in her early 30s, felt horrible, non-specific symptoms. So there wasn’t any one specific thing, there was just non-specific, felt awful. Had been to OB-GYN, had been to a general surgeon, had been to endocrinologists, all kinds of different physicians and no one could figure out what the problem was. So we sat and talked.And I may have told this story in the past because it was pretty profound but I don’t remember. So we sat and talked for a little bit, and I said, “Well, when did you start feeling bad?” And she said, “November of 2012.”
Courtney: She knew.
Dr. Chad: Exactly.
Courtney: What happened in November of 2012?
Dr. Chad: Nothing happened in November. And in fact, I was asking her about that, and she couldn’t relate it to anything. She went through a divorce a year before that, couldn’t really tie it to that. So then, we couldn’t tie it to anything. So I said, “Well, tell me about your periods.” And she said, “Oh, I don’t have any of those periods.” And I was, “Why?” And then she pointed to the inner part of her upper arm, and she said, “Well, I got this thing. And I said, “When did you get that?” She said, “October 2012.”
Courtney: There you go.
Dr. Chad: I was like, “I think we’re done.” She had been to multiple different physicians and it doesn’t take a physician to figure out if you do something, you make an intervention. You do something and a month later, they start having problems, maybe those two are associated.
Courtney: Right. You’re not going to see that immediately and that’s why no one was connecting that, unfortunately. But with any hormone, you’re going to not really see benefit for two to eight weeks. So there you go.
Dr. Chad: Exactly, it takes a while.
Courtney: That’s a perfect timeline.
Dr. Chad: Yes. So I said, “Well, do you want to remove that now or do you want to remove it later?” And she said, “Are you kidding? Let’s get it out.” So we took her to the other room, cut it out right then. And she came back a month later, just in tears, and was almost mad at the medical community because no one had-
Courtney: No one had suggested that-
Dr. Chad: -figured this out. And she was like 98% improved just by removing that thing-
Courtney: That’s crazy.
Dr. Chad: -which contains progestins. And that was the source of her whole problem. No, not everyone that has those things get those kinds of symptoms, but that’s a classic example of one that definitely has that problem.
Courtney: I think it’s higher than we really know because if you look at the knowledge base of the community, the medical community, and what they’re doing about it, no one’s really tracking what the side effects really are, so I think that they’re absolutely skewed. A lot of patients don’t know to really associate that or their practitioners aren’t really listening to them that they think that could be it. And so I think the literature on the side effects and the percent of side effects is much lower than we really give credit for.
Dr. Chad: There’s absolutely no question. And so often, patients will come in with these vague complaints of, “I just feel bad.” Well, what’s that from? It’s almost like we just blow it off and dismiss it.
Courtney: Right. Put them on something else.
Dr. Chad: And those things-
Courtney: Put them on anti-depressant.
Dr. Chad: I like to think of your body as a nice car. And that thing should be running-
Courtney: Revved up, is that what you’re saying, it should be revved up? [laughs]
Dr. Chad: You should be capable of revving up.
[laughter]
Dr. Chad: And so many people aren’t. They’re just putting along and they won’t have seven cylinders that are firing and one of them is knocking. But the car is running, so we’re like, “Well, you don’t have a disease. You’re fine, your labs are normal.”
Courtney: Right. “You haven’t had a heart attack yet or no cancer. You’re pretty healthy.”
Dr. Chad: Exactly. And it’s crazy.
Courtney: It is crazy.
Dr. Chad: All right. So let’s take a little timeout for one second and we’ll be right back here.
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And, Courtney, we’re back. Let’s continue delving into all these issues with the problems that can come along with oral contraceptives and birth control pills.
Courtney: What I really want to get out and really make almost a public service announcement with this is that we need a strong movement of women and providers who are going to use natural hormones, natural progesterone for some relief, or get to the root issue of a regular heavy menses premenstrual syndrome symptoms.
Dr. Chad: I 100% agree with. The funny thing is is I was taught that the only reason you need progesterone is to counteract the effects of estrogen in so far as the uterus goes.
Courtney: Right. And I’ve heard that. That seems to be with the consensus of what’s being taught out there.
Dr. Chad: Right. And I was actually taught that after a hysterectomy, whether you have your ovaries or not, there’s absolutely no need for progesterone. I was taught that.
Courtney: And I’ve heard patients reiterate that to me. And so you really just have to go back through and reeducate. And with these younger women, Chad, let’s talk about root causes of low progesterone. What can we do beyond just giving them progesterone, not that that’s wrong? Because, as long as it’s bioidentical, we can do it.
Dr. Chad: Sure.
Courtney: But there’s a lot. If you just sit, and listen, and connect to patients about their lifestyle, their stress, their dietary habits, they almost give you the foundational answers of what’s going on and what’s wrong here.
Dr. Chad: That’s right. So what you’re telling me, though, is that there’s an answer beyond another pill?
Courtney: 100% what I’m telling you.
Dr. Chad: That’s awesome.
Courtney: There is a lot. It may seem common sense, but never underestimate the level of stress on someone, how that affects hormones because it actually does. If you look at the adrenaline function in different processes in the body, a lot of things are affected by our stress levels. Antidepressants, I see young teenagers and kids all the time on anti-depressants. And I understand 100% when we really got somebody who’s really struggling, but once again, I think we can go to the root cause of those issues. Sugar, major problem, estrogen dominance, we see that all the time.
Dr. Chad: But it tastes so good.
Courtney: It’s so addicting, isn’t it?
Dr. Chad: Like a drug.
Courtney: [laughs] Saturated fats, and I would even add in the hormones in our foods.
Dr. Chad: Yes, hormones in our foods, just like with antibiotics and things like that, major, major, major problems.
Courtney: Absolutely. And here’s a big one: deficiency of vitamins and minerals. There’s four key ones that absolutely are linked to low progesterone: vitamin A, and I’ve actually been using vitamin A at high doses for five to seven days for young women with heavy periods, and that’s really their only symptoms, is the heavy bleeding. And we’re reversing their heaviness, we’re really making marked improvement of that. B6, vitamin C, and zinc, all of those have been shown to cause low progesterone. We can test for those 100%. There’s little harm in trying some doses of this and see if that takes care of their symptoms. And it really makes it a lot easier to manage those patients with their PMS symptoms and their heavy cycles.
Dr. Chad: Going back to you, that underlying cause and your problem isn’t because of a pill deficiency, all of those nutrients or components can be very, very important. We do a lot of testing on that stuff and we see a lot of deficiencies, and you find that deficiency. Saw one actually today. You’d think I saw a thousand patients today based on the way I’m talking.
Courtney: [laughs]
Dr. Chad: But there were just some pretty profound cases that I saw today, and one of them, we did our nutritional analysis, the full spectrum nutritional analysis six months ago, and she had multiple deficiencies. Came back feeling quite a bit better and repeated her nutritional test and she had zero deficiency. She had a couple of borderlines, but absolutely no deficiency. So those are the things that we can absolutely address.
Courtney: Absolutely. And the last one I would say is decreased thyroid hormone which is a touchy subject. I think you did Podcast Number nine on that one, but it absolutely can affect progesterone levels.
Dr. Chad: So thyroid can impact that kind of stuff?
Courtney: It can impact so, so much.
Dr. Chad: You know thyroid’s a passion of mine?
Courtney: I know. You’re the thyroid –
Dr. Chad: It’s a big deal.
Courtney: Yes, it is. It is, totally.
Dr. Chad: Okay. Give me an example of a patient that has had an issue, maybe it’s like hipper complaints story time or something like that.
It’s Story Time-
Courtney: Yes. I won’t give any names or any details here but, I actually had a real good case a 28-year old female who came in for fatigue. She actually had a history of thyroid disorder. She already knew that, abnormal menses, heavy periods, irritability. She complained of acne, excess hair on her upper lip and I think a little bit on her abdomen, bloating, headaches round her cycle. She tried oral contraceptives at the recommendation of her physician. She did not tolerate due to side effects. She just felt crummy. Five to six years prior to her coming in, she had stopped the birth control and she’d been on it for only two years.
She had a weight gain and she really had a hard time losing the weight back, even though she’d been off the birth control for five or six years. She’d been trying to get pregnant for nine months. Here we go in fertility issues here. Periods, fairly regular. They’d last seven-eight says. The first four days were super heavy. Sleep, she had difficulty falling asleep. She could get about seven hours on average, got lots of issues there. She had had some diarrhea what she thought was gluten intolerance, just really a mess from that standpoint, from gut-health standpoint.
We tested her. We did some blood work; we did some saliva testing on her adrenals, sort of hormone precursors, DHEA and such. We found that her progesterone was low, her cortisol was low one three out of four points. DHEA was low normal; there we go probably from the birth control and just high stress gut health, a lot of things that could be affecting the adrenal glands and also will contribute to a low DHEA. So, we really just steers at her own progesterone, we supported her adrenals, we did some supplements and dietary changes helped her gut health. Rammed up her thyroid management and really went based off her symptoms, not just chasing the labs.
Dr. Chad: Right.
Courtney: And in six weeks Chad. She came back in six weeks for her just her follow-up appointment and she had seen some improvement already at six weeks. Came back at four months, periods totally tolerable, much less cramping, bloating, acne had completely resolved and we steers up her progesterone. She had been dealing with the hormone issues for how many years and in six months, we basically healed her.
Dr. Chad: That’s amazing.
Courtney: That’s all the time. That’s all the time.
Dr. Chad: Yes. Yes. It’s so common and just across the border with everything that we look at. Everything that we do, it’s like you said, the solution is almost never a pill. Now we can manage things. We can manage a disease with a pill. We can manage it fairly well as long as controlling your numbers and parameters and things like that. But, how many people are we making better? It’s frustrating. So what can someone do if they want birth control or they are on birth control pills and we want to get off of them? We want some kind of contraception that’s going to be effective and it’s not going to cause all these problems. So what do we need to do? What can I do?
Courtney: That’s such an individualized plan Chad. I really encourage them to come into the office, give us a call and let’s sit down and really go through that. There’s a number of different natural birth control options ranging from counting our days to diaphragm use to using-
Dr. Chad: Abstinence.
Courtney: [laughs] Right. That’s not always a good option.
[laughter]
Courtney: Using the ParaGard IUD which is synthetic hormone free. That’s all we can do in that regard. Never just yank someone totally off of their birth control unless it’s like plain obvious. We’ve just got to stop this dead in its track. A lot of times I’ll add a little bit of biogenetical progesterone and to start help imagining the symptoms and give them a little bit of balloon effect on that and then take them off the birth control one to two months later. So it’s a little bit more of a smooth transition for the patient.
And, it really just get back to what can be foundationally wrong with the patient’s health, as there’s some things that we can do fixing diet, that’s almost everybody. How can we help stress levels better? How can we look at vitamin deficiencies that could be happening? Address those things and just really use the root cause and I see all the time. I should say all the time. There’s a couple of providers in the area and I’m sure this happens across the country that will just say, well I’ll just focus on the guy’s health, that’s the route and in often times it’s a huge route. But if you just do that you’re going to take a long time to really get after this and really heal it. So taking a comprehensive approach, go ahead and fill the bucket up with the hormones that they are deficient in. While you plug the holes of why they’re leaking the hormone out when they don’t have it?
Dr. Chad: Exactly.
Courtney: And its one-two punch.
Dr. Chad: I like the way you said that, because I like to do everything from a controlled perspective and from a functional medicinal perspective we want to fix the underlying causes but sometimes that takes time. One of the things I love about what you do is you get control of that stuff right up front and get them feeling better as quickly as possible and then working on their underlying problem and trying to either lower their dose or get them off of that. For you guys listening, this is one of the reasons that she is so good at what she does. Because, she takes the time to listen to her patients and individualizes the therapy because there is no one-size-fits-all and it’s truly an art based on science. And you do such a great job and you have got so many patients so dedicated to you and the way you practice it and this is why, because you make a huge difference.
Courtney: Thank you. Thank you so much.
Dr. Chad: Of course. It’s them saying it. If you have hormone issues and you are in Tulsa or Oklahoma area, then you need to see Courtney. There’s no one better around. So, any final words?
Courtney: Fight for yourself if you’re a woman out there. Fight for yourself, study up, do the right thing for your body. Most of you guys know what’s going on with yourselves. You can timeline that. You have an idea. You just need a provider to come beside you and guide you through that. Buy for yourself and your provider are they listening, look at the literature.
Dr. Chad: There’s a lot of it out there. Buy good stuff out there.
Courtney: Do the right thing for patients. You’ll change your practice.
Dr. Chad: Amen. Well thanks for listening to this week’s podcast with Dr. Chad Edwards and with Courtney. Tune in next week. We’re continuing to go Against the Grain.
[background music]
Marshall: Thanks for listening to this week’s Podcast with Dr. Chad Edwards. Tune in next week we will be going Against the Grain.
[00:37:13] [END OF AUDIO]
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