HYPOTHYROID: A Comprehensive Assessment

by Dr. Jennifer Abercrombie N.D. | Guest Featured Author and Founder of The Naturopathic Wellness Center in Los Angeles, CA.

The thyroid is known as the regulator of metabolism. But it also has far reaching effects to mood balance (implicating depression and anxiety), menstrual cycle regulation, sex hormone balance, lipid metabolism, growth, development, carbohydrate metabolism, release of stomach acid for digestion, and gastrointestinal motility among others. Many people show normal thyroid function on laboratory work, but still are clinically hypothyroid.

How the Thyroid Works

The hypothalamus and pituitary release hormones TRH (thyrotrophin releasing hormone) and TSH (thyroid stimulating hormone), to tell the thyroid to start producing hormones. The thyroid then produces roughly 80% as T4 (less bio-active) and 20% as T3 (very bio-active) into circulation. As the hormones are circulating around the body, the liver, kidney, gut, muscles, and central nervous system will convert T4 to T3 as more active hormone is needed. Under stress, whether emotional or physiological, more T4 will be converted to reverse T3. Reverse T3 is an un-usable form that, if in excess, can block normal T3 receptors, making you feel more hypothyroid despite a leveling of hormones in the blood.

Various Types of Hypothyroidism

Because the thyroid has many effects throughout the body, there are many different types of hypothyroidism. When it comes to treatment, you have to treat the specific type of hypothyroid condition to achieve optimal results. A hypothyroid state is not a normal balanced state in the body. To successfully treat the thyroid, you have to address what triggered the condition.
1. Hypothalamus/Pituitary Thyroid Axis: Suppression of the HPT axis can happen anywhere along the line. Specifically, the axis can become suppressed if there is a deficiency in dopamine or serotonin (neurotransmitters that balance mood), cytokines that are released from chronic inflammation or infections, and high cortisol from chronic stress.
2. Auto-immune Association: In certain individuals, a genetic predisposition to a health disorder can be triggered and the immune system may begin attacking the thyroid. This can cause an initial flare inducing a hyperthyroid state, followed by a hypothyroid state.
3. Down Regulating the Production of Hormones: The production of thyroid hormones can be down regulated by low progesterone, high estrogen, oral contraception, elevated cytokines that are released from chronic inflammation or infections, high cortisol levels from chronic stress, low serotonin and dopamine, gastrointestinal dysbiosis (20% of T4 is converted to T3 in the gut via healthy gut flora), poor diet, and deficiency in nutrients that are needed to make the thyroid hormone: iodine, Vitamin A, Vitamin D, selenium, and zinc.
4.·Resistance to Thyroid Hormone: If too much thyroid hormone is produced, the body builds a resistance to it as a form of protection from the active T3 hormone. This can be caused by high estrogen, high testosterone, insulin resistance (commonly seen in diabetes and polycystic ovarian syndrome, or PCOS). The thyroid receptors may also become resistant to the hormone from elevated pro-inflammatory Th1 cytokines from chronic inflammation, persistent elevated cortisol from chronic stress, deficient vitamin A, and methylation defects as seen with elevated homocysteine.

The Gut Connection

Thyroid hormone is needed to produce stomach acid. If the stomach doesn’t produce enough stomach acid during digestion, the pH of the small intestine will start to become more alkaline, the pancreas will release less enzymes, and food will begin to become undigested which you may see in your stool. All of these will start to disrupt a healthy bacterial flora in the small intestine leading towards food sensitivities, inflammation and cytokine release, and a damaged gut lining. The inflammation created will cycle back and disrupt thyroid hormone production and can create thyroid receptor resistance. Thyroid hormones also control gut motility, so having lower levels of the hormones will make you more constipated, again altering the healthy biome of bacteria in the gut.

The Adrenal Connection

When there is chronic stress and elevation of cortisol, T4 gets converted into reverse T3. Reverse T3 binds to the T3 receptors, blocking cells from accessing the active T3 hormone. But stress is more than just emotional. Stress is also a physiological event that is created by elevated cytokines from chronic inflammation, food and environmental sensitivities, undigested proteins, leaky gut, chronic infections (viral, bacterial, yeast, parasite), liver congestion, and heavy metal toxicity.

Laboratory Assessment

Typically a hypothyroid state is not created by just one factor. It is a combination of multiple triggers where over time the body can no longer adapt. The body becomes overwhelmed. Therefore, laboratory assessment needs to take into consideration the various factors that can trigger the thyroid. Some of the laboratory tests to consider include a nutrient analysis to determine which cofactors and nutrients are depleted or too elevated, functional adrenal assessment of cortisol, heavy metal load, gastrointestinal health, iodine status, thyroid antibodies, and conversion pathways of the thyroid hormones.

Epigenetics

Epigenetics is the idea of how external factors affect the expression of genes. Especially with individuals who have hashimotos or grave’s disease, treatment goes beyond just giving thyroid medication. Treatment needs to assess the factors that alter gene expression. Very similar to the factors that trigger a hypothyroid state, the items that can trigger genetic expression are usually a combination of events. This can include adrenal dysfunction from chronic stress, inflammation and elevated cytokines from chronic infections, congested liver function, disruption in gastrointestinal flora and abnormal digestion, deficient nutrients, poor nutrition habits, and heavy metal burden.

 Take Home Message

When it comes to assessing thyroid conditions, treatment is much more intensive than just giving thyroid medication. Underlying factors that created the condition need to be addressed. Because thyroid hormones effect every cell, a whole body approach is needed that assesses how each system affects and is effected by the thyroid.

For more information or to set an appointment with one of our doctors, please call 303 545 2021 or email DrMartin@nawellness.com

Naturopathic Womens Wellness

1295 Yellow Pine Ave. Boulder CO 80304

P: 303 545 2021   F: 303 545 2003

E: DrMartin@nawellness.com

Dr. Hillary Martin

Happy Valentines Weekend!

Enjoy the Love ~  Its Good for your Heart!

Q&A: PMS, Why? And What I Can Do For Relief!

 --Do you know what percent of women experience period cramps? 

At least 60% of menstruating women experience PMS including menstrual cramps but less than half that number have difficulties that affect their quality of life due to pain and discomfort and requiring the need for intervention. Cramping can also be noted in some women at midcylce during ovulation, called “mittleschmerz.” This pinching sensation often passes quickly in a few hours to days and can be noted but unremarkable.

--What makes a woman more likely to experience period cramps? 

Menstrual cramps are a natural process in the female cycle pronounced in the luteal phase(second half of the cycle) closer to the onset of menses. If fertilization and pregnancy is not intact in the uterus then within 24-48 hours of starting your period the hormones estrogen and progesterone start to drop initiating a cascade of hormones to be released. These hormones create mild contractions in the uterus to break down the endometrial lining and expel it over the next 3-7 days as a normal menstrual period. Although a natural process it should be an easy and tolerable transition without upsetting ones quality of life. Some women make more of the contractile hormones called prostaglandins and leukotrienes. They are not only associated with contraction and relaxation of muscle tissue but they also create an inflammatory processes in the body to spark healing on the surrounding tissues. If there is excess contraction and inflammation in the pelvic cavity pre-menses then cramping will be more severe. Dysmennorhea is the term for painful menses that can be associated with an underlying cause including heightened contracture, inflammation, high emotional stress, as well as physical causes like uterine fibroids, endometriosis and cervical polyps.

--What are some hormonal and emotional reasons women may experience cramps, irritability, bloating or other PMS-related symptoms during their monthly cycle? 

PMS symptoms can be exacerbated for most women during times of stress. This is due to the relationship between sex hormones(estrogen and progesterone) and stress hormones(cortisol). When the body is producing high amounts of cortisol to deal with stressors, biochemically, it uses the same cholesterol backbone from food in the diet to make cortisol as it does to make estrogen and progesterone(E/P). This then upsets the E/P ratios in the body and steals from its reserves to make cortisol instead of keeping E/P in balance. Stress and cortisol also take a lot of energy in the form of blood sugar using up reserves more quickly. Simultaneously at the onset of menses as the progesterone drops this causes another drop in blood sugar so women can become irritable, anxious, depressed and crave sugar. Some studies have hypothesized that some neurotransmitters are intimately linked to the menstrual cycle and that specifically serotonin, “the happy hormone,” drops after ovulation. Women with lower levels of serotonin can suffer form more severe depression and mood instability in the second half of there cycle and worse at menses.

Bloating and cramps are worse for some women than others based on the levels of inflammation in the body that will be elevated pre-menses due to the stimulation of prostaglandins and leukotrienes.

--With such easy access to over-the-counter pain relievers of all sorts, it's easy for women to forget that their are alternative ways to ease these monthly pains. What are some types of foods you'd recommend to a patient to help ease period symptoms naturally? 

Diet and lifestyle intervention can have an enormous affect on PMS and cramps. A whole foods diet with a focus on anti-inflammatory foods can decrease pelvic inflammation and help support E/P ratios. Animal fats are high in inflammatory prostaglandins where as vegetable oils will an have antagonistic effect. A high fiber, vegetable based diet will lower overall inflammation. Fruits, legumes, whole grains, nuts and seeds all support reducing inflammation in the body as well as preventing constipation. Easily moving bowels will decrease pressure in the pelvic cavity and lessen bloating and potential cramping. Fiber also promotes excretion of excess estrogens that are not in balance to progesterone in women with estrogen dominant cycles and generally present with more aggressive PMS. Foods high in B6 such as fish, eggs, walnuts, bananas, prunes, avocado and cauliflower can support serotonin pathways and mood changes. Dark leafy greens. Almonds, pecans, cashews, brown rice, avocado and dried apricots are all high in magnesium that can promote relaxation of the muscle contractions easing cramps. Foods high in iron(beans. Nuts, salmon, kale, spinach, dandelion, broccoli, black strap molasses) can also improve energy levels and prevent fatigue due to blood loss during menses. Staying hydrated and preventing water retention will decrease overall bloating systemically and lower pelvic congestion. It is recommended to drink half of your body weight in ounces of water daily. Ie at 150 pounds you would drink 75 ounces of water daily. Foods high in potassium can help reduce water retention(spinach, peas, parsley, tomatoes, oranges, apples, avocados, raisins).

--What are some types of foods you'd advise your patients to avoid during their period -- or foods that may make their symptoms worsen during that time of the month? 

Decreasing fat intake especially animal fats can lower prostaglandin induced inflammation and contractions as well as reduce circulating excess estrogens in the body. Less animal foods, more plants! Avoid sugars. I know your body may crave it but it will increase inflammation in the body, increase water retention, increase cravings and disturb the glycemic balance in the body causing hyper then hypoglycemia, exacerbating mood swings and irritability. Sugar also impairs estrogen metabolism. PMS is more common in women with high sugar diets and is associated with higher estrogen levels. Caffeine in concert with sugar has a detrimental affect on mood and PMS. Caffeine over time heightens the hypoglycemic response and therefore anxiety, depression, irritability and insomnia. Excess salt reduces potassium in the blood and stresses the kidneys ability to maintain fluid volume leading to water retention and increased sensation of bloating. Alcohol also upsets the blood sugar balance as well as dehydration and retention. It is best to stick to 0-1 alcoholic beverages daily during menses to reduce symptoms associated with PMS.

--Are there any old wives' tales you've heard patients talk about? Care to set the record straight?

I have seen many patients with moderate to severe PMS have a huge improvement in symptoms with a general multivitamin and whole foods diet. Castor oil packs applied to the abdomen can provide muscle relaxation to the pelvis and warm comfort. Homeopathic remedies for you constitution can reduce symptoms and overall well being.

--Are there any activities you'd recommend/not recommend to a patient who experiences period symptoms? 

Exercise and stress reduction are the two best activities you can indulge in for PMS. Women who exercise regularly report no to less PMS and improved concentration, mood, endorphins and less pain. Exercise elevates serotonin levels and lowers cortisol. Yoga, biking and swimming can be great ways to increase blood flow and circulation to the pelvic cavity and reduce pain and inflammation. Exercise lowers stress levels in the body but for more reflective relaxation meditation, reading, laughing with friends and creative hobbies can be a way to lower cortisol.

-Anything else on this topic you'd like to add? Any additional expert advice is welcome and encouraged!

If all else fails and the cramps begin I love to use Viburnum(crampbark)  as a uterine tonic for period pain pain that is crampy and comes in waves. If PMS affects your life every month where you need medical intervention, pain management or birth control I highly suggest a full naturopathic evaluation for simple natural solutions for peace of mind and pain free quality of life!

Vitamins to Relieve Menstrual Cramps

Calcium and Magnesium

Calcium and Magnesium supplementation can decrease cramping symptoms secondary to PMS. Although lacking thorough scientific evidence the theory is that calcium can alter smooth muscle responsiveness associated with PMS while magnesium can increase the pain threshold. Muscles need calcium to maintain muscle tone and relax after contraction. Not having enough calcium in the body can increase muscle cramping including PMS cramping. Ruth Trickey, author of “Women’s Hormones and the menstrual cycle states that magnesium deficiencies can cause premenstrual tension, cramping and an overall increase in PMS.

Take 800-1000 mg of calcium a day and up to 1000 mg of magnesium per day.

B Vitamins

B vitamins, especially B3 and B6, can act as enzyme catalysts to improve cellular function. B6 can improve cramping associated with PMS by increasing the levels of magnesium being absorbed into the cells. Pizzorno, in his book, “The Clinician’s Handbook of Natural Medicine,” states that patients given a multivitamin with hi-doses of B6 and magnesium have 70% reductions in premenopausal and postmenopausal symptoms, this is including menstrual cramping. B3 may relieve menstrual cramping by causing vasodilation which increases blood flow and oxygen to the uterus.

You can take up to 100 mg of B3(niacin) twice a day and 50 mg of B6 three times a day.

EFAs

EFAs are hormone like substances that make omega-3 and omega-6 fatty acids. Prostaglandins(PGs)are made from omega-6 fatty acids, linoleic acids, that are consumed in the diet. Linoleic acid(omega-6) needs enzymes like magnesium and B vitamins to convert it to linolenic acids(omega-3) which are anti-inflammatory and antispasmodic. Omega-6 derived PGs are inflammatory markers that can lead to painful uterine contractions and decrease blood flow to the uterus. High levels of PGs can lead to increased muscle contraction, inflammation and pain. Tori Hudson, N.D. and professor of gynecology at The National College of Naturopathic Medicine, claims that menstrual cramping or dysmenorrhea, has been associated with an increased level of prostaglandins.  In order to decrease levels of inflammatory PGs consume 500 – 1000 mg of Omega-3 fatty acids, one to three times a day. Omega-3’s can be found in flax seed oil and fish or cod liver oil. Do not take EFA’s if you are on blood thinners or have a bleeding disorder.

Dr. Hillary Martin

Naturopathic Womens Wellness

www.naturopathicwomenswellness.com

1295 Yellow Pine Ave.

Boulder Co 80304

303 545 2021

Measles & Prevention 2015

Measles is a virus so treat it like all viral infections and keep immunity boosted, get plenty of fluids, WASH HANDS, avoid heavily populated areas that can have high risk exposure. Keep your children home if they are sick

Symptoms of Measles

Signs and symptoms of measles appear 10-14 days after exposure and may include fever, cough, runny nose, inflamed eyes, sore throat and rash. The classic sore throat presentation may have small bluish-white spots in the mouth or the back of the throat called ‘Koplik spots” definitive of measles. The rash will start at the top and move down from the torso and arms to the legs and lower body. The virus will be contagious for about 8 days, starting 4-5 days before the rash appears and following 4-5 days after. 

• Contact your doctor immediately if any of these symptoms present themselves.

Having a vitamin A deficiency. If you don't have enough vitamin A in your diet, you're more likely to contract measles and to have more-severe symptoms.

Vitamin A. People with low levels of vitamin A are more likely to have a more severe case of measles. Giving vitamin A may lessen the severity of the measles. It's generally given as a large dose of 200,000 international units (IU) for two days.(http://www.mayoclinic.org/diseases-conditions/measles/basics/risk-factors/con-20019675 )

Best Antivirals: Elderberry, Andropgraphis, Astragalus and Osha, Vit A(bet carotene), Vit C, Zinc. Incorporate Vit D, probiotics and healthy, whole food diet for immune support.

Naturopathic Womens Wellness

1295 Yellow Pine Ave. Boulder CO 80304

P: 303-545-2021  |  F: 303-545-2003 |  E: DrMartin@nawellness.com

|  Dr. Hillary Martin  |

Beauty From the Inside Out: Skin Disorders, Stress and Aging

November 2014

Beauty From the Inside Out: Skin Disorders, Stress and Aging

Most of you can relate to the acne you had in your early teens, the premenstrual outbreaks, acne that appeared to flare up with stress or after all-nighters with pizza and junk food but what about now?

Are you between the ages of 25-40 with acne that wont quit?

Your skin is a reflection of your health from the inside out. Healthy, glowing, well-hydrated skin is a sign of good digestion, absorption, hydration, stress management and hormone balance. Your skin is the largest organ in the body and one of the five organs your body uses for elimination of toxins.  The skin, liver, kidneys, lungs and bowels all work together to rid the body of waste and become symptomatic when overloaded. You have seven layers of skin cells that store fat, water, glucose and salt; act as a channel for absorption and secretion; regulate body temperature; and acts a major producer of endocrine hormones. The skin directly links the brain to the nervous system through touch, pain, and temperature. Ayurvedic medicine refers to the skin as the body’s “second brain,” and that its appearance mirrors our internal physiology, mental emotional state and hormonal connection.[1]

If you struggle with chronic skin conditions you know that it rarely, if ever, has to do with “dirty” surfaces or lack of hygiene. So why in a world of incredible skin products, regimens and magical ointments, salves, antibiotics and medications are you still breaking out?

Distress:

Our stress responses are regulated by the autonomic nervous system made up of the sympathetic and parasympathetic branches to regulate “fight or flight” and “rest and digest” responses. These two systems work together to stay in balance and keep us happy, energetic, rested and digesting properly. Distress signals cause a large imbalance in the systems and over time it gets harder and harder to get back to center and feel balanced. This happens due to the natural process of aging as well as chronic stress. The sympathetic nervous system is unable to shut off and overrides the ability of the parasympathetic to turn on so energy is affected, maldigestion and malabsorption begins and cortisol levels rise stealing the backbone of hormones needed to regulate sex and thyroid hormones. This is the same nervous system that takes signals from the skin cells to the brain and back again…see the connection! Cortisol secretions affect blood sugar levels and therefore keep sugars in the blood longer affecting the circulation and hydration to the capillaries in the skin. Changes in estrogen and progesterone ratios begin and lead to disturbances in the menstrual cycle, infertility, PMS, PCOS and andropause in men. As you can see stress causes imbalances in the body that eventually show up in the skin as acne, cysts, eczema, infections, and accelerated aging.

Diet:

Digestion is directly affected by stress in our lives and we unfortunately live in a society dominated by the sympathetic nervous system. Maldigestion and malabsorption of nutrients leads to symptoms of constipation, diarrhea, colitis, gas, IBS, and GERD which all further the imbalance in the autonomic nervous system. The food we eat and the choices we make fortify the skin cells with nutrients, fluids, healthy fats and collagen. Low gut integrity with poor stomach acid, enzymes, flora and poor food choices will increase inflammation to the skin and lead to outbreaks, eczema, cystic acne and redness/flares. An anti-inflammatory Mediterranean type diet high in vegetables and fruits, healthy fats or an additional Omega 3 oil with DHA, appropriate enzymes and probiotics will improve gut-skin health. Nutritional supplements such as Zinc, Vitamins A, C, E and D are also valuable in supporting the skin. Your body is 70-80% water and that water encompasses each and every cell in the body. Stay hydrated with an average of 6-8 glasses of water daily.

“There are significant data supporting the role of diet in acne. Our Western diet includes many dairy sources containing hormones.The natural function of milk being to stimulate growth, it contains anabolic steroids as well as true growth hormones and other growth factors. The presence of 5α-pregnanedione, 5α-androstanedione, and other precursors of 5α-dihydrotestosterone add to the potency of milk as a stimulant of acne. In addition, foods with significant sugar content and other carbohydrates yielding high glycemic loads affect serum insulin and insulin-like growth factor-1 levels, both of which promote increased production of available androgens and the subsequent development of acne.”[2]

Detox:

The 5 organs of elimination need to be working properly to remove toxins from the body. Toxins are mainly filtered from the blood by the liver, secreted in the sweat, expired out of the lungs during respiration, and excreted through bowel movements and urine. Toxic load will have a large impact on phase 1 and phase 2 liver detoxification pathways. If these pathways are not working well toxins will back up in the blood and be recirculated into the system to be excreted through the skin developing in acne and skin inflammation. Body odor and bad/sour breath is also a strong indicator of toxic overload. Irregular bowel movements and gastrointestinal upset as well as scant yellow urine, UTIs and dehydration are signs of poor detoxification. Healthy diet, exercise, hydration and regulated liver support are necessary to encourage elimination of toxins and lower the total body burden for radiant skin.

Acne Resolution:

1. 1.      Skin Hygiene: Use a simple cleanser and toner twice daily ending with skin hydration lotions or oils that may include hyaluronic acid or C-peptide serum. You don’t want to increase your toxic load with your skin care regimen, including make-up. Less is more for skin products. A good rule of thumb is if you can eat it you can put it on your skin. I use coconut and avocado oil for hydration, a simple toner with lavender or tea tree in a hydrosol and a pure cleanser we had compounded by Great Earth Pharmacy. 
2. Eat clean and lean. Avoid high glycemic foods, dairy products, refined carbohydrates and processed fats food. Stick to a Mediterranean style anti-inflammatory diet. Consider supplementing with omega fatty acids, zinc, Vitamin C, A, D and E. Stay hydrated. Drink half of your body weight in ounces daily.
3.  Make sure you are eliminating properly. Have at least one bowel movement daily, easy to pass. Have any gastrointestinal upset, IBS, constipation, diarrhea, gas and bloating properly addressed by your doctor.
4. Enhance your detoxification pathways by supporting the two phases of liver detox with antioxidants, detox herbs and supplements.
5. Manage stress and hormone imbalances. Don’t underestimate the power of stress and its relationship to the skin. If the signals are getting clogged or crossed the result will hit you right in the face!

---

[1] Raichur, Pratima, Absolute Beauty, Harper Perennial 1997.

[2]  Clinical Dermatology (2010) Nov-Dec; 28(6):598-604

10 Reasons Why Handheld Devices Should Be Banned for Children Under the Age of 12

http://m.huffpost.com/us/entry/4899218

Cris Rowan Become a fan 

pediatric occupational therapist, biologist, speaker, author

10 Reasons Why Handheld Devices Should Be Banned for Children Under the Age of 12

Posted: 03/06/2014 3:35 pm EST Updated: 03/09/2014 3:59 pm EDT

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Hild TechnologyHandheldsEducational TechnologyChild ViolenceChild DepressionChild AnxietyChild AggressionADHDScreen SenseTechnology AddictionAutismLearning DifficultiesChild Technology GuidelinesSleep DeprivationParents News

The American Academy of Pediatrics and the Canadian Society of Pediatricsstate infants aged 0-2 years should not have any exposure to technology, 3-5 years be restricted to one hour per day, and 6-18 years restricted to 2 hours per day (AAP 2001/13, CPS 2010). Children and youth use 4-5 times the recommended amount of technology, with serious and often life threatening consequences (Kaiser Foundation 2010, Active Healthy Kids Canada 2012). Handheld devices (cell phones, tablets, electronic games) have dramatically increased the accessibility and usage of technology, especially by very young children (Common Sense Media, 2013). As a pediatric occupational therapist, I'm calling on parents, teachers and governments to ban the use of all handheld devices for children under the age of 12 years. Following are 10 research-based reasons for this ban. Please visit zonein.ca to view the Zone'in Fact Sheet for referenced research.

1. Rapid brain growth
Between 0 and 2 years, infant's brains triple in size, and continue in a state of rapid development to 21 years of age (Christakis 2011). Early brain development is determined by environmental stimuli, or lack thereof. Stimulation to a developing brain caused by overexposure to technologies (cell phones, internet, iPads, TV), has been shown to be associated with executive functioning and attention deficit, cognitive delays, impaired learning, increased impulsivity and decreased ability to self-regulate, e.g. tantrums (Small 2008, Pagini 2010).

2. Delayed Development
Technology use restricts movement, which can result in delayed development. One in three children now enter school developmentally delayed, negatively impacting literacy and academic achievement (HELP EDI Maps 2013). Movement enhances attention and learning ability (Ratey 2008). Use of technology under the age of 12 years is detrimental to child development and learning (Rowan 2010).

3. Epidemic Obesity
TV and video game use correlates with increased obesity (Tremblay 2005). Children who are allowed a device in their bedrooms have 30% increased incidence of obesity (Feng 2011). One in four Canadian, and one in three U.S. children are obese (Tremblay 2011). 30% of children with obesity will develop diabetes, and obese individuals are at higher risk for early stroke and heart attack, gravely shortening life expectancy (Center for Disease Control and Prevention 2010). Largely due to obesity, 21st century children may be the first generation many of whom will not outlive their parents (Professor Andrew Prentice, BBC News 2002).

4. Sleep Deprivation
60% of parents do not supervise their child's technology usage, and 75% of children are allowed technology in their bedrooms (Kaiser Foundation 2010). 75% of children aged 9 and 10 years are sleep deprived to the extent that their grades are detrimentally impacted (Boston College 2012).

5. Mental Illness 
Technology overuse is implicated as a causal factor in rising rates of child depression, anxiety, attachment disorder, attention deficit, autism, bipolar disorder, psychosis and problematic child behavior (Bristol University 2010,Mentzoni 2011, Shin 2011, Liberatore 2011, Robinson 2008). One in six Canadian children have a diagnosed mental illness, many of whom are on dangerous psychotropic medication (Waddell 2007).

6. Aggression 
Violent media content can cause child aggression (Anderson, 2007). Young children are increasingly exposed to rising incidence of physical and sexual violence in today's media. "Grand Theft Auto V" portrays explicit sex, murder, rape, torture and mutilation, as do many movies and TV shows. The U.S. has categorized media violence as a Public Health Risk due to causal impact on child aggression (Huesmann 2007). Media reports increased use of restraints and seclusion rooms with children who exhibit uncontrolled aggression.

7. Digital dementia
High speed media content can contribute to attention deficit, as well as decreased concentration and memory, due to the brain pruning neuronal tracks to the frontal cortex (Christakis 2004, Small 2008). Children who can't pay attention can't learn.

8. Addictions
As parents attach more and more to technology, they are detaching from their children. In the absence of parental attachment, detached children can attach to devices, which can result in addiction (Rowan 2010). One in 11 children aged 8-18 years are addicted to technology (Gentile 2009).

9. Radiation emission
In May of 2011, the World Health Organization classified cell phones (and other wireless devices) as a category 2B risk (possible carcinogen) due to radiation emission (WHO 2011). James McNamee with Health Canada in October of 2011 issued a cautionary warning stating "Children are more sensitive to a variety of agents than adults as their brains and immune systems are still developing, so you can't say the risk would be equal for a small adult as for a child." (Globe and Mail2011). In December, 2013 Dr. Anthony Miller from the University of Toronto's School of Public Health recommend that based on new research, radio frequency exposure should be reclassified as a 2A (probable carcinogen), not a 2B (possible carcinogen). American Academy of Pediatrics requested review of EMF radiation emissions from technology devices, citing three reasons regarding impact on children (AAP 2013).

10. Unsustainable
The ways in which children are raised and educated with technology are no longer sustainable (Rowan 2010). Children are our future, but there is no future for children who overuse technology. A team-based approach is necessary and urgent in order to reduce the use of technology by children. Please reference below slide shows on www.zonein.ca under "videos" to share with others who are concerned about technology overuse by children.

Problems - Suffer the Children - 4 minutes
Solutions - Balanced Technology Management - 7 minutes

The following Technology Use Guidelines for children and youth were developed by Cris Rowan, pediatric occupational therapist and author of Virtual Child; Dr. Andrew Doan, neuroscientist and author of Hooked on Games; and Dr. Hilarie Cash, Director of reSTART Internet Addiction Recovery Program and author ofVideo Games and Your Kids, with contribution from the American Academy of Pediatrics and the Canadian Pediatric Society in an effort to ensure sustainable futures for all children.

Technology Use Guidelines for Children and Youth

Please contact Cris Rowan at info@zonein.ca for additional information. © Zone'in February

Follow Cris Rowan on Twitter: www.twitter.com/zoneinprograms