By guest blogger Jordan Hoffman
Stephanie here: In the late summer and early fall of last year I began experiencing increasingly painful periods. I was bleeding very heavily, taking up to 12 Advil per day without relief, and was very concerned about what was happening in my reproductive tract. Our LA clinic opened in May and therefore I didn’t have a gynecologist here. I knew if I did they would suggest that I take oral contraceptives, which I do not tolerate, or get an IUD, which I did not want. One of my patients told me Jordan Hoffman, an LA-based acupuncturist, and this weeks guest blogger, helped her resolve recurrent yeast and urinary tract infections. I set up an appointment and expected to receive acupuncture treatments for my symptoms. Instead, we discovered some interesting things that correlated with my gynecological demise.
Our LA clinic became very busy very fast. I was eating on the run and in between patients. My diet changed in that I started eating easy, low prep things like packaged string cheese, cottage cheese, salads with cheese, yogurt, etc. I was exhausted and drinking triple the amount of coffee I used to. I was also eating chicken sausage, chicken in salad, chicken everything because it was easy.
Jordan told me I needed to take out dairy and chicken, replace coffee with tea (caffeine is okay, coffee is not) and take an individualized herbal supplement that he made for me. My first thought was that he was definitely trying to make me miserable. I love cheese, and I am from New Jersey, I have been a coffee drinker my entire life. However, I was uncomfortable enough that I would take this experiment on for a month and time would tell.
It worked. The next month I had NO cramps. I did not even know my period was coming. I have now been through four cycles successfully, even though I do drink one cup of coffee a day now (sorry Jordan!). This experience taught me that diet can have a profound influence on our bodies. Dietary modifications are low-risk with possible significant therapeutic benefit. In this week’s blog Jordan will tell us why.
Okay, take it away Jordan!
Thanks Steph! Simply put: cow milk is for cows, goat milk is for goats, and human milk is for humans. Every species produces milk specific to its own species’ needs and digestive capabilities. And every species stops drinking its own milk after infancy.
Except humans.
Not only do we drink other animals’ milk but we are lead to believe from an early age: “Milk—It does a Body Good!” And yet, every day I see patients with profound and wide-ranging ill effects from consuming any and all dairy products in any quantity whatsoever. As such, ZERO dairy is the only amount of dairy that is fit for human consumption. Almond, soy and rice milks are very good substitutes.
This article is going to focus on dairy and its role in various medical conditions that may lead to or worsen pelvic pain. No matter the origin, chronic musculo-skeletal imbalances can lead to organ dysfunction and chronic organ dysfunction can certainly lead to musculo-skeletal imbalances.
Irritable Bowel Syndrome– Chronic Constipation
Irritable Bowel Syndrome (IBS) is a common catch-all diagnosis for alternating bouts of constipation and diarrhea with accompanying cramping and pain. Stress is often the default cause given to IBS. But while it can definitely play a role, stress does not cause problems alone. Rather, it exacerbates pre-existing ones. Stress plus the pathogens introduced to the gut from dairy can lead to IBS.
Dairy is a known allergen that can cause constipation, especially in children (1). You can easily do an Immunoglobulin E (IgE) blood test to check for food allergies, like to dairy. Yet, in many instances, patients have brought me their allergy tests showing no IgE response to dairy. Puzzled, I did some more research. IgE is the most likely or common immune response from our body to an allergen. But it is by no means the only response. In fact, an allergy to cow milk showing up as constipation may not even be mediated by IgE (2), revealing a less than complete picture painted by those tests.
Sixty percent of the protein content in dairy is casein, which when introduced to our digestive system becomes Beta-Casomorphine (BCM). Casein is used to make glue. Ever wonder why the logo used for Elmer’s Glue is a cow? Casein. Now notice the second part to that word: “morphine.” Just like opiate drugs, BCM can exert a numbing and paralyzing effect on our intestinal motility (3), and an analgesic and addictive response in our brain and nervous system compelling us to want more. Casein can also trigger a histamine response (4) in our intestines leading to more inflammation and irritation which can lead to more constipation.
Another aspect of dairy that can lead to chronic constipation is in its bacteria load. Pasteurization occurs at 162 degrees Fahrenheit for 15 seconds. Yet, to sterilize water we are advised to boil it at 212 degrees Fahrenheit for several minutes. There are bacteria that can survive pasteurization. In fact, the United States allows for a somatic cell count (SCC) of up to 750,000 per ml (5). Whether those cells are active pathogens like Mycobacterium Avium Subspecies Paratuberculosis (MAP) (6) or E. Coli (7), or non-active due to effective pasteurization, our immune system still recognizes them as foreign and kicks in to gear with an inflammatory response.
Inflammatory Bowel Disease
The Standard American Diet (S.A.D.) has historically placed the main focus of each meal on animal protein, and doesn’t even take into account the glass of milk on the side, the cheese along with the protein, or the ice cream for dessert. Severe inflammatory bowel diseases like Ulcerative Colitis and Crohn’s Disease are linked to the over-consumption of animal fats and the under-consumption of fiber (8), which is absent in all forms of animal protein but abundantly present in beans, peas and lentils—superior sources clean protein. Such diets can even compromise our intestinal clearance of bacteria, mentioned earlier, leading to further inflammation (9).
Hormone Dysregulation
One of the simplest ways to link food choice and the pelvis is that everything flows downhill, especially when it comes to hormones, urogenital and reproductive health. While many of our environmental pollutants can exert an adverse effect higher up the endocrine system chain at the pituitary level, the first place I tend to look for culprits is diet.
Cows are fed and bred to lactate throughout their pregnancy with particular elevated milk production in the latter half of gestation. As such, even regardless of whether they are injected with exogenous hormones, the cows’ own hormones can show up in its milk. Dairy products you consume account for 60-70% of all dietary sources of estrogen (10) with at least 6 different hormones also being found in milk, including progesterone, and testosterone (11). One way we excrete hormones from the body is through stool. Studies show that there is a direct correlation between fecal weight and fecal estrogen content (12). And with the constipating effect of dairy, we now can see yet another link between chronic digestion dysfunction and hormone dysregulation.
For men, this undue influence on their endocrine function can show up as erectile dysfunction (also an indication of atherosclerosis aided by the cholesterol in dairy), low sperm counts and ejaculatory volume (13), and testicular and prostate cancers (14). For women, this can show up as irregular and painful periods, endometriosis (15), Polycystic Ovarian Syndrome (16), and breast and ovarian cancer (17).
Where to begin
Accepting the truth about dairy flies in the face of American identity and all we have been conditioned to believe since we were kids about this primary food in the SAD. But don’t believe me and the research I have done or the results I have seen with patients. Believe yourself. Come off dairy, all forms completely. Read labels. Ask questions in restaurants. Go dairy-free for at least 4 weeks and then if you are still curious, introduce it and only it in a meal and see how you feel the next couple of days. Most of my patients will immediately feel poorly—stomach aches, sinus congestion, knee pain, etc. For some, it may only clog the arteries of their heart or disrupt their menstrual cycle, both of which take time to reveal themselves. Let the decision to cut out dairy come from your own personal experience guided by critical thinking and a willingness to experiment with self-awareness and truth.
Cheers,
Jordan
Jordan Hoffman is a California Licensed Acupuncturist, a Diplomate in Oriental Medicine and Nationally Board Certified in Chinese Herbology, specializing in Addiction, Internal Medicine, Pain Management and Nutritional and Lifestyle Counseling. He maintains his acupuncture practice in West LA and Canoga Park, CA. For more information, please visit http://www.
References:
- J Pediatr. 1995 Jan;126(1):34-9. Chronic constipation as a symptom of cow milk allergy. Iacono G, Carroccio A, Cavataio F, Montalto G, Cantarero MD, Notarbartolo A.
- J Pediatr Gastroenterol Nutr.2010 Aug;51(2):171-6. doi: 10.1097/MPG.0b013e3181cd2653. Cow’s-milk-free diet as a therapeutic option in childhood chronic constipation. Irastorza I, Ibañez B, Delgado-Sanzonetti L, Maruri N, Vitoria JC.
- 2000 Jun-Aug;34(3-4):181-6. Effect of opioid active therapeutics on the ascending reflex pathway in the rat ileum. Allescher HD, Storr M, Piller C, Brantl V, Schusdziarra V..
- Int Arch Allergy Immunol.1992;97(2):115-20. A naturally occurring opioid peptide from cow’s milk, beta-casomorphine-7, is a direct histamine releaser in man. Kurek M, Przybilla B, Hermann K, Ring J.
- Determining U.S. Milk Quality Using Bulk-tank Somatic Cell Counts, 2010. United States Department of Agriculture Animal and Plant Health Inspection Service. http://www.aphis.usda.gov/animal_health/nahms/dairy/downloads/dairy_monitoring/BTSCC_2010infosheet.pdf
- J Food Prot.2010 Jul;73(7):1357-97. Assessment of food as a source of exposure to Mycobacterium avium subspecies paratuberculosis (MAP). National Advisory Committee on Microbiological Criteria for Foods.
- What Is the Current Milk Quality in the U.S.? Scott J. Wells, Stephen L. Ott. Centers for Epidemiology and Animal Health, USDA-APHIS-VS. file:///C:/Users/Jordan/Documents/Research/Current%20Milk%20Quality%20in%20the%20U.S..html
- Am J Gastroenterol.2011 Apr;106(4):563-73. doi: 10.1038/ajg.2011.44. Dietary intake and risk of developing inflammatory bowel disease: a systematic review of the literature. Hou JK, Abraham B, El-Serag H.
- Dig Dis.2014;32(4):389-94. doi: 10.1159/000358143. Epub 2014 Jun 23. Dietary clues to the pathogenesis of Crohn’s disease. Pfeffer-Gik T, Levine A.
- Med Hypotheses.2001 Oct;57(4):510-4. Is milk responsible for male reproductive disorders? Ganmaa D, Wang PY, Qin LQ, Hoshi K, Sato A.
- Food Addit Contam Part A Chem Anal Control Expo Risk Assess.2012;29(5):770-9. doi: 10.1080/19440049.2011.653989. Epub 2012 Feb 14. Development of an LC-MS/MS method to quantify sex hormones in bovine milk and influence of pregnancy in their levels. Regal P, Cepeda A, Fente C.
- N Engl J Med.1982 Dec 16;307(25):1542-7. Estrogen excretion patterns and plasma levels in vegetarian and omnivorous women. Goldin BR, Adlercreutz H, Gorbach SL, Warram JH, Dwyer JT, Swenson L, Woods MN.
- Am J Clin Nutr.2013 Feb;97(2):411-8. doi: 10.3945/ajcn.112.042432. Epub 2012 Dec 26. High dietary intake of saturated fat is associated with reduced semen quality among 701 young Danish men from the general population. Jensen TK, Heitmann BL, Jensen MB, Halldorsson TI, Andersson AM, Skakkebæk NE, Joensen UN, Lauritsen MP, Christiansen P, Dalgård C, Lassen TH,Jørgensen N.
- Med Hypotheses.2003 May;60(5):724-30. The experience of Japan as a clue to the etiology of testicular and prostatic cancers. Ganmaa D, Li XM, Qin LQ, Wang PY, Takeda M, Sato A.
- Reprod Sci.2014 Oct 29. pii: 1933719114556487. [Epub ahead of print] 17β-Estradiol and Lipopolysaccharide Additively Promote Pelvic Inflammation and Growth of Endometriosis. Khan KN, Kitajima M, Inoue T, Fujishita A, Nakashima M, Masuzaki H.
- Turk J Med Sci.2014;44(5):781-6. Insulin-like growth factor 1, liver enzymes, and insulin resistance in patients with PCOS and hirsutism. Çakir E, Topaloğlu O, Çolak Bozkurt N, Karbek Bayraktar B, Güngüneş A, Sayki Arslan M, Öztürk Ünsal İ, Tutal E, Uçan B, Delıbaşi T.
- Med Hypotheses.2003 Feb;60(2):268-75. The experience of Japan as a clue to the etiology of breast and ovarian cancers: relationship between death from both malignancies and dietary practices. Li XM, Ganmaa D, Sato A.
FAQ
What are pelvic floor muscles?
The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.
What is pelvic floor physical therapy?
Pelvic floor physical therapy is a specialized area of physical therapy. Currently, physical therapists need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical therapy education in this unique area.
What happens at pelvic floor therapy?
During an evaluation for pelvic floor dysfunction the physical therapist will take a detailed history. Following the history the physical therapist will leave the room to allow the patient to change and drape themselves. The physical therapist will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical therapist will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical therapist will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical therapist will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.
What is pudendal neuralgia and how is it treated?
Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.
Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.
What is interstitial cystitis and how is it treated?
Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.
Who is the Pelvic Health and Rehabilitation Team?
The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical therapists who work at PHRC have undergone more training than the majority of pelvic floor physical therapists and as a result offer efficient and high quality care.
How many years of experience do we have?
Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.
Why PHRC versus anyone else?
PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.
Do we treat men for pelvic floor therapy?
The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical therapists focus solely on people with vulvas, this is not the case here.
Do I need pelvic floor therapy forever?
The majority of people with pelvic floor dysfunction will undergo pelvic floor physical therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.
Comments
Wow ty for this article! I am so addicted to dairy and can’t seem to give it up even though I experience many negative symptoms from consuming it. Nasal congestion, constipation, body odor, painful periods, pelvic and bladder pain. I knew about casein being the protein in dairy but never anything beyond that. Now it makes sense why I am so addicted to something that causes mean ongoing pain. This is a real eye opener ty again.