​Hair thinning and/or hair loss is a familiar experience for many, especially as we age. It’s a topic close to home, as I’ve struggled with my own personal battle with hair loss. Until recently, the cause of male or female pattern baldness was not widely understood and thought to be primarily to be an inherited trait. But it turns out that a specific androgen – DHT – plays a significant role in hair loss. 

​What is DHT?
Dihydrotestosterone, or DHT, is an androgenic hormone derived from testosterone. We often think of testosterone as being mostly a male hormone, but it can also be found in smaller amounts in females, and is essential for mood, energy, and reproduction.
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In men, the androgen group of hormones, including DHT, play a significant role in the development of male sex characteristics such asdeepening the voice, body hair growth, increased muscle mass, growth of male reproductive organs, and how fat is stored in the body.
 
While testosterone is the most abundant androgen found in men, playing the greatest role in controlling and maintaining many physiological and reproductive processes, DHT also helps influence these processes. In fact, DHT has demonstrated to be 2.5x more biologically active than testosterone, however it is found in significantly smaller amounts.

​The use of hormonal birth control one of the most common and effective ways to prevent pregnancy, as well as manage unwanted symptoms of reproductive health.

Hormonal birth control, whether a pill, an implant, or a patch, all functions in a fairly similar way. They introduce synthetic hormones into the body to prevent ovulation and increase cervical mucus – a tandem effect that helps prevent pregnancy. Birth control pills are also prescribed to help alleviate symptoms of certain gynecological conditions, like endometriosis, and regulate menstruation.

However, if you’ve have been diagnosed with a chronic gut dysfunction disorder and are struggling to treat it, your birth control may be an attributing factor.

      PCOS is a medical condition that affects hormone levels in women, impacting 5%–20% of women of reproductive age worldwide and characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. Women with PCO end up producing a higher amount of male hormones, like testosterone, and often experiencing resistance to the metabolic hormone, insulin. These imbalances can lead to issues with acne, and missed menstrual periods (impacting fertility), amongst other symptoms. The 2003 Rotterdam criteria are currently the internationally accepted criteria by which PCOS is diagnosed.  

      However, the pathogenesis of polycystic ovary syndrome (PCOS) is poorly understood. Part of the research conducted on the origination of the disease has shown that the likelihood of PCOS development in women may be determined at birth. Research in primates suggests that excess fetal androgen exposure may predispose the infant to later development of PCOS through alternations in the epigenome (1). If there is an imbalance of hormones from PCOS during pregnancy, then there is an increased likelihood the baby may also develop PCOS if the infant is born female. Additionally, exposure to testosterone prior to pregnancy could lead to PCOS even when women have children later. 

Polycystic Ovarian Syndrome (PCOS) is one of the leading medical conditions now impacting women of reproductive age, and can also have substantial impacts on a woman’s physical and emotional well-being. We’ve already covered symptoms and diagnostic testing of PCOS here, but let's dive deeper into one key hormonal disruption that seems to be particularly troublesome for my patient population – hyperandrogenism.

​Hyperandrogenism is common in PCOS, often seen as elevated testosterone and DHEA levels on blood work. And while these two hormones are often seen as synonymous when evaluating total androgenic burden, there is a significant difference between the two. Testosterone and DHEA are both classified as androgenic hormones, however some women with PCOS may have elevated testosterone, with normal DHEA levels, and vice versa. You also don't have to have cysts on your ovaries to present with hyperandrogenism (in fact, only about 20% of women with high androgens have cystic ovaries), and cysts on your ovaries don't always mean you’ll have high androgens. Have I lost you yet?

     Autoimmunity is an umbrella term for a number of medical condition with one common problem: the immune system. In autoimmunity, the body’s immune system mistakenly identifies healthy cells as invaders, and attacks them. This disease can present in various forms, and can affect any part of the body. For some, autoimmunity can disrupt hormone production, as in Hashimoto’s or Graves. In other people, it can present as symptom of inflammation, fatigue, and pain. Some people even experience neurological changes, as in cases of MS.
     And while autoimmunity is not news to modern medicine, the increased number of reported cases per year is. It poses the questions -  why are incidence reports on the rise, what, if anything, is causing its increase, and is there anything we can do about it?

​According to a new study presented by Dr. El-Salhy at the United European Gastroenterology week in Spain, fecal microbial transplants (FMT) may significantly improve the pain and distress caused by irritable bowel syndrome, if transplants come from what has been termed a 'super-donor'.
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The double-blind, randomized control trial study found that 75-89% of recruits aged 18-75 receiving 30-60 g of endoscope administered feces into the duodenum donated same day from a human 'super donor' reported significant benefits in their overall IBS symptoms after 3 months, with no long term adverse effects (1). Slightly greater benefits were observed in the patients receiving higher dose transplants and/or repeat transplants (2). Furthermore, Dr. El-Salhy suggested that preliminary results show 90-95% of the patient who responded are still well 1 year later, and 50% are 'cured' (3). 

Calories in versus calories out was the de facto weight loss equation for decades. To lose weight, you simply reduce the number of calories consumed while increasing the number of calories used. However, the simple equation that we have adhered to as part of a healthy lifestyle may have actually been hindering our weight loss efforts. As our understanding of health and nutrition improves, so does what we know about the simple calorie equation – and this knowledge is changing the plate of the modern diet.

1. Not all calories are created equal.  
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One reason why strictly counting calories can be an ineffective way to lose weight is that not all calories are good calories. While the energy content of calories is essentially the same in that they are an equal unit of energy, calories derived from whole foods are more effectively processed by the body than those found in processed foods. In other words, where a particular calorie comes from will have varying effects on hunger, hormones, and weight.