A big girl with a hidden hormone problem

Last week I saw a 32 year old woman who had battled with excess weight for many years. She was very frustrated – she had tried very hard to lose weight but it came off slowly and then she regained it all too quickly. She had seen a hormone specialist (endocrinologist) who had told her there was nothing wrong with her hormones and that she did not have Polycystic Ovarian Syndrome (PCOS) because her testosterone levels were not elevated and she did not suffer with acne and facial hair.

I begged to differ with the endocrinologist
; because this woman had the tell tale signs of PCOS in her pelvic ultrasound which showed excessive follicles lined up around the periphery of her ovaries. These were trapped eggs (follicles) that had failed to ovulate and if an egg does not ovulate it will not produce progesterone. Her history revealed that she did not menstruate regularly and she only had 5 to 7 menstrual cycles a year; this is because she did not produce the progesterone required to bring on a menstrual bleed.

She had a somewhat “Cushingoid appearance” with a very fat round face and a large fatty belly. Her blood cortisol levels were at the upper limit of normal and this is common in overweight younger women. All these hormonal imbalances were making her overweight and disrupting her metabolism and unless I fixed them she would have a life long battle with obesity and would become diabetic later on.

I prescribed natural progesterone cream to give her a regular menstrual cycle and stimulate weight loss. I also prescribed a low carbohydrate eating plan with lots of protein and raw vegetable salads to help her liver. I also prescribed supplements of magnesium and Glicemic Balance capsules to lower her high insulin levels, as this is vital to promote fat burning and weight loss.

Pro Fem cream contains natural progesterone and is rubbed into the skin once daily after a shower.

I am sure this woman will do well with her weight loss and her general health because it is quite possible to correct the hormonal imbalances she suffers with which are causing her excess weight – namely

Low progesterone due to PCOS
High cortisol levels
High insulin levels


Do you think you have a hidden or misdiagnosed hormonal imbalance causing your weight excess? If so, we'd love to read your comments.




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autoimmune liver disease

Autoimmune liver disease can respond well to nutritional medicine but how long will it take before it improves?

Generally speaking we have found that the time frame depends on how long you have had the liver inflammation and how enthusiastic you are to follow the program to heal your liver. In our medical clinics in Sydney we have found that there is always significant improvement after 4 months if the patient is compliant. Autoimmune liver disease can be caused by several different factors, often working together to make the liver inflammation worse. A blood test should be done to check your genotype for the genes that predispose to gluten intolerance and if these are present, it is vital to avoid gluten.
I recommend the following program -
Selenium 100 mcg daily
Liquid fish oil or flaxseed oil - one tablespoon twice daily just before food
Livatone Plus - 2 capsules daily
Probiotics to improve gut flora
The diet should consist of 40% raw fruits and vegetables as well as some raw juices made freshly
Love your liver and live longer
Dr Sandra Cabot

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Tips for a healthy thyroid gland

Hi it's Dr Cabot here ! (Tuesday 16th February 2010) and I am in Phoenix with my naturopath Christine Ki and we were checking the comments to our blog on thyroid problems.

I would like to thank everyone who has made comments on our blogs; you all sound like great people and it makes us feel worthwhile that our knowledge can help you so much.

I would like to add a few things about thyroid disease. In pre-menopausal women I have found that both over active and under active thyroid conditions are often associated with deficiency (inadequate production) of progesterone. The thyroid condition can be helped by the use of progesterone cream (Fem Pro cream). If the thyroid condition is auto-immune, the use of a selenium supplement is vitally important, as it treats the cause of the problem - namely elevated auto-antibodies. Liquid fish oil acts as a natural anti-inflammatory in cases of auto-immune thyroid disease - I suggest one to two tablespoons daily, just before food.

Overactive thyroid is often caused by stress and trying to fit too much into your life - if so, get more rest and relaxation and take a good magnesium supplement - like MAGNESIUM COMPLETE - I call magnesium, The Great Relaxer!

Stay well and believe in yourself
Dr Sandra Cabot




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Dramatic rise in the incidence of esophageal cancer

According to the Australian Cancer Council, the rate of esophageal cancer in Australia has more than doubled in the last 25 years. Presumably the figures would be similar for other western nations including the USA and Europe.

The esophagus is the tube that runs from your mouth to your stomach. Esophageal cancer starts in the cells that line the esophagus. Because the lining is quite thin, cancer cells usually quickly spread to surrounding tissues and can then move to other parts of the body (metastasize).

Esophageal cancer can be difficult to pick up in the early stages because the symptoms can be mild and are often ignored.

Common symptoms of esophageal cancer include:

• Hoarse voice

• Coughing

• Indigestion and reflux

• Difficulty swallowing and/or pain while swallowing

The biggest factors that cause esophageal cancer are obesity, smoking, high alcohol intake and chronic heartburn and indigestion. Alcohol and cigarettes have an irritating effect on the lining of the esophagus and they promote damage to DNA (thereby increasing the risk of cancer).

Overweight people are more likely to suffer with reflux and heartburn because extra fat in the abdominal area places greater pressure on the abdominal organs and increases the risk of a hiatus hernia. However, anyone can experience heartburn and reflux regardless of their weight.

Long term reflux can lead to what is known as Barrett’s esophagus. This occurs when acid from the stomach comes up into the esophagus and burns and irritates the delicate esophageal lining. If this is allowed to continue for years, the cells lining the esophagus undergo changes that make them very prone to becoming cancerous. Barrett’s esophagus is usually diagnosed with an endoscopy, where a doctor places a tube down your throat in order to view your esophagus. Anyone with chronic reflux or heartburn should have this test. If you have a chronic cough you may have reflux but not be aware of it. Sometimes a cough is the only symptom of a digestive problem.

Luckily esophageal cancer is very easy to prevent in most cases, by following a healthy diet and lifestyle. The tips below will help to prevent esophageal cancer:

• Don’t smoke, and keep your alcohol consumption low. Obvious.

• Avoid being overweight. Excess weight held in the abdominal area is the most dangerous. The easiest way to lose weight is by avoiding sugar and high carbohydrate foods like pasta, bread, breakfast cereals, sweet drinks and all foods made of flour. See our Syndrome X book for a low carbohydrate eating plan.

• Make sure your digestion is good. Bloating, indigestion, heartburn, reflux, burping and flatulence are all signs that something is wrong. The first step is to eliminate junk food, soft drinks and chewing gum. If the problem persists you may have a food intolerance. Most commonly this is to dairy products, wheat, gluten, soy, corn or citrus fruits. You can try eliminating these foods from your diet as a test, or see a naturopath or nutritionist for guidance.

• Research has shown that selenium deficiency increases the risk of esophageal and stomach cancer. The Netherlands Cohort Study followed 120, 852 men and women aged between 55 and 69 years. The participants were followed for 16.3 years. The people with the highest selenium intake were significantly less likely to develop esophageal squamous cell carcinoma (ESCC), esophageal adenocarcinoma (EAC) and gastric cardia adenocarcinoma (GCA). It is very difficult to get enough selenium from your diet in most parts of the world. Brazil nuts are a good source of this mineral; apart from that few foods contain significant quantities. We strongly recommend you take a selenium supplement each day as it is a powerful antioxidant and helps to protect you against several types of cancer.

Ref. Steevens J, et al. Selenium status and the risk of esophageal and gastric cancer subtypes: the Netherlands cohort study. Gastroenterology


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Don't let cravings sabbotage your weight loss

Approximately 70 percent of overweight people are suffering from a chemical imbalance called Syndrome X, which impairs their ability to lose weight. One feature of Syndrome X is to have elevated blood levels of the hormone insulin. This hormone encourages the conversion of dietary carbohydrate into fat, and promotes the storage of fat. Insulin also has the effect of inhibiting the body's ability to burn fat. The most effective way of lowering insulin levels and hence losing weight, is to follow a lower carbohydrate, higher protein eating plan.



Our overweight patients have had great success following this eating plan. However, if you have a large amount of weight to lose, or it is coming off quite slowly, it is easy to lose your motivation and slip off the wagon so to speak. Stress, depression, boredom and social functions can easily sabotage your best efforts. None of us are perfect all the time, it is normal to have slip ups every now and then.

Going off the eating plan every now and then will really not do any harm. It is more important what you are doing 90 percent of the time. The problem is that high carbohydrate, and sugary foods can be addictive, especially if you are prone to low blood sugar levels (hypoglycaemia) or depression. Once you become accustomed to eating these foods again, your cravings can come back more intense than ever, and it becomes harder and harder to stop. Thus it becomes much more difficult to go back to the eating plan. Some of our patients have told us that they feel like an alcoholic when it comes to bread and sweets; once they start eating them again they can't stop until they've eaten the whole packet!

Here are some tips you may find useful for getting back on track and controlling cravings:

Make sure you eat first class protein at each of your meals. This means seafood, or lean meat, poultry or eggs. If you are a vegetarian you must combine a nut with a seed, with a legume to obtain complete protein. The protein will have the effect of stabilising your blood sugar levels, thus getting you off the sugar cravings roller coaster.

Eat enough so that you feel satisfied at the end of your meal, and are not searching for something to eat two hours later. Be creative with your meals, make them colourful and interesting. You can make salads delicious by dressing them with olive or macadamia nut oil, balsamic or apple cider vinegar. You need to enjoy what you are eating so that you don't feel deprived and can keep at it.

Enjoy healthy snacks consisting of protein, such as raw nuts and seeds, which can be combined with fruit. You could also make a smoothie using a whey based protein powder that is sweetened with stevia. The smoothie can be made using unsweetened soy milk, almond milk, water or diluted coconut milk. If you add some fruit and ice you can have a delicious, filling treat that won't impair your ability to lose weight.

Drink at least two litres of water each day. This is essential for your metabolism to function efficiently, and it will pick up your energy levels. Water is great for reducing hunger and cravings, if you have a large glass of water, you will often find that you are not that hungry after all. Many people find that squeezing some lemon or lime juice into water and sipping it through the day is good for controlling cravings.

There are certain herbs and nutrients that work together to improve the sensitivity of the body's cells to insulin. This is desirable because it means the pancreas will not need to produce excessive amounts of insulin. This will therefore help with weight loss and reduce cravings and hunger. A combination of the herbs Gymnema sylvestre and bitter melon, along with chromium, magnesium, lipoic acid and carnitine is best. These can be taken combined in capsule form before each meal, and will make the eating plan significantly easier.

When trying to lose weight, it is important to remember that you are not going to reach your goal weight in a month. Be patient and be kind to yourself. Don't lose sight of your goal, and remember that you are working toward a healthier body as well as a slimmer one. It is important to enjoy the journey toward weight loss, and not just the destination.



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Case study: Under active thyroid gland

Carol arrived at our clinic overweight and exhausted. She was so tired that she actually had to put her elbows on the table and rest her head in her hands as she spoke to me for an hour. Carol weighed 80 kilos and her healthy weight range is between 65 and 70 kilos.

Carol has hypothyroidism caused by Hashimoto’s thyroiditis. This was diagnosed at the age of 19 and Carol is now 35 years old. Since that time she has been overweight and has suffered some degree of fatigue, aching muscles and fluid retention. In the last year those symptoms had intensified, plus Carol had developed new health problems:

--She felt stiff and sore when she got out of bed each morning. Carol dreaded having to face each day.
--Carol had a constantly blocked nose, mucus in her throat and she had frequent colds and flu.
--She had just recently recovered from a bout of thrush, which she suffered with regularly.
--Carol had a bloated abdomen, felt nauseous much of the time and had occasional bouts of diarrhea for no reason.

Carol had been taking Oroxine/Synthroid (thyroxine) at an alternating dose of 100mcg one day and 150mcg the next day. She also took B vitamins to help with stress.

I assessed Carol’s blood test results and discovered that her TSH was 4.0 mIU/L, indicating that she was not taking enough thyroxine. I sent Carol for a urinary iodine test and her result showed extreme deficiency. Her urinary iodine level was 18 ug/L and a normal level should be above 100.

I asked Carol to increase her thyroxine to 150mcg each day. Hashimoto’s thyroiditis is an autoimmune condition where the immune system produces antibodies that attack and destroy the thyroid gland. Most patients will continue to experience some symptoms of an under active thyroid gland unless they work on improving their immune system.

In order to achieve this I placed Carol on a gluten and dairy free diet and put her on a bowel detox. 80 percent of the immune cells in our body are found in our digestive tract, therefore the digestive function must be addressed in order to improve the immune system. As Carol was severely iodine deficient, I also gave her a supplement containing iodine, combined with other nutrients essential for healthy thyroid gland function.

After eight weeks Carol returned a different person. She had a big smile on her face and had regained her enthusiasm for life. Carol was thrilled to have lost seven kilos. She did not exercise during that eight weeks but said she now had the energy to, and starting an exercise program was her goal.

Carol’s muscles no longer ached and she was no longer puffy. She was able to fall asleep quickly and sleep solidly through the night. Therefore she woke with energy and looked forward to each new day. Carol’s digestion improved dramatically and she no longer suffered with nausea, bloating or diarrhea.

Carol will continue with a gluten and dairy free diet for another couple of months, when she will be reassessed again. She has not found the diet difficult to stick to, and the dramatic improvement in her health has provided ample motivation to continue it. In the majority of cases we recommend people with Hashimoto’s thyroiditis follow a gluten free diet for life.

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Is vitamin K Deficiency aging you before your Time?

Like most people, you’ve probably never thought much about vitamin K. It certainly doesn’t receive anywhere near as much media coverage as vitamins C or D; however optimal vitamin K levels are essential for good health.

Recent research has found that being deficient in vitamin K places you at greater risk of heart disease, cancer and osteoporosis, effectively shortening your life and reducing its quality.

Vitamin K is a fat soluble vitamin; therefore it is in the same family as vitamins A, D and E. Its main function in the body is blood coagulation, also known as blood clot formation. It is very important for the blood to be able to clot when necessary, otherwise bleeding would not be controlled and large volumes of blood could be lost after minor cuts or injuries. Excessively heavy menstrual bleeding is sometimes caused by vitamin K deficiency. The drug warfarin (Coumadin) works to prevent blood clots by inhibiting the action of vitamin K.

Apart from blood clot formation, vitamin K is required in the body for the following functions:

• Bone mineralization

Vitamin K is required by proteins involved in bone formation and it enables the entry of calcium into bones. Vitamin K deficiency increases the risk of osteoporosis.

• Cell growth

Vitamin K is required for proteins involved in cell growth, cell division and cell death. Studies have shown that vitamin K deficient people are at increased risk of cancer.

• Artery health

Research has shown that deficiency of vitamin K increases the risk of hardening of the arteries that travel to the heart and brain, as well as hardening of the arteries in the kidneys. It is thought that vitamin K helps to prevent calcium deposits from forming in arteries. Deficiency of this vitamin increases the risk of heart attacks and strokes.

Where is vitamin K found?

There are two main forms of vitamin K: vitamin K1 and vitamin K2. K1 is found in plants; particularly green leafy vegetables. The richest sources of vitamin K are spinach, collard, kale, cabbage, Asian leafy vegetables such as bok choy, broccoli, parsley, lettuce and extra virgin olive oil. Vitamin K2 is made by bacteria in your intestines. How much you produce is determined by your digestive health, the levels of good bacteria in your intestines and whether you have recently used antibiotics.

Who needs extra vitamin K?

• People with osteoporosis or osteopenia.

• Anyone wishing to keep their arteries healthy and avoid a heart attack or stroke.

• People with a digestive disorder that impairs absorption of vitamin K or production by beneficial bacteria; these conditions include celiac disease, ulcerative colitis or Crohn’s disease.

• People taking long term or frequent doses of antibiotics.

• People with a liver disease that can impair storage of vitamin K in the body.

Raw vegetable juices – the best natural source of vitamin K

Making your own raw vegetable juices will improve your health, give you more energy, strengthen your immune system, as well as give you a hefty dose of vitamin K. Remember that dark green leafy vegetables are the best source of this vitamin; these can be mixed with some carrot, celery and beetroot for flavor and additional nutrients.
For delicious juice recipes see our book Raw Juices can Save your Life.

You can eat these vegetables cooked as well, as cooking does not destroy vitamin K.

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Gluten Intolerant Women more Likely to have Autistic Children

A new study has found that women with an autoimmune disease are up to three times more likely to have a child with autism than the general population. The autoimmune diseases included in this study were celiac disease, type 1 diabetes and rheumatoid arthritis.

Celiac disease is an autoimmune disease whereby ingestion of gluten causes damage to the lining of the small intestine. This can cause digestive problems such as bloating and diarrhea, however many cases of celiac disease cause no digestive symptoms at all, yet damage still occurs to the body. In type 1 diabetes the immune system attacks the insulin producing cells of the pancreas, leaving the body unable to manufacture sufficient insulin. In rheumatoid arthritis the immune system attacks the joints, causing pain, immobility and disfigurement.

Autoimmune diseases are extremely common and they are more common in women than men. Other examples of autoimmune diseases are Hashimoto’s thyroiditis (causing an under active thyroid), Graves’ disease (causing an over active thyroid), ulcerative colitis and Crohn’s disease (affecting the digestive tract), multiple sclerosis, lupus and others.

Research carried out at the Johns Hopkins University collected data on 3,325 Danish children diagnosed with autism spectrum disorder. The children were born between 1993 and 2004. The data showed that women with an autoimmune disease are more likely to have a child diagnosed with autism. The increased risk for mothers with type 1 diabetes was a little less than double; for rheumatoid arthritis it was 1.5 times, but for celiac disease it was more than three times greater.

Autoimmune disease causes a great deal of inflammation and tissue damage in the body; the inflammation can affect the developing fetus while in its mother’s uterus. Women with celiac disease are also more prone to giving birth prematurely and having a small birth weight baby. Both of those factors are associated with an increased risk of autism.

Autism is thought to be an immune system disorder (rather than a brain disorder), and this study further confirms this belief. Approximately 80 percent of your immune system is located in your digestive tract; therefore digestive problems affect your immunity as a whole and your child’s immunity if you become pregnant.

Luckily there is a lot that can be done to correct immune system function and overcome autoimmune disease. This particular study referred to undiagnosed or untreated celiac disease. If a celiac sticks to a gluten free diet 100 percent of the time and addresses nutritional deficiencies that go hand in hand with the condition, their children are not at increased risk of autism.

We actually recommend that anybody with an autoimmune condition avoids all gluten and cow's milk, regardless of the specific type of autoimmune disease. These diet changes, combined with the right nutritional supplements are extremely successful in the treatment of autoimmune disease.

Source: Association of Family History of Autoimmune Diseases and Autism Spectrum Disorders. Pediatrics July 5, 2009

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