Fragrance: The New Secondhand Smoke
By Dr. Justin Marchegiani
Have you ever walked into a bath and body store, full of scented bath bombs and candles, and left with a headache, sore throat, or itchy nose? Those of us who are more sensitive may have already connected the dots between artificial fragrances and feeling foggy. While scented products are generally used with the positive intention of changing the scent of a person or a room, many people don’t realize the consequences. For the more sensitive among us, reactions can be immediate, but we are all at risk for the long-term effects of toxic fragrances.
What is “Fragrance”?
“Fragrance” (or “parfum”) is listed as an ingredient in practically everything these days: body wash, shampoo, soap, perfume, laundry detergent, fabric softener, hairspray, dish soap, household cleaning products… the list goes on and on. While any of these may list the ambiguous “fragrance” as an ingredient, they all have very different scents. Which leads us to the question: what exactly does “fragrance” mean?
Seeing the word fragrance or parfum on an ingredient list indicates a “trade secret” recipe that can be composed of hundreds of synthetic chemicals, selected from a database of 5,000 various components. Not only are companies not required to disclose which chemicals they use, none of these thousands of chemicals has to be tested for safety. There are some that have been studied, and the health effects are seriously scary. Reproductive harm, respiratory issues, and some of these fragrance chemicals are known neurotoxins.
Fragrance has been linked to:
- Endocrine disruption
- Hormone imbalance
- Brain fog
- Memory and concentration issues
- ADHD
- Headaches and migraines
- Allergies
- Respiratory problems
- Birth defects
- Damaged sperm
One example we can look at are phthalates, which help chemicals absorb into the body (alarm bells are already ringing). What are the associated risks? Reproductive system birth defects, hormonal changes, reduced sperm motility and concentration, increased damage to sperm DNA, obesity and insulin resistance, Type 2 diabetes, thyroid irregularities, asthma, and skin allergies, miscarriage, and infertility, to name a few.
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EWG product testing found phthalates in nearly 75% of name-brand products, while not a single product listed phthalates as ingredients. This is because phthalates fall under the umbrella of a secret ingredient, and can be slipped into the chemical cocktail that results in one simple word, fragrance, on the ingredients list.
Second-Hand Fragrance
Think about the potential health effects linked to using phthalates that we listed above. This is just one of 5,000 ingredients that are mixed together to create a product’s fragrance. None of these chemicals are required to be tested for safety, yet we are exposed to them every single day!
Some of us are more sensitive than others and have an immediate reaction to scented products, and will avoid purchasing them. However, the majority of the population (unwittingly) still uses these toxic products. Perfume, scented laundry, hair products, air fresheners… Just like cigarette smoke, these fragrances create an aura of fragrance that pollutes the air. At their core, second-hand smoke and today’s fragrance epidemic are both battles over indoor air quality.
What Can We Do?
Shop with your dollars, and purchase products that are fragrance-free or contain truly natural ingredients, like pure essential oils. In fact, essential oils can take the place of a variety of scented products. doTERRA On Guard Cleanser is made of pure essential oils, including cinnamon, clove, eucalyptus, and wild orange. A lavender essential oil can be mixed with a carrier oil (coconut, avocado, olive, rosehip, etc.) to create a natural moisturizer. Shopping for fragrance-free products is not hard, but making them yourself adds an extra layer of fun & personalization!
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References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1740925/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5093181/
https://www.national-toxic-encephalopathy-foundation.org/fragsmoke.pdf
https://www.ncbi.nlm.nih.gov/pubmed/28683407
My Lab Tests Are Normal But I Still Have Symptoms
By Dr. Justin Marchegiani
I see patients all the time in my practice that tell me they don’t feel right, yet their medical doctor tells them their lab tests are normal. The typical response from the average medical doctor will be something like this: “It’s all in your head. You may benefit from taking an antidepressant.” Or if you’re a woman, it may be blamed on female hormone issues, and the next solution may be to go on a birth control pill to help normalize your cycle.
Intuitively, people know something’s wrong even if their lab tests aren’t totally in the red. The most common response I hear in my practice—
“My lab tests are normal, but I still don’t feel well!”
The problem with this scenario is there are physiological, biochemical, and hormonal explanations for why patients feel the way they do. Conventional medicine typically gives these patients no answers and worst of all, can sometimes make them feel as if they’re making it up.
In the world of functional medicine, we tend to look at things differently than your conventional medical doctor. Most lab tests have originated to include 95% of the population into the normal values. So if your medical doctor tells you your labs look fine, that just means you fit into that 95% category, or two standard deviations away from the mean if you are into statistics.
Anyone that has walked around an airport for just a little bit of time will be able to tell you 95% of the population doesn’t fit into the healthy category. Conventional medicine makes a massive assumption that the absence of disease is health. This is like saying the absence of being poor on the street means you’re rich! I hope my analogies help drive the point home that these assumptions are absurd!
Why the Answers to Symptoms Get Missed by Conventional Lab Testing
As society gets sicker and sicker and sicker, we know the reference ranges get wider, and wider, and wider. So if you are someone that may have been healthy to begin with, and then have a sudden drop in your health, you may still fall within that normal reference range. Thus, being told nothing is wrong.
It’s really not your medical doctor’s fault. Conventional medicine trains physicians to look for pathologies or disease, and this is a good thing. Where this paradigm falls short is when you aren’t sick enough to fall into the category of being diagnosed with a disease. So what do you do next?
Essentially, conventional medicine is saying, “Go home, continue doing what you’re doing, get sicker, and then maybe we’ll be able to diagnose you with something in a few years.” Intuitively, that doesn’t sound right to me. We need to look at things in a more sensitive way so we can pick up this slow and steady breakdown before it becomes a major problem.
Your body is designed to adapt to stress. Maladaptation is the number-one sign that your health is starting to decline. If your body loses the ability to adapt to the various stressors in your life, you will eventually come down with some type of disease. The goal of functional medicine is to figure out where the underlying stressors are coming from. Using specific lab markers that are sensitive, we can chart your overall health function on a spectrum so as we start incorporating treatments, we have objective and subjective markers of improvement.
Functional medicine can look at the exact same labs and potentially pick up subtle things that conventional medicine may not. Click here to get your labs assessed.
Thyroid Lab Testing and the Inadequate TSH Test
Most people have low thyroid symptoms even though their thyroid lab tests are normal! The standard panels that are looked at are typically a TSH test (a brain hormone) and T4 test (a storage thyroid hormone). It always bothers me that conventional doctors very rarely look at the active thyroid hormone (T3) to assess a thyroid problem. Especially since the research over time has shown that TSH testing isn’t the best to assess thyroid function. If TSH is elevated, it’s a surefire sign of thyroid dysfunction, but it’s a marker that tends to elevate late in the game.
Above are the markers that I commonly run on my patients to assess which pattern of thyroid dysfunction they have. Thyroid antibodies are also looked at to assess if there is an autoimmune disease at play. Most conventional physicians totally ignore thyroid antibody testing completely because it doesn’t change the conventional treatment; Synthroid will be given either way. Knowing whether or not a patient has an autoimmune thyroid disease (Hashimoto’s thyroiditis) can make all the difference in the world.
When we are dealing with Hashimoto’s, it’s the immune system that is out of balance. It is destroying the thyroid gland. It doesn’t make sense to put all of our focus on the thyroid gland if the immune system is attacking it daily. Some people with Hashimoto’s (hypothyroidism) may need thyroid hormone depending on how bad the damages is. I always recommend getting a full assessment like the one above before it is recommended. Hashimoto’s patients will typically respond better on a combination of T3 and T4, like in Nature-Throid, or a bioidentical thyroid glandular instead of a synthetic T4 medication.
Adrenal Testing
Assessing the glands that help control and regulate stress is very important to your health. Your body is designed to be healthy, and part of being healthy means adapting to stress. Your adrenals are instrumental at producing hormones throughout the day that are designed to do just that.
Cortisol is secreted in a pulsatile fashion, higher in the morning and then tapering off throughout the day. Cortisol is designed to help stabilize blood sugar and help deal with stress and inflammation. The more dysfunctional our adrenals become, we start progressing into deeper stages of adrenal fatigue. This is where our brain (the master controller) isn’t able to communicate with our adrenals properly and we develop HPA axis dysfunction. This is nothing more than communication breakdown that can be fixed with proper diet, lifestyle, stress management, and a properly prescribed adrenal program (specific to your pattern of adrenal fatigue).
Blood Test Markers for Health
Looking at blood test markers from a CBC, CMP, or lipid panel can provide a pretty good idea of how the body’s systems are functioning.
Digestion
When we see digestive markers, like albumin, globulin, creatinine, BUN, or serum protein, out of balance, it can tip us off that we may be dealing with some digestive inflammation, low stomach acid, leaky gut, and/or malabsorption.
Energy systems
We can look at markers like RBC, Hgb, Hct, MCV, MCH, MCHC, and ferritin, which are markers for an anemia. An anemia typically deals with deficiencies in certain B vitamins, like folate or B12 and/or iron. Most conventional doctors tend to miss these subtle imbalances. And they can contribute to a person’s inability to transport oxygen, create energy, and convert T4 (inactive thyroid hormone) to T3 (active thyroid hormone).
Inflammation
When we see blood sugar markers, like fasting blood sugar, hemoglobin A1C, or insulin, out of balance, it is a good sign there is inflammation. There are more specific markers that can be looked at, like C-reactive protein, ESR (erythrocyte sedimentation rate), fibrinogen, and a triglyceride-to-HDL ratio greater than 2.
Infections
When we assess white blood cell (WBC) function, long-term low WBC can be indicative of a chronic infection, while elevated WBC can be a sign of an acute infection. This rule is the same for the WBC’s constituents as well. Below is a list of the specific components of WBCs. We are looking at the markers below in a more sensitive range than the standard lab range, so we can pick up more subtle infections.
- Neutrophils: Potential bacterial infection including H.pylori
- Lymphocytes: Potential viral infection
- Monocytes: Potential parasitic infection and recovering from an infection
- Eosinophils: More specific for a potential parasite infection
- Basophils: Can increase due to allergies, inflammation, or parasites.
- Alkaline phosphatase: When low, a sign of zinc deficiency, which is a key immune-system nutrient
Stool Testing
Most people who are tired and moody and have weight gain and hormone imbalances tend to have an infection! I have tested hundreds of patients, and I would say, based on my experience, over 70% have a parasite, bacteria, or fungal infection.
Yet in First World countries, it still isn’t accepted, by and large, that these infections can cause a problem. But having worked with many patients with these infections and having helped to remove the infections, I can tell you I’ve seen significant changes, and my patients will tell you the same.
These infections can cause classic GI symptoms, like bloating, gas, constipation, diarrhea, and acid reflux. These infections, at the same time, can cause symptoms that are more nuanced, like depression, hormone imbalances, fatigue, neurological issues, skin issues, and weight gain. It’s hard to connect the dots when these infections aren’t causing the typical symptoms you would see in Third World countries (distended bellies and such).
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So What Do I Do Next?
If you are told that your lab tests are normal but you know something deeper is wrong, you are probably correct. Most of these problems if left alone only get worse and take more time and money to fix later on.
If you need help getting to the bottom of your health challenges, click here!
Natural Remedies for Hormonal Imbalance, Infertility, PCOS and PMS
By Dr. Justin Marchegiani
There are many natural remedies for hormone imbalance in the functional-medicine world, yet they tend to the be the last line of defense most women reach for. It’s easier to get a birth control pill or antidepressant to fix the symptoms of hormone imbalance, but this does nothing to address the underlying cause.
If you’re a female and suffering from infertility, PMS, polycystic ovarian syndrome (PCOS), or other hormonal symptoms, this is a strong sign your body is out of balance and not expressing optimal health. Fertility and hormone balance is a natural by-product of health, and without it, our species wouldn’t be here today. I urge every woman to dig a little deeper into what’s driving her infertility and/or female hormone imbalances.
Just 30 to 40 years ago, women would routinely get pregnant on their honeymoon. Today, women are spending upward of $15,000 per in vitro fertilization (IVF) treatment, some needing multiple treatments to conceive.
Why can’t I get pregnant?
It is possible to mimic your hormones with Follistim, Lupron, or Clomid to manipulate your brain into thinking you are healthy enough to get pregnant. Your body is wise, and is not letting you have a child for a reason; it knows the hormonal environment is not optimal to produce a healthy baby.
The hidden chemical stressors in your body can activate certain genes epigenetically. When these genes are activated, it predisposes you and your child to autoimmune/chronic inflammatory conditions, like asthma, heart disease, allergies, and learning disorders (1, 2, 3).
When we look at the underlying cause of infertility, 40% is on the woman’s side, 40% is on the man’s side, and 20% is unknown.
Both men and women should adhere to similar dietary and lifestyle principles to help support and nourish their bodies. A diet that is nutrient dense, anti-inflammatory, and low in toxins is essential for optimal health and for a growing a baby.
Factors to Consider
Women who are trying to get pregnant need to make sure their diet has adequate fat for the formation of their soon-to-be child’s nervous system; adequate meal timing to stabilize blood sugar; and the avoidance of all toxins from pesticides, grains, and refined foods.
If you are trying to get pregnant, you need to form a cohesive team with your partner. There needs to be a combined effort of the couple engaging in health-sustaining habits. Though the female grows the child inside her body, the quality of the sperm and the support regarding nutrition and lifestyle habits are just as important.
One Caveat
As long as your partner’s sperm count, motility, and morphology have been assessed and there are no issues regarding the female’s reproductive anatomy, then you are a great candidate to start a natural female-hormone-balancing program.
There may be 5% of women that need IVF treatment to conceive. I personally would recommend IVF last. The natural hormone-balancing diet and lifestyle programs can work over 90% of the time. IVF may help you get pregnant, but it does nothing to ensure a healthy pregnancy and optimal health for your child.
According to research, as well as my clinical experience, women that have IVF or go into a pregnancy unhealthy to begin with tend to suffer from more hormonal related issues post pregnancy, have a more difficult time losing weight, and have an increased risk for postpartum depression (4).
To All Men out There
Sperm counts have been dropping over the last 40 years significantly and so have the reference ranges regarding what normal may be. Due to these drops in the reference range, I urge men to be in the top 25% of the range to ensure adequate health. Consider anything in the middle of the range inadequate to standards just 30 to 40 years ago. (5)
Women’s Cycle: The Two Phases of Your Cycle
The first half of your cycle is the follicular phase. This is where estrogen predominates. The second half of your cycle is the luteal phase. This is where progesterone predominates.
The Domino Effect of Healthy Hormones and Pregnancy
Step 1
Progesterone and estrogen drop at the end of the cycle, which signals bleeding, or your period. The sloughing off of your endometrial lining is important to reset your body so it has a chance for pregnancy the next time it ovulates.
Step 2
The bleeding that occurs during your period stimulates FSH—a brain hormone. FSH stands for follicle-stimulating hormone which stimulates the follicle to start growing.
Step 3
As the follicle starts growing, it stimulates estrogen to increase. As estrogen increases, it starts to thicken the endometrial lining. Estrogen stimulates growth, which is needed for the uterine lining.
Step 4
As estrogen reaches its peak around day 12 or 13 of your cycle, ideally, it stimulates an increase in LH (luteinizing hormone).
Step 5
When LH increases, it stimulates progesterone to increase around day 15 of your cycle.
Step 6
The rise of progesterone, which was preceded by a rise in estrogen, signals ovulation. This when you can get pregnant, and it’s only about a three-day window. Progesterone causes the uterine tissues to mature (to grow up), which provides the right environment for the egg to implant into it.
Step 7 (optional)
The egg is ejected into the fallopian tube where it has the potential to come in contact with sperm as the egg makes its way down to the uterus.
Step 8 (optional)
The fertilized egg embeds itself into the uterine lining as the corpus luteum (the scar from where the egg formed in the ovary) stimulates progesterone through the production of human chorionic gonadotropin (HCG).
Step 9
Progesterone and estrogen drop out around day 27 or 28 of the cycle, which then signals menstruation (your period). The whole process then repeats itself again.
Fun Fact: HCG is what is typically tested to confirm pregnancy. Elevated HCG will get you a positive on your home pregnancy test.
Problems in the Luteal Phase
The luteal phase needs to be at least 12 to 15 days long to ensure there is enough time for adequate progesterone to be made. If progesterone levels fall off early in the luteal phase (symbolized by the red lines above), it’s because of stress. Stress comes in physical, chemical, and emotional factors. Essentially, progesterone, your pro-gestational hormone that holds the egg in place, actually can get converted downstream in the cortisol.
With chronic stress we see progesterone falling out early in the cycle, which can make it very difficult to sustain a pregnancy. This progesterone deficit makes it very difficult for the egg to stay implanted, and it will eventually slough off causing a potentially thicker period that particular month, or maybe even no period at all. Low progesterone over time can cause your cycle to be anovulatory (without a period), or you may have even been told you have premature ovarian failure.
Throughout our cycle, on average, we have 22 to 25 times more progesterone than estrogen. This is a normal, healthy balance. When stress occurs and progesterone gets converted downstream, we start seeing a state of what’s called estrogen dominance. We start seeing an excess of thickening of the uterine lining. Women may notice fibroids, endometriosis, and fibrocystic breasts.
These hormone imbalances may manifest themselves at the end of your cycle as PMS, headaches, fatigue, migraines, breast tenderness, and uterine pain. All these symptoms are primarily driven by a state of estrogen dominance.
PCOS
PCOS (polycystic ovarian syndrome) occurs when androgens in the female cycle become elevated. As androgens elevate in the cycle, it throws off the upstream brain hormones, so communication from the brain to the ovaries becomes disconnected (6).
One of the most important triggers of PCOS is chronic ups and downs in blood sugar (reactive hypoglycemia), or insulin resistance. The elevation in insulin up-regulates certain enzymes in the body (17–20 lyase), which can accelerate the conversion of female hormones to male hormones (testosterone). That’s why it’s common to see acne, abnormal hair growth, and ovarian cysts as a by-product (7, 8).
What’s the Deal with Birth Control Pills?
When we take birth control pills (BCPs), we shut down the upstream signaling to our brain known as the HPG axis (hypothalamus, pituitary, gonadal axis—see picture below). FSH and LH, essentially, are the conductors of this beautiful hormonal orchestra. In this orchestra we have the strings, the flutes, and all the different instruments you can imagine. If the conductor of the orchestra goes on vacation, it’s very easy for this beautiful music to sound like noise.
Taking this analogy back to hormone land, as hormonal imbalances occur due to physical, chemical, and emotional stressors, they essentially mug the conductor. They knock the conductor off the stand, and the hormones start to go awry.
Women who take BCPs do see a benefit. Their hormones may stabilize, which may help their mood, PMS, and skin issues in the short term. The ups and downs of the hormones in the cycle are somewhat leveled out by this artificial, yet steady, bombardment of hormones.
The symptom-relief experience from BCPs is real. There are ways to produce the same results, if not better, through natural hormone-balancing protocols that address the underlying cause of the issues. When the underlying cause is addressed, there is less chance of the typical side effects of BCPs, including weight gain, blood clots, increased risk of a breast cancer, and potential difficulty conceiving down the road.
“Women who were on oral contraceptive birth control pills may experience a few months of being infertile while the synthetic hormones work their way out of their body. Women who were on the Depo shot on the other hand, can experience infertility between six months to a year.”
~Dr. Lauren Streicher of Gynecologic Specialists of Northwestern
Other Available Methods
If you are using a BCPs to prevent pregnancy, there are other natural non-hormonal methods out there. My favorite is the rhythm method (if you are in a stable long-term relationship). Other methods can be used, including a non-hormonal IUD (ParaGard). This can be used in conjunction with a diaphragm and/or a condom for extra security. If your hormones are stable, there is only a small window in your cycle when pregnancy can occur, so make sure proper precautions are made.
What You Need to Do!
If you are struggling with hormonal-related symptoms and are looking to get pregnant, there are some action items you should make ASAP!
Step 1
Make the right diet and lifestyle changes to stabilize your hormones and blood sugar for success.
Step 2
Avoid common toxins that may come from pesticides in your food and chemicals in your makeups and hygiene products. The toxins in these products are xenoestrogens in nature and can mimic the hormone estrogen. Most women are already in a state of estrogen dominance, and this bombardment off additional synthetic estrogen only makes the problem worse.
Step 3
Get assessed! If you are not assessing, you are guessing! If you are having hormonal issues and you want to get pregnant, you need to see where the root of your hormonal issues are coming from.
Are the hormonal imbalances coming from a thyroid issue, adrenal issue, female hormone issue, or chronic infection? It may even be a combination of all of them like I see with most patients.
Step 4
Step 5