From: Guy R. Schenker, D.C. February, 2001 Dear Doctor, Imagine one of your female patients who is hypoglycemic, and who has a little trouble with her weight, and who suffers from allergies, plus anxiety. Her menstrual cycle is a never ending source of grief, as she experiences PMS accompanied by fluid retention and increased anxiety for nearly two weeks out of the month, followed by menses which include painful cramping. She has also had indigestion for years, and it seems to be getting steadily worse. IMAGINING THIS PATIENT SHOULDN'T REQUIRE MUCH IMAGINATION AT ALL, SINCE YOU PROBABLY HAVE DOZENS WHO FIT THIS DESCRIPTION. Providing care for this patient shouldn't really be too complicated. All you need do is give her a high protein diet and mega doses of nutrients for her hypoglycemia; give her antihistamines for her allergies; give her antacids for her indigestion; give her prostaglandin inhibitors for her menstrual cramps; give her antidepressants in the morning and tranquilizers in the evening to stabilize her mental/emotional state; and, of course, give her a diuretic to control her fluid retention. Or -- you could simply apply the knowledge you have learned from your experience with NUTRI-SPEC to understand that all those many and diverse symptoms derive from one fundamental cause -- estrogen stress. A couple of months ago we gave you a long list of devastating conditions associated with excess estrogen. We then began to explain how this catabolic stress hormone specifically causes each of those listed conditions. We gave you all the references from the scientific literature explaining how estrogen is not only a cause, but perhaps the primary cause, of allergies and asthma. We showed that it can even cause allergies and asthma in children of women who have used estrogen. Last month we gave you the complete story on how estrogen not only does not protect against osteoporosis, but rather is actually a destroyer of bone. Among the estrogen associated conditions we have not yet discussed in detail are seizures, anxiety (often accompanied by hyperventilation), and hypoglycemia with its associated food cravings. I have an interesting case from my own practice to illustrate these three symptoms of estrogen stress in one patient. I had been treating a teenage patient chiropractically since she reached puberty for an osteochondrosis of the knee. She had been stable and reasonably strong for several years and was only coming in several times a year. Then, at about age 16 she experienced what she and her mother referred to as a, "spell." What she had actually experienced was an absence seizure. Her mother brought it to my attention and asked for my opinion, at which time we did NUTRI-SPEC testing on the girl. Our tests showed parasympathetic and respiratory alkalosis -- so we explained to the mother and daughter how the "spell" was related to low blood sugar and what they could do about it from a dietary standpoint (and recommended the parasympathetic dietary recommendations). We did not offer any specific NURTI-SPEC supplementation. The brat only sporadically followed our advice and had several more absence seizures during the next year. When we tested the patient and found the parasympathetic and respiratory alkalosis patterns persisting consistently, we explained to mother and daughter that we could give the patient supplements that would probably help considerably in controlling these mild seizures, but that dietary compliance was essential along with the supplementation -- and that since the diet itself would probably control the seizures, why not just be more conscientious about the diet just to prove that it would work? They agreed, and the girl went many months without a seizure. Regrettably, however, she slipped up at the most inopportune time. She had a seizure while driving a car, and had an accident. Following is a summary of the letter I wrote to the neurologist who reviewed her case to determine whether she should or should not be permitted to drive, along with the references I attached. Our office has been monitoring Jennifer Adams' seizure disorder since its onset in the Spring of 1998. The patient's history plus our clinical tests suggest that there may be three causative factors underlying her seizure disorder: 1. Hypoglycemia 2. Excess estrogen 3. Hyperventilation/respiratory alkalosis Virtually every time Jennifer has had a seizure it has been either when she is in a fasting state or within a couple of hours after consuming a concentrated sugar unaccompanied by fat or protein. The second interesting point from her history is that virtually all her seizures have occurred while she was premenstrual. We have tested the patient repeatedly and found that she consistently shows signs of hyperventilation/respiratory alkalosis, including elevated respiratory rate accompanied by elevated urine and saliva pH's. Several references have been attached showing causative relationships between seizures and each of these three factors. Also, it is worth noting that these three conditions are interrelated in that they can cause or exacerbate each other. We have suggested that since there is much evidence in the literature supporting use of a Ketogenic Diet to control seizures, and, since Jennifer appears to have seizures which are exacerbated by high carbohydrate and low protein and fat intake, that she modify her diet to include fat and protein at each of three meals daily. SEIZURES AND HYPERVENTILATION Adams D., Lueders H., Hyperventilation and 6-hour EEG recording in evaluation of absence seizures. Neuro. 1981, Sep;31(9):1175-7. Meiley C., Forster F., Activation of partial complex seizures by hyperventilation. Arch Neurol. 1977, Jun;34(6):371-3. HYPOGLYCEMIA AND HYPERVENTIALTION Steel J., et al. Hyperventilation or hypoglycemia? Diabet Med. 1989, Dec;6(9):820-1. Drake M., Paroxysmal hyperventilation responses in the adult EEG. Clin Electroencephalogr. 1986, Apr;17(2):61-5. ESTROGEN AND HYPOGLYCEMIA Chiodera P., etal. Effects of estrogen induced hypoglycemia on plasma oxitocin levels in bulemia and anorexia nervosa. Metabolism. 1991, Nov; 40(11):1226-30. SEIZURES DECREASED BY KETOGENIC DIET Bough K., etal. Higher ketogenic diet ratios confer protection from seizures without neurotoxicity. Epilepsy Res. 2000 Jan; 38(1):15-25. Tallian K., etal. Role of the ketogenic diet in children with intractable seizures. Ann Pharmacother. 1998 Mar;32(3):349-61. SEIZURES AND HYPOGLYCEMIA Areif, A., et al, Mechanism of seizures in hypoglycemia. J Clin Invest 1974, Sept; 54(3): 654-63. Burton, R., Raskin N. Remediable seizure disorder due to alimentary hypoglycemia. Neurology. 1970, Apr; 20(4): 380. Sussman, K., et al. Plasma insulin levels during reactive hypoglycemia. Diabetes. 1966, Jan; 15(1): 1-4. Bolli, G. Fanelli C., Unawareness of hypoglycemia. N Engl J Med, 1995, Dec 28; 333(26): 1771-2. French J, Frengley P. Hypoglycemia induced seizures following a marathon. NZ Med J. 1983 May 25; 96(732):407. Ratcheson R, Blank A, Ferrendelli J. Regionally selective metabolic effects of hypoglycemia in brain. J Neurochem 1981 Jun; 36(6):1952-8. Soykal, Glass A. Ketotic hypoglycemia, an important cause of seizures. Clin Pediatr. 1967, Jun; 6(6):368-72. SEIZURES AND ESTROGEN Jacono J., Robertson J. The affects of estrogen, progesterone, and ionized calcium on seizures during the menstrual cycle of epileptic women. Epilepsia. 1987, Sep-Oct; 28(5):571-7. Backstrom T., Epileptic seizures in women related to plasma estrogen and progesterone during the menstrual cycle. Acta Neurol Scand 1976, Oct; 54(4):321-47. Buntner B., Rosciszewska D. [Urinary excretion of estrogen fractions in women with epileptic seizures during the pre-menstrual period.] Neurol Neurchir Pol. 1975, May-Jun;9(3):311-7. (Polish) The references you have just read do a very nice job of illustrating how everything is related to everything -- and the folly of treating isolated symptoms. Note particularly the reference on estrogen as a cause of hypoglycemia. This study is one of many to show the connection between estrogen and hypoglycemia, but I chose this one because it goes a step further -- implicating estrogen excess as causative in bulimia and anorexia nervosa. The three references cited on estrogen as a direct cause of seizures are also particularly interesting. You must use this information clinically. If you have any patients who have seizures who are either on birth control or considering estrogen replacement therapy, please show them these references and stop them from making a big mistake. The neurotoxic effects of estrogen don't stop with seizure disorders. There is considerable evidence implicating estrogen as at least a contributing factor in such diverse neurological diseases as multiple sclerosis, amyotrophic lateral sclerosis, and Alzheimer's disease. Can I make the point any more clear? Estrogen makes you old, makes you fat, makes you tired, makes you depressed, makes your sinuses inflamed, makes you miserable in almost every conceivable way. Get your patients off the estrogen, now. The osteoporosis issue is the last ditch stand of the estrogen peddlers. After several decades of trying to promote estrogen as a cure for everything under the sun including heart disease and certain types of cancer, their claims became so obviously dishonest that they had to withdraw them. Osteoporosis is the only alleged benefit that most people have still been snookered into believing is valid. Now you (and your patients) know the truth. So -- should any woman, under any circumstances take estrogen? If menopause has been surgically induced at an early age, then a woman definitely needs hormone replacement therapy. But, all the hormones should be replaced, not just estrogen. At the very least a woman should take enough progesterone to balance the very small dose of estrogen that she needs. Since the typical doctor understands nothing of the many physiological roles played by progesterone, it is assumed that progesterone is unnecessary. After all, since the two most obvious roles of progesterone are to initiate menstruation when implantation does not occur, and to support a pregnancy if implantation does occur -- and since after menopause a woman will be neither menstruating nor having a baby, why use progesterone? Their ignorance of the importance of progesterone is appalling and inexcusable. If a woman needs hormone replacement she should do everything possible to make sure that the estrogen to progesterone ratio is maintained near its physiological normal. Quantitatively speaking, the amount of estrogen she needs (even after surgical menopause) is a tiny fraction of what is typically prescribed. A prescription for Premarin or Ogen contains several times as much estrogen as a woman made when she was in her 20's. Why is such a huge dosage prescribed? Because such a pharmacological dose will immediately relieve the distressing hot flashes and other symptoms associated with a drop in estrogen. Recently I tested a 63 year old woman on Premarin who was given the lowest dosage of the medication available. Her estrogen levels were more than 6 times as high as normal for her age, and higher than the normal levels for a 25 year old woman during much of her monthly cycle. This woman has suffered terrible physical and emotional symptoms from this estrogen, not the least of which is the destruction of her thyroid. When a woman is faced with menopause that is not surgically induced, it is virtually never a good idea to take estrogen. If the menopausal symptoms are more than she cares to handle, then she ought to consider hormone replacement therapy, not with estrogen but with the important hormone precursors pregnenolone and DHEA. Pregnenolone and DHEA are hormones with many physiological activities of their own in addition to being the precursors to progesterone and estrogen and testosterone. Next month we'll give you the specific protocols for these. Meanwhile, get your patients off estrogen using the gradual withdrawal we described last month. Sincerely, Guy R. Schenker, D.C.