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~Seek first to understand, then be understood~
If you're looking for information on a particular topic, type that word in the search box below. If I have written about that subject, a list of posts will appear. If no posts come up, I haven't written about it...yet. Emails, and questions in the comments section for possible posts, are welcome.
I have a "friend" who shows up once a month. She turns my world upside down, over and over again.
I am a good person, caring and sweet, but when she comes to visit, I could rip off your head.
She takes no prisoners, foul words she does spout, I try to keep the words in, she lets them come out.
People don't understand me, or what this is about, to have this creature inside my head.
I despise who I am, half of the time, I feel sorry for my daughter, family and friends.
There's no way to describe it, for those who don't know, it's a living nightmare, she really needs to go.
~Neysia Manor, Rest in Peace

Wednesday, September 29, 2010

PMDD and Nutrition

Okay, after all those posts telling you what you need to avoid, I promised to take a break and tell you some of the good and positive things you can do to lessen and help manage your PMDD. Because there is no cure for PMDD. Get that straight in your head right now--no matter what anybody on the internet or on television promises you. There is no cure. Period. You can make it go away for a while by either masking it with a various assortment of drugs, or by making positive lifestyle changes and treating yourself the way you deserve to be treated.

But if you don’t keep up indefinitely whichever path you choose, day in and day out, the PMDD will be back—and most times with a vengeance.

One of the best natural things you can do to manage your PMDD (in addition to reducing the stress in your life, exercising regularly, and getting enough rest) is to pay very close attention to what you eat. Nutrition, nutrition, nutrition. Any body responds well to good nutrition, but a woman with PMDD in particular needs to pay attention to her nutritional needs if she wants to keep her hormones functioning at optimal levels and in balance.

Recently I attempted a ten-day detoxification fast, with the goal of ridding my body of accumulated toxins, re-setting my metabolism, and re-establishing my hormonal balance. I went eight days without solid food, and would have gone longer, if I didn’t have a four-hour community service commitment I had to go to. I wasn’t sure what would be involved, or if we would be eating, and I decided I’d rather go off the fast than have to explain what I was doing and why I wasn’t eating. People can be so touchy about that, if they offer you food and you don’t eat it.

I needed a day to switch gears before going on this outing with my church, so I stopped the fast at the end of day eight.

While I was on the fast, I felt great hormonally. Never better. No mood swings, lots of energy, an amazing clarity of mind, and all sorts of warm, fuzzy feelings of well-being.

I went off the fast, and the very next day, my PMDD returned. My first thought was it was because of something I was eating. My best guess is that something is meat and dairy products. Why? Because unless you go specifically hunting for sources of meat and dairy products that are antibiotic and hormone-free…which I do most of the time but didn’t take the time to last week…you’re going to get some of those substances in the meat and dairy products you consume (including cheese, cream, butter, yogurt and milk), and it’s going to affect your own delicate hormonal balance.

And boy, did it, in my case. Why? Because those first couple of days off the fast, I treated myself to a big bowl of cottage cheese and tomatoes, using the last home-grown tomatoes of the season. I’ve always considered real cottage cheese (the full fat kind, not that low fat stuff) more tasty than ice cream…so it’s my special treat, and when the home grown tomatoes are in season…I can’t resist.

But after two days of feeling like my old PMDD self, I started resisting. And when I started resisting, I started feeling better. Then, two days ago, I went on a road trip, where for the most part, only fast food and vending machine food was available. The next morning, I couldn’t seem to wake up, couldn’t get my day started at all. I was in a total fog and couldn’t shake it to save myself.

The culprits? Coffee, cheese and crackers, and (even though the fast food place said it was home made) a very tasty Sloppy Joe.

So in an attempt to revive the energy and clarity of my food fast, I went back to the basics—oatmeal, fresh fruits and vegetables, seeds, nuts and other whole foods. I ended the day by making a very tasty and filling vegetable soup, with no interest at all in my usual accompanying cheese and crackers.

Today I feel 100% better. We’ll see what happens in the days to come as I continue to eat no meat that isn’t hormone-free, no cheese, and drink no milk.

I’m not saying this will work for you, but it’s definitely something I am willing to try, after having felt so good and energetic those eight days I didn’t eat or drink any of the above. The only things I actually missed in those eight days were fruit, salad, and nuts.

How interesting, that given the chance to strip things down to the bare bones, by eating no solid food for over a week, that the things my body craved were all good and healthy foods. Proof positive that if you just listen to your body--not your emotions, as in emotional eating--it will steer you to the right kinds of fuel. The only reason I went after the cottage cheese, was because I knew my days for eating the last fresh tomatoes of the season were limited.

I also found it interesting that while fasting I didn’t give chocolate a second thought. Wanting some never entered my mind. I also had absolutely no desire to eat anything made with refined sugar or flour—and still don’t. It totally amazes me. The fast was drastic, yes, but in a sense it did reset my hunger mechanisms. And I did ease into it by eating mostly salads for a few days before I began.

Although yesterday (with my PMDD going on) I did crave chocolate, but since the fast I find I don’t care for the taste of solid chocolate, and so instead of eating my regular brand of chocolate, I switched to drinking more of the healthy Mocha Cappuccino drink I have recommended before, from Bolthouse Farms.

It’s doing the trick, so as long as that works, I am a happy camper.

But, like I said, this is only what is working for me, and I am, as always, a work in progress. According to Ann Louise Gittleman, who wrote Super Nutrition for Women: A Food-Wise Guide for Health, Beauty, Energy and Immunity, particularly good nutritional choices for women who have PMDD include:

Blackstrap molasses
Sea vegetables (check out your local health foods store)
Sesame Seeds
Sunflower seeds
Whole brown rice

What about Vitamins and Supplements?

Supplements can help, but should never replace food. The body works best with healthy food. By healthy I mean whole, natural, nutrient-rich foods. Not processed foods of any kind (like my beloved cheese). Vitamin and mineral supplementation can quickly send you into imbalance if you use them to try to make up for eating a nutrient-poor diet—meaning lots of processed food and fast food on the run--especially if you take more of any vitamin or mineral than you need.

More does not equal better in most, if not all cases of vitamin supplementation.

Beyond a daily pharmaceutical grade multi-vitamin (not just something off the shelf at your local discount store—sorry!), or daily pharmaceutical grade multi-vitamin pack, and some added calcium and magnesium, maybe some extra vitamin C during cold season, you need to get most, if not all of your PMDD nutritional needs from the foods you eat. The benefit of a daily multi-vitamin is to offset the daily depletion of nutrients from our bodies due to environmental pollutants such as smoke, carbon dioxide, pesticides, chemical-based cleaners, perfumes, deodorizers, air fresheners and the like, and medications of any kind, over the counter or prescription, including birth control pills (which cause deficiencies of folic acid and vitamins B 6 and B 12—both integral to mood stability).

In short, with all the toxins we are exposed to daily, a good multi-vitamin just keeps you from ending your day in the negative column. It gives you a good baseline to start from, but you still need to eat right to feel strong and healthy.

Our bodies know best. We need to learn to listen to them carefully and treat them well, so that they can do the same in return. Only when we choose to take charge of our health--when we decide to take control of our diets and make good and healthy food choices--will we have any hope of getting off the PMDD Not-So-Merry-go-round, and finally managing our unruly hormones.

Short version: Eat whole, natural foods as close to the source as possible; go organic whenever you can afford it; avoid all processed foods and as many medications as you can, both over the counter and prescription; take a daily pharmaceutical grade multi-vitamin or vitamin pack; make sure you get some added calcium and magnesium; minimize the environmental toxins in your home and work space; exercise regularly; get plenty of rest; and de-stress your life as much as possible.

A more detailed breakdown of each of these items will appear in blog posts to come.

Wednesday, September 15, 2010

Finding a Doctor to Help You With Your PMDD

Update:  March 2018...I have been getting a lot of requests for names of naturopathic doctors lately...I refer everyone to the American Association of Naturopathic Physicians.  A good nurse practitioner in your area can also be of great help.  I realize these links are for Americans, but perhaps you can find a similar organization in your country.  I wish you all the best and let me know how you make out!  In the meantime, here is my original post, written just over two years ago:

Someone had asked if I’d ever looked into saliva hormone testing, and the answer is yes. Once, last summer and fall. This post will be long, but I hope it will be of some help and consolation to those who are meeting dead end after dead end in your own search for relief from your PMDD.

Imagine my joy last summer when I opened my local paper to find a special supplement for women, and discovered, after all my years of searching, that my town had a genuine hormone specialist.

Or at least that’s what the ad said. My experience, unfortunately, didn’t bear that claim out.

My first visit to this woman was a resounding disappointment. I’d waited until I was in the throes of an episode to call for an appointment, so that she could see for herself what I was dealing with, but was told I’d have to wait several weeks for an appointment.

Once I finally got there, symptom-free, the upshot was she wasn’t at all familiar with PMDD, had no idea what I was talking about, and when I tried to describe it to her, how I am perfectly fine and happy most days of the month, but then there is that one week that everything goes awry emotionally, in conjunction with my menstrual cycles, she just looked at me and asked, “Have you talked with a psychiatrist about this?”

Yes, I said, I have, but it’s not a psychological problem, it’s a hormonal imbalance in the brain (ergo why I am here) due to a dip in serotonin (aka a mood-elevating hormone) on those days, that causes the D part of PMDD, or depression.

“Depression!” she says, her eyes practically lighting up. “Then what you need are anti-depressants.” No, I repeat, because it doesn’t happen but a few days a month. The rest of the month I am fine. Healthy, happy, whole, and sane.

I explain the situation to her again. She decides I must be in denial, puts Depression down as my diagnosis (which I discover after I go online to find out what the diagnostic codes she has written on my receipt and lab test requests mean) and hands me a home saliva hormone testing kit.

Send this in and call me to schedule an appointment to discuss the results, she says, practically shoving me out the door. Oh, and that will be $100. Next!

The thing is, I have to wait until I have another episode of PMDD to take the test, because I want to do the test while the PMDD is happening, and an episode has just passed, so it takes another month for me to even do the test.

In the interim, since it is clear that the true focus of this woman's practice is elsewhere, as in botox injections and chemical peels (both of which are truly hazardous to your hormones), and the hormone testing is apparently just some sort of sideline, I call all around town to find someone else to help me sort out my unruly hormones.

No deal. Only she and one other doctor in town are doing this kind of hormonal testing and the other one was a man and couldn't see me for at least three months.

So I do the test. I knew it was a mistake the minute I dropped the samples off at the UPS shipping post. The instructions had been so specific about keeping the saliva samples in the freezer and mailing them off THE NEXT MORNING. You could go with UPS or the postal service, but I knew the US mail didn’t go out before three around here anyway, so I opted for UPS.

I walk in with my little test kit, and the woman says, “Fine, just leave it on the counter.”

“When do they pick up?” I ask. “Oh, sometime this afternoon.”

In the meanwhile, my little kit sits out in the open on the counter of a store that has its front doors wide open to the fall sunshine. How could the samples not be corrupted?

I ask this of the doctor when I see her three weeks later, and she looks at me like I’ve grown two heads. “I don’t know,” she says. “It’s not a problem.”

Well, I see it as a problem, because my test results turned out to be totally unexpected and off the charts in some areas, and she can’t explain why. She just kept looking at the results, and circling them, and saying nothing more than, “Well, that’s what it is. As you can see, its…high.”
She drew in some upward arrows for effect.

It turns out, that according to the test results, instead of a deficiency in my hormones, I have an excess in some areas. This causes a problem for the doctor, because apparently the standard procedure is, she tells me I am low in this, this, and that, and then tells me I am in luck, as she has just the supplements I need on hand.

Be very wary of any kind of testing that comes complete with (their own) name brand products as the solution to your problems.

Fortunately, however, she was out of the one thing I was deficient in, Vitamin D. I told her that was okay, I’d manage to get some on my own (from a company I know and trust).

In the meantime, I ask the doctor, “How do you get rid of excess hormones?” She looks at me. “I don’t know.”

Well, I know the answer exists, because I read it somewhere, but I don’t remember where, because it was just something I'd read and had no idea I’d be needing.

“I’ll call the lab and see what’s going on with these results,” she says. “Why don’t you make an appointment for next week to come back and find out what they said?”

This time I looked at her. “Why don’t you just call me and tell me what they said?”

She agrees to do so. So I ask her what could possibly cause my hormone levels to be so high. I know the answer. I want to see if she does. After all, I’m the one paying her to tell me what the problem is. She fumbles badly until I give her a clue, then she takes off with it, all the while, asking, “You know what I mean?”

Yes, Doctor. I know what you mean. I also know that you’re winging it here and it shows.

In the end, she decides I need more testing, and bounds out of the room to figure out what test I need.

"Why do I need to take a different test?" I ask. "Because this one is better than the other one," she says, which leads me to wonder why she didn't give me the better test $500 ago.

No matter. No way am I doing this saliva test thing again, which several doctors in my research books have found to be unreliable. They recommend blood serum tests instead.

I ask her if there aren’t any blood serum tests I can take to get a better picture of what’s going on. “Why?” she asks. “It won’t do any good.”

This is the exact quote I have read over and over again in my books about women seeking help for hormonal issues, being shut down by their doctors who either have been trained to say or truly believe blood hormone tests aren’t reliable.

But how can the home-collected saliva tests be? It’s impossible. At least when you have samples taken at a lab, be they blood, urine, or saliva, they keep them refrigerated, and transport them in refrigerated containers. God only knows where my samples sat during the five days it took to get to the lab. I sent my samples off the morning of the 25th. They weren’t tested until the 29th.

To find out more about the subject, I went to what was billed as a seminar on saliva hormone testing, sponsored by a local pharmacy. A compounding pharmacy, one that can create individual prescriptions for women with hormonal imbalances, once the testing kits show where they are deficient. The room was filled with about forty women, all middle-aged.

The presentation was completely on target and informative. The information was correct. But it was a marketing presentation all the same. Go to your doctor, ask for these kits, get your hormones tested, then come back to us for a consult and we will mix up the perfect prescription for you.

Sounds like a dream come true to women who can’t sleep, can’t lose weight, are either bitchy or want to cry all the time or both at the same time, have hot flashes, headaches, backaches, swelling, cramping, bloating, joint pain and are either losing their hair or growing a moustache, just to name a few symptoms. And don’t forget, we’re all exhausted, and not interested in sex.

But they warn you the testing is imperfect, and it may take a few tests to get your prescription right, and you will need to be tested every three months thereafter to make sure the hormones they are giving you are the right ones for you.

They do not mention the cost, nor that it is not covered by insurance, nor that there are only two doctors in town who subscribe to this method of testing, and one of them is a woman who apparently doesn’t know the first thing about interpreting the results. All she knows is how to hand you a kit and say, “Call me for an appointment to get the results.”

This is the same woman who after speaking with me for 15 minutes, strongly suggested I go on anti-depressants as the solution to my hormonal problems, which I refused, because 1) I'm not depressed, and 2) countless case studies show that taking anti-depressants only makes your PMDD symptoms worse.

Hormonal imbalances are so individual, because each woman’s physical make up and life stressors are so different, that prescribing one pill to take care of them is like asking every woman to wear a one-size-fits-all-tent dress.

This time, after seeing the supposedly high levels of my hormones, in particular my serotonin level, which is what the SSRI anti-depressant would supposedly boost, the doctor did a complete 180 degree turn-around. As I was leaving, I asked her, just to make sure, “Now, you don’t recommend the anti-depressants any more, correct?” And she looked at me. “Well, you’re the one who said you wanted to go natural, right? You can’t do that if you’re on anti-depressants.”

A few weeks later I got a call from her office, informing me that the supplements for my depression that my test results indicated I needed were in and I could come in and pick them up.

I said, "I'm sorry, but I'm not depressed, and at this point I have lost all confidence in your office's ability to help me with my hormonal problem, so I won't be picking up any supplements."

I received a call from the doctor the next day, placing the blame on the receptionist, who obviously had "misunderstood my situation."

Professionalism at its finest. Blame someone else. The receptionist hadn't misunderstood anything. Not when I knew the doctor herself had diagnosed me with depression.

I then asked the doctor if she had called the testing company (as she had said she would when I was in her office) to find out why my results were so abnormally off the charts, and she said that no, she hadn't, because, well, "The results are the results."

And besides, she said, "I didn't give you all the results anyway."

"You didn't?" I asked, stunned.

"Well, no," she said impatiently, "because you wouldn't be able to handle all the information at once." These things take time, she insisted. It takes more than a couple of visits to sort everything out.

Needless to say, I never returned.

April 2012 Update:  I recognized the "hormone specialist" I wrote about above in the check out line at our local whole foods co-op.  The clerk was chatting about a television show she had watched the night before and the doctor asked, "Does it have to do with money?  Because I only know about things that make money."

Everybody laughed.

But I knew she was telling the truth.

After my useless encounter with her, I went to an endocrinologist, for whom I had to wait several more months to see. She was a lovely woman, well-informed, empathetic and understanding, since she herself happened to be going through menopause.

However, she was not a fan of bio-identical hormones. We talked a while, and then, comfortably leaning back in her chair she said, "As a medically-trained doctor, I can only give you advice based on the information that has been clinically proven. Your choices are anti-depressants, birth control pills, or hormone replacement therapy."

(The HRT she was talking about, however, was the conjugated estrogen therapy proven to cause several potentially fatal side effects by the Women's Health Initiative Study. (More on this in another post, since this one is already so long).)

"But as a woman," she added, then leaned forward and looked me in the eye, "When you find the answer, call me." She held up her hand to her ear to mimic using the phone.

This are only two examples of how frustrating it can be to find answers for your PMDD. Some doctors claim to have the answers but don't, some can only speak to what they have been taught, others are willing to help, but don't know what to do.

Meanwhile, month after month rolls around, and we suffer.

I managed to talk her into doing some blood tests for my estrogen and progesterone levels. "I'll order the tests," she said, "but what are you going to do with the results?"

"I don't know yet," I said, "but I'll figure something out."

In the end it turned out the tests she ordered for me weren't quite what I needed, but I didn't know it at the time. I've since learned more on the subject, and after more than a year's worth of PMDD episodes later, I managed to get my primary physician to request the serum blood tests that I needed, per the instructions on page 385 in Dr. Elizabeth Vliet's book, It's My Ovaries, Stupid!  We then started a bioidentical hormone regimen that finally saved my sanity. 

Yes, in the end I was able to work with my primary care practitioner, who, per the instructions in Dr. Vliet's book, prescribed bioidentical hormones for me in the form of an estradiol patch (the right dosage for me was .075mg/day, but you can start at .0375 mg and go up to 2.0 mg), and 200 mg of prometrium (progesterone capsules), which I still take daily.  For seven years, this bioidentical combination was a huge help with both my symptoms of perimenopause, and my PMDD. (March 2018: I have now reached menopause and reluctantly no longer use the patch.) 

Other effective things I found to help ease my PMDD were all lifestyle changes - diet, exercise, self-awareness, self-care when an episode descended, and vitamin supplementation.  For a list of what I took then and/or now take daily, please email me at info(at)livingwithpmdd(dot)com. I do not provide it here, because I am constantly fine-tuning my efforts to be well.

And that is all I want for you.  To be well.

Wednesday, September 8, 2010

Food Cravings Have Nothing to Do With Willpower!

I've struggled for most of my life with food cravings. While trying to figure out the reason my New Year's resolution to lose some weight worked so well the first three months and then....just stopped...I came across this article from a wonderful site on women's health, called Women to Women.

I'd like to share it here so you don't beat yourself up for not losing weight when you've been trying everything you can think of to shed some pounds. For more information and the entire article, go here. The sections in bold print are lighbulb moments for me, especially since--after I hit a plateau on losing weight with Weight Watchers--I was determined to kick it up a notch. For three months straight I went to the Y five times a week and did 45 minutes of cardio. Didn't lose a pound. Upped it to 45 minutes of cardio and 15 minutes of walking for an added boost. No change. Signed up for a walking challenge and walked 200 miles in 100 days. Didn't lose a pound. (But things did tighten up and shift around a little, which was nice :)) Switched it around again to a more balanced two miles of cardio and two miles of walking in one hour, five times a week and....still nothing.

But those cravings, they still come around like clockwork, so here goes...

Cravings have nothing to do with willpower! (This, I thought, was fantastic news!)

An enormous percentage of women crave sugar, carbohydrates, or alcohol. In most cases, these food cravings are not true eating disorders, but instead are signs of hormonal imbalance caused by a lack of healthy nutrition.

Your personal issue may be the afternoon snack (often chocolate or candy or a food that’s also heavy in carbohydrates), too many potato chips, the extra glass of wine at night, or a hundred other variations. But the underlying mechanism, and the way to curb cravings, is the same. And it has nothing to do with willpower, or your lack thereof!

Food cravings mean that the body has its signals mixed up. When we are exhausted or blue, we have low blood sugar and/or low serotonin, and the body signals the brain that it needs a pick-me-up. This signal causes a sugar craving or carbohydrate craving.

Serotonin is our basic feel-good hormone. If serotonin is low, we feel sad or depressed. And hormonal imbalance or weak digestion can lead to low serotonin. Unfortunately, sugars and simple carbohydrates release a short burst of serotonin — we feel good for a moment, but soon return to our low-serotonin state — then crave more sugar and simple carbohydrates. It’s a downward spiral.

If you eat a low-fat diet in the hope of losing weight, you unintentionally make the problem worse. If, like millions of women, you have eaten a low-fat, high-carbohydrate diet for many years, or followed fad diets, the odds are good that you have become at least partially insulin resistant. Insulin is responsible for maintaining stable blood sugar levels by telling the body’s cells when to absorb glucose from the bloodstream. Being insulin resistant means your body stops responding to insulin, and instead grabs every calorie it can and deposits it as fat.

So no matter how little you eat, you will gradually gain weight. At the same time, your cells cannot absorb the glucose they need, so they signal your brain that you need more carbohydrates or sugars. The result is persistent food cravings.

Even worse, insulin resistance leads directly to obesity, diabetes, and heart disease. Many experts believe it is the root cause of the epidemic of those diseases in America today. And a low-fat diet makes it far more likely you will suffer from this condition.

Millions of American women are now trying the Atkins Diet or the South Beach Diet. While these diets are an improvement over the conventional low-fat, high-carbohydrate diet, they can worsen your metabolic problems, because dieting itself is stressful to the body. So many women need to heal their metabolism first before even considering weight loss. (This is what I have been working on ever since I gave up dieting, and actually, it's going well. Haven't lost a pound yet, but my overall energy and feelings of well-being have improved considerably, and when the PMDD episodes come, they're often much milder, and always much shorter than they used to be.)

Another cause of food cravings is adrenal fatigue. If you are under a great deal of stress, or suffer from insomnia or sleep deprivation, you are probably exhausted much of the time. This leads to adrenal fatigue or outright adrenal exhaustion, which in turn signals the body it needs a pick-me-up. You may resort to sugar or carbohydrate snacks or coffee during the day and carbohydrates or alcohol at night, all of which exacerbate the problem. (For more info on this, please read my things a PMDD woman needs to avoid posts.)

How to curb cravings

Women who blame themselves for their food cravings only worsen their mood and increase their need for serotonin. That’s when a pattern of emotional eating can develop. Remember, there are biological causes for sugar cravings, and your carbohydrate craving is rarely just a behavioral problem. The root problem is more likely inadequate nutrition.

How to break this vicious cycle? To reduce food cravings, the body needs real support — and lots of it. We have seen over and over that eating healthy foods, adding pharmaceutical–grade nutritional supplements and moderate exercise can almost miraculously curb cravings. Your metabolism will heal itself when provided with the necessary nutritional support. If it has been damaged, the process can take some time, but it will happen. The good news is — you don’t have to give up chocolate!

(As an aside, I have discovered this wonderful mocha chocolate drink that satisfies my chocolate cravings, while being very healthy. It's called Mocha Cappucino, from Bolthouse Farms, and comes in the refrigerator section (usually near the produce) in your grocery store. When only solid food will do, I find that two Dove Dark Bites does the trick. Often, it's only a taste of what we crave that will satisfy the craving.

So stop blaming yourself, start eating healthier foods, find a way to get more rest (essential for a PMDD woman) and exercise, (I've taken up Qigong, which is basically slow range of motion exercises and deep breathing). Any kind of exercise will do, but I've found walking helps me the most. Last, but not least, get yourself some really good pharmeceutical grade nutritional supplements. I know they're not cheap, but girlfriend, you're worth it.

And if you don't take care of you, nobody else is going to do it for you.

Wednesday, September 1, 2010

The Female Brain

Short and sweet today. If you only read one book this year, let it be this one! You won’t regret it. Once you do, you’ll realize how normal you are. That alone makes it worth its weight in gold.

Until next time…happy reading!