Acupuncture, Endometriosis, Fertility and Pregnancy, For Providers, Menopause and Beyond, Prism Blog, Surgical Recovery, Transgender Wellness

Treating Post-Surgical Constipation

photo credit: Practical Cures on flickr CC

Constipation is extremely common post-surgery, especially in combination with constipating pain killers, less physical activity, and irregular fluid and food intake. Often a bowel movement is required before a hospital will let a patient go home, so encouraging this process is especially beneficial to get you home sooner.

Acupuncture

Acupuncture is extremely useful for alleviating postoperative constipation. Studies have shown that patients receiving regular acupuncture post-surgery actually perform better (have more frequent, easier,  less painful, more complete bowel movements) than those taking laxatives or stool softeners.

Points on your arms, legs, and abdomen are most frequently chosen for this purpose, especially points on either side of your navel and points on the stomach and large intestine ‘meridians’ (lines along the body in Chinese Medicine, sort of like dermatomes).

Acupressure

Several of these points can also be used at home as acupressure points for constipation. Press each point lightly (no more than an inch deep for abdominal points, about the pressure of holding hands for arm and leg points) for about 30 seconds at a time:

Massage

Belly massage is also helpful. You can find a Chi-Nei-Tsang practitioner near you, or watch this video demo to perform a similar belly massage yourself. You can also refer to the illustrated steps available here. There are many methods of breathing exercises for constipation as well that massage your belly from the inside!

Herbs

Acupuncture can be complemented with some herbs that stimulate bowel motility like:

Nutrition

Hydration is key. Drink plenty of water and incorporate more warm foods and beverages to wake up your digestive system gently. Try ginger tea, hot water with lemon, and bone broth. If you urinate more frequently than every 2 hours you may be drinking too much or too fast. If you urinate less frequently than every 5 hours you are dehydrated!

Eat warm, easy-to-digest foods like rice porridge, oatmeal, and mashed sweet potato or yams. When you’re ready, try lamb or vegetable and mushroom soup. Give your family and friends recipes to make for you during your recovery, such as: Magical Mineral Broth, Congee, and Almond flour ginger cookies.


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 more herbal estrogens, ideas, and resources see my previous posts: Feminizing Herbs and “The Basics.”


Further study:

  Acupuncture at ST25 and BL25   Acupuncture at LI11 and ST37   Acupuncture at ST25, BL25, LI11 and ST37   Medicine:oral use of mosapride citrate: 4-week oral use, 5mg, three times daily 0.5 hour before meal   Total
SBMs [1]
[units: times per week]
Mean (Standard Deviation)
  2.7  (1.9)   2.5  (1.7)   2.9  (2.0)   2.9  (2.8)   2.8  (2.1)
Bristol scale [2]
[units: units on a scale]
Mean (Standard Deviation)
  2.8  (1.3)   2.9  (1.4)   3.0  (1.5)   2.7  (1.4)   2.9  (1.8)
Degree of straining during defecation [3]
[units: participants]
0   5   8   9   5   27
1   63   60   68   59   250
2   68   69   58   72   267
3   30   35   28   31   124
no defecation   2   0   2   3   7

 

Acupuncture, Endometriosis, Fertility and Pregnancy, For Providers, Menopause and Beyond, Neuropathy, Prism Blog, Scar Reduction, Surgical Recovery, Transgender Wellness

Acupuncture for Scar Treatment

Why Should We Treat Scars?
Scars may not only be cosmetically undesirable, but may also have an impact on the health of the individual. This is especially true for very large scars; scars with abnormal coloration, lumpiness, numbness, tingling, itchiness, heat or cold sensations, achiness or pain, tenderness to touch, and muscle restriction.
Such scars and associated adhesions can indicate or lead to nerve and blood vessel damage, decreased range of motion and muscle strength, increased likelihood of future injury, and chronic pain (especially pins and needles, tingling, and numbness). Scars are especially notable on the torso, where underlying adhesions can impair bowel function, chronic pelvic pain or infertility, depending on the site of the scar.
In Chinese medicine, significant scars are considered to block the flow of the meridians, (similar to the nerve and blood vessel damage pointed to by Western medicine) causing not only pain and decreased circulation, but also potentially impaired internal organ function depending on the meridian affected.

Scar Treatment with Acupuncture and Herbs
Scars that are at least two weeks old can be treated with acupuncture and herbal medicine.
A 2014 study used local acupuncture (“surrounding the dragon“: using needles directly around and through the scar) with distal points (4 gates and ST36). After eight treatments in 5 weeks the scar pain had reduced from a 7/10 to a 1-2/10. Such treatments can not only reduce scar pain, but also help to break up scar tissue and adhesions, increase local circulation, and aid healing. This leads to flatter, smaller, less noticeable scars and a reduction of keloiding.
Moxibustion (a gentle warming treatment achieved by burning dried mugwort), may also be used. Small amounts of moxa may be burned directly on the skin -with a sesame oil cream as a medium to prevent burns- around the scar, or a stick of rolled moxa may be burned above the site to warm the area. Both methods are pleasant and effective.
Topical herbs can also be very beneficial for scar healing. It is generally best to apply your liniment of choice over the affected area before bed and cover with a tshirt (or other clean soft article of clothing depending on the site of the scar), so that it has plenty of time to soak in without washing or sweating which would interfere with product absorption during the day.

Which Topical Should You Choose?
  • Prism’s Scar Oil has frankincense and other essential oils that break up scar tissue in a tamanu oil base, a great oil for reducing the appearance of scars, including keloids.
  • Zheng Gu Shui is beneficial for deep scars that may have adhesions to underlying tissues (for example surgical scars). They can improve local circulation, healing of the scar and the area that was injured, and reduce associated pain. It is better for healing and restoring health to the area than for cosmetic scar reduction.
  • Wan Hua Oil prevents scarring, increases blood circulation, reduces swelling, and helps regenerate damaged tissues. Once the wound closes, massage the oil directly over the scar daily to prevent scarring and promote healing. This option is best to prevent cosmetic scars from surgery. It is also effective for scars from burns.
  • Aloe aids scar healing and reduces infection and swelling. If used during the healing process it can reduce the formation of scars. Be sure to use 100% aloe (fresh is best), not aloe with alcohol or other additives that can dry and irritate the area.
  • Ching Wan Hung oil promotes healing and new tissue growth, reduces scarring, and prevents infection. It is especially effective for scars from burns.
  • You can also use castor oil compresses, to break up deeper scar tissue and adhesions, but I don’t recommend this for new scars that are still healing (or any open wounds).

Note: Many people recommend the usage of Vitamin E on scars, but newer research shows that Vitamin E does not help reduce the appearance of scars, and in the case of surgical scars can actually make scars more visible due to the development of irritation or contact dermatitis.


Providers: read more about acupuncture scar treatments from Skya Abbate, DOM.

Additionally, my colleague, Dena Gold LAc, suggests a Japanese style version of surrounding the dragon that involved needling slightly outside the scar, towards and under under the scar superficially enough that the needle falls rather than roots. Dena also suggests checking the fire points of the channel the scar intersects and if they are tender, needle the metal and water points of that channel before treating the scar directly.


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 more herbal estrogens, ideas, and resources see my previous posts: Feminizing Herbs and “The Basics.”

 

Acupuncture, For Providers, Press, Prism Blog, Transgender Wellness

Article Published in CJOM: Making Clinics Trans-Inclusive

I’m so honored to have had my article (First Steps Towards Making Your Clinic Trans-Inclusive) recently published in the California Journal of Oriental Medicine (CJOM), a semiannual peer-reviewed publication of the California State Oriental Medical Association (CSOMA). My hope is that this article will help other practitioners to start making their clinics more trans, queer, and gender spectrum inclusive.

To read the full article, subscribe to CJOM, pick up a copy at your local Acupuncture College, or view in PDF: Page One and Page Two.


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

Herbal Trio for Breast Development

Trans women can use herbal estrogens and progesterones with a medical provider to:

  • if you don’t want to use hormones or undergo surgery, but still want to create physical changes in your body.
  • 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.
  • to compliment your synthetic hormone regimen.

These are my top three favorite herbs focusing on breast tissue development. They can be taken all together or individually, following the instructions of your healthcare provider and directions for dosage on the bottle.

You can expect it to take at least a month to notice any changes, which will likely start with breast tenderness, swelling under the nipple, or slight areola growth. Understand that changes will not increase as fast or dramatically as with synthetic hormones, but nonetheless herbal estrogens and progesterones are a desirable alternative for many people.

If you are taking synthetic estrogens, eliminate the hops from this regimen as it can increase systemic estrogen levels.This trio of herbs may also be used to maintain breast growth created by synthetic hormones if you want to stop taking hormones, though you should always get your hormone levels checked regularly by your healthcare provider to make sure you are maintaining your desired levels.

Herbal Trio for Breast Development:

  • Hops
    • Hops have 0.2-20% the potency of estradiol and can increase estrogen levels in the body.
    • It is commonly used to increase lactation as it acts on the milk ducts of the breast. It may have a side effect of lactation in some people.
  • Maca
    • Maca is known for its effects of creating curves, and is fairly inexpensive.
    • It is known for its aphrodisiac effects, and can increase erectile capacity, stamina, and sperm counts -which may either be viewed as extra benefits or side effects depending on your goals.
    • It also boosts the immune system and helps combat osteoporosis.
  • Fenugreek
    • 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.

Taking your herbs:

  • Be cautious of interactions with other herbs, supplements, and medications you’re taking! Herbs are safe when used correctly, but can have dangerous interactions if you use them carelessly.
  • You can take these herbs all at once if that is easier for you to remember.
    • However, because maca increases energy and hops have a mild sedative effect, you might try taking maca in the morning and hops before bed.
  • Where you get your herbs has a major influence on their effectiveness. Some herb companies have much higher quality standards and produce a stronger product with less additives. Any of these brands are good options to look into further:
    • Gaia and Herb Pharm both have great quality herbs in a variety of options: Hops, Maca, and Fenugreek.
    • 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!
    • If you take synthetic hormones (or other medications), you could take your fenugreek as part of their liver cleanse combo to support your liver.

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 more herbal estrogens, ideas, and resources see my previous posts: Feminizing Herbs and “The Basics.”

Prism Blog, Transgender Wellness

The Masculinizing Diet

This is a follow-up post to my post, “Nutritional Guidelines for Transgender Patients.” See the original post here. This article is an excerpt from my research paper, “Nutritional Guidelines for Transgender Patients,” which was written for practitioners of TCM who can use this information as part of a holistic diet tailored to client’s constitutions. It is not intended to function as medical advice. Because every body can respond differently, before beginning or changing your diet always consult a healthcare provider. I have included a few gems in here for practitioners, if you don’t have an understanding of TCM theory you may skip over the italicized portions.


To start, proper general nutrition is important, including plenty of healthy fats, avoiding animal products raised with hormones and processed or refined foods, and adding more fresh fruits, vegetables, and high quality protein.

As long as there are not contraindications based on your underlying constitution, a testosterone supportive diet should be high fiber, low carb and include a lot of vegetables and a moderate amount of protein.

This diet along with herbs and acupuncture can cause a slight elevation in testosterone levels in some people. However, please note that these diets alone will not have a significant effect.

Table 2: Trans-masculine Dietary Suggestions

  1. Limit carbohydrates -especially starches- and increase fiber, fruits and vegetables.
  2. Add white mushrooms, bee pollen, royal jelly, and/or celery. Meat in general is more yang, but especially poultry, lamb, wild game, tuna, lobster, salmon, and shrimp are beneficial for a masculinizing diet.
  3. If taking testosterone, add brazil nuts and garlic, and avoid salt.

Yang:
A mildly yang nourishing diet is generally safe for most people however care should be taken in following this diet long term if yang deficiency is not present. It is important to note that trans men who have just begun taking testosterone often have some degree of yin deficiency, and this diet would be inappropriate in that case. Always talk to your healthcare provider when making dietary changes.

A yang tonifying diet includes more warming, sweet, pungent foods (Pitchford, p. 54), and avoiding raw and cold temperature foods (Pitchford, p. 95). Meat, especially poultry, lamb, wild game, tuna, lobster, salmon, and shrimp are especially good, but if the client experiences side effects from the testosterone, especially high red blood cell counts, meat should be cut down. Once taking testosterone, a yang tonifying diet would have to be greatly modified and monitored by a TCM practitioner or discontinued since testosterone tends to create more yin deficiency and blood heat rather than yang deficiency.

Lowering Estrogen:

A high fiber diet can decrease blood estrogen levels by removing estrogen from the body before it can be reabsorbed in the bowel (Griffith, p. 158). Carbohydrates and especially starches should be limited as well because high blood sugar and associated high insulin levels can in turn raise estrogen levels. In addition, trans men should always avoid animal products raised on hormones (Cole and Han, p.75), since these hormones are estrogenic.

Anyone taking hormones should include sulfurous foods like garlic, dark leafy greens, and egg yolks, as well as lemons and limes, shiitake, reishi, dark leafy greens and cruciferous vegetables (cooked only if taking estrogens), to detox the body. Sulfur gives the liver the ability to get rid of toxins such as synthetic hormones (Duvall), tonifies the kidneys, warms yang, and benefits the skin (Caruso-Radin). Cruciferous vegetables, except for brussels sprouts and broccoli, stimulate testosterone production and flush out estrogen (Prodragonist), and celery has androgen like properties (Midnight). Lignans in sesame and whole grains -also in flax but that has an estrogenic effect- (Petersen), interfere with the enzymes that are involved with the production of estrogen (Duvall). Methionine, which aids estrogen breakdown (Marz, p.85), is found in many animal products; especially tuna, cheese, salmon, wild game, and shrimp, and also nuts, especially walnuts (Marz, p. 86), so protein should come especially from these sources. It is also important to balance excess methionine with glycine from bone broths (Caruso-Radin).

White button mushrooms also prevent testosterone to estrogen conversion (Prodragonist), and bee pollen and royal jelly may increase testosterone levels (Balch, p. 457). Acidophilus in lactofermented foods breaks down metabolites of estrogen (Balch, p. 588), as well as soothing the digestive tract which can be irritated by hormones. DHEA -via combining wild yam and cholesterol as described above is known to cause acne, hair loss, facial hair, and deepening voice in female assigned people (Griffith, p. 158-159), reminiscent of many of the effects of testosterone, and these “side effects” could be used to the client’s benefit. However, as DHEA can be converted to either estrogen or testosterone, it is important to monitor your hormone levels with a doctor when using this method.

Countering Side Effects:

Side effects from testosterone include high blood pressure, high red blood cell count, and high cholesterol. High blood pressure may be prevented somewhat by following a low salt, sugar, and caffeine diet, including avoiding foods with preservatives, aged meat, anchovies, avocado, fava beans, and pickled herring (Balch, p. 438). High blood pressure, if it occurs, can also be eased by selenium (Balch, p. 437), which is found in brewer’s yeast, brazil nuts, pork, eggs, liver, lamb, beef, tuna, and lobster (USDA). Selenium astringes yin, anchors yang, and calms shen (Caruso-Radin), allowing it to calm liver yang rising causing hypertension. High cholesterol, another potential side effect of testosterone use, can be helped with apples, cold water fish, dried beans, garlic, olive oil, carrot juice, and limiting sugars and oils to only unrefined cold or expeller pressed oils and naturally sweet foods like fruit (Balch, p. 442).

Vitamin C in citrus and brightly colored fruits and vegetables boosts testosterone levels, clears heat, stops bleeding, resolves toxins, and calms the shen (Caruso-Radin), potentially helping to stop the menses, prevent toxicity from hormone use, and ease initial mood swings as well as heat side effects, such as hypertension, hives, hot flashes, and acne. Vitamin E can also help reduce hot flashes common with starting testosterone (Balch, p. 512). Vitamin E is found in green vegetables, milk, liver, and nuts, and nourishes the blood and yang from a TCM perspective (Caruso-Radin), potentially countering liver yang rising due to deficient heat. Vitamin A, such as that in grass-fed whole dairy, bright orange and yellow fruits and vegetables and dark leafy greens (Caruso-Radin), is somewhat depleted by testosterone use (Gaby, p.175), so these foods should be increased in the diet.

Overall, a simple high fiber, low carb, moderate protein diet with plenty of vegetables should be followed for trans men. Good proteins to include are tuna, cheese, salmon, wild game, shrimp, lamb, and raw unsalted walnuts, peanuts, and almonds. White button mushrooms, bee pollen, royal jelly, brightly colored fruits and vegetables, lactoferments, beans, cruciferous vegetables, celery, sesame seeds, tomatoes, pears, and apples are great additional foods. If taking testosterone, clients should follow a low salt diet and add brazil nuts and garlic.


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

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.


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

The Soy Controversy

“Women consuming the equivalent of two cups of soy milk per day provides the estrogenic equivalent of one birth control pill… men who consumed the equivalent of one cup of soy milk per day had a 50% lower sperm count than men who didn’t eat soy. –Chris Kresser’s Paleo Code

Soy is often touted as a natural source of estrogen, but is it safe to use either for this purpose or as a food?

“About two ounces of soy products per day may be sufficient to ward off hot flashes and other symptoms” of menopause (Wright & Morgenthaler, Natural Hormone Replacement for Women over 45). However, as an estrogen source, it may not be the safest food option.

Soy is present in nearly every packaged and processed food in the U.S, in fact, the average American gets up to 9% of our calories from soybean oil alone. Compare this to about 2 teaspoons per day in China and 9 teaspoons per day in Japan, most of which is fermented soy, which neutralizes the toxins (like trypsin inhibitors that inhibit protein digestion and affect pancreatic function, and phytic acid, which reduces absorption of minerals like calcium, magnesium, copper, iron and zinc) that are present in most of the soy we consume in the U.S. (Chris Kresser’s Paleo Code)

Unfermented soy also increases our requirement for vitamin D and B12 (the opposite of fermented soy which provides these vitamins!), and disrupts endocrine function (potentially causing breast cancer and thyroid problems). Processed unfermented soy often actually contains carcinogens as well. (Chris Kresser’s Paleo Code)

It is not fully known how soy consumption may impact synthetic hormones, and it’s nearly impossible to avoid all soy since it’s in most of the food we consume, but it would be wise for most people to avoid eating the major processed soy foods like tofu, soy milk, and soy protein isolate. Fermented soy still contains estrogens, but is not as disruptive (or potentially carcinogenic) to our natural hormones, and is probably a safe food for most people.

I would generally recommend that people transitioning towards the masculine side of the spectrum avoid soy foods, and for those looking for natural sources of estrogen, there are many safer feminizing herbs and foods out there. For example, “flax contains substances called lignans, which have been shown to have estrogen-like qualities” (Wright & Morgenthaler). A few foods have small amounts of identical-to-human hormones [about 1-2% potency of human hormones] (Wright & Morgenthaler), including:
Rice, apples, date palm, pomegranate (estrone)
French bean seedlings (estradiol)
rice, licorice (estriol)


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: 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.


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

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.


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.

 

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.