FUNCTIONAL MEDICINE BLOG
Includes over 800 monographs reporting on emerging studies in the medical and scientific literature of practical clinical importance, easily searched for content.
Adolescent oral contraceptive use predicts lasting risk for adulthood depression
In this study, the authors found that women who had used oral contraceptives during adolescence show an increased risk for depression in adulthood, even years after that exposure.
Systemic thyroid hormone effects with levothyroxine can fall short
Systemic thyroid hormone status—the systemic effects of thyroid hormone activity—has been further confirmed to be insufficient with levothyroxine therapy in a significant percentage of cases, even though laboratory levels of TSH and T4 are normalized...
TSH elevation associated with pregnancy problems
TSH (thyroid stimulating hormone) when elevated even within the 'normal' range at preconception, can result in adverse pregnancy outcomes.
Levothyroxine therapy and normal TSH yet hypothyroid symptoms
A significant proportion of patients treated with levothyroxine continue to experience residual symptoms of hypothyroidism, including psychological and metabolic effects, due to inadequate conversion of T4 to T3.
Circadian rhythms of inflammation
Treatment of chronic inflammation can be enhanced and adrenal suppression minimized by circadian dosing of anti-inflammatory medication.
Thyroid hormone conversion affects hypothyroid treatment
Dosing strategies solely based on a TSH definition of euthyroidism neglect the important role of FT3, which has recently emerged as an equally significant parameter in defining thyroid physiology... in cases where an FT3–FT4 dissociation becomes increasingly apparent following dose escalation of l-T4, an alternate treatment modality, possibly T3/T4 combination therapy, should be considered.
Adrenal suppression by inhaled steroids is common
A clinical study just published in the European Journal of Endocrinology offers evidence that inhaled steroids...frequently cause serious adrenal suppression. They also show that simply measuring morning cortisol can help indicate whether adrenal insufficiency is occurring.
Fatigue: inflammation and autoimmunity
Severe fatigue, associated with chronic fatigue syndrome (CFS) or another disorder, has as a core underlying cause chronic inflammation...there are sufficient robust multiple lines of evidence to support the proposition that the severe fatigue and profound disability experienced by people with the neurodegenerative, neuro-immune and autoimmune diseases discussed here is largely driven by peripheral immune activation and systemic inflammation either directly or indirectly by inducing mitochondrial damage.
Low-normal thyroid function and cardiometabolic disorders
Observational studies suggest that low-normal thyroid function may be implicated in the pathogenesis of CVD. Low-normal thyroid function could also play a role in the development of MetS, insulin resistance and CKD...
Hormone replacement in menopause and ovarian cancer risk
Hormone replacement in menopause must be evaluated thoroughly on an individual basis with careful attention to the important benefits and risks. This includes of course objective measurements of bioactive hormone levels before and during hormone replacement at appropriate intervals, including analysis of benign versus troublesome estrogen metabolites. Regarding adverse effects that must be weighed, an important study just published in The Lancet brings to light a significant risk for ovarian cancer in current and past users of hormone replacement.
Subclinical hypothyroidism in pregnancy
Subclinical hypothyroidism has been associated with multiple adverse maternal, fetal, and neonatal outcomes...On the basis of current evidence, we believe it is reasonable to recommend treating women with new onset subclinical hypothyroidism during pregnancy.
Antioxidants in excess can increase inflammation and blunt benefits of exercise
Antioxidants, even glutathione, taken in excess can increase rather than ameliorate harmful inflammation...The use of antioxidants must be calibrated with careful consideration of the balance between protective and suppressive effects according to the needs of the individual patient.
Thyroid autoimmunity affects cognitive and emotional function
Autoimmune thyroiditis is "associated with cognitive and affective disorders also in the euthyroid [normal thyroid hormone level] state. Thereby thyroid antibodies might play a direct role or indicate an autoimmune process."
Thyroid in heart, metabolism, brain, kidney; vital importance of T3
Thyroid disorders have widespread impact and although subclinical hypothyroidism and low triiodothyronine (T3) syndrome are common they are frequently overlooked in practice.
Breast cancer survival is enhanced by higher serum levels of vitamin D
Breast cancer survival is linked to higher serum levels of 25-hydroxyvitamin D [25(OH)D] according to evidence presented in a meta-analysis just published in the journal Anti-Cancer Research...Higher serum 25(OH)D concentrations were associated with lower fatality rates in patients with breast cancer. Patients with the highest concentration of 25(OH)D had approximately half the fatality rate compared to those with the lowest concentration
Cognitive impairment associated with low but still 'normal' TSH
A study just published JCEM (The Journal of Clinical Endocrinology & Metabolism) offers evidence that TSH (thyroid stimulating hormone) levels when low but still 'normal' are associated with cognitive impairment and dementia.
Progesterone and irritable bowel syndrome, headaches and irritable bladder
Progesterone plays a role in preventing or ameliorating irritable bowel syndrome by inhibiting the release of histamine. This applies to numerous conditions including migraine, interstitial cystitis (painful/irritable bladder), dysmenorrhea and others.