Prism Blog, Transgender Wellness

Nutrition for Transitioning

This article is an excerpt from my research paper, “Nutritional Guidelines for Transgender Patients.” It is not intended to function as medical advice. Before beginning or changing your diet, always consult a healthcare provider.

Nutrition is an important part of Chinese Medicine that should not be overlooked especially when working with clients taking hormones and other medications, as those medications can have significant effects on a client’s digestive system and nutrient absorption.

For any client, it is most important to start with a basic healthy diet. Clients should try to avoid animal products raised with hormones, salty and fried foods, sugar, white flour, chocolate, processed or refined foods, soy, alcohol, and caffeine, and to add more fresh fruits and vegetables (Gladstar, p. 84-85). Clients should also try to avoid too much raw or cold food and drinking with meals; and focus on chewing thoroughly, eating slowly, and eating a variety of foods (Caruso-Radin). Eating plenty of healthy fats helps to support mental health since fats form the myelin sheaths that coat nerve and brain cells, allowing them to function more effectively (Midnight). Fats also support the body in making hormones, many of which are derived from cholesterol (Midnight). Starting with these guidelines, specific nutrients may be used to support synthetic hormones and create a new healthy balance based on the client’s goals. Nutrition is extremely important for anyone’s health, but is especially valuable in a transitioning process which can cause both bodily and mental stress. Creating a diet that fits a client’s goals can ensure more compliance as well as enhance the work being done with other modalities.

Read more here on masculinizing and feminizing specific diets!

References:

American Pregnancy Association. Folic Acid. June 2014. Retrieved from americanpregnancy.org/pregnancy-health/folic-acid/

Balch, Phyllis and Balch, James. Prescription for Nutritional Healing, 3rd edition. Avery, Penguin Putnam Inc, New York. 2000.

Bennett, Alan. How to Convert Cholesterol to Pregnenolone. Livestrong: Health. January 28, 2015. Retrieved from livestrong.com/article/72359-convert-cholesterol-pregnenolone

Caruso-Radin, David. Nutrition East and West. Course at AIMC Berkeley, Winter 2015.

Coffman, Melodie Anne. Which Foods are Rich in CoQ10? Livestrong. January 10, 2014. Retrieved from livestrong.com/article/256149-what-foods-are-rich-in-coq10/

Cole, B. and Luna Han, editors. Freeing Ourselves: A Guide to Health and Self Love for Brown Bois. 2011.

Earthangel, Reverend Doctor. The Importance of a Healthy Diet. The House of Sissify: The Herbal Encyclopedia. 2005. Retrieved from sissify.com/feminization-hormones/healthy-diet

Erickson-Schroth, Laura. Trans Bodies, Trans Selves: A Resource for the Transgender Community. Oxford University Press, New York, NY. 2014.

Gaby, Alan R. and The Healthnotes Medical Team, editors. A-Z Guide to Drug-Herb-Vitamin Interactions, 2nd edition. Three Rivers Press of Random House, NY. 2006.

The Gale Group. Ipriflavone. AltMD: Gale Cengage Learning. 2008. Retrieved from altmd.com/Articles/Ipriflavone–Encyclopedia-of-Alternative-Medicine

Gladstar, Rosemary. Herbal Healing for Women. Fireside of Simon & Schuster Inc, NY. 1993.

Griffith, H. Winter. Vitamins, Herbs, Minerals and Supplements: The Complete Guide, revised edition. New York, NY. 1988.

Kerns, Michelle. Foods with the Highest Content of Quercetin. Livestrong: Food and Drink. June 23, 2014. Retrieved from livestrong.com/article/301326-foods-with-the-highest-content- of-quercetin/

Kerns, Michelle. Foods Containing L-Carnitine. Livestrong: Food and Drink. August 25, 2015. Retrieved from livestrong.com/article/22647-foods-containing-l-carnitine

Marz, Russel B. Medical Nutrition from Marz, 2nd ed. mni-Press, U.S. 1999.

Midnight, Dori. Holistic Health for Transgender & Gender Variant Folks. Ohlone Herbal Center, Research Papers. December 28th, 2009. Retrieved from ohlonecenter.org/research- papers/holistic-health-for-transgender-gender-variant-folks/

Petersen, Julia, Johanna Dwyer, Herman Adlercreutz, Augustin Scalbert, Paul Jacques, and Marjorie McCullough. Dietary Lignans: Physiology and Potential for Cardiovascular Disease Risk Reduction. Nutrition Review, 68 (10), p. 571-603. October, 2010. Retrieved from ncbi.nlm.nih.gov/pmc/articles/PMC2951311

Pitchford, Paul. Healing with Whole Foods: Asian Traditions in Modern Nutrition 3rd edition. North Atlantic Books, Berkeley, CA. 2002.

The Prodragonist. More Queer Herbs (Masculine). July 24, 2013. Retrieved from belladonnaquixote.wordpress.com/2013/07/24/more-queer-herbs-masculine/comment- page-1

Renee, Janet. List of Foods that Contain Glutamine. Livestrong: Food and Drink. January 9, 2014. Retrieved from livestrong.com/article/249890-list-of-foods-that-contain-glutamine

Transgender Nutrition Considerations. February 27, 2013. Retrieved from transidentified.com/2013/02/27/transgender-nutrition-considerations

UCSF Medical Center. Guidelines for a Low Sodium Diet. University of California San Francisco. Retrieved from ucsfhealth.org/education/guidelines_for_a_low_sodium_diet

United States Department of Agriculture (USDA). National Nutrient Database for Standard Reference Release 27. Agicultural Research Service. Retrieved from ndb.nal.usda.gov/ndb/nutrients

ivCan include a variety of identities that do not fit into the categories of “man” and “woman.” Some terms are gender neutral, genderqueer, non-binary gender, gender non-conforming, and gender fluid, among others. Sometimes people with these identities also consider themselves trans and may or may not undergo medical transition.


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


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Prism Blog, Transgender Wellness

Herbs for Transitioning: Masculinizing Herbs

This is a follow-up post to “The Basics.” Also see the feminizing herbs post here.

Hormones and surgery can be expensive or not accessible. Herbs can also be used if you don’t want to use hormones or undergo surgery, but still want to create physical changes in your body, or after being on synthetic hormones for many years to maintain the changes that you have made without the side effects of continued synthetic hormone use. Note: Most are unlikely to have a significant effect without any other transition methods.

Vitex: The Regulating Herb

Vitex is a hormone normalizer that works with the pituitary gland to keep progesterone stable and prevent  it from converting to estrogen or testosterone. This helps to hold secondary sex characteristics that have developed with synthetic hormones. Technically, it increases LH and reduces FSH, which increases progesterone and reduces estrogen and testosterone. This helps it regulate emotions, prevent acne, hormonal edema and bloating, and it can help you transition onto and off of synthetic hormones, as well as stabilize fluctuations in hormones while taking hormones.

These herbs can be used instead of synthetic hormones:

(Ex. to create small changes if hormones are not desired, or after years of taking hormones to maintain changes.)

  • Example combination: pine pollen, ashwaganda, Lu Rong
  • ashwaganda- steroidal precursor to T… and an adaptogen that helps build your immune system!
  • Yohimbe– promotes and supports testosterone levels
  • ginseng/Ren Shen- “yang tonic” in TCM, yang is both the masculine energy in TCM (ex. Ren Shen is sometimes used for impotence), and the energy needed to create change (ex. transition). DO NOT take while on testosterone.
  • sassafrass
  • pine nuts & pine pollen- closest approximation to human androgens
  • wild oats
  • Lu Rong/young deer antler- contains deer testosterone
  • blue cohosh- to stop periods, often taken with black cohosh. ONLY take this herb under supervision of a professional herbalist, it can be dangerous or cause opposite of desired effects if used incorrectly.
  • Blends:
  • Foods:

These herbs can help support synthetic hormones:

(DO NOT combine these with your medications without discussing with a healthcare provider.)

  • buplerum/Chai Hu- for emotional stability
  • stinging nettle– decreases “bound” testosterone and increases “free” or usable testosterone. also provides lymphatic and immune support.
  • white button mushroom- prevents testosterone conversion to estrogen
  • prickly ash- smoothes and eases voice transformation

For side effects of synthetic herbs:

(DO NOT combine these with your medications without discussing with a healthcare provider.)

  • He Shou Wu- for hair growth, prevents male-pattern baldness
  • saw palmetto- prevents male-pattern baldness, especially when combined with 10-30mg zinc daily
  • B5- to prevent acne
  • marshmallow- for constipation
  • motherwort/Yi Mu Cao
  • kavakava, california poppy, skullcap/Huang Qin, lemon balm, aralia or damiana- for emotional imbalances
  • bitters- for digestive symptoms
  • echinacea
  • yarrow
  • turmeric/Jiang Huang
  • nettle
  • dandelion/Pu Gong Ying, milk thistle/Shui Fei Ji-for liver damage
  • garlic/Da Suan- for high cholesterol & blood pressure
  • red root, cleavers, and ocotillo- for lymphatic drainage – to prevent reproductive cancers
  • hawthorne berry/Shan Zha can help prevent cardiovascular problems (which can occur with long-term T use), but can react with pharmaceutical heart medicines and shouldn’t be combined with them.

DON’T combine synthetic hormones with St. John’s wort/Guan Ye Lian Qiao, it stresses the liver. It also encourages bleeding, so avoid before SURGERY too!

References include:
http://www.sfherbalist.com/holistic-health-for-transgender-gender-variant-folks/
http://midnightapothecary.blogspot.com/


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


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Prism Blog, Transgender Wellness

Androgel: Info for Trans Men

Androgel can be used to initiate or maintain the development of male secondary sex characteristics, as well as virilization (clitoral enlargement) and cessation of menstrual periods.

Though testosterone levels return to baseline 48-72 hours after last dose, most changes (such as cessation of the menstrual period and muscle/fat redistribution) reverse if Androgel treatment is stopped; however, voice changes, facial and body hair, genital growth, and male-pattern baldness persist.

Showering 2-6 hours post-dose decreases testosterone by 13%; using lotion on the application site 1 hour after increases testosterone 14%.

Excess testosterone is converted to DHT (which causes male pattern baldness) and estradiol (a form of estrogen), and can therefore cause adverse effects. This makes finding the appropriate dose and getting hormones checked regularly very important.

It is important to apply gel only to the area of your shoulders that can be covered by a t-shirt, since skin-to-skin contact within 2 hours of application can significantly increase testosterone levels in others (research shows a 280% increase in cis women with skin-to-skin contact vs. only 6% if covered with a t-shirt). Also, remember to wash your hands right away afterwards to prevent transmission as well!

You may experience an increase in urinary disorders or other side effects. It is important to continue to perform regular self chest exams to check for lumps if you still have breast tissue (including tissue near the armpits which often is not removed during top surgery). You should also get your blood pressure, red blood cell counts (to monitor for blood clots), cholesterol and T4 levels checked regularly to monitor for these side effects.


Full Review of Research Follows:

Continue reading

Prism Blog, Transgender Wellness

Estrogen and Blood Clot Risk in Trans Women

Estrogen produced by the body lowers blood concentrations of several clotting factors and speeds the rate at which clots dissolve. Estrogen also suppresses production of a factor which is involved in enlarging the size of a clot, and is also beneficial to cholesterol levels. (This may be why cisgender men are about 18% more likely to develop DVT than cisgender women.)

Administered estrogen, however, actually increases plasma fibrinogen, the activity of coagulation factors, and platelet activity. This explains why estrogen medications increase blood clots (in both transgender women and cisgender women taking birth control or hormone replacement therapy). Oral estrogen also significantly increases “bad” cholesterol in trans women, while decreasing the level of “good” cholesterol, which can lead to clogged arteries, increasing chances of clots.

Highest risk: Combining antiandrogens (like spironolactone) with oral ethinyl estradiol (birth control pills) carries a much higher risk of thrombosis than any other regimen. Trans women taking birth control pills are 20 times more likely to suffer from DVT than the general population. Premarin also carries a higher risk of DVT than injectable estrogen, though not as high as birth control. This is most often the case for hormones that are procured without a prescription. Prescribed HRT for trans women in the U.S. usually includes spironolactone and 17-beta estradiol (aka micronized estradiol), rather than ethinyl estradiol. This regimen is much less likely to produce clots.

Other risk factors: lack of exercise, long periods of immobility (such as long airline flights), genetic clotting risk, injuries (broken bones especially), liver stress (support liver while taking hormones!), high blood pressure, type 1 diabetes. Aspirin therapy is often recommended if over age 40 because of increased plasma concentrations of coagulation factors. Smoking increases factor XIII, thrombin, and fibrinogen, which increase clotting risk. Smokeless nicotine does not carry the same risk, and abstention from smoking for a period of only 2 weeks significantly decreases the rate of fibrinogen synthesis. Risk is highest within the first year of estrogen use, potentially because oral estrogen is more common than injectable estrogen during this time.

Recommendations:

  • Using injectable rather than oral estrogen of any kind (if using oral estrogen make sure it’s 17-B estradiol)
  • Taking baby aspirin for the first year of HRT if over age 40
  • Supporting your liver metabolism
  • Exercise regularly
  • Quit smoking (or switch to smokeless tobacco for at least the first year of HRT)
  • Test for genetic clotting risk
  • Check blood pressure regularly and maintain safe levels

Symptoms of DVT: inexplicably warm area on your lower leg which persists for more than an hour, localized swelling, redness, pain, shortness of breath, chest pain, symptoms of stroke. CALL 911!


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.


Resources:
http://www.atsjournals.org/doi/full/10.1513/pats.200407-038MS#.VIKVP8mJkTA
http://www.ncbi.nlm.nih.gov/pubmed/2960241
http://transascity.org/deep-vein-thrombosis-and-hormone-use/
http://www.pharmacologyweekly.com/custom/archived-content/pharmacotherapy/51
http://www.sciencedaily.com/releases/2013/09/130930162226.htm
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096855/
A Personal Story: bloodisthickerthanwaterr.wordpress.com/2015/01/13/my-blood-clot-story-2/

Prism Blog, Transgender Wellness

Herbs for Transitioning: Feminizing Herbs

This is a follow-up post to “The Basics.” Also see the transmasculine post here.

Hormones and surgery can be expensive or not accessible. Herbs can also be used if you don’t want to use hormones or undergo surgery, but still want to create changes in your body, or after being on synthetic hormones for many years to maintain the changes that you have made without the side effects of continued synthetic hormone use. Note: Most herbs are unlikely to have a significant effect without any other transition methods.

DO NOT combine these with your medications without discussing with a healthcare provider.

Vitex: The Regulating Herb:

Vitex (Vitex agnus) is a hormone normalizer that works with the pituitary gland to keep progesterone stable and prevent  it from converting to estrogen or testosterone. This helps to hold secondary sex characteristics that have developed with synthetic hormones. Vitex increases LH and reduces FSH secretion, which increases progesterone relative to estrogen and testosterone (Wright & Morgenthaler, Natural Hormone Replacement). This helps it regulate emotions, prevent acne, hormonal edema and bloating, and it can help you transition onto and off of synthetic hormones, as well as stabilize fluctuations in hormones while taking hormones.

Estrogenic, Progesterogenic, and Anti-Androgenic Herbs:

  • Example combination: Vitex, Hops, Maca, and sprouted Fenugreek
  • Rhodeola Rosea is a controversial herb, however, the most informative sources I’ve found say that it increases estrogen levels unless they are already unnaturally high (such as when taking estradiol), in which case it decreases them. Overall this is a strong herb that should be used with caution and medical supervision.
    • If you have had estrogen sensitive breast cancer, bleeding disorders, diabetes, or take acetazolamide, alpha-glucosidase inhibitors, anti-anxiety agents, antibiotics, anticancer agents, antidepressants, anti-inflammatories, antivirals, COMT inhibitors, drugs that affect the cardiovascular system or the immune system, P-glycoprotein-regulated agents, sedatives, theophylline, or stimulants, you should use caution or avoid this herb.
  • Maca is known for its effects of creating curves, has estrogenic effects, and is fairly inexpensive. It is also known for its aphrodisiac effects, and can increase erectile capacity and sperm counts, which may be a positive or negative thing for you depending on your goals. It also boosts the immune system and helps combat osteoporosis (which can be a side effect of taking spironolactone). Also available in a women’s libido blend.
  • Chaste tree berry/Vitex (Vitex agnus-castus) mimics progesterone, is also considered to be mildly estrogenic, and increases breast size by stimulating the development of milk ducts. It can therefore have a side effect of causing lactation.
  • Black cohosh/Sheng Ma (Cimicifuga racemosa) contains several compounds in its root (aceteine, formononetin, and triterpenes) that, though not estrogenic themselves, create similar effects to estrogen and can increase breast size. It decreases LH and increases estrogen in relation to progesterone [opposite of Vitex] (Wright & Morgenthaler). Only use this herb under supervision of an herbalist.
  • Fenugreek/Hu Lu Ba (Trigonella foenum-graecum) seeds contain a compound (diosgenin) that’s estrogenic and promotes breast tissue growth. Sprouted seeds contain much more diosgenin than the unsprouted seeds, so breast enlargement is more noticeable if you sprout the seeds first. Fennel works in much the same way.
  • Hops have 0.2-20% the potency of estradiol
  • Dong Quai/Dang Gui (stimulates estrogen receptors, providing some estrogen stimulus to receptor sites (Wright & Morgenthaler), however, it is not actually estrogenic itself.
  • False Unicorn (used during menopause for estrogen replacement)
  • Licorice (somewhat anti-androgenic and mimicks estrogen). Licorice also notably counteracts side effects of spironolactone (the most common anti-androgen used in the U.S.) like low blood pressure, gastic upsets, fatigue, dehydration, and frequent urination.
  • Other options from other pracititioners, I can’t vouch for any of these myself:
    • Pennyroyal (never take the oil internally!)
    • Goats Rue (promotes lactation)
    • Southernwood
    • Red Clover/Hsun Tsao
    • Caraway
    • Partridge Berry
    •  Anise
    • Raspberry Leaf
    • Mugwort/Ai Ye
    • Yarrow (encourages progesterone)
    • Cramp bark (mildly estrogenic)
    • Turmeric (mildly estrogenic)
    • Alfalfa
    • Burdock
    • Evening Primrose
    • Pau D’Arco
  • Blends:
    • Phytoestrogen Herbal from Vitanica
    • My Evanesce has several herbal blends, most of which have many unnecessary added ingredients, but their Feminol product has a more useful blend of dong quai, black cohosh, chaste tree, white kwao krua, fennel, fenugreek, licorice, kudzu, sarsaparilla, boron, plus b6, d3, and b12. They recommend taking all of their formulations at once which is not only completely unnecessary as they mostly contain the same ingredients but also could lead to dangerous dosages of the herbs. Do not do this and do your own research!
    • “HRT Companion” formula (formulated for side effects of synthetic hormones)
  • Foods:

Note: DON’T combine synthetic hormones with St. John’s wort/Guan Ye Lian Qiao, it changes the way that medications are metabolized. It also encourages bleeding, so avoid before surgery too!


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.


References include:
http://www.sfherbalist.com/holistic-health-for-transgender-gender-variant-folks/
http://midnightapothecary.blogspot.com/

Acupuncture, Menopause and Beyond, Prism Blog, Surgical Recovery

10 Reasons LGBTQ Seniors Should Get Acupuncture

  1. LGBT older people face significant health disparities, “linked to a lifetime of stigma, discrimination, violence and victimization; higher poverty rates; a lack of access to LGBT-competent providers; and low rates of health insurance coverage” (Out & Visible). Therefore, LGBTQ older adults need even more access to healthcare.
  2. Acupuncture helps to protect the immune system and prevent the potentially dangerous infections that become more likely as we age.
  3. Acupuncture eases pain and arthritis as well as strengthening bones to prevent osteoporosis and injuries, so you can maintain mobility and reduce the need for surgeries and medications.
  4. Acupuncture lowers blood pressure and strengthens the circulatory system, preventing potentially life threatening cardiovascular events.
  5. LGBT elders “deal disproportionately with mental health concerns, which is a primary risk factor for social isolation” (Sage USA). Acupuncture reduces anxiety and depression, helps you to adapt constructively to change, and to move through grief.
  6. Acupuncture helps your body prepare for surgery and to heal faster after surgery, reducing complications and need for pain medications.
  7. Acupuncture does all of this without having to worry about drug-drug interactions!
  8. AIMC Berkeley is an LGBTQ safe space so you don’t have to worry about healthcare discrimination. “44% of transgender older people worry that their relationships with healthcare providers would be negatively affected if their gender identities were known, as opposed to 20% of LGB older people” (Autostraddle on LGBTQ Seniors).
  9. Treatment is determined based on the individual, not the illness. All the symptoms are seen in relation to each other leading to a unique treatment for each patient instead of cookie cutter prescriptions.
  10. You get more time with a practitioner than you would with an MD. With 60 minute appointments, Katrina can take time to really listen to you.

All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


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Acupuncture, For Providers, Prism Blog, Transgender Wellness

Yin and Yang; Masculine and Feminine

 

“Instead of saying that all gender is this or all gender is that, let’s recognize that the word gender has scores of meanings built into it. It’s an amalgamation of bodies, identities, and life experiences, subconscious urges, sensations, and behaviours, some of which develop organically, and others which are shaped by language and culture. Instead of saying that gender is any one single thing, let’s start describing it as a holistic experience.” –Kate Bornstein & S. Bear Bergman (Gender Outlaws)

Most diagnoses in Chinese medicine, represent the interaction between hot and cold, day and night, yin and yang, masculine and feminine. However, Chinese medicine’s outlook on these dualities is actually much more inclusive of LGBTQ identities when you look beyond this basic binary.

Yin and yang, though often associated with male and female, are more accurately represented by masculine and feminine. Masculinity and femininity are indeed seen as opposites, but they are also in a constant state of transformation from one into the other, and at each stage yang contains yin and yin contains yang.

Basic Principles of Yin & Yang/Masculinity and Femininity:

1. Masculinity and Femininity are opposites

2. Masculinity and Femininity are interdependent: There is always masculinity within Femininity and femininity within Masculinity

3. Masculinity and Femininity are mutually consuming and in a constant state of transformation of one into the other

In this way, masculinity and femininity cannot exist without both opposing each other and containing a piece of the other. Most people in discussing yin and yang theory today, and even most Chinese Medicine practitioners, only focus on the first principle, which alone can be used to reinforce our culture’s thinking of gender as binary. However, traditionally this medicine was much more inclusive of gender variations and spectrums!

Further Sources:
genderevolve.blogspot.com
acupuncturetoday.com


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.

 

For Providers, Prism Blog, Transgender Wellness

How to Ask About Gender Pronouns for Healthcare Providers

  1. When asking about gender or pronouns, consider your intentions. Do you need to know a patient’s gender/sex-related medical history for your treatment? Or do you just need to know their preferred name and pronouns to develop practitioner-patient rapport? Knowing what your goals are will help you decide what and how to ask. Remember, curiosity is never an appropriate reason to ask personal questions of your patient.
  2.  Ideas for asking about gender or preferred pronouns include the following: “Which pronouns would you like me to use for you?” or “How would you like me to refer to you?” (This one is great if you’re not sure if you need to ask about pronouns. Patients can respond simply with “I go by Katie, not Katherine,” or, “Please call me Mrs. Smith.” Other patients may take this opportunity to share preferred pronouns or other information with you). Another good option is, “I like to ask all my patients which pronouns they prefer. Would you mind telling me yours?” Patients may feel more comfortable responding if they know you’re not singling them out.
  3. How do we know when we should ask patients questions about their identities? If you are just curious, don’t ask. There are many website available for you to educate yourself. Use patient time only to gather information relevant to their health concerns and goals. It is appropriate to ask how a patient would like you to refer to them, and what hormones they are taking because you need to know how to refer to them and medications may affect what herbs you prescribe. Though more sensitive, it can also be relevant to ask what your patient’s plans are for transitioning (or not transitioning) so that you can best support their goals.
  4. What’s the basic difference between gender and sex? Take a look at the “genderbread person” to learn the basic difference between sex and gender. As a generalization, gender is is your head; it’s how you identify. Sex is what the doctor decides you are when you’re born, based on your genitals at birth.
  5. The hardest part: Both gender and sex are social constructs! Your sex is decided based on your genitals at birth, which do not necessarily match with your chromosomes, what internal reproductive organs you have, what sex hormones or secondary sexual characteristics you will have, or even what your genitals will look like later in life. Most people like to think of sex as black and white (male, female, and nothing else), but this simply doesn’t match up with reality.

All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.

Endometriosis, Fertility and Pregnancy, Menopause and Beyond, PCOS, Prism Blog, Transgender Wellness

Can Vitamins Treat Hormonal Acne?

Vitamin B5 supplementation can reduce acne caused by testosterone!

B5, also known as pantothenic acid, limits oil production in the sebaceous glands of the skin, a common cause of acne. Testosterone causes these glands to produce more oil, so vitamin B5 reverses this process, without counteracting any of the other desirable effects of T.

Doses of 500mg up to 5 g a day were used in the study, however 5mg is the standard recommended dose. It’s safer to start with a smaller dose and work your way up; I wouldn’t recommend going higher than 1g a day without working with a healthcare provider. Also, be cautious with any supplements if you are using oral testosterone, as it can be very hard on the liver.

B5 can also help lower cholesterol, which can be important with long-term testosterone use. It also helps speed wound healing and can be helpful for rheumatoid arthritis.

B5 is available in the diet, though it is often lost in processing, so fresh foods have significantly higher amounts than processed foods. The best sources are brewer’s yeast, wheat germ, corn, cauliflower, kale, broccoli, tomatoes, avocado, egg yolks, beef (especially organ meats), poultry, milk, legumes, peanuts, sunflower seeds, whole-grains, lobster, and salmon. Soybeans and sweet potatoes also contain large amounts, but be cautious with them as they have an estrogenic effect.

B5 is a water soluble vitamin, so it’s not stored in your body if you take too much (unlike vitamin D), but it does need to be filtered out by your body to get rid of it, which can stress your liver and kidneys. Overdose on B5 can cause diarrhea, an increased risk of bleeding, and a deficiency of other B vitamins, especially B1/thiamin. For this last reason, you may consider taking a B complex rather than just B5.

B5 can interfere with tetracycline (an antibiotic) function, so don’t take them at the same time. It can also increase the effects of certain alzheimer’s medications so should be used with caution if taking Donepezil, Memantine hydrochloride, Galantamine, Rivastigime, or other Cholinesterase inhibitors.

One study noted that taking L-carnitine along with B5 supplementation allowed patients to take higher amounts, since L-carnitine aids in the breakdown and absorption of B5. The study recommended 250mg a day, though the standard dose is up to 3 g a day. It is important to note, however, that the addition of l-carnitine can actually cause smoother skin with smaller pores (the opposite of testosterone’s effects), and weight loss; so consider whether you want those effects before taking it. High doses can cause diarrhea, increased appetite, body odor, and rash. L-carnitine can also make thyroid hormone replacement less effective; it can be beneficial for those with hyperthyroidism, but detrimental to those with hypothyroidism. It can also increase the risk of seizures in people with epilepsy.

http://umm.edu/health/medical/altmed/supplement/vitamin-b5-pantothenic-acid#ixzz2iezHBkjN
http://umm.edu/health/medical/altmed/supplement/carnitine-lcarnitine
http://www.trans-health.com/2001/tranzit/


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


Contact us to see if your insurance covers services at our office!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.

Prism Blog, Transgender Wellness

Herbs for Transitioning: The Basics

Herbs can be used for many aspects of transitioning: transitioning with herbs alone, switching from synthetic hormones to herbs to maintain secondary sex characteristics, and supporting the body with herbs and nutrition to counteract side effects of synthetic hormones.

The Basics:

It’s first important to take care of your body with proper nutrition so that you can handle the changes  and stress that will accompany transitioning. All hormones are made of fat, so it’s important to eat good fats (raw oils & omega 3s especially) to help your body form and transform those hormones, and also to coat your nerve cells (their myelin sheaths are also made of fat) to help you cope with stress and stay emotionally healthy. Fats form the boundaries of our cells–they keep out and let in what we want to–we need good fats in our bodies to have good boundaries physically and emotionally!

We ALL have the same hormones, just in different amounts and we USE different amounts of them too. Furthermore, we can change how our bodies use the hormones we already have. Every body makes progesterone from cholesterol, and that progesterone can turn into estrogen OR testosterone. The estrogen and testosterone in our bodies can also convert back and forth (estrogen to testosterone and vice versa). This is the reason you want to get your hormone dosages right: if you take too much, your body is just going to convert it into another hormone to maintain balance in your system. This could actually counter the desired effects of the hormone you are taking: too much estrogen in your system and your body will start converting it to testosterone, counteracting the changes you want to make.

Coming up with a plan for your body:

There are many different options for transitioning, even when just using synthetic hormones. Progesterone itself helps to build tissue and can often be useful for developing breasts (taken externally) or muscle tissue (taken internally). Aromatase is what turns testosterone into estrogen, so you can take extra aromatase instead of (or in addition to) taking estrogen. Likewise, you can take aromatase inhibitor to prevent that testosterone from turning into estrogen, instead of taking testosterone. There are many options for prescription hormones; it’s important to talk to your doctor about what will work best for your body.
For most people, herbs aren’t going to change your hormones drastically alone, so you might choose to start out taking synthetic hormones and, once you’ve achieved the effect you want, use herbs to lower your dose of synthetic hormones or switch to herbs entirely. Herbs can maintain the hormone levels and characteristics you’ve built up with synthetic hormones. This is a good alternative to the sometimes health damaging side effects of long-term synthetic hormone use.


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References include:
http://www.sfherbalist.com/holistic-health-for-transgender-gender-variant-folks/


All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.


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