You have probably noticed in life that every silver lining has a cloud! In the case of HRT, the cloud is called progestogen (a synthetic form of the hormone progesterone).

Up to now it has all looked pretty good: whether you have hot flushes, vaginal and bladder problems, mood changes, or even feelings of insects crawling over your skin, replacing oestrogen gives you a good chance of ending these troublesome symptoms of the menopause. HRT even protects you against osteoporosis, and reduces your chance of having a heart attack. It all sounds too good to be true.

If you have had a hysterectomy, you can skip this slightly depressing chapter, because progestogen is not a word that need bother you. But if you still have a uterus (womb) and are considering taking HRT.

Progesterone is produced in the ovaries after the ovulation phase of the menstrual cycle, and in pregnancy. Its main function is to prepare the womb for a fertilised egg, and to maintain the pregnancy. It also thickens the lining of the womb, reduces secretions from the cervix (the neck of the womb), prevents ovulation, contributes to the retention of water and salt, and works with oestrogen to stimulate milk cells in the breasts. During a menstrual cycle that doesn’t result in pregnancy, it is the production of progesterone that contributes to the pre-menstrual feelings of bloatedness, breast tenderness, and general irritability. So although it has an important role to play in the menstrual cycle and pregnancy, progesterone is not exactly an unmixed blessing, and its presence in HRT causes the single most important reason why women who have not had a hysterectomy either don’t want this form of treatment at all, or don’t stay on it for more than a few months.

*21\42\4*

Various procedures have been developed in recent years which aim to destroy the endometrium in women experiencing excessive bleeding that is resistant to control by drug therapy. The heavy or prolonged bleeding may be caused by fibroids, adenomyosis, postmenopausal hormone therapy or drugs designed to thin the blood (anticoagulant therapy). These procedures do not appear to be helpful in relieving pain associated with menstruation.

The destruction process is carried out using a hysteroscope, an instrument described previously in this chapter. A fibre optic camera threaded through the hysteroscope records the view which is seen by the surgeon on a video screen. The surgeon, who needs good hand-eye coordination, watches the image on the screen, enabling him or her to guide various instruments in the confined space of the uterus. These instruments can include a ball heated by an electrical current (called a rollerball), an electrically heated wire loop (called a resectoscope) or a laser. The procedure is referred to as an endometrial resection when the electrically heated ball or wire loop is used to produce electrocoagulation (also called diathermy) of the endometrium, and an endometrial ablation when heat from a laser is used. The rollerball method of endometrial resection destroys the endometrium by rolling the coagulating ball over it like a paint roller, the electrocoagulation loop removes or ploughs several furrows in it, and the laser vaporises it. In the case of endometrial ablation, light from the laser passes down an optical fibre inserted into the hysteroscope and the surgeon moves the tip of the laser to draw a fine beam of light across the endometrium. In radiofrequency ablation, high energy radio frequency waves are applied to the endometrium instead of the high energy laser beam. A thermal method of removing the endometrium which involves passing hot water into the uterus is also being developed. Early studies suggest it is just as effective as methods using laser or electrocoagulation and may have advantages over them in terms of safety.

Comparisons of the resectoscope and the laser suggest that the former is cheaper, more readily available in hospitals, faster to use, takes less time for doctors to become competent with, is more robust and results in fewer complications. As the techniques alter, however, claims to superiority may be short-lived. A study comparing the newer ablation technique of radiofrequency with endometrial resection claims the former is simpler to perform, less time-consuming and possibly safer. However its cost is higher and the success rate is comparable.

Women having these procedures can receive either a general anaesthetic or a local anaesthetic with light sedation, although, for the laser treatment, a general anaesthetic is currently the norm. A few women bleed heavily immediately after the operation; but, for most, light post-operative bleeding gradually turns into a light discharge that disappears completely over about four to six weeks. Periods may continue, and in most cases they are light. Most women are in hospital for a day or overnight, and many have resumed work within a week or two. A year after an endometrial ablation or resection, about 85% of women report having reduced their use of sanitary pads or tampons by more than half; some have no bleeding at all, while for others heavy bleeding is still a problem. Looked at over a ten-year time frame, there is still a dearth of data.

The endometrium is well-known for its regenerative powers, provoking speculation that removing the endometrium is just ‘one more operation of doubtful value* that women are being encouraged to have. One study of more than 400 women who had endometrial resections for fibroids, endometriosis or adenomyosis found that about 20% developed a recurrence of heavy bleeding within four years, in some cases within a few months of the procedure.10 Some of these women chose to have the procedure repeated but, after a second try, about 40% of this group were still having bleeding problems. Overall, about one in every eight women who had an endometrial resection ended up having a hysterectomy within four years. Women who had a repeat resection were even more likely to resort to hysterectomy, with more than one in three such women eventually having the operation.

*39\198\4*

NREM sleep represents three-quarters of the time spent in sleep. Although a great deal of study has been carried out on the psychology of dreams, no one has yet studied the psychology of NREM sleep, but I will try to make amends here. Biologists and physiologists like to classify our state of awareness into two main types, the conscious state and the unconscious state. This grouping should not be confused with Freud’s concept of the conscious and unconscious mind.

The unconscious state is a state in which we are not aware of anything and from which we are not easily aroused. It includes such experiences as a black-out after a head injury, the complete blank while under general anaesthetic, and so on.

The conscious state, on the other hand, is a state in which we are continuously aware of what goes on around us or of what we are thinking. We can account for all events continuously. So we can describe how we got out of bed in the morning, got dressed, had breakfast, went to work, said hello to the pretty secretary, worked hard, had a wonderful lunch with the secretary, went back to the office to work even harder, came home, had dinner, watched television, went to bed (still thinking about the wonderful lunch) … and then there is a blank, until we get out of bed again the next morning. (For the lady readers, please change ‘pretty secretary’ to ‘handsome assistant’, but note that the pretty secretary here just happens to be my wife!)

An interesting feature of the above is that we are able to give a continuous account until after our thoughts of ‘the wonderful lunch’. A blank follows. We are not unconscious, as we can be aroused easily. However, we are not conscious either, as there is a blank in the continuous account of the day’s event. This blank is NREM sleep, during which there is no thinking, no memory, and no account of what goes on, very much like the blankness we have when undergoing general anaesthetic. NREM sleep is classified under the conscious state because it is arousable, but it is much more like the unconscious state, as we have no thinking or memory and cannot give a continuous account of what goes on.

*37\174\4*

EXERCISES-WHERE AND WHEN TO DO THE EXERCISES

We should fit the exercises into our way of life in as natural a way as possible. At first we want to do them in circumstances in which we ourselves feel secure. Otherwise we cannot let ourselves go off guard. This is important in the initial stages; then as we become more secure we can do them almost anywhere. Most men do them for five minutes before leaving for work, and then for a longer period after their evening meal. The housewife finds it best after she has seen her husband off to work and the children to school. There is no need to be by one’s self while doing them, and many husbands and ‘ wives do them while the other is reading the paper or watching TV. Mothers can do the exercises while sitting in front of the TV while the children are absorbed in the programme.

About ten minutes twice a day is all the time required for the exercises. This is very little indeed. Yet quite a few people with real tension and distress of mind have told me that they have been unable to find the time to do them. Strange as it may see, these are usually people whose time is not in any great demand. They are both sick and lazy; and because of their failure to find time for a few minutes’ practice each day their condition drags on. I explain this to them, and they set about their practice in a more determined fashion. Their tension is eased. They soon come to do things more easily and quickly, and much time is saved.

Two business executives who suffered from chronic anxiety have independently learned to do the exercises as they sit in the train on the way to the city. A number of executives merely tell their secretary that they are on no account to be interrupted for ten or fifteen minutes. A factory worker told me that he retired to the toilet for five minutes twice a day so as to do the exercises, and by this means was able to manage his anxiety symptoms.

A works foreman takes his car in the lunch hour, drives to a quiet street, and does his exercises sitting in the car. Many people become tense in the muscles of the back and neck when they are driving. Such people get help by practising conscious muscular relaxation as they drive along. Of course, they must first learn to do this by practising the exercises in the ordinary way.

Undoubtedly one of the best ways is to let the exercises become a routine habit so that we do them regularly without thinking about it. For instance, I have had a number of patients who have made the exercises part of the routine of the morning shower. We get out of bed, and we do a number of things quite automatically—use the toilet, clean our teeth, wash our face, have our shower, dry ourselves, and put on our clothes. These events follow each other in routine fashion. There is no mental decision as to whether we clean our teeth or not, it is something that just happens by act of habit. Now let us establish a new habit. We come out of the shower; we get dry; with the towel around us, we sit on the stool, on the side of the bath, or we squat on the floor—just for three minutes—and we feel the relaxation all through us. Letting it become part of our regular routine ensures that we do not forget, and there is no mental effort in bringing ourselves to do it. After the shower we are fresh, and in a good state of mind for the mental exercises. Remember that it is better to do our exercises when we are fresh and alert, rather than when we are tired and weary at the end of the day, even though physical relaxation might come more easily then.

In addition, it is usual for those of us who are tense to experience a good deal of variation in our tension. We have good days and bad days. When we feel easy in ourselves we are inclined to forget that we were ever tense. As a result, on our good days it is common to neglect doing our exercises. This is a mistake. If we practise our exercises when we feel good, we ward off the bad patches. They gradually become less frequent and less severe. On the other hand, when we are unusually tense or. Upset we can get help by our mental exercises, but it is much more difficult to do them, particularly in the initial stages when we have not yet fully mastered the technique.

This principle is demonstrated very clearly in cases of asthma. During an asthma attack, particularly a bad one, it is quite hard to do the exercises. I therefore tell asthmatic patients that I can help them best by seeing them when they are not actually in an attack. I can then teach them the exercises easily. They practise at home, and the experience of many has been that the attacks gradually cease.

Those who do physical exercises soon learn to combine them with the mental exercises. This can be done in two ways. We can set aside a few minutes each day before we start the physical exercises. Alternatively, and this is a very good way, we can combine the two. As we do the physical exercises, we relax our minds.

Some people like doing the exercises while sitting outside in the open air. The sun is on our face, wind blows the hair, distant sounds come to us; we let go, and all this aids the calm and integration within us.

People have sometimes asked how long they should keep doing the exercises. I suppose the answer is, “As long as they are doing you good.” Many people find that the immediate problem ceases in a few weeks and they discontinue the exercises. Nevertheless, I think the exercises remain with them unconsciously, and become part of the mental attitude of their daily life. Others whom I have spoken to have kept doing the exercises regularly for long periods, saying that they feel the exercises help them in a more general way than just the removal of anxiety symptoms—that in some strange way they add to the quality of their living. I am sure you can see by now that this is a very different approach to illness than swallowing pills. Other things are involved which are very deep in our nature. The quality of the relaxation and the mechanisms involved will depend on the unique personality of the particular individual. But don’t just drop the exercises at the first sign that your symptoms are subsiding.

*63\57\2*

Therapeutic fasting is a total abstinence from food. The purpose of fast is to promote healing and restore health.

Therapeutic values of fasting are well documented by a large number of scientific investigations, studies, research, and practical observation. Doctors who employ fasting testify that it indeed “works.” As Dr. Adolph Mayer asserted, “Fasting is the most efficient means of correcting any disease.” *

But how can mere abstinence from food accomplish such remarkable healing results?

The therapeutic value of fasting is based on the following physiological facts:

Autolysis is a known metabolic phenomenon of self-digestion or disintegration of the body’s own tissues.

Therapeutic fasting induces the development of autolysis and directs its physiological effect for constructive healing purposes.

To clarify: when disease takes hold of the body it is usually because of the weakened defensive mechanism and impaired normal functions of the vital organs. Due to continuous neglect in feeding the body properly and failure to observe the other rules of health, the glandular activity and metabolic rate slows down and the eliminative organs lose their efficiency. Many of the toxins and metabolic wastes remain in the body and are deposited in the tissues, causing autointoxication. In rheumatic diseases these wastes, such as uric acid crystals and mineral compounds, are deposited in the joints and soft tissues. In the case of high blood pressure, these metabolic wastes are deposited in arteries and small blood capillaries, constricting them and hindering the normal flow of blood. In self-defense the

heart increases arterial and capillary pressure to push blood through the plugged vessels.

Now, we must recognize the fact that the body’s own healing powers are constantly trying to correct any and all defects, disturbances, and damages if given the slightest chance. Such a chance and opportunity for self-regeneration and healing is made possible during the fast

First, during prolonged fast (after the first three days) the body will burn and digest its own tissues by the process of autolysis, or self-digestion. In its wisdom—and here lies the secret of the extraordinary effectiveness of fasting as curative therapy!— the body will only decompose and burn those substances and tissues which are diseased, damaged, or of lesser importance to the body economy, such as all morbid accumulations, tumors, abscesses, damaged tissues, fat deposits, etc. These are consumed and utilized first. The essential tissues of vital organs are spared.

Second, the eliminating and cleansing capacity of the eliminative organs—lungs, liver, kidneys, and skin—is increased during fasting, and masses of accumulated metabolic wastes and toxins are quickly expelled. This is evident in the following typical symptoms of fasting: offensive breath, dark urine (concentration of toxins in urine ten times higher than normal-Professor E. G. Schonk), continuous and generous discharge of feces, skin eruptions, perspiration, catarrhal elimination, etc.

Third, a fast affords a physiological rest to the digestive and protective organs of the body. After fasting, the digestion and utilization of food is greatly improved, which makes the assimilation of all the important nutrients more effective.

Fourth, a fast exerts a normalizing and stabilizing effect on all the physiological, nervous, and mental functions. The nervous system is regenerated; mental powers improved; glandular chemistry and secretions are normalized.

It is easy to see, then, why fasting is such an effective therapeutic measure in treatment of a great variety of diseases, including arthritis.

*20\176\2*

Before the development of CT scanning, simple skull X-rays or air-encephalograms (in which the structure of the brain was outlined by injected air) were the only techniques available. These have been superseded entirely. Another technique, angiography, is still used in some patients with epilepsy due to a structural cause. In this technique, an iodine-containing solution which is opaque to X-rays is injected directly into one or other carotid artery (in the neck), or through a catheter introduced into the brachial (elbow) or femoral (groin) arteries and passed into the region of the carotid. Immediately after the injection, a series of X-ray pictures are taken which outlines the arteries and veins containing the iodine solution. This technique identifies precisely any abnormal blood vessels and may be extremely valuable if surgery is being considered on an angioma or tumour. Advances in MRI mean that the circulation can usually be imaged by special pulse techniques and image processing software, so angiography is likely to be superseded in the near future.

Other imaging techniques are available at research centres. These include positron emission tomography (PET), or single photon emission computerized tomography (SPECT). In these procedures, variations in function in different parts of the brain can be imaged.

The technique involves injecting a glucose solution, or breathing oxygen, either of which is labelled with a specially marked atom. The oxygen or glucose is taken up and metabolized by different parts of the brain at different rates. The marker atoms attached to the oxygen or glucose allows images to be obtained which may show an area or areas of the brain which take up a lot of oxygen and glucose during a seizure, and which could be an epileptic focus. Between seizures, the same areas are relatively silent. Such studies may help neurologists and neurosurgeons decide on the suitability of a child or adult for epilepsy surgery.

*52\188\2*

Although the granule-like lesions of sarcoidosis are most frequently found in the lungs, they may also develop in the heart, liver, spleen, muscles, and bones. The ailment seems to have some strong autoimmune components. The only case treated with CMO responded very well, relieving pain and inflammation and restoring normal function to the affected areas.

Asthma-Asthma is a different matter. Although it is a chronic inflammatory disease of-the airway, patients respond in unpredictable ways to CMO. Some respond well but others actually worsen.

Asthma is often divided into two basic categories: intrinsic and extrinsic. The intrinsic type is a straightforward reaction to things like irritating substances, infection, cold air, exercise, emotional upset, etc. The extrinsic type involves an immune reaction to pollen or other substances to which the asthmatic is allergic or sensitive.

Unfortunately there’s no telling how either type will respond to CMO, so we recommend that its use always be managed by a physician. We also suggest that initial doses be very small, perhaps only one capsule daily for a couple of days with increases by an additional capsule per day every other day. No one is likely to run into serious trouble that way. Any indication of sensitivity should be immediately discussed with your physician. CMO should be taken in divided doses, half in the morning and half in the evening. Once a dosage totalling six capsules daily is reached it should be maintained at that level.

*73\142\2*

Symptoms: discolored urine, puffy eyes, headache and high blood pressure.

Home care:

Most cases of nephritis are mild and pass unnoticed. If the symptoms are marked enough to be recognizable, the child requires medical attention.

Precautions

-    If the child’s eyes are puffy, or the urine is scanty and dark, the child may have nephritis.

-    If symptoms of nephritis are pronounced enough to be noticed, take the child to the doctor.

-    Nephritis usually follows a strep infection. Watch for the condition to follow a strep throat or impetigo, even if the infection is being treated with antibiotics.

There are many forms of nephritis, or inflammation of the kidneys, but the form that is most common in children usually follows a streptococcal infection such as strep throat, scarlet fever, or streptococcal impetigo. The first symptoms of nephritis develop one to three weeks after the onset of a strep infection, and these symptoms are usually mild. In fact, most cases of nephritis probably go unnoticed (or undiagnosed) and pass without treatment. Occasionally, however, nephritis starts abruptly and the illness is severe. Most children recover completely from nephritis, but a few develop chronic kidney disease.

*159/84/5*

Chromium is a trace mineral increasingly thought to be vital in the production of diabetes, but

so far the work has mostly been done on Type 2 diabetes. Early research in rats found that

abnormal glucose metabolism could be corrected by adding chromium (as brewer’s yeast) to the

diet.

The biological significance of this trace element has only recently been recognized, but now that it has been there are signs that many people are short of it. Chromium is physiologically active in the body in only one inorganic form (the trivalent form). This inorganic (non-living) type of chromium is very inactive in the body compared with another chromium-containing compound-the organic complex called the glucose tolerance factor (GTF). It is not known exactly what this is but it appears that animals have only a limited ability to produce it themselves and so need external sources. GFT is the only known form in which chromium can cross the placenta. When trivalent chromium is given orally less than 1 per cent is absorbed.

Chromium’s main function is to help insulin control the body’s sugar levels. Experiments with

animals have found that glucose (sugar) metabolism is quickly impaired if the animals are fed

diets poor in chromium and that giving the element soon returns the situation to normal.

Because animal work has found that chromium-deficient animals develop diabetes-like

symptoms, it was natural to ask whether a similar mechanism could be at fault in human

diabetics. Several reports have suggested that giving chromium has had beneficial effects on

diabetics and in one study four out of six maturity -onset diabetics improved with a dose of 250 micrograms of chromium a day. Other studies have found that diabetics put out more chromium in their urine than do non-diabetics. Studies of poorly-nourished children in Jordan, Turkey and Nigeria found that they grew faster when given extra chromium. In spite of this circumstantial evidence there are no definite indications that diabetes is caused by a deficiency of chromium, and it is certain that many diabetics will not be improved simply by taking chromium.

Unfortunately, the refining of foods removes a very substantial part of their chromium. Blackstrap molasses, honey and raw sugar are rich in chromium but white sugar has almost none. This is especially unfortunate since chromium is needed if the body is to handle sugar effectively, as we have seen. White bread contains only one third of the chromium of the original whole wheat and this, of course, goes for anything made from white flour.

The food richest in chromium is brewer’s yeast but whole-grain bread, nuts, shellfish, liver, kidneys, grape juice, beef and beer are also rich sources.

As with many other trace elements, absorption is very poor, especially from tablets. Overall, only about 3 per cent of the chromium in our food is absorbed, so with our relatively chromium-deficient diet there is not much of a safety margin.

The recommended daily intake of chromium varies from 5 to 100 micrograms a day. Given that the body needs to absorb about 10 micrograms a day and that only 3 per cent is absorbed, perhaps the amount we consume should be even higher than 100 micrograms.

*3/72/5*

If you have a specific ailment, like polycystic ovaries or endometriosis, you should consult a good herbalist or health professional with experience in using herbs so that the remedy can be tailored to your individual needs.

If you have been told that you have a hormone imbalance or your cycles are irregular then it is worth taking the herb agnus castus over a few months, as this is a good balancing herb. It is an adaptogen which means that, whether you suffer from a low level of one hormone or an excess of a different one, you can take agnus castus and achieve normal levels. Buy an organic tincture of agnus castus and take 1 teaspoon three times a day for three or four months or until you conceive.

Warning

Herbs have to be used with caution once you are pregnant. There are some that are especially useful in the late stages of pregnancy (raspberry leaf, for example). But, once you are pregnant, it is important only to take herbs with professional advice. If you are actually having medical hormonal treatment for fertility you should stop taking herbs but keep taking the nutritional supplements.

Case History

Susan and her partner were 30 and 31 and had been trying to have a baby for four years before they came to see me. They had been told they had unexplained fertility and had four unsuccessful attempts at IUI. Susan had a lot of problems with her periods. She had a regular cycle but had heavy bleeding with spotting and headaches before her period and at ovulation her abdomen would swell up and she would feel sick.

I asked them to be screened for any infections and the test came back positive to one infection so they both took antibiotics and were then re-tested to make sure they were all clear. Susan was deficient in a number of nutrients, including zinc, selenium, calcium and magnesium, and her partner had low zinc and high aluminum levels. I therefore recommended that he cut out canned drinks and switch to an aluminum-free deodorant. I also used a combination of balancing herbs such as agnus castus to alleviate Susan’s spotting and heavy bleedings, as I was concerned that the imbalance causing the problem with Susan’s cycle was also a factor in her inability to conceive. Susan and her partner followed the Four-Month Plan and waited until their mineral levels were back to normal. Nine months from their first appointment they conceived.

*56/73/5*