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MO: List the 5 classes of lipid & water soluble hormones and identify components of each.
- LIPID SOLUBLE:
- 1) Steroid Hormones (derived from cholesterol; include cortisol, testosterone, DHEA, pregnenolone, sex hormones)
2) Thyroid Hormones (iodine atoms + tyrosine; include T4 & T3)
- WATER SOLUBLE:
- 3) Amines (modified amino acids; include adrenaline, noradrenaline, histamine)
4) Peptides & Proteins (chains of amino acids; include HGH, insulin, glucagon, serotonin, CCK, gastrin, oxytocin, anti-diuretic hormone)
5) Eicosanoids/Prostaglandins (derived from fatty acids; include PG1, PG2, PG3)
MO: Big Ideas for Endocrine Health
1. Endocrine is a system of complex relationships. Always support the whole as well as the parts.
2. Respect the endocrine individuality of each client.
3. Always address The Foundations first.
MO: Describe how the Foundation of DIGESTION supports the endocrine system
Hormones are made from fatty acids, proteins, minerals, etc. that we take into the body as food. Without adequate stomach acid to break down proteins, adequate enzymes and bile to break down all food components, we cannot digest and assimilate the necessary nutrients for hormone production.
MO: Describe how the Foundation of BLOOD SUGAR HANDLING supports the endocrine system.
It is futile to attempt any endocrine support without first ensuring blood sugar handling is healthy. This is because the pancreas, liver and adrenals are all intimately involved in blood sugar handling, and when one of them (particularly adrenals or liver) takes a hit due to poor blood sugar regulation then all the endocrine functions that organ performs take a hit and the entire, complex endocrine web is disrupted.
MO: Describe how the Foundation of MINERAL BALANCE supports the endocrine system.
Every endocrine organ has a mineral on which it is particularly dependent:
- – Thyroid…iodine
- – Prostate…zinc
- – Pituitary…manganese
- – Pancreas…chromium
- – Gonads…selenium
- – Adrenals…copper
MO: Describe how the Foundation of FATTY ACID BALANCE supports the endocrine system.
EFAs and other fats are critical to the entire endocrine system. The body cannot make hormones without fats.
Endocrine factories are inside the cells and phospholipids control what goes in and out of the cell.
A healthy cell membrane is also needed for the cellular/hormonal communication to take place.
MO: Describe how the Foundation of HYDRATION supports the endocrine system.
- Hydration supports the efficient transport of hormones throughout the body.
- Hydration ensures proper viscosity of the blood and interstitial fluids.
MO: Describe how a chronic stress response degrades the endocrine system
- A chronic stress response leads to chronically elevated cortisol, which wreaks havoc with entire endocrine mechanism.
- Number one problem is adrenal exhaustion, which leads to low DHEA and low progesterone, abnormal estrogen/progesterone ratios, which feed back to pituitary imbalances.
- Elevated cortisol decreases liver's ability to detoxify
- Elevated cortisol decreases T3 production
- Elevated cortisol contributes to obesity, which then contributes to estrogen dominance and altered fatty acid metabolism (for prostaglandins & inflammation).
MO: Describe and perform functional evaluation for Pituitary.
Bennett's Pituitary Reflex - above nose just above globella, a little indentation. Will feel "spongy" and client will report dull (not sharp) pain upon palpation. Feel for sponginess first, then palpate firmly.
MO: Describe & perform Functional Evaluation for Thyroid.
- Costal Margin Tenderness (for Thyroid function) - costal margin is point where cartilage meets bone on each rib.
- Chapman Thyroid - 2nd intercostal spaces on each side of sternum, close to sternum. Right relates more to thyroid; left relates more to heart.
- Pretibial Edema - press w/ finger and look/feel for indentation that remains more than 10 sec.
MO: Describe the Pituitary/Hypothalamus Point (FE for Endocrine).
- Locate the ridge between the eyebrows and find a small soft spot just above (the 3rd eye). Check for tenderness or spongy feeling. Another way to find the point is to start with your index finger in the middle of the forehead and gently drag your finger to the “V” formed by the bone structure between the brows. Palpate for tenderness, A>P.
- DOES LNT.
MO: Describe the Costal Margins Tender to Palpation test (FE for Endocrine).
- This is a test of the thyroid, and is a "general tenderness" rating. Client should rate the overall tenderness on a scale of 1-10. Must be tender all the way down to be an indicator.
- You may use either the medial edge of the hand in a rocking motion, or the fingertips. Palpate the mid mammary line, at the point where the bone changes to cartilage (costal/chondral margins).
- Start at the clavicle, mid-mammary line, and move down the rib cage, following the costal/chondral margins. FOLLOW THE LINE OF THE RIB CAGE; SKIP OVER THE BREASTS ON WOMEN. Finish by palpating across the bottom and up the medial aspect of both ribs.
- DOES LNT.
MO: Describe Chapman Reflex Thyroid (FE for Endocrine).
- 2nd Intercostal Space, Bilateral. Second intercostal spaces, next to the sternum. Palpate A>P, for tenderness. Record R and L indicators.
- There is a theory that the point on the right is more of a Thyroid indicator and the left is more of a Heart indicator. This is NOT absolute.
- DOES LNT.
MO: Describe the Pretibial Edema test (FE for Endocrine).
This is a thyroid indicator.
Locate the flattest part of the tibia about 1/3 of the way between the ankle bone and the knee. Press firmly into the bone for 2-3 seconds then run your finger back over the spot very lightly to feel for a depression. The deeper and longer-lasting the depression, the more significant.
- NONE - Disappears immediately, or very shallow
- MILD – Disappears within 10 seconds
- SEVERE - Remains longer than 10 seconds
MO: Describe the Breast Tenderness test (FE for Endocrine).
- The practitioner may ask the client to palpate their own breast tissue and ask them to describe any tenderness. For client comfort, practitioner may demonstrate palpation on their own breasts and ask client to do the same. If client is female, precede test by asking if she experiences breast tenderness with menstruation and if so, is she currently menstruating. Rate tenderness on a 1-10 scale.
- DOES LNT.
MO: Describe Medial Heel test (FE for Endocrine).
- This is a reflex for Prostate/Uterus.
- Bilateral. Locate the point halfway between the medial malleolus (ankle bone) and the medial aspect of the calcaneus (heel bone). Feel for a small indentation (not the valley just posterior). Press laterally and rate tenderness. Record both R and L indicators.
- DOES NOT LNT.
MO: Describe Chapman Iliotibial Band test (FE for Endocrine).
- Chapman Reflex Prostate/Uterus – This point overlaps part of the Chapman Colon Reflex. It is middle third portion along the iliotibial band at the point where the client’s hand will reach when held against the side of their leg. Palpate approximately 2” superior and 2” inferior to their fingertips. Check for tenderness and nodulation.
- DOES LNT.
MO: Describe Chapman Reflex Prostate/Uterus - Pubic Symphysis (FE for Endocrine).
- Chapman Reflex Prostate/Uterus – Always ask permission to palpate in this area or use the client’s own hands to palpate.Begin by asking the client to find the top edge of their pubic bone. Place both index fingers, or thumbs together at the mid-point of the pubic bone and then move them laterally the width of 1-2 fingers. This is the Outer palpation on the pubic bone (Inner is for Ovaries/Testes). The palpation is on the superior edge of the bone, pushing down S>I toward the feet, NOT A>P. Record both R and L indicators.
- DOES LNT.
MO: Describe Chapman Reflex for Ovaries/Testes (FE for Endocrine).
- Chapman Reflex Ovaries/Testicles – Always ask permission to palpate in this area or use the client’s own hands to palpate.
- Begin by asking the client to find the top edge of their pubic bone. Place both index fingers together at the midpoint of the pubic bone. This is the Inner palpation on the pubic bone (Outer is for Uterus/Prostate). The palpation is on the superior edge of the bone, pushing down S>I toward the feet, NOT A>P. Check for tenderness. Record both R and L indicators.
- DOES LNT.
MO: Describe Inside Arch test (FE for Endocrine).
- This is an indicator for Ovaries/Testes.
- Bilateral. While holding the client's foot with your hands, bend the foot slightly to reveal the apex of the arch (the highest point). The point is not on the side of the foot nor is it on the bottom of the foot, it is on the transition point between the two (the edge of the bone). Palpate for tenderness and congestion. Palpate for tenderness by pressing directly into the foot. Record both R and L indicators.
- DOES NOT LNT.
MO: Describe two ways in which the administration of HRT or BHRT can exacerbate endocrine problems
- Giving hormones will directly squelch the HPT/PT Negative Feedback loop.
- Creation of Hormonal Resistance: Symptoms of deficiency in the presence of excess (remember insulin resistance?)
- Progesterone, pregnenolone and DHEA can increase already high cortisol levels in cases of chronic stress.
- Giving testosterone to men (without testing) can increase both DHT and estrogen levels.
- Giving estrogen to women in insulin resistance can increase already high testosterone levels.
- Giving estrogen inappropriately to women causes “estrogen dominance” which is at the root of most female cancers, uterine and breast fibroid incidence and ovarian cyst occurrence.
What is the suggested nutritional therapy strategy for supporting a client with endocrine imbalance (thyroid problems, PMS...)?
- Start with 2-3 months on The Foundations, emphasizing blood sugar regulation.
- Ensure good fatty acids are in the diet
- Ensure minerals are balanced
- Support the adrenals
- IF the client is having discomfort, simultaneously support the specific, weakened organ(s), never at the expense of the Foundations.
- General support for the endocrine system
- Reevaluate as needed.