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Tag Archive for: hormonal issues

Posts

preventing compression fractures

8 Steps That Can Help You Prevent Painful Compression Fractures

May 9, 2023/in Bone Health, Lifestyle/by Lisa Lilienfield, MD

Research shows that one-quarter of post-menopausal women eventually suffer from compression or collapsing of some vertebrae, the bones that comprise the spinal column. Compression fractures can not only increase one’s risk of future fractures, but they can also compromise one’s ability to function and may cause disabling chronic back pain.

Although these injuries are common, they can usually be prevented, delayed, or mitigated by adopting a healthy lifestyle that includes:

1. Engage in resistance training, such as weight training, yoga, or Qigong every other day, ideally for 30-60 minutes per workout.

There is good news for those who struggle to find those 30-60 minutes: a 10-year study that was completed in 2015 measured the bone mineral density (BMD) of 741 participants pre and post-yoga regimen. Participants who routinely engaged in 12 yoga poses each day for just 12 minutes showed a reversal of osteoporotic bone loss.

2. Do weight-bearing exercises like running, walking, or hiking, for at least 30 minutes each day.

Weight-bearing exercises work against gravity and stimulate bone cells to produce more bone.

3. Get your Vitamin-D levels tested to ensure that they’re between 50-70 ng/mL.

If your levels are low, consider getting more sunshine (exposing some of your skin for 15-30 minutes each day) and taking a supplement. Most people need between 3,000 to 5,000iu of supplementation, but some may need up to 10,000 international units. If you take Vitamin-D supplementation, your 25-hydroxy Vitamin-D level should be checked twice a year.

4. Check your calcium and magnesium intake.

Women should consume a total daily amount of calcium between 1200 and 1500 mg, with no more than 600 mg from supplemental calcium. Taking in more than this amount in supplemental form can lead to an increased risk of heart disease and kidney stones. Good sources of dietary calcium are sardines, white beans, almonds, oranges, leafy greens, and dairy.

Taking magnesium can increase bone mineral density and reduce fracture risk.

5. Consider bioidentical hormone replacement therapy.

Before prescribing medications, we at Kaplan Center explore the possibility of using bioidentical estrogens and progesterone or estrogen analogues like Evista to prevent bone loss.

6. Talk with your doctor before using medications to treat bone loss.

Because most of these medications work by decreasing bone breakdown, this can potentially cause more brittle, unhealthy bone, and result in fractures of the femur and jaw necrosis. We generally reserve medication treatment for those with severe osteoporosis or a history of pathological fractures. Before considering bisphosphonates, like Fosomax, Actonel, Boniva, Reclast, or a newer injectable, Prolia, it is recommended to complete dental procedures before starting treatment for osteoporosis. Report any persistent jaw or thigh pain to your healthcare provider immediately.

Another treatment option is Miacalcin, a synthetic version of the hormone, calcitonin. It has been shown to build bone more in the spine than in the hip, offering users some pain relief. Two alternatives to the bisphosphonates and Miacalcin are Forteo and Tymlos, synthetic versions of a hormone called parathyroid hormone which also builds bone. Some of these drugs, however, carry warnings about an increased risk of bone tumors called osteosarcoma.

7. Consider Bone-Density Imaging

It’s important to evaluate the effectiveness of any medications or hormone replacement therapies you may use because each individual inevitably has their own unique response to a given treatment. A bone-density test can help measure the therapeutic benefits of any treatment path you have chosen.

8. Vitamin K supplementation.

Research on Vitamin K and postmenopausal bone loss has shown that it can have a positive effect on bone strength. This 2022 meta-analysis that looked at 16 randomized controlled trials and included 6,425 subjects concluded that “Vitamin K2 supplementation has a positive effect on the maintenance and improvement of [bone mass density lumbar spine] in postmenopausal women, and it can also reduce the fracture incidence”. Supplements are a great way to improve your health, but you should always discuss any new supplements or medications with your provider to ensure that it would be a good option for your unique health profile.

In sum, there’s a lot you can do to keep your bones strong! So, do it!

If you would like to talk to a Kaplan provider about any of the treatments above, please give us a call at 703-532-4892.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

This article was originally published online in May, 2018. Its content was reviewed and updated in May, 2023.

Additional References

Castiglioni S, Cazzaniga A, Albisetti W, Maier JA. Magnesium and osteoporosis: current state of knowledge and future research directions. Nutrients. 2013 Jul 31;5(8):3022-33. doi: 10.3390/nu5083022. PMID: 23912329; PMCID: PMC3775240.

Rondanelli M, Faliva MA, Tartara A, Gasparri C, Perna S, Infantino V, Riva A, Petrangolini G, Peroni G. An update on magnesium and bone health. Biometals. 2021 Aug;34(4):715-736. doi: 10.1007/s10534-021-00305-0. Epub 2021 May 6. PMID: 33959846; PMCID: PMC8313472.

hormonal_balance

Hormones, The Great Communicators

January 6, 2021/in Conditions, Hormone Health, Long Covid, Women's Health/by Lisa Lilienfield, MD

A look at some of the causes of hormonal imbalance.

Somewhere in the middle of the brain is a control center called the limbic system, or the old mammalian brain. Here, amongst a host of structures, are two glands of the endocrine system: the hypothalamus and pituitary glands. These glands act as a hub for the body’s chemical messengers called hormones.

Hormones travel from one endocrine gland to the next to communicate messages from the brain that control a number of biological functions. For example:

  • The hypothalamus tells the pituitary to produce thyroid-stimulating hormone (TSH), which tells the thyroid to produce thyroid hormone, which feeds back to turn down the hypothalamus and pituitary. This is called a feedback loop.
  • The pituitary produces a hormone that travels down to the gonads (ovary and testes) to tell them to produce estrogen or testosterone.
  • The hypothalamus and pituitary tell the adrenals to produce cortisol, which is needed in times of an acute stressor, to increase blood pressure, glucose production, and suppress the immune system.

This whole structure is called the Hypothalamic Pituitary Adrenal Thyroid Gonadal Access, or HPATGA.

With age, both women and men undergo natural changes that interrupt this communication system and produce hormonal imbalances; but most of the time it’s external factors, like environment, diet, and lifestyle, that are to blame.

Symptoms that individuals experience vary greatly; among the more common symptoms are sleep disruptions, unexplained weight gain or loss, changes in mood, sex drive, and energy levels. When left unchecked these imbalances can contribute to more serious clinical conditions.

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Causes of hormonal imbalances

Let’s start with the diet.

First and foremost, the gut and its entire bacterial flora are intricately connected to our immune system. We know that 1% of the U.S. population has Celiac disease, a condition where the gluten in wheat, barley, and rye causes inflammation in the gut and destroys the natural barrier in the small intestine to large proteins and toxins. This has been associated with autoimmune disorders like rheumatoid arthritis, lupus, multiple sclerosis, Type 1 diabetes, and autoimmune thyroid disease.

Similar issues are observed in people who are gluten intolerant, which by some estimates account for over 6% of the population.

There has also been identified a non-gluten protein in wheat called ATI (amylase trypsin inhibitor) that has been associated with autoimmune disorders[1].

For example, in autoimmune thyroiditis, the thyroid gland is attacked and becomes inflamed. As a result, it can produce too much thyroid hormone (Graves’ disease), or stop producing thyroid hormone leading to hypothyroidism (Hashimoto’s disease). A leaky, inflamed gut from gluten and other wheat proteins can be the cause or further aggregate these conditions.

What about lifestyle?

A busy, high-stressed lifestyle can cause the overproduction of cortisol from the adrenal gland which can results in an increased risk of diabetes, inflammatory diseases like heart disease and cancer, disruption of sleep, and an increase in anxiety and fatigue. Since cortisol suppresses the immune system, those who are chronically stressed get sick more easily. Cortisol also suppresses estrogen and testosterone, and interferes with the conversion of T4 thyroid hormone to the more active T3, resulting in fatigue, weight gain, irregular menses, chronic pain, and depression.

How does the environment affect hormones?

There are environmental toxins called endocrine disruptors that actually bind to hormone receptors and increase or decrease these hormones unnaturally. Examples of endocrine disruptors include pesticides like DDT, plastics that contain phthalate and bisphenol A (BPA), and industrial chemicals like PCBs. There are also glyphosate-based weed killers (like Roundup®) that are used in agriculture and end up in our food. These herbicides damage DNA and act as an antibiotic killing off our good digestive bacteria and disrupt the proper functioning of the immune system.

How to support hormonal balance

1. EVALUATE DIET AND MEDICATIONS. 

What we eat and the medicines we take make a difference. Food is code, meaning food turns genes on and off. If someone carries genes for Celiac disease, diabetes, or cancer, these genes can be turned on – or off – by specific types of food. Eat to minimize inflammation in the gut and promote the growth of highly diverse, good bacteria, which research shows is associated with good health.

There is evidence that over the past several decades, the newer wheat strains like dwarf wheat which are so loaded with gluten and other proteins, are causing more and more people to develop Celiac and non-Celiac gluten wheat intolerance, leading to leaky gut and autoimmune disorders[2]. Anyone with an autoimmune thyroid condition or other autoimmune disorder should eliminate gluten.

In addition, the overuse of antibiotics and other pharmaceuticals reduce the beneficial bacteria in the gut. Minimizing the use of medications, and eating fermented foods, probiotics, and dietary fiber that feeds our good bacteria promotes good gut health and decreases the likelihood of autoimmune disorders.

2. ASSESS STRESS LEVELS.

Stress can lead to chronically elevated cortisol. How can we lower cortisol levels and restore the natural cortisol pattern? We need to take the time to assess our stress levels. Are we working too many hours, sitting too long, staying up too late, worrying about yesterday and tomorrow, and coming up with excuses for not exercising and eating poorly? All of these practices increase cortisol which increases the risk of diabetes, hypertension, and heart disease, and affect our hormones. It is imperative that we slow down, prioritize, take time to move, eat well, sleep, seek help and support when needed, and get connected with the community and loved ones.

Yoga, Tai Chi, meditation, weight training, and aerobics help tremendously with stress and lower cortisol. Research is now showing that sitting too long can be as bad as smoking!

3. ELIMINATE TOXINS.

Environmental toxins are tougher to deal with, but minimizing the toxins we are exposed to, and eating foods that naturally detoxify like deeply colored and cruciferous vegetables, foods with omega 3 fatty acids (i.e. fish oil or other sources), and supplementing with magnesium, vitamins B and C, are just a few ways to support the liver’s detoxification process.

Every year since 2004 the Environmental Working Group assesses the sampling of pesticides in our food source from the U.S. Department of Agriculture and the Food & Drug Administration and makes a recommendation as to which fruits and vegetables should be consumed as organic and which are safe as non-organic (EWG Guide to Pesticides in Produce). As previously mentioned, herbicides like Roundup® are showing up in wheat, corn, soybeans, and a host of other foods. Shopping wisely for foods like grass-fed beef (not grain-fed), free-range chicken and eggs (organic may not be enough), wild-caught fish (rather than farm-raised), dairy products without hormones, and buying organic produce from the list put out by EWG, are ways to minimize your exposure to toxins.

Household cleaners, personal care products, and plastic bottles can also have endocrine-disrupting chemicals, so using glass instead of plastic, and minimizing exposures to these chemicals is recommended.

As we age, there is a natural decline of our gonadal hormones (estrogen, progesterone, and testosterone) and in some cases replacement hormones are beneficial. There are ways that we can minimize the risk associated with hormone replacement by using bio-identical hormones, which are closest to natural hormones, and by supporting the metabolic process with diet to reduce any harmful metabolites of hormones that could increase the risk of disease.

To support you in your journey to good hormonal health, I recommend hormonal testing, functional digestive testing when indicated (stool, urine, and breath tests), a dietary consultation to plan a healthy low-inflammation diet, meditation, yoga, a regular exercise plan, adequate sleep, and a look at any potential toxic exposures that could disrupt your hormones, the Great Communicators!


1 Consumption of wheat amylase trypsin inhibitors enhances autoimmune encephalitis in mice. Oral presentation, 16th International Celiac Disease Symposium, 2015, Zevallos

2 Akil Palanisamy, MD, The Paleovedic Diet

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

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