"...The story that follows is excerpted from a longer account by Mary Cupp, who has given reprint permission. Please do not take it as a base of Dr. Northrup bashing. The point here is not who Mary’s physician was, but rather the crucial information about the connections between heavy bleeding, hypothyroidism, and Vitamin A. So many women suffer in a similar manner! Just before menopause, I myself ended up having a D&C and a blood transfusion due to life-threatening heavy bleeding. It’s probably only due to the cheapness of my HMO that it wasn’t a hysterectomy. And yes, it turned out that my thyroid levels were low and that there was a Vitamin A problem, judging by the yellow tinge of my skin, but it was only after menopause that I began studying hormones and figured out some connections.
Mary Cupp writes:
In October, 1983 I read an interview in "East/West Journal" in which Dr. Northrup spoke of treating endometriosis, fibroid tumors, and heavy periods etc. (all conditions that I was suffering from) with diet and vitamins. The article included two case histories of women who avoided hysterectomies through diet. One of them was titled "Escape from Hysterectomy".
I arranged a consultation in June of 1986, while on a trip to Maine. She recommended a strict vegetarian diet, eliminating all dairy foods and eggs, and substituting soy milk for dairy. I went back to Virginia where I commenced the diet. Initially it did help to alleviate my pain, but over time my general health gradually deteriorated.
Shortly after this I moved to Maine. By this point the bleeding had stopped but I was still in a great deal of pain. I went to Women to Women and after an intake visit, and was sent to an iridologist/nutritionist who suggested that I use concentrated food supplements, such as bee pollen and chlorella, rather than vitamin pills. Over the next year I developed severe anemia. When I saw Dr. Northrup some time afterwards I had just been put on heavy iron supplementation. Her initial recommendation was a hysterectomy, the very surgery I had come to her to avoid. I refused...
...Something didn't feel right. If I would ask her what had helped other women, she would simply reply that every case was different and that she had never seen a case like mine. And she continued to urge a hysterectomy...
...I went to the emergency room with a blood count of 5.3 (normal is 11-15). I could barely stand up. Dr. Northrup was called. She said, "That's it, that's it, you're having a hysterectomy first thing tomorrow morning! I'm going to do as I was taught (i.e. in medical school). This time I'm taking charge!" She told me that she would no longer be my doctor if I refused to submit to the surgery. Although I was given four units of blood (which for me added fear to the trauma), I was not given anything to stop the bleeding. Under these conditions I saw no way out and so, under duress, I signed the release. Yet even then, I was still literally begging Christiane to leave my uterus in. I recall her saying, "Well, you know you've tried everything."
About six months after the surgery (Dec, 1993), I came upon a newsletter called "Second Opinion" by Dr. William Campbell Douglass M.D., which carried a column on alternative treatments. It discussed menorrhagia and cited a study in the 1977 South African Medical Journal using vitamin A in its treatment. It cited a 92.5% cure rate. It also mentioned that this treatment is used at Johannesburg General Hospital in South Africa and has a documented 92% cure rate over a ten year period. I subsequently took vitamin A in very high doses (100,000 IU per day) for about two months. This produced a dramatic improvement in my general health and alleviated a number of long standing symptoms.
I was puzzled by this as I had been taking a number of multiple vitamin preparations, eating lots of vegetables and drinking carrot juice. I had seen more than six nutritional professionals. Yet none of them had picked up on the fact that I needed vitamin A! I researched the vitamin and was able to uncover the underlying problem. Suddenly the mystery of my illness became transparent!
What I found out was that there are two forms of vitamin A. One of these, beta carotene, found in vegetables, is not true vitamin A but a precursor which must be converted by an enzyme in the presence of thyroxine, the thyroid hormone, if it is to be utilized as vitamin A by the body. I had been somewhat aware of the two forms, however most writing on nutrition, and the nutritionists with whom I had consulted, all recommended carotene as the preferred form in which to take the vitamin. What was emphasized is the fact that carotene can never be toxic in any amount, therefore it is considered safer. Additionally, the two forms are often treated as if they were interchangeable. Most multiple vitamin supplements currently on the market substitute beta carotene, unit for unit, for vitamin A and many do not label clearly that the switch has been made. (I had taken such supplements) What is rarely mentioned is that only the animal form has any vitamin A activity before conversion takes place. The rate of conversion varies in a normal population from about one third to one sixth.
What is even more rarely mentioned is that certain medical conditions such as diabetes and low thyroid in particular, may block conversion altogether. Thus a seemingly healthy vegetarian diet may be dangerously low in vitamin A for persons in these categories because of their inability to utilize carotene sources of the vitamin. Serious malnutrition may result if preformed vitamin A is not taken. The deficiency of vitamin A is extremely hard on the thyroid and the pituitary - organs central to women's health. Low thyroid is extremely common in women with gynecological problems, especially dysfunctional uterine bleeding, and is a leading cause of hysterectomies. The thyroid condition is often overlooked, as frequently it does not show up on standard blood tests which are notoriously unreliable. (My tests results were normal, but my symptoms showed a classical profile for low thyroid.) I came to realize that, as a vegetarian, I had depleted my bodies vitamin A levels by not understanding this problem.
I also noted that certain foods frequently used by vegetarians fall into a category called goitrogens (from goiter) which tend to suppress thyroid activity further. This group includes otherwise good foods such as broccoli, kale, millet, and most notably soy. (Recall that Dr. Northrup recommended soy milk to replace dairy.) It has been well reported that infants on soy formula and adults consuming soy isoflavones often develop goitre and hypothyroidism. In one study, women consuming soy isoflavones developed disruptions of the menstrual cycle for up to three months after the soy was discontinued.
I further came to realize that taking iron for anemia, without vitamin A, could trigger hemorrhaging. This is because iron and vitamin A work synergistically in building blood. Therefore taking iron alone lowers vitamin A levels. (This is exactly the sequence that triggered my hemorrhage.) What is necessary, when this happens, is to take preformed vitamin A in very high doses - just the opposite of what I had been taught. High does are indicated and therapeutic in these circumstances because the bodies stores of the vitamin have become depleted, requiring large doses to return the body to a state of health.
From this research it became clear to me that the vegetarian diet Dr. Northrup had recommended could be dangerous for some women if not supplemented with preformed vitamin A. I strongly suspected that it may have been the underlying cause of my bleeding.
When I opened the book, I found what I had feared. Dr. Northrup specifically recommended up to 100,000 IU per day of vitamin A for up to three months in her section on menorraghia (p.141- 143), citing the reference in the 1977 South African Medical Journal. She was also aware of the thyroid connection to bleeding (from medical school) and claimed to do prolactin hormone testing in cases of bleeding. Yet she had never even mentioned any of these connections to me the during the entire four years that I was bleeding! I was devastated.
Endometriosis occurs when the endometrium does not slough off normally at menstruation. It is usually accompanied by menorrhagia (heavy bleeding), severe menstrual cramps, and pain with defecation, intercourse and even ovulation.
In severe cases the endometrium or lining of the uterus migrates to other sites such as the intestines and the bladder. The islands of the endometrium cause pain when they go through the cycle of menses and bleed as if they were normal uterine tissue. Cysts and fibroid tumors are common side effects.
It is thought that endometriosis and related disorders are associated with a disruption in the estrogen-progesterone cycle, resulting in high levels of estrogen and low levels of progesterone. In monkeys, exposure to dioxin, which is an estrogen-like compound, resulted in moderate to severe endometriosis.23 In horses, endometrial fibrosis has been treated successfully with dimethyl sulfoxide (DMSO), which is approved for use in animals but not in humans.24
Orthodox treatment includes estrogen-blocking drugs, such as Danocrine, and laser treatment of the endometrium. Unfortunately Danocrine can provoke many side effects, including weight gain, fatigue, dizziness, headaches, acne, increased facial hair, pelvic and back pain, breast problems, cramps, hot flashes, depression, rashes and allergies.
When laser treatment is not successful, the only remaining surgical option is hysterectomy. In fact, the leading cause of hysterectomy is excessive bleeding, often associated with endometriosis.
Most popular books on endometriosis warn patients not to eat animal foods such as butter, liver and eggs because these contain arachidonic acid, a long-chain fatty acid which serves as the substrate for localized tissue hormones–called prostaglandins–that provoke inflammation.
Actually endometriosis is not really an inflammation of the type that occurs after an injury; and arachidonic acid also serves as the substrate for prostaglandins that counteract inflammation.25 The irony–actually the tragedy–of this advice is that animal foods like butter, liver and eggs are excellent sources of vitamin A.
And endometriosis and excessive bleeding respond very well to vitamin A therapy. In South Africa, vitamin A has been used as standard practice for the treatment of menorrhagia (excessive bleeding) since 1977 with a 92 percent cure rate!26
Virtually every popular book dealing with women's health contains fundamental misinformation on vitamin A, asserting that vitamin A from animal foods is toxic and recommending carotenes from plant sources instead.
Typical of the confusion about vitamin A is this statement from a book on endometriosis: "Vitamin A taken too enthusiastically can be toxic, since it is stored in the liver. Beta-carotene, however, is not converted into vitamin A unless the body requires it, and you cannot suffer from toxic levels of it."27
Actually natural vitamin A from cod liver oil and other animal sources is not toxic except in very large amounts. The liver is exquisitely designed to store vitamin A so that this vital nutrient is available in times of scarcity. Many conditions prevent the conversion of beta-carotenes into true vitamin A, including low thyroid function; and even individuals who convert beta-carotene easily cannot obtain optimum amounts from plant foods.28
Finally, both synthetic vitamin A and synthetic beta-carotenes can be toxic.29 Yet books on women's health usually recommend supplements containing the synthetic forms.
Calcium, phosphorus, magnesium, zinc, potassium, iron and good quality protein are all recommended for endometriosis and related conditions. Yet the body cannot absorb these minerals and protein without adequate amounts of natural, animal sources of vitamin A and D in the diet.
Iron deficiency is a critical problem for women suffering from heavy bleeding but iron cannot be absorbed without adequate vitamin A.30 Many women have reported that bleeding worsened when iron was given without supplementation with vitamin A.
Food sources of vitamin A. Remember that "many conditions prevent the conversion of beta-carotenes into true vitamin A, including low thyroid function; and even individuals who convert beta-carotene easily cannot obtain optimum amounts from plant foods". (from above link)
Unfortunately, the vast majority of popular books on nutrition insist that humans can obtain vitamin A from fruits and vegetables. Even worse, FDA regulations allow food processors to label carotenes as vitamin A. The label for a can of tomatoes says that tomatoes contain vitamin A, even though the only source of true vitamin A in the tomatoes is the microscopic insect parts. The food industry, and the lowfat school of nutrition that the industry has spawned, benefit greatly from the fact that the public has only vague notions about vitamin A. In fact, most of the foods that provide large amounts of vitamin A—butter, egg yolks, liver, organ meats and shellfish—have been subject to intense demonization.
Under optimal conditions, humans can indeed convert carotenes to vitamin A. This occurs in the upper intestinal tract by the action of bile salts and fat-splitting enzymes. Of the entire family of carotenes, beta-carotene is most easily converted to vitamin A. Early studies indicated an equivalency of 4:1 of beta-carotene to retinol. In other words, four units of beta-carotene were needed to produce one unit of vitamin A. This ratio was later revised to 6:1 and recent research suggests an even higher ratio.5 This means that you have to eat an awful lot of vegetables and fruits to obtain even the daily minimal requirements of vitamin A, assuming optimal conversion.
But the transformation of carotene to retinol is rarely optimal. Diabetics and those with poor thyroid function, a group that could well include at least half the adult US population, cannot make the conversion. Children make the conversion very poorly and infants not at all — they must obtain their precious stores of vitamin A from animal fats6— yet the low-fat diet is often recommended for children. Strenuous physical exercise, excessive consumption of alcohol, excessive consumption of iron (especially from "fortified" white flour and breakfast cereal), use of a number of popular drugs, excessive consumption of polyunsaturated fatty acids, zinc deficiency and even cold weather can hinder the conversion of carotenes to vitamin A,7 as does the lowfat diet.
Carotenes are converted by the action of bile salts, and very little bile reaches the intestine when a meal is low in fat. The epicure who puts butter on his vegetables and adds cream to his vegetable soup is wiser than he knows. Butterfat stimulates the secretion of bile needed to convert carotenes from vegetables into vitamin A, and at the same time supplies very easily absorbed true vitamin A. Polyunsaturated oils also stimulate the secretion of bile salts but can cause rapid destruction of carotene unless antioxidants are present.
It is very unwise, therefore, to depend on plant sources for vitamin A. This vital nutrient is needed for the growth and repair of body tissues; it helps protect mucous membranes of the mouth, nose, throat and lungs; it prompts the secretion of gastric juices necessary for proper digestion of protein; it helps to build strong bones and teeth and rich blood; it is essential for good eyesight; it aids in the production of RNA; and contributes to the health of the immune system. Vitamin-A deficiency in pregnant mothers results in offspring with eye defects, displaced kidneys, harelip, cleft palate and abnormalities of the heart and larger blood vessels. Vitamin A stores are rapidly depleted during exercise, fever and periods of stress. Even people who can efficiently convert carotenes to vitamin A cannot quickly and adequately replenish vitamin A stores from plant foods.
Foods high in vitamin A are especially important for diabetics and those suffering from thyroid conditions. In fact, the thyroid gland requires more vitamin A than the other glands, and cannot function without it.8 And a diet rich in vitamin A will help protect the diabetic from the degenerative conditions associated with the disease, such as problems with the retina and with healing.
Weston Price considered the fat-soluble vitamins, especially vitamin A, to be the catalysts on which all other biological processes depend.9 Efficient mineral uptake and utilization of water-soluble vitamins require sufficient vitamin A in the diet. His research demonstrated that generous amounts of vitamin A insure healthy reproduction and offspring with attractive wide faces, straight teeth and strong sturdy bodies. He discovered that healthy primitives especially value vitamin-A-rich foods for growing children and pregnant mothers. The tenfold disparity that Price discovered between primitive diets and the American diet in the 1940s is almost certainly greater today as Americans have forsworn butter and cod liver oil for empty, processed polyunsaturates.
In Third World communities that have come into contact with the West, vitamin-A deficiencies are widespread and contribute to high infant mortality, blindness, stunting, bone deformities and susceptibility to infection.10 These occur even in communities that have access to plentiful carotenes in vegetables and fruits. Scarcity of good quality dairy products, a rejection of organ meats as old fashioned or unhealthful, and a substitution of vegetable oil for animal fat in cooking all contribute to the physical degeneration and suffering of Third World peoples.
Supplies of vitamin A are so vital to the human organism that mankind is able to store large quantities of it in the liver and other organs. Thus it is possible for an adult to subsist on a fat-free diet for a considerable period of time before overt symptoms of deficiency appear. But during times of stress, vitamin A stores are rapidly depleted. Strenuous physical exercise, periods of physical growth, pregnancy, lactation and infection are stresses that quickly deplete vitamin A stores. Children with measles rapidly use up vitamin A, which can result in irreversible blindness. An interval of three years between pregnancies allows mothers to rebuild vitamin A stores so that subsequent children will not suffer diminished vitality.
One aspect of vitamin A that deserves more emphasis is its role in protein utilization. Kwashiorkor is as much a disease of vitamin-A deficiency, leading to impaired protein absorption, as it is a result of absence of protein in the diet. High-protein, lowfat diets are especially dangerous because protein consumption rapidly depletes vitamin-A stores. Children brought up on high-protein, lowfat diets often experience rapid growth. The results—tall, myopic, lanky individuals with crowded teeth, and poor bone structure, a kind of Ichabod Crane syndrome—are a fixture in America. High-protein, lowfat diets can even cause blindness as occurred once in Guatemala where huge amounts of instant nonfat dry milk were donated in a food relief program.11 The people who consumed the dried milk went blind. Primitive peoples understood this principle instinctively, which is why they never ate lean meat and always consumed the organ meats of the animals that served them for food.
Growing children actually benefit from a diet that contains considerably more calories as fat than as protein.12 A high-fat diet that is rich in vitamin A will result in steady, even growth, a sturdy physique and high immunity to illness.
The great discrepancy between what Science has discovered about vitamin A and what nutrition writers promote in the popular press contributes to awkward moments. The New York Times has been a strong advocate for lowfat diets, even for children, yet a recent NYT article noted that vitamin-A-rich foods like liver, egg yolk, cream and shellfish confer resistance to infectious diseases in children and prevent cancer in adults.13 A Washington Post article hailed vitamin A as "cheap and effective, with wonders still being (re)discovered," noting that recent studies have found that vitamin-A supplements help prevent infant mortality in Third World countries, protect measles victims from severe complications and prevent mother-to-child transmission of HIV virus.14 The article lists butter, egg yolk and liver as important sources of vitamin A, but claims, unfortunately, that carotenes from vegetables are "equally important."
Vitamin-A vagary confuses the public and contributes to continued acceptance of lowfat dogma, even among Science writers.