Oct
21
2017

Bioidentical Hormone Replacement

Recently Medical News Today published an article on bioidentical hormone replacement in the Sept. 19, 2017 edition.

Although it was partially informative, I felt that there was an underlying bias against the use of bioidentical hormone replacement. The article made it sound as if hormone replacement therapy would not be safe. But the opposite is true with bioidentical hormone replacement.

Why are many women afraid of bioidentical hormone replacement?

At the time when there was a lot of confusion about hormone replacement therapy (HRT) the results of the Women’s Health Initiative (WHI) made it even more confusing. After all there was one trial to show once and for all that HRT would be beneficial. The expectation was that HRT prevents osteoporosis, heart attacks and breast cancer. But the results were quite different. Instead the study found a 41% increase in strokes, 29% increase in heart attacks, 26% increase in breast cancer, 22% increase in total cardiovascular disease and a doubling in the risk for blood clots.

Missing information about synthetic hormones

What the authors of the study did not explain was the fact that it was the properties of the synthetic hormones, progestin and Premarin were responsible for the negative effects. Had research insisted to perform the study with bioidentical hormones, the results would have been quite the opposite! With bioidentical hormone replacement we see the prevention of heart attacks and clots; cancer rates are lower than controls, and the prevention of osteoporosis is another benefit. The end result is a reduction in mortality rates. But the horrifying results that are due to the use of synthetic hormones and that the WHI warned about linger on in the minds of many women.

The use of bioidentical hormone replacement

Dr. John Lee pointed out in several of his books that the physician should only replace hormone loss with bioidentical hormones. He also pointed out that physicians should only replace those hormones that are at low levels or missing. This means that the woman should have confirmatory blood tests like FSH, LH, blood estrogen and salivary progesterone. If estrogen and progesterone are missing, the physician usually starts the woman on progesterone cream first. After two months, when laboratory tests show a saturation with progesterone , the addition of estrogen can follow, typically as the Bi-Est cream. This is a mix of estriol and estradiol.

Caution to balance against estrogen dominance

Progesterone is started first to balance against the potential cancer-inducing effect of estradiol. With the addition of progesterone a balance is the result, and estrogen will not cause breast cancer. This is also why Bi-Est is used: it is a mix of estriol and estradiol. Estriol is neutral with regard to causing breast cancer. Estradiol is the main natural estrogen in a woman, so some of it is necessary to make the woman feel normal. This is how the body receptors are functioning. But estradiol alone, when not in balance with progesterone, can cause breast cancer and uterine cancer.

The key is that only women who need bioidentical hormones should receive it. There are some women whose blood tests do not show a lack of estrogen, but only a lack of progesterone. These women should receive replacement with bioidentical progesterone to re-establish the hormone balance between estradiol and progesterone.

Safety of bioidentical hormone replacement products

As I have mentioned before, the Women’s Health Initiative in 2002 showed that on Premarin and progestin, two synthetic hormone products women came down with breast cancer, heart attacks, stroke, and thromboembolic events. They were using the synthetic drugs, namely conjugated equine estrogen and medroxyprogesterone acetate. The reason these women had to suffer these side effects was because their physicians insisted in using “pure hormones that a drug company had manufactured”. But these synthetic hormones were not pure hormones; they were adulterated with side chains so that pharmaceutical companies could patent them. These side chains made the synthetic hormones not fit the body’s hormone receptors. And this is the reason why the synthetic hormones created chaos in form of breast cancer, strokes and heart attacks.

Women’s Health Initiative authors whitewashed study results

Instead of admitting their mistakes, the full truth never became public. Instead the authors of the WHI study stated that it would be necessary to limit hormone replacement in menopause to the minimum amount of synthetic hormones to control symptoms, and their use should not exceed more than 5 years. These authors never distinguished between bioidentical hormones that fit the body’s hormone receptors and the synthetic hormones that irritated or blocked the body’s hormone receptors. There are thousands of women in Europe who have been on bioidentical hormones for decades, and they are doing just fine!

Bioidentical hormones in balance have no side effects

The truth is that bioidentical hormones –as long as they are kept in balance-do not have any side effects. Bioidentical hormones are the same that a woman produces in her ovaries before menopause sets in. The production of her bioidentical hormones kept her healthy. But the treating physician needs to carefully watch the balance of the hormones in the woman who is replaced with bioidentical estrogen and progesterone. This means that she needs to get enough progesterone to counterbalance estrogen stimulation. Hormones are constantly changing and if you don’t measure them, you don’t know what you are dealing with.

Dr. Lee said to measure hormone levels

John Lee showed a long time ago that you should measure hormones and identify those women who are truly hormone deficient. These are the ones who need hormone replacement. However, physicians should use only bioidentical hormones to replace what is missing. And they should also replace only as much as necessary to normalize the levels. This is also the level where postmenopausal symptoms disappear. Dr. Lee noted: “A 10-year French study of HRT using a low-dose estradiol patch plus oral progesterone shows no increased risk of breast cancer, strokes or heart attacks”.

How is bioidentical hormone replacement done?

The best method is usually a bioidentical hormone cream applied to the forearms or to the chest wall once per day. This avoids the first-pass metabolism where the hormones, if absorbed from a pill in the gut have to pass through the liver. Part of the hormones can get metabolized and some of the hormone effect may disappear. By applying bioidentical Bi-Est cream and progesterone cream to the skin, the hormones get directly absorbed into the blood stream and can do their job without interference. The treating physician can prescribe different amounts of the bioidentical hormones depending on saliva tests or blood tests. 1 or 2 months later repeat blood or saliva tests can follow to verify that the amounts of the replacement hormones and their absorption are adequate for the patient’s need.

What are the side effects of bioidentical hormone replacement?

Normally, when estrogen and progesterone are in balance, there should be no side effect. However, in the beginning of replacement therapy sometimes one of the hormones gets too high. If this happens with estrogen replacement, the woman becomes estrogen-dominant. She would experience symptoms of bloating, fatigue, weight gain, depression, headaches, loss of sex drive. She can also develop uterine fibroids, endometriosis and hypothyroidism. It was Dr. John Lee who first described this (Ref.1). There can also be mood swings, craving for sweets, irritability, and sluggishness in the morning. The key is to cut back on the estrogen dosage; alternatively, if progesterone is low in saliva tests, this hormone may need an increase, which would rebalance estrogen. At the end of fine-tuning of bioidentical hormone replacement the woman will feel normal and have no negative side effects, but the process of fine-tuning may take several months.

Difficulties to measure progesterone levels

Dr. David Zava, PhD gave a talk on breast cancer risks. This was a presentation at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. Dr. Zava, who runs the ZRT laboratory spent some time to explain how to measure progesterone in a physiological way.

Blood (serum) progesterone levels do not adequately reflect what the hormone tissue level is like in a woman’s breasts. On the other hand saliva hormone levels are giving an accurate account of what breast tissue levels are like.

Progesterone blood levels versus progesterone tissues levels

Dr. Zava gave an example of a woman who received an application of 30 mg of topical progesterone. Next, laboratory tests observed hourly progesterone levels in the serum and in the saliva. The serum progesterone levels remained at around 2 ng/ml, while the saliva progesterone levels peaked 3 to 5 hours after the application. It reached 16 ng/ml in saliva, which also represents the breast tissue progesterone level. Dr. Zava said that the important lesson to learn from this is not to trust blood progesterone levels. Too many physicians fall into this trap and order too much progesterone cream based on a misleading blood test. This leads to overdosing progesterone. With salivary progesterone levels you see the physiological tissue levels, with blood tests you don’t. Dr. Zava emphasized that testing blood or urine as progesterone hormone tests will underestimate bio-potency and lead to overdosing the patient.

Bioidentical Hormone Replacement

Bioidentical Hormone Replacement

Conclusion

Bioidentical hormone replacement, properly done, does not cause cancer, does not cause blood clots and prevents heart attacks and strokes. It also prevents osteoporosis and the associated fractures in older women. The key is that the natural hormones fit the body’s own hormone receptors. The reason why menopausal symptoms appear is that natural hormones (estrogen and progesterone) are missing. With the replacement of the missing hormones in a menopausal woman through bioidentical hormone replacement, the menopausal symptoms disappear. Contrary to the Women’s Health Initiative in 2002 when patients received synthetic hormones, there are no breast cancers, no heart attacks and no strokes with bioidentical hormone replacement. What is even better is that these women will live without all the postmenopausal problems, and their life expectancy will be about 10 years longer than without bioidentical hormone replacement.

References

Ref. 1. Dr. John R. Lee: “What your doctor may not tell you about menopause: the breakthrough book on natural hormone balance”. Sept. 2004.

Incoming search terms:

Aug
26
2017

Decreased Sperm Counts In Men

What do decreased sperm counts in men tell us about our world? A recent study has shown that over the past 40 years males in many centers that tested for sperm counts have lost 50% of the sperm count that was normal in the 1970’s. The question is, what could have caused this? Nobody has definite answers. But here are the factors that the Mayo Clinic lists for low sperm counts.

Medical causes of decreased sperm counts in men

  • A varicocele: A varicocele is dilatation of veins close to the testicles. It is presumed that this leads to a higher temperature inside the testicles and this causes a lowered sperm count and poor sperm quality.
  • Antisperm antibodies can cause infertility. Due to low sperm counts.
  • Infections in the testicles reduce sperm production. Gonorrhea and HIV infection are some of the common infections.
  • Some men develop retrograde ejaculation. With this the sperm enter the bladder on ejaculation instead of coming out from the tip of the penis. Alpha-blockers, a type of blood pressure medication can do this as a side effect. But there are also various health problems that can cause retrograde ejaculation like diabetes, surgery to the prostate, urethra and bladder. Spinal injuries can be also a cause of retrograde ejaculations. In many cases the sperm production in the testicles is still present and sperm could be sampled from there for artificial insemination.
  • Tumors of the pituitary gland can interfere with hormone production of testosterone and sperm counts will fall or stop. But other pituitary hormones, thyroid hormone and adrenal gland hormones are needed for fertility.
  • Chromosome defects like Klinefelter syndrome and others can be a cause of abnormal development of the male genitals with low or missing sperm production.
  • Celiac disease is a bowel disease that is due to gluten sensitivity. It causes low sperm counts and infertility, which responds to a gluten free diet. Sperm counts normalize with this diet.
  • There are medications that can decrease sperm production like chemotherapy, anabolic steroid use, antifungals and certain antibiotic medications and some ulcer medications.

Lifestyle causes leading to decreased sperm counts in men

Certain lifestyles and occupations can cause a man to have a decreased sperm count.

  • Drinking alcohol excessively can reduce testosterone production, which decreases sperm count.
  • Recreational drug use: steroids to increase muscle mass cause testicular atrophy and decreased sperm count. Cocaine and marihuana also decreases the sperm count.
  • Certain occupations like welding from exposure to heat and truck driving from prolonged sitting have been associated in some studies with infertility. But there are other studies that could not confirm this correlation.
  • Smoking: Men who smoke have lower sperm counts than men who don’t smoke.
  • Excessive weight: Obese men transform some of their testosterone into estrogen through the action of the enzyme aromatase, which is amply present in fat cells. This leads to low testosterone levels and low sperm counts.

Environmental causes of decreased sperm counts in men

The environment in terms of heat production around the scrotum or exposure to chemicals or ionizing radiation can lower sperm counts in men.

  • Heat around the testicles: studies do not all agree, but there is a tendency for low sperm counts when using saunas and hot tubs frequently. Sitting for longer times or using a laptop computer for longer periods can also increase the temperature of a man’s scrotum and lead to a low sperm count.
  • Exposure to heavy metals like lead, mercury and others can be the cause of infertility.
  • Exposure to radiation can reduce sperm production. With high doses of radiation sperm production may cease entirely. With lower radiation exposures sperm counts may be down for several years before they recover to normal.
  • Industrial chemicals: exposure to fumes from certain chemicals can lead to low sperm counts; benzenes, herbicides, pesticides, xylene, toluene, painting materials and organic solvents are on this list.

Recent study about decreased sperm counts in men as an indicator

We have now reviewed the major causes of low sperm counts in men. I like to revisit the recent sperm study I mentioned in the beginning of this blog. It is unlikely that men in North America, Europe and Australia would spontaneously produce less than 50% of the sperm than men 40 years earlier had produced. The next puzzling fact is that the study found normal sperm production in men in Africa, South America and Asia.

This points to epidemiological differences that reduce the sperm count in men in North America, Europe and Australia. In view of the multitude of possible causes it will require a task force that does a comparative study worldwide looking at exposure history, diets, social habits and other factors.

Fertility clinics are thriving because couples want children. With low sperm counts of males there is more infertility than there was in the past. Density gradient centrifugation is a reliable method of enriching sperm counts.

In the past a couple had no problem getting a successful pregnancy when they wanted it. Now couples often have to be assessed in a fertility clinic because of problems with regard to decreased sperm counts in men, which can cause infertility.

Decreased Sperm Counts In Men

Decreased Sperm Counts In Men

Conclusion

A new study has noticed that over the past 40 years many men have developed low sperm counts. This has caused significant problems with fertility among couples. Fertility clinics are busy trying to help these couples. Density gradient centrifugation has become a common technique to enrich sperm samples prior to artificial insemination. It is a puzzle why the recent study has found normal sperm counts in samples of men living in Africa, South America and Asia. In contrast men living in Europe, North America and Australia have 50% lower sperm counts. The reason may be multifactorial. It will require a team of experts to sort out this discrepancy and hopefully find an answer for men in Europe, North America and Australia to bring their sperm counts back to normal.

Incoming search terms:

Jul
29
2017

Some Drink Milk, Others Are Lactose Intolerant

Some drink milk, others are lactose intolerant; this is the fact about drinking milk.

For a long time the dairy marketing board advertised with the slogan: “Got milk?”. But dairy milk consumption has declined over the past decades.

Why this is has been reviewed in this article. I like to review the problem of lactose intolerance, milk as a source of calcium to prevent osteoporosis and offer alternatives to milk consumption.

Lactose intolerance

Milk cows have been around in Europe for about 6000 years. But not everybody can tolerate milk products. Most of the Europeans, North Americans and Australians have adjusted the digestive enzymes in their duodenum to produce enzymes, called lactase that digest milk sugar (lactose) into glucose and galactose. But up to 75% of the world population (Africa, South America, Asia) is lactase deficient; they cannot tolerate dairy products. They get abdominal cramping, intestinal gas, bloating, diarrhea, nausea and vomiting from drinking a glass of dairy milk. This link explains why goat milk is better than cow’s milk for those who cannot tolerate cow’s milk.

It is also interesting that many people who are lactase deficient can tolerate cheeses, yogurt and other fermented milk products as the fermenting bacteria have digested the lactose.

Other problems with dairy products

Problems with mass production of dairy items are the following:

  • Concentrated Animal Feeding Operations (CAFO) are responsible for the majority of milk products on grocery market shelves. This means that the animals are fed unnatural corn, which leads to deficiencies and omega-6 fatty acids in the milk products.
  • Antibiotics are given to prevent infections among the herds of animals.
  • Bovine growth hormone (bST, bovine somatotropin) is administered to stimulate more milk production. The antibiotics lead to superbugs in humans, the bST may be causing autoimmune diseases and breast cancer in humans. The healthiest milk is milk from grass-fed cows. It is high in omega-3 fatty acids. All of the milk products derived from this type of milk are also healthy.

Milk as a source of calcium

One key advertising slogan of the dairy industry used to be that milk would be such a good source of calcium, which would prevent osteoporosis. But milk also has a lot of animal protein in it, which acidifies blood. This means that the kidneys use calcium to neutralize acidic blood and excrete calcium. The net result is that there is more calcium leaving the body as some of the calcium from the bone is also used to keep the balance between acidity and alkalinity.

This 12 year long Harvard Nurses’ Health Study involving 77, 761 women between the ages of 34 to 59 showed that a higher consumption of milk did not protect against hip and wrist fractures.

The myth that full fat milk causes heart attacks and strokes

There is another myth floating around, namely that full fat milk would be bad for the heart because of increased saturated fatty acids. But an Australian study showed that full fat milk is healthier for you than milk with less fat.

After 14.4 years of follow-up the group that consumed the most milk compared to the lowest fat intake group had a 69% lower death rate from cardiovascular disease!

A 2016 study showed that consumption of plain yogurt was associated with better health outcomes on the long term. Be more concerned about the sugar content than the fat content of yogurt!

Prevention of osteoporosis

Too many years have been wasted to sell the false concept of increasing milk consumption (“Got milk?”) for increased calcium intake and possible osteoporosis prevention. It was sold like a mantra: Milk-calcium-osteoporosis prevention. Now we know the real truth behind the false advertising mantra: milk provides protein and calcium, but calcium is poorly absorbed and the acidified blood is alkalinized through calcium from milk and from the bone being excreted into the urine. The end result is a net loss of calcium from the bone, as it is more important to the body to keep the blood’s acid/base stable than to increase the calcium level in the bone. Sadly all the high consumers of milk from the Harvard Nurses’ Health Study ended up having fractures from osteoporotic bones.

Prevention of osteoporosis requires intake of vitamin D3, vitamin K2 and calcium (supplement or diet) as I have reviewed in this blog. In addition regular exercise is also very beneficial as is bioidentical sex-hormone replacement. It is interesting that a large clinical trial that I mentioned in this blog showed after 7 years that there were 35% to 38% less fractures of the hip than in the placebo group. Vitamin K2 is essential to keep calcium in the bones and to keep calcium out of the blood vessel walls. Vitamin D3 is important for calcium absorption through the gut wall and to deposit calcium into bone. Without all of these ingredients it is not possible to prevent osteoporosis.

Alternatives to milk consumption

  1. One obvious step is to replace cow’s milk by goat milk. As you can see from this link, there are many advantages to goat milk. What I find important is the fact that those with lactase deficiency often can tolerate goat milk while they would otherwise react to cow’s milk. There are also many goat milk products like cheese and yogurt, all of which are very healthy. They do not contain any antibiotics or bovine growth hormone (bST), which is only used in cows. Goat milk products are also an excellent source of protein.
  2. You can eat a more vegetable-based diet. A lot of vegetables and fruit have calcium and protein in them.
  3. You can consume almond milk instead of cow’s milk. The downside to know is the fact that almond milk is not a significant source of protein. It has the advantage of being slightly alkaline; this will ensure that the calcium absorbed in the gut will reach the bones as long as you also supplement with vitamin D3 and vitamin K2. The many “fake milk” products such as rice milk, coconut milk and hemp milk are also poor protein sources. The only product higher in protein is soymilk. But soy has its own problems: over 90 % of the crop in North America is genetically engineered, and soy is a known allergen. As of recent, another product based on pea protein is available, and the protein content is excellent, so it is worth looking for it (It is called “Ripple”).
Some Drink Milk, Others Are Lactose Intolerant

Some Drink Milk, Others Are Lactose Intolerant

Conclusion

Drinking milk as a source of protein and calcium has become an obsession a few decades back. In the meantime it turned out that drinking milk tips the acid-base balance in the direction of acidity. This causes osteoporosis, as the kidneys excrete all of the calcium from milk that is absorbed. On top of that even more calcium is taken out from bones to recalibrate the acid-base balance.

Up to 75% of the world population is lactose intolerant. They get sick from drinking cow’s milk. But they usually tolerate goat milk quite well. Considering the fact that antibiotics are used in cow milk production and recombinant bovine growth hormone as well, I have joined the crowd that prefers goat milk instead of cow’s milk. I take the supplements I mentioned for bone maintenance (vitamin D3 and K2) and I get lots of calcium also from vegetables and salads. I have no lactose intolerance, but that’s my take on milk.

Incoming search terms:

May
05
2017

New Treatments For Premenstrual Syndrome

Dr. Pamela W. Smith gave a talk about new treatments for premenstrual syndrome (PMS). She presented this talk on Dec. 11 at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. The original title was “New Treatment Modalities for PMS”.

Signs and symptoms of PMS

Dr. Smith discussed signs and symptoms of PMS first. She showed 9 slides where she listed all of the symptoms of PMS that commonly occur.

Symptoms are varied; they can mimic various psychological problems like anxiety, depression, panic attacks and more. But physical symptoms like abdominal bloating, acne, back aches, and asthmatic attacks are also common. There are a myriad of more symptoms of PMS: constipation, cramps, clumsiness, dizziness, drowsiness, decreased sex drive, facial swelling, forgetfulness, fatigue, headaches, a herpes-like outbreak, hot flashes, sensitivity to light and noise, insomnia, joint pains, mood swings, palpitations, restlessness, poor memory, sore throat, tearfulness, vomiting and weight gain.

What do we know about PMS?

  1. There is no definitive test that would help in the diagnosis of PMS. But we do know that there is a hormone dysfunction that leads to a monthly recurrence of symptoms during the two weeks prior to the woman’s menstruation. When her period begins or shortly after all of these symptoms disappear.
  2. PMS is very common; 70to 90% of women have a certain degree of PMS. In 20 to 40% of women symptoms are severe. Many researchers have shown that there is a problem in the feedback loop between the pituitary gland and the ovaries. This leads to a decrease of progesterone production in the ovaries. The result is an overabundance of estrogen, which is called estrogen dominance.
  3. But things can get complicated when other hormone changes occur. A woman may also turn hypothyroid. When she gets closer to menopause estrogen deficiency may also develop. Electrolyte disturbances can occur from high estrogen levels causing excessive aldosterone levels. This would lead to high sodium and low potassium blood levels. The end result may be an activation of the renin-angiotensin system, which could cause high blood pressure.
  4. Neurotransmitters are often disbalanced. When serotonin is low in the brain, depression can develop. Noradrenalin deficiency leads to a lack of focus, energy and memory.
  5. Hypoglycemia is also common among women with PMS. This may be due to cravings for sweets and consumption of starchy foods. Women who crave sweets may also consume caffeine excessively. But caffeine increases prostaglandin production in the body. This leads to breast tenderness, abdominal cramping, arthritis and back pains.
  6. A partial hysterectomy can cause PMS in a woman who never before had symptoms of PMS. The current school of thought is that blood supply to the ovaries after a hysterectomy has decreased, and this could be the reason for the onset of PMS.
  7. The birth control pill can bring on PMS due to the progestin component in it.
  8. Tubal ligations can also be a cause: 37% of women who had tubal ligations develop PMS. The reason is a change in hormone production. In these women estrogen is produced to a higher degree than progesterone is.
  9. Pregnancies, miscarriages and abortions can also bring on PMS.

Lab tests for women with PMS

Although there is no single test that would be able to diagnoses PMS, a variety of abnormal tests are often abnormal in association with PMS. Frequently there is deficiency for vitamin A, B6, E, magnesium, potassium, zinc and trace minerals. Calcium can be too high or too low, but blood tests will reveal that.

Four PMS types

Dr. Smith said that PMS has been divided into 4 subcategories depending on the main symptoms.

  • PMS A: Anxiety
  • PMS C: Carbohydrate craving
  • PMS D: Depression
  • PMS H: Hyperhydration

PMS A is associated with estrogen excess and progesterone deficiency. There is a diminished stress response in the hypothalamus/pituitary/adrenals axis. Symptoms are mainly anxiety, irritability, insomnia and emotional lability.

PMS C is associated with sugar craving, hypoglycemia, headaches, heart palpitations and spontaneous sweating.

PMS D is leading to increased neurotransmitter degradation. Symptoms consist of depression, crying, despair, feeling hopeless, fatigue, low libido, apathy and insomnia.

PMS H is caused by increased aldosterone activity triggered by estrogen surplus in the late luteal phase. Symptoms are weight gain, swelling of hands and feet, a feeling of bloating, breast tenderness or engorged breasts. Women will find that their clothes simply fit tighter.

Migraine headaches in PMS

Some women with PMS are plagued by migraine headaches. It may have started in puberty or after taking birth control pills for contraception. Sometimes the onset is after a pregnancy, miscarriage or abortion. When PMS develops and a woman has migraines, they usually occur around the same time in her menstrual cycle. With pregnancy the migraines disappear in the last trimester when progesterone hormone production from the placenta is the highest.

Hormonally related headaches can occur for 4 main reasons.

  1. When estrogen and progesterone are on the rise around the time of ovulation
  2. When a woman has hypoglycemia (due to hyperinsulinemia)
  3. When estrogen levels are changing
  4. When there is estrogen dominance

Treatment for PMS

Dr. Smith explained in detail the various treatment modalities for PMS. Treatment has to be personalized according to what type of PMS the doctor thinks that the patient is suffering of.

Dietary factors

In the beginning it is important to pay attention to the diet. Studies have shown that PMS patients tend to eat too many carbs and too much refined sugar compared to patients without PMS. PMS patients also eat too many dairy products and too much sodium. In addition PMS patients are deficient in iron, manganese and zinc. A good start is a Mediterranean diet, which is at the same time anti-inflammatory.

The recommendations is to eat 6 small meals a day. Avoid caffeine and alcohol. They are antagonists to the B complex vitamins. By avoiding sugar, you also avoid fluid accumulation and magnesium deficiency. A low fat, high-complex carb diet helps reduce breast tenderness. Reducing fat and increasing fiber in the diet decreases estrogen levels in the blood. These steps help PMS symptoms.

Nutritional supplements

Magnesium, vitamin B6, A, D3, E, L-tryptophan, calcium, zinc, fish oil (EPA/DHA) and evening primrose oil are the main supplements recommended for PMS patients. Your healthcare provider can advise you what you should take and what dosage.

Exercise

Regular exercise has very beneficial effects on reducing many symptoms of PMS. Even as little as 8 weeks of exercise -as was done in this study- had a significant effect. Exercise elevates endorphin levels, improves blood sugar stability, decreases norepinephrine and epinephrine in the brain and helps to decrease estrogen levels. This will control blood sugar levels, reduce anxiety, reduce estrogen-related symptoms and increase satisfaction.

Thyroid medication

Many women with PMS have borderline hypothyroidism or are overtly hypothyroid. In these cases the patient should receive small amounts of thyroid hormones.

Progesterone

Progesterone is the one hormone that is found persistently lacking in most PMS patients. The best test for this is a saliva hormone test, because this reflects the tissue levels. Blood levels test too low and are useless. Bioidentical progesterone cream is applied transdermally (through the skin) from day 14 to 25 of each menstrual cycle. Micronized progesterone pills are also bioidentical and could be used instead of the cream.

Botanicals

There are a number of home remedies, which are heavily promoted on the Internet. They may, however, not be as effective as advertised.

  1. Black Cohosh is said to balance estrogen and is anti-spasmodic.
  2. Chasteberry decreases LH and prolactin. It raises progesterone, acts as a diuretic and binds opiate receptors. This reduces PMS related aches and pains.
  3. St. John’s Wort helps these symptoms: anxiety, depression, mood swings, feeling out of control and pain.
  4. Ginkgo biloba is a mild blood thinner. Women who are on blood thinners should not use it! It improves depressive symptoms and mood, has anti-inflammatory effects and helps with anxiety control.
  5. Saffron: In a clinical trial the Saffron group did significantly better in PMS symptom control than the placebo group.  Saffron is rich in magnesium, vitamin B6, iron and other nutrients that are missing in PMS patients, which explains the effectiveness of this botanical.
  6. Other botanicals: Other botanicals are Lavender, Motherwort, and Dandelion.

Candidiasis

Due to prolonged exposure to high sugar and refined carb intake many women with PMS suffer from candidiasis (chronic yeast infection). Anti-Candida programs help to eradicate Candida overgrowth, which often improves several PMS symptoms.

Mind/body therapy

Cognitive-behavioral therapy helps for depression and anxiety. Hypnotherapy, yoga and biofeedback therapy are also useful methods.

New Treatments For Premenstrual Syndrome

New Treatments For Premenstrual Syndrome

Conclusion

At the present time there is a better understanding of PMS than in the past. Progesterone deficiency and other hormone weaknesses seem to be at the center of this condition. But vitamin and mineral deficiencies also play a role. The healthcare provider should order some baseline blood tests and hormone tests for the patient, including a saliva progesterone level.

Treatment consists of a combination of steps taken simultaneously. The dietary approach comes first: a Mediterranean diet will be beneficial. Next add nutritional supplements. Regular exercise is essential. Finally bio-identical hormone replacement of the missing hormones is necessary.

If there is an underlying chronic candidiasis infection, it needs treatment. The choice of drug would be nystatin. Some botanicals may be helpful, as discussed. When anxiety and depression are important parts of the PMS symptoms, mind/body therapy (such as cognitive therapy etc.) may also be helpful.

The key with PMS treatment is to not give up, but to re-evaluate the condition, if the initial attempt does not bring full relief. By not giving up and using all modalities of treatment the patient will be able to get rid of the condition, eliminate the symptoms of PMS and achieve well being.

Incoming search terms:

Apr
08
2017

Breast Cancer Risks

Dr. David Zava, PhD gave a talk on breast cancer risks. This was presented at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. The detailed title was: “The Role of Hormones, Essential Nutrients, Environmental Toxins, and Lifestyle Choices on Breast Cancer Risk”.

He pointed out that both estrogens and progesterone are safe hormones, as long as they are not overdosed and they are balanced. Unfortunately many women in menopause have too much estrogen on board as the ovaries are still producing them, but there is a lack of progesterone, the moderating hormone that makes estrogen safe.

In the following I am summarizing Dr. Zava’s talk with regard to the essential messages, but leaving away much of the highly technical detail that was presented as this would dilute the message of this blog. I will include a few links for those who are inclined to read more details about the topic.

Balance between estrogen and progesterone

Most of her life a woman is used to cyclical hormone changes between estrogen and progesterone. When a woman no longer ovulates in premenopause and menopause there is a surplus of estrogen and a lack of progesterone. Having no ovulation means that there is no corpus luteum developing, where in the past progesterone was made. This creates a disbalance where estrogen is dominating; it is called “estrogen dominance”.

This is a dangerous hormone disbalance, because the breast ducts are stimulated to grow and the modifying, calming effect of progesterone is missing. Mixed into this is that the stress hormone, cortisol also can make the effect of estrogen worse. On the other hand Dr. Zava showed slides from studies where progesterone was replaced through a skin progesterone cream (percutaneous bioidentical progesterone cream). Plasma and breast tissue concentration of progesterone were measured in 40 premenstrual women. They had been diagnosed with breast lumps and were scheduled for surgery. One group was treated with progesterone cream for 10 to 13 days; the other group was the placebo group. At the time of surgery the plasma (blood) values were unchanged, but progesterone levels in breast tissue were elevated more than 100-fold over the values from the placebo group who had been treated with a neutral skin cream. The same experiment also showed that progesterone reduced the number of proliferating epithelial cells (experimental progesterone group). Estrogen on the other hand was shown to increase the number of proliferating epithelial cells (placebo group).

Another example that Dr. Zava gave was a study where 25 mg of bioidentical progesterone cream applied directly to breasts of premenopausal women increased breast tissue progesterone 100-fold, while blood concentrations of progesterone remained the same. Again breast stimulation by estrogen of normal epithelium cells was decreased by progesterone.

How to measure progesterone levels

Dr. Zava who runs the ZRT laboratory spent some time to explain how to measure progesterone in a physiological way. He said that these experiments and others that he also projected tell a clear story. Blood (serum) progesterone levels do not adequately reflect what tissue levels in a woman’s breasts are. On the other hand saliva hormone levels do give an accurate account of what breast tissue levels are like. A woman received 30 mg of topical progesterone application. She then had hourly progesterone levels in the serum and in the saliva done. The serum progesterone levels remained at around 2 ng/ml, while the saliva progesterone levels peaked 3 to 5 hours after the application. It reached 16 ng/ml in saliva, which also represents the breast tissue progesterone level. Dr. Zava said that the important lesson to learn from this is not to trust blood progesterone levels. Too many physicians fall into this trap and order too much progesterone cream, which leads to overdosing progesterone. With salivary progesterone levels you see the physiological tissue levels, with blood tests you don’t. Dr. Zava said: avoid using venipuncture blood or urine in an attempt to interpret hormone test levels, as you will underestimate bio-potency and overdose the patient.

Historical failure of estrogen replacement therapy (ERT)

A review of breast cancer would not be complete without mentioning the Women’s Health Initiative (WHI). The U.S. National Institutes of Health (NIH) initiated this trial in 1991.

  1. The WHI ended suddenly in July 2002. The authors stated: “The overall health risks exceeded benefits from use of combined estrogen plus progestin for an average 5.2 year follow-up among healthy postmenopausal US women.” The study found a 41% increase in strokes, 29% increase in heart attacks, 26% increase in breast cancer, 22% increase in total cardiovascular disease, a doubling of blood clots. The recommendation made by this study was to discontinue PremPro.
  2. Another study that was mentioned was “Breast cancer and hormone-replacement therapy in the Million Women Study”.  In this study postmenopausal women were given HRT with synthetic hormones, either estrogen alone or estrogen mixed with a progestin (in British English “progestagen”. After 5 years estrogen alone was associated with a 30% increased risk of developing breast cancer. HRT with an estrogen-progestagen mix was associated with a 100% increased risk of developing breast cancer.
  3. Unfortunately in both of these human experiments the wrong hormone substances were used, namely synthetic estrogens and synthetic progestins. They are NOT identical with natural estrogens and progesterone that a woman’s body makes. As long as the hormones used for hormone replacement therapy are chemically identical to the natural hormones, the body will accept them as they fit the natural hormone receptors in the body. It is the misfit of synthetic hormones that blocks the estrogen receptors or the progesterone receptors. You can readily see from the illustrations of this link that there is a fine balance between the workings of these receptors and there is absolutely no room for patented side chains that Big Pharma introduced into synthetic HRT hormones. The other problem of both these studies was that every woman was getting the same dose of hormones and that nobody measured their estrogen blood or estrogen saliva hormone levels. In retrospect the regulatory agencies should never have allowed these “hormones” to hit the market.

Breast cancer develops in three stages

Dr. Zava explained that it has been known for some time that there are 3 stages involved in the development of breast cancer.

  1. Initiation

Damage to the DNA of one of the cells types in the breast is what starts the process in the development of breast cancer. This can be done by catechol estrogen-3,4-quinones as was shown by these researchers.

Aromatase inhibitors can be used to reduce estrogen in overweight or obese women where aromatase is present in fatty tissue. The reason obese women have more breast cancer is likely from the extra estrogen production from androgens, male hormones produced in the adrenal glands that get converted by aromatase into estrogen.

Iodine/iodide has been shown to alter gene expression, which reduces breast cancer development, but also slows down cell division in existing breast cancer. The authors suggested to use iodine/iodide supplements as adjuvant therapy in breast cancer treatment.

  1. Promotion

The next step is that something has to promote the DNA mutation into becoming part of a cancer cell. Estrogen quinones are dangerous estrogen metabolites. They can form from catechol estrogens (other metabolites of estrogen) by reactive oxygen species. But selenium, a trace mineral can interrupt the formation of estrogen quinones, which stops the breasts cancer promotion process. A study from the Klang Valley, Malaysia showed that selenium showed a dose-response effect with respect to prevention of breast cancer; the more selenium in the food, the less breast cancer occurred.

  1. Progression (includes invasion and metastases)

Several factors can help the breast cancer cells to progress, grow bigger locally and eventually move into other areas of the body as metastases. Dr. Zava showed several slides where details of metabolic processes were shown and how changes in some of these would lead to progression of breast cancer. Estrogen excess is a common pathway to breast cancer. The key is to balance it with progesterone, supplements, remove anything that causes estrogen overproduction like obesity (via the aromatase pathway).

The fallacy of overdosing or underdosing

When estrogen is overdosed, it becomes aggressive as indicated before; it can initiate DNA mutations that can cause breast cancer. If it is under dosed, the lack of estrogen can cause heart attacks, strokes and osteoporosis. When estrogen is balanced with progesterone a postmenopausal woman feels best and she is protected from the negative effects of estrogen.

Measures that help prevent breast cancer

  1. When supplementing with bioidentical hormones, keep estrogen within physiological limits and don’t overdose. This can be measured through blood tests or saliva hormone tests. Your most important natural opponent of estrogen is progesterone, which is usually missing in menopause. Measure hormones using tests (progesterone only with saliva tests, estrogen either by blood tests or saliva tests). Don’t rely going by symptoms.
  2. Keep the progesterone to estrogen ratio (Pg/E2) at an optimal range, which is in the 100- to 500-fold range. Measure the saliva hormone level of both progesterone and estrogen and calculate. Remember that progesterone serum levels are meaningless. The much higher progesterone level protects the postmenopausal woman from estrogen side effects. Here is a statement worth noting: “Until evidence is found to the contrary, bioidentical hormones remain the preferred method of HRT.” This was the conclusion of a study using bioidentical hormones, where the protection from breast cancer and heart attacks and strokes was also noted.
  3. Increase fiber intake and reduce red meat consumption. This will eliminate conjugated steroid hormones in the stool. It also increases the sex hormone binding globulin in the blood, which limits the bioavailability of estrogens. Fiber absorbs bile toxins and removes them from the body.
  4. Calcium-D-glucarate is a supplement that will decrease beta-glucuronidase. The estrogens were conjugated with the purpose to be eliminated, but beta-glucuronidase causes the conjugated estrogens to be reabsorbed.
  5. Probiotics likely stimulate the immune system and help reduce the risk of breast cancer.
  6. Avoid toxins like petrochemical pollutants and toxic chemicals. Avoid trans fats. If toxic, heavy metals are present (arsenic, cadmium, lead, mercury) remove these. Some naturopaths use EDTA chelation to do this.
  7. Supplements: sulforaphane (broccoli), EGCG (green tea), alpha-lipoic acid (antioxidant), cruciferous vegetables, resveratrol, selenium and iodide/iodine, N-acetyl cysteine-glutathione. All these supplements/nutrients will prevent estrogen to go to the “dark side”. The dark side is the formation of toxic 4-OH estrogen that could further be converted into catechol estrogen-3,4-quinones that can damage DNA and cause mutations.
  8. Increase methylation of catechol estrogens: vitamin B1, B6, B12 and folic acid. Methyl donors also are useful for this purpose: MSM (methylsulfonylmethane), SAMe, and Betaine.
  9. Improve your diet (Mediterranean type), exercise moderately, reduce stress, and replace hormones in physiological doses as discussed under point 1 and 2.
Breast Cancer Risks

Breast Cancer Risks

Conclusion

Dr. David Zava, PhD gave an interesting talk at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. It became clear that estrogens, when unopposed by enough progesterone, could cause mutations in breast tissue of women and cause breast cancer. He also reviewed two major clinical trials where hormone replacement therapy (HRT) was used. The problems with these were the synthetic estrogen hormones that caused breast cancer and the synthetic progestins that also behaved like estrogens (not like progesterone) and caused even more breast cancer. The lesson to be learnt from this is that only bioidentical estrogens and progesterone can be used in hormone replacement for menopause. Also, the hormones must be balanced as discussed under point 2 of measures that help to prevent breast cancer. In addition there was a list of other useful supplements given that can be taken to reduce the danger of breast cancer.

Incoming search terms:

Mar
25
2017

How Stress Affects Our Hormone System

Dr. Andrew Heyman gave a talk recently about how stress affects our hormone system. His talk was presented at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. It was entitled “Understanding the Stress, Thyroid, Hormone Connections & Prioritizing Systems”.

Dr. Heyman stressed that there is a triad of hormonal connections that is important to remember: the thyroid hormones, the stress hormones (adrenal glands) and the pancreas (insulin production). We need a balance of these hormones for optimal energy production and circulation. Under stress our sugar metabolism can derail, we develop obesity and fatigue. When balanced we experience vitality and wellbeing.

Metabolic activation pathways

Dr. Heyman projected a slide that showed the metabolic activation pathways. He stated that a number of different factors could influence the hormone system:

  • Diet: trans fats, sugar, too many carbs, food allergies.
  • Drugs: drug-induced nutrient depletion (over-the-counter drugs, prescription drugs).
  • Physical exercise: frequency and type matters.
  • Environmental exposure: chemicals, pesticides, herbicides, heavy metals, plastics, molds, and pollens.
  • Stress: physical stress, psychogenic stress.
  • Genetics: methylene-tetra-hydro-folate reductase enzyme deficiency (MTHFR mutation), APOE genes, lack of vitamin D
  • Disease: past or present conditions, active disease or syndromes.

Target areas within your system

The target areas in your system are the

  • Pancreas, where blood sugar can rise because of insulin resistance. Too much insulin production causes inflammation, hormone disbalances, kidney damage, and hardening of the arteries through plaque formation.
  • Thyroid gland, which gets activated by TSH (thyroid stimulating hormone), but can also be affected negatively by autoantibodies).
  • Brain: decrease in serotonin resulting in anxiety, depression and food cravings; decreased melatonin causing sleep disturbances; increased ghrelin and decreased leptin secretion leading to overeating and obesity.
  • Liver/kidneys: both of these organs are important for detoxification; the liver produces thyroid binding globulin, which when increased can lower the free thyroid hormones.
  • Immune system (gut, lymph glands): the Peyer’s patches in the gut mucosa produce a large portion of the immune cells; lymph glands, the bone marrow and the spleen supply the rest. A leaky gut syndrome can affect the whole body, causing inflammation and autoimmune reactions.
  • Hypothalamus/pituitary/adrenal glands: this is the main axis of the stress reaction. If the brain is stressed, the hypothalamus sends a cascade of activating hormones via the pituitary gland and the adrenal glands. This leads to cortisol overproduction, and release of epinephrine and norepinephrine from the center of the adrenal glands. High blood pressure, anxiety, heart palpitations, arrhythmias and more can develop from this.

Hypothalamus/pituitary/adrenal glands activation and clinical effects

The main hormone axis of the stress reaction goes from the hypothalamus via the pituitary gland to the outside surface of the adrenal glands where cortisol is released. It is also called the HPA axis. Stressed people make too much cortisol, which weakens immune functions, reduces human growth hormone production, increases belly fat, increases blood pressure and reduces insulin action. Stress also reduces estrogen production in women and testosterone production in men.

The final clinical presentation is osteopenia, then osteoporosis with spontaneous fractures of bones. There is cardiovascular disease leading to heart attacks and strokes, and cognitive decline with memory loss. There are complications with infections. Also the metabolic syndrome can lead to obesity and type 2-diabetes.

Stress and the hippocampus

In the center of our brain there is a memory-processing unit, the hippocampus that converts short-term memory into long-term memory. Repeated stress interferes with normal hippocampus function. High cortisol levels interfere with the proper functioning of the hippocampus causing memory problems.

Chronically elevated cortisol levels from chronic stress have been shown to lead to hippocampus atrophy and can cause Alzheimer’s disease.

Effects of chronic stress

Chronic stress leads to cardiovascular disease, to diabetes, chronic inflammation, Alzheimer’s disease, thyroid disorders, cancer, neurological disorders and autoimmune diseases. Inflammation research has shown that with chronic inflammation tumor necrosis factor-alpha (TNF-alpha) is released, as key player of chronic inflammation. This however leads to the release of other inflammatory kinins like IL6 and others. The resulting chronic inflammation can cause Crohn’s disease, rheumatoid arthritis, insulin resistance, dementia, metabolic syndrome, obesity and atherosclerosis with associated markers (decreased HDL, increased LDL, CRP and triglycerides).

Hormone imbalance causes disease

  1. Excess cortisol production from stress leads to Th2 type inflammatory kinins; usually associated with this is a reduction of DHEA (a male hormone in the adrenal glands), which leads to reduced Th1 type kinins. The end result is chronic inflammation. When chronic stress has tired out the adrenal glands, a four-point salivary cortisol level test shows a flat curve. This indicates adrenal gland fatigue or, if worse, even adrenal gland insufficiency. Such a pattern is found in patients with leukemia, breast cancer, uterine cancer, prostate cancer, pituitary gland cancer and lung cancer.
  2. The metabolic syndrome is associated with dysregulation of the HPA axis. People who have this syndrome have a high morning serum cortisol level. High cortisol increases the risk to develop metabolic syndrome.
  3. Metabolic connections: high cortisol leads to a partial blockage of thyroid hormones, which in turn leads to hypothyroidism. Hypothyroidism will affect glucose tolerance, and if not treated leads to type 2 diabetes.

In a large study involving 46,578 members of Kaiser Permanente Northwest it was determined that for every 1 point above a fasting glucose level of 84 mg/dL there was an additional 6% risk to develop type 2 diabetes over the next 10 years.

Pathological hormone disturbances

The following hormone patterns were discussed in detail, an increased cortisol level, increased insulin level and decreased thyroid levels.

Elevated cortisol

Prolonged elevation of cortisol leads to atrophy of the hippocampus with brain atrophy and Alzheimer’s or dementia. The immune system gets altered, there is lower DHEA hormone leading to weaker muscles and weakened immunity. There is insulin resistance (decreased insulin sensitivity), decreased serotonin and increased depression. Carbohydrate cravings lead to weight gain (central obesity). Changes in the thyroid metabolism leads to hypothyroidism.

Increased insulin level

People who develop high insulin levels are usually sugar or carbohydrate addicts. As they gain weight they change their metabolism into the metabolic syndrome. The extra insulin that is floating around triggers the insulin receptors to become less sensitive (also called “resistant”). The people love to eat. They snack frequently on protein bars and candy bars. As they gain weight, their energy goes down and they often develop painful joints. This prevents them from being physically active. They notice episodes of foggy thinking. Women complain of frequent yeast infections.

The body tries to compensate by slightly decreasing thyroid hormones and slightly increasing cortisol levels.

Decreased thyroid levels

There is increased lactic acid production and decreased insulin sensitivity. Oxidative stress is increased. The patient is depressed and cognition and memory are reduced. The gut has slower motility. The mitochondria, the energy packages in each cell are reduced and functioning less productively. Cardiac function is reduced.

The body tries to compensate for the primary thyroid weakness by slightly elevating insulin and cortisol.

Treatment of stressed hormone system

Before the doctor can treat a disbalanced hormone system, blood tests have to be done that show what kind of hormone constellation is present. Dr. Heyman suggested the following support with supplements.

Treatment of thyroid disorders

Thyroid supplementation may involve any of these: Selenomethionine, iodine, chromium, thyroid glandular, tyrosine, ferritin, Ashwagandha, coleus forskohlii, 7-keto DHEA, ferritin and iron. Other possible supplements that were mentioned by Dr. Heyman were Rhodiola, schisandra, ginseng, Rg3, eurycoma longifolia, neuromedulla glandular, DHEA, tryptophan/5 HTP, licorice, Cordyceps.

This, however, is not all. Missing thyroid hormones have to be replaced with a balanced T3/T4 medication like Armour thyroid.

Adrenal support

The following supplements are used to support adrenals: Adrenal glandular, vitamin C, adrenal cortex extract, Holy Basil, Pharma GABA, Magnolia/Phellodendron, L-theanine, sterols & sterolins.

Pancreatic support

These supplements support the insulin production in the pancreas:

Chromium, vitamin D, magnesium, alpha-lipoic acid, fish oil, micro PQQ, bitter melon, cinnamon, arginine, vanadium, benfotiamine (synthetic derivative of B1 vitamin) and Bergamot.

Dr. Heyman completed his talk by giving a few patient examples, explaining what blood tests showed, what the hormone disbalance was, and which treatment options were helpful.

How Stress Affects Our Hormone System

How Stress Affects Our Hormone System

Conclusion

Dr. Andrew Heyman gave a talk at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. He talked about how stress affects our hormone system. Symptoms from stress can stem from different causes including hormone disbalances. Conventional medicine would simply treat the symptoms. However, this will not be successful with stress-induced hormone disbalances, because it does not treat the causes. Causal treatment of the hormone disbalance will restore the person’s wellbeing and the symptoms will disappear at the same time. Anti-aging medicine and integrative medicine are attempting to follow this approach.

Incoming search terms:

Feb
25
2017

Heart Health Improves With Hormone Replacement

Dr. Pamela Smith gave a lecture in December 2016 showing that heart health improves with hormone replacement. Her talk was part of the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9 to Dec. 11, 2016) in Las Vegas, which I attended. The title of the talk was: “Heart health: The Importance of Hormonal Balance for Men and Women”. Her keynote lecture contained 255 slides. I am only presenting a factual summary of the pertinent points here.

1. Estrogen

Observations regarding risk of heart attacks

  1. Women have a lower risk of heart attacks before menopause compared to men of the same age.
  2. Heart attack rates go up significantly after menopause.
  3. Estrogen replacement therapy may reduce the risk of heart attacks by 50% for postmenopausal women.

Lipid profile after menopause

There is an elevation of LDL cholesterol, total cholesterol and triglycerides as well as lower HDL cholesterol levels. All of this causes a higher risk of heart attacks for postmenopausal women. Estrogen replacement therapy increases the large VLDL particles, decreases LDL levels and raises HDL-2. These changes are thought to be responsible for helping reduce heart attack rates in postmenopausal women who do estrogen replacement therapy (ERT).

Difference between oral and transdermal estrogen replacement

When estrogen is taken by mouth, it is metabolically changed in the liver. This reduces the protective effect on the cardiovascular system. In contrast, transdermal estrogen (from commercial estrogen patches or from bioidentical estrogen creams) has a higher cardioprotective effect. The liver does not metabolize transdermal estrogen. Dr. Smith explained in great detail using many slides how estrogen prevents heart attacks. Details about this would be too technical for this review. Apart from lipid lowering effects there are protective effects to the lining of the arteries. In addition there are metabolic processes in heart cells and mitochondria that benefit from estrogens. The end result is that postmenopausal women who replace estrogen will outlive men by about 10 years. Stay away from Premarin, which is not human estrogen, but is derived from pregnant mares. Also the tablet form is metabolized by the liver, which loses a lot of the beneficial effects that you get from transdermal estrogen. 

How can you document the beneficial effects of estrogen replacement?

  1. Carotid intima measurements in postmenopausal women on ERT show a consistent reduction in thickness compared to controls.
  2. The physical and emotional stress response is reduced compared to postmenopausal women without ERT.
  3. Hormone replacement therapy in postmenopausal women reduces blood pressure. Measurements showed this effect to be due to a reduction of angiotensin converting enzyme (ACE) by 20%. This is the equivalent of treating a woman with an ACE inhibitor without the side effects of these pills.
  4. Coronary calcification scores were lower in postmenopausal women on ERT than a control group without ERT. These calcification scores correlate with the risk for heart attacks.
  5. Oral estrogen replacement leads to proinflammatory metabolites from the liver metabolism of estrogen. This is not found in the blood of women using transdermal estrogen. The anti-inflammatory effect of transdermal estrogen is another mechanism that prevents heart attacks.
  6. Postmenopausal women on ERT had no increased risk of heart attacks or venous thromboembolism (clots in veins). Menopausal women without ERT have a risk of 40% of dying from a heart attack. Their risk of developing breast cancer is 5.5%, the risk of dying from breast cancer is about 1%. Oral estrogen use was associated with venous thromboembolism.
  7. Estrogen has antiarrhythmic effects stabilizing the heart rhythm. Dr. Smith said that in the future intravenous estrogen might be used to prevent serious arrhythmias following heart attacks.

Estrogen levels in males

Males require a small amount of estrogens to maintain their memory, for bone maturation and regulation of bone resorption. But they also need small amounts of estrogen for their normal lipid metabolism.

However, if the estrogen levels are too high as is the case in an obese, elderly man, there is an increased risk of heart disease. Factors that lead to increased estrogen levels in an older man are: increased aromatase activity in fatty tissue, overuse of alcohol and a change in liver metabolism, zinc deficiency, ingestion of estrogen-containing foods and environmental estrogens (also called xenoestrogens).

2. Progesterone

Progesterone is significantly different from the progestin medroxyprogesterone (MPA). MPA was the oral progestin that was responsible for heart attacks and blood clots in the Women’s Health Initiative. MPA increases smooth muscle cell proliferation. This in turn causes hardening of the coronary arteries. In contrast, progesterone inhibits smooth muscle cell proliferation, which prevents heart attacks. Progesterone also lowers blood pressure and elevates HDL cholesterol, but MPA does not.

Progesterone in males

In a small study Depo-Provera was given to males for 17 days. Blood tests showed a lowering of triglycerides, LDL cholesterol and Apo A-1.

3. Testosterone

Testosterone replacement in women

Testosterone in women does not only increase their sex drive, but also relaxes the coronary arteries in women who were testosterone deficient. This allows more blood flow to the heart. In postmenopausal women testosterone replacement lowered lipoprotein (a) levels up to 65%. The physician will only replace testosterone in women who have either enough of their own estrogen production or else have been replaced first with bioidentical estrogen. Otherwise testosterone alone can cause heart attacks in women.

Elevated testosterone in women with PCOS

Women with polycystic ovary syndrome (PCOS) can have increased testosterone levels when they go through premenopause or menopause.

Women with PCOS are at a higher risk to develop diabetes, heart disease and high blood pressure. 50% of women with PCOS have insulin resistance. 70% of women with PCOS in the US have lipid abnormalities in their blood.

Elevated testosterone levels in the blood can lower the protective HDL cholesterol and increase homocysteine levels. Both can cause heart attacks.

Women with PCOS have a 4-fold risk of developing high blood pressure.

Testosterone replacement in males

A 2010 study showed that low testosterone levels in males were predictive of higher mortality due to heart attacks and cancer. Low testosterone is also associated with high blood pressure, heart failure and increased risk of cardiovascular deaths. There was a higher incidence of deaths from heart attacks when testosterone levels were low compared to men with normal testosterone levels.

Low testosterone is also associated with the development of diabetes and metabolic syndrome, which can cause heart attacks.

It is important that men with low testosterone get testosterone replacement therapy.

DHT (Dihydrotestosterone)

DHT is much more potent than testosterone. Conversion of testosterone leads to DHT via the enzyme 5-alpha-reductase. While testosterone can be aromatized into estrogen, DHT cannot. Some men have elevated levels of DHT. This leads to a risk of heart attacks, prostate enlargement and hair loss of the scalp.

Andropause treatment

Only about 5% of men in andropause with low testosterone levels receive testosterone replacement in the US. Part of this is explained by rumors that testosterone may cause prostate cancer or liver cancer. The patient or the physician may be reluctant to treat with testosterone. Bioidentical testosterone has been shown to not cause any harm. It is safe to use testosterone cream transdermally. It does not cause prostate cancer or benign prostatic hypertrophy.

An increase of 6-nmol/L-serum testosterone was associated with a 19% drop in all-cause mortality.

Testosterone helps build up new blood vessels after a heart attack. Testosterone replacement increases coronary blood flow in patients with coronary artery disease. Another effect of testosterone is the decrease of inflammation. Inflammation is an important component of cardiovascular disease.

Testosterone replacement improves exercise capacity, insulin resistance and muscle performance (including the heart muscle).

Apart from the beneficial effect of testosterone on the heart it is also beneficial for the brain. Testosterone treatment prevents Alzheimer’s disease in older men by preventing beta amyloid precursor protein production.

4. DHEA

Dehydroepiandrosterone (DHEA) is a hormone produced in the adrenal glands. It is a precursor for male and female sex hormones, but has actions on its own. It supports muscle strength. Postmenopausal women had a higher mortality from heart disease when their DHEA blood levels were low.

Similar studies in men showed the same results. Congestive heart failure patients of both sexes had more severe disease the lower the DHEA levels were. Other studies have used DHEA supplementation in heart patients, congestive heart failure patients and patients with diabetes to show that clinical symptoms improved.

5. Melatonin

Low levels of melatonin have been demonstrated in patients with heart disease. Melatonin inhibits platelet aggregation and suppresses nighttime sympathetic activity (epinephrine and norepinephrine). Sympathetic activity damages the lining of coronary arteries. Melatonin reduces hypoxia in patients with ischemic stroke or ischemic heart disease. Lower nocturnal melatonin levels are associated with higher adverse effects following a heart attack. Among these are recurrent heart attacks, congestive heart failure or death. Melatonin widens blood vessels, is a free radical scavenger and inhibits oxidation of LDL cholesterol. Melatonin reduces inflammation following a heart attack. This can be measured using the C-reactive protein.

In patients who had angioplasties done for blocked coronary arteries intravenous melatonin decreased CRP, reduced tissue damage, decreased various irregular heart beat patterns and allowed damaged heart tissue to recover.

6. Thyroid hormones

It has been known for more than 100 years that dysfunction of the thyroid leads to heart disease. Hypothyroidism can cause heart attacks, hardening of the coronary arteries and congestive heart failure. Lesser-known connections to hypothyroidism are congestive heart failure, depression, fibromyalgia, ankylosing spondylitis and insulin resistance. Some cases of attention deficit hyperactivity disorder (ADHD) with low thyroid levels may successfully respond to thyroid replacement.

Thyroid hormones improve lipids in the blood, improve arterial stiffness and improve cardiac remodeling following a heart attack. Thyroid hormones help with the repair of the injured heart muscle. They also work directly on the heart muscle helping it to contract more efficiently. Lower thyroid stimulating hormone (TSH) values and higher T3 and T4 thyroid hormone levels lead to improved insulin sensitivity, higher HDL values (= protective cholesterol) and overall better functioning of the lining of the arteries.

Dr. Smith said that thyroid replacement should achieve that

  • TSH is below 2.0, but above the lower limit of normal
  • Free T3 should be dead center of normal or slightly above
  • Free T4 should be dead center of normal or slightly above

Most patients with hypothyroidism require replacement of both T3 and T4 (like with the use of Armour thyroid pills).

7. Cortisol

Cortisol is the only human hormone that increases with age. All other hormones drop off to lower values with age. The adrenal glands manufacture cortisol. With stress cortisol is rising, but when stress is over, it is supposed to come down to normal levels. Many people today are constantly overstressed, so their adrenal glands are often chronically over stimulated. This can lead to a lack of progesterone. It also causes a lack of functional thyroid hormones as they get bound and are less active. When women have decreased estradiol in menopause there is a decline in norepinephrine production, production of serotonin, dopamine and acetylcholine. Women with this experience depression, lack of drive and slower thought processes.

Heart Health Improves With Hormone Replacement

Heart Health Improves With Hormone Replacement

Conclusion

Seven major hormones have been reviewed here that all have a bearing on the risk of developing a heart attack. It is important that these hormones are balanced, so they can work with each other. Hormones can be compared to a team that works together and is responsible for our health. If one or several of the team players are ineffective, our health will suffer. For this reason hormone replacement is crucial. Hormones have effects on mitochondria of the heart muscles cells. They stabilize the heart rhythm as in the case of estradiol. But they can also strengthen the heart muscle directly through DHEA and estrogens in women and DHEA and testosterone in men. Thyroid hormones are another supportive force for the heart and can even be used therapeutically in chronic heart failure patients. When people age, many hormones are produced less, but blood tests will show this. Replacing hormones that are missing can add years of active life.

Taking care of the symphony of hormones means you are taking care of your most important organ, the heart!

Incoming search terms:

Feb
18
2017

Weight Gain In Menopause

Dr. Tasneem Bhatia, also known as Dr. Taz gave a lecture about weight gain in menopause. This was part of the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. The full title of the talk was “Hormone Balance and Weight Control in Menopausal Women”. Dr. Taz practices integrative medicine at CentreSpring MD, Atlanta. GA.

A few statistics about menopause

Weight gain in menopause is common. There are 50 million women who suffer from this in the US. Globally 300 million women have this problem. The average weight gain is between 5 and 50 pounds. There may be a small percentage of women where a genetic component comes in, and where all the females in the ancestry had a weight problem after menopause. But we do not know for certain what is genetic and what is due to hormone deficiency. It is only in the last few decades that doctors have determined how important hormone deficiencies are in menopause.

It has been determined that 10 million women who are over 40-years-old need treatment in long-term care facilities.

We will see below that when this knowledge is incorporated into a treatment schedule, the weight problem can normalize. In this case 2/3 of the cost of caring for postmenopausal women with obesity and diabetes can be reduced.

Pathophysiological changes in menopause

There are three intertwining aspects that drive weight gain in menopause. There is an altered metabolic rate, and less calories are burnt, which makes you gain weight when you eat the same amount of calories. Secondly there is a significant decline of three key hormones, estrogens, progesterone and thyroid hormones in menopause. Third, as the weight rises and the other mentioned hormones are missing, it is harder for the pancreas to keep up with insulin production and insulin resistance is developing. I will explain this further below.

1. Decreased energy expenditure

With the lack of the ovarian hormones there is a slowing of the resting metabolic rate. There is also decreased energy expenditure from reduced fat oxidation. Overall there is less need to consume the same amount of calories as before. But the hormonal changes trigger hunger and cravings.

2. Ovarian aging

With ovarian aging there is less estrogen production in the ovaries. This leads to less ovulation in the premenopausal period. A lack of ovulations creates a lack of progesterone production. When there are anovulatory cycles, there is no progesterone producing corpus luteum reducing progesterone production further. When estrogen and progesterone are missing, this is a stress on the thyroid gland that is trying to partially compensate for the lack of the ovarian hormones. Eventually though thyroid hormone production is reduced and hypothyroidism sets in. This is very hard on the adrenal glands that produce cortisol. For some time the adrenal glands can compensate for missing thyroid hormones with cortisol overproduction. But in time adrenal gland fatigue develops.

3. Insulin resistance

Insulin resistance can lead to diabetes, which becomes a real menace together with the metabolic changes of obesity.

Health risks of weight gain

Dr. Taz pointed out that there are very specific risks associated with the metabolic changes around menopause. There is an increased risk for heart attacks and strokes as LDL cholesterol and triglycerides are elevated and arteries get calcified from circulating calcium that was leaked out from the bones into the blood stream.

Osteoporosis is common in menopause; the brittle bones lead to an increased risk of fractures in the hips, wrists and vertebral bodies.

There is also increased risk of cancer in postmenopausal women, particularly breast cancer and colon cancer. The higher the weight, the more risky it is for these women to get one of these cancers.

Alzheimer’s disease and cognitive decline is also very common in menopause. This may be directly related to a lack of estrogen and progesterone, but may also have to do with overconsumption of sugar and starchy foods.

Hormone changes in menopause

Hormone changes in menopause can be complex. It is not only a lack of estrogens and progesterone that are the problem. All hormones work together. When there is weakness in one area (in the ovaries with menopause), those hormones that are acting in the same way or in opposition to ovarian hormones will be affected. In this way it is understandable that the thyroid gland can develop a weakness (hypothyroidism) or why the adrenal glands are over stimulated first, but will eventually suffer with adrenal fatigue in future. In a similar way the pancreas produces too much insulin, partially because weight gain stimulates this. Typically the physician finds the fasting insulin level elevated with menopausal obesity. But as insulin levels are too high, the body’s insulin receptors get lazy and do not respond fully to insulin anymore. This is called insulin resistance. In time insulin resistance can lead to diabetes.

1. Lack of estrogen

A lack of estrogen in menopause is likely the single most important reason for weight gain in menopause.  As estrogen secretion declines, visceral obesity increases. There is also impaired insulin regulation. With obesity there is an additional risk of developing diabetes.

2. Progesterone

Progesterone is the other female hormone that is reduced with menopause. Bioidentical progesterone cream can prevent osteoporosis and hot flashes in menopause. Bioidentical progesterone replacement can also help a menopausal woman to sleep better. In menopause the production of progesterone goes down by 75% while estrogen production drops down by 35%.

3. Hypothyroidism

Hypothyroidism (with elevated TSH blood tests) is commonly found in menopausal women. This is known to be associated with weight gain. As a result it is important to check for hypothyroidism in menopausal women. It is important to check for micronutrients like iodine, selenium and iron and if they are low, supplementation may be necessary. Some women develop an inflammatory thyroiditis, called Hashimoto’s disease. This can be confirmed with a thyroid nuclear scan. The reason this is important to recognize is that after several years when it burns itself out, hypothyroidism develops often, which requires thyroid hormone replacement.

4. Cortisol response

The cortisol response to stress is suboptimal due to the decreased progesterone levels in menopause. Adequate amounts of progesterone are needed to synthesize cortisol. But in a group of menopausal women following a significant stressful event cortisol production was much higher than in non-stressed women.

5. Other hormones

Other hormones like leptins and melatonin are also contributing to weight gain in menopause. In rat experiments where ovariectomies (mimicking menopause) were performed, there was a clear relationship between low estrogen levels and weight gain; higher estradiol doses inhibited leptin expression resulting in weight normalization.

Leptin and melatonin are influencing insulin regulation. This can in time lead to diabetes in connection with weight gain. It is at this point when a woman’s body shape can turn from a healthier pear shape to an unhealthy apple shape. The extra visceral (abdominal) fat is very active metabolically and causes inflammation in the body. These changes can lead to high blood pressure, heart attacks, strokes and digestive dysfunction.

Treatment of weight gain in menopause: food, hormones and lifestyle

How do you treat a complex problem like weight gain in menopause? It is no surprise that this will require a number of treatment modalities in combination.

1. Diet

It is important to start on an anti-inflammatory diet like the Mediterranean diet. Any extra sugar should be cut out as surplus carbohydrates lead to fat deposits and higher blood lipids. Dr. Taz suggested a 1200-calorie diet. Reduce salt intake. Eat more food during the day until 4 PM, nothing to eat after 8 PM. Increase plant-based foods, lower or eliminate trans fats. Increase foods rich in probiotics (bifidobacteria) like kefir, yogurt and kombucha.

2. Exercise 

Do some exercise in a gym where you combine a treadmill for 30 minutes with 25 minutes of weight machines for strength training. Aim for doing this 5 times per week. But it would be more beneficial doing it every day. Have additional activity bursts on and off during the day. Exercise has been shown to increase HDL cholesterol, which protects from heart attacks and strokes.

3. Stress management

Supplements like adaptogens help the adrenal gland to better cope with stress. These are available through your health food store. Meditation, yoga, self-hypnosis will all help to refocus and protect you from stress. B-complex vitamins and vitamin C strengthen your immune system and give you more energy. Building and maintaining community is another factor in reducing stress.

4. Establishing healthy sleep

Many postmenopausal women have poor sleep habits, partially from hot flashes (due to estrogen deficiency), partially from melatonin deficiency and also from progesterone deficiency. In the next section I will describe how to normalize these hormones. But in addition you need to educate yourself to go to bed between 10 PM and 11 PM every night and to sleep 7 to 8 hours. If you go to bed later, you will disturb your diurnal hormone rhythm and this will interfere with a normal sleep pattern. There is an age-related reduction of melatonin production in the pineal gland. This is why many postmenopausal women are deficient in melatonin. You may need 3 mg of melatonin at bedtime. If you wake up in the middle of the night you could take another 3 mg of melatonin. You may experience a few nightmares as a side effect; otherwise melatonin is very well tolerated.

5. Bioidentical hormone replacement

The complex hormone deficiencies described above are responsible for the many symptoms of menopausal women including weight gain. It is important to work with a knowledgeable health care provider who knows how to prescribe bioidentical hormones. Typically blood tests and possible saliva hormone tests are done before replacement. This establishes which hormones have to be replaced. Typically bioidentical progesterone is replaced first. Secondly, estrogen is added as Bi-Est cream, if blood levels indicate that it is low. If thyroid is required because of a high TSH level (meaning hypothyroidism) supplementation with Armour or a similar balanced T3/T4 combination is started. If fasting insulin levels are high, the doctor may want to start metformin as this is known to normalize insulin resistance. Blood tests have to be repeated from time to time to ensure adequate hormone levels.

6. Supplements

Every woman treated will likely require different supplements. But magnesium is one mineral that is often missing in the diet. 250 mg of magnesium twice a day will be enough for most women and men to balance internal metabolic reactions. Magnesium is a co-factor to many enzyme systems. Vitamin K2 (200 micrograms daily) and vitamin D3 (around 4000 to 5000 IU per day) in combination are important to prevent osteoporosis. Apart from these there are many options to take other supplements. Ask your healthcare provider what you should take.

Weight Gain In Menopause

Weight Gain In Menopause

Conclusion

This was a fast review of what Dr. Taz explained in a talk about weight gain in menopause. There are complex hormone changes that need to be addressed. A well-balanced diet like the Mediterranean diet needs to be followed. Stress management skills need to be learnt. A regular exercise routine needs to be followed. Healthy sleep patterns have to be reestablished. And missing hormones need to be replaced not in synthetic forms, which are toxic to the body, but in the bioidentical forms. Postmenopausal women will feel better when this comprehensive treatment program is in place; and in time they will feel normal again.

Incoming search terms:

Sep
17
2016

Seven Steps To Live Over 100 Years

Forbes invited me to publish a blog I wrote for Quora, “Seven steps to live over 100 years”.

The topic of habits by people who live more than a hundred years has been reviewed many times in the media. It continues to be popular. Here are seven things you can do to stay healthy followed by an explanation why.

Seven steps to live over 100 years – step1: Stay active

You want to stay active every day, even if you retire. You want to move and keep your mind busy. Part of that is to do a daily formal exercise routine to keep those muscles toned, which will prevent falls in the future.

Explanation: when you keep your muscles toned and you move about, your balance organ and coordination remains sharp, you are less likely to fall and break a hip. 50% of those who sustain a hip fracture die.

Seven steps to live over 100 years – step 2: Eat a healthy diet

Eat a Mediterranean type diet or follow the Okinawan diet. These diets contain less meat (or no meat as in the Seventh Day Adventist diet), but lots of vegetables and fiber. This keeps your cholesterol down, your arteries open and your metabolism controlled, preventing diabetes. If you are not obese and you have no diabetes, you are going to be OK with your cardiovascular system for decades to come.

Explanation: Heart attacks are still on top of the mortality list. Avoid them and you got it made, if you want to make it to 100 and beyond. But we need to stay away from the poor fats and the obsession about eating beef. Red meat, if eaten too often gives you a higher risk of getting cancer and heart disease. So eat it only once a week at the most, the rest would be chicken, turkey meat or fish. Nothing wrong with a vegetarian meal, let’s say kidney beans or lentils on a day in between. This still gives you protein for your muscles, but spares you a heart attack.

Seven steps to live over 100 years – step 3: Take care of your teeth

Brush your teeth and floss every day. This will control the bacteria in your mouth and prevent leakage into your blood affecting your heart valves. Studies have shown that this prevents heart attacks.

Explanation: When I heard this first about 20 years ago, I found it strange. But the literature is clear: chronic gingivitis is associated with bacteria that grow on the gums and spread into your blood. They can then colonize your heart valves and even the lining of the arteries, particularly where there is already hardening of the arteries (arterial plaque). This can lead to heart valve disease like mitral valve disease or heart attacks.

Seven steps to live over 100 years – step 4: prevention of disease

See your physician right away if there is a new skin lesion or anything that is different on your body. Removal of early cancer and treatment of any early medical condition is always easier to treat than waiting until it is out of control. Particularly with cancer treatment at an early stage, which usually involves only a small surgical procedure, this will reward you with a ripe old age.

Explanation: I learnt this point in general practice. Patients who waited until small problems become big problems were always much worse off than patients who saw me for small problems that we could remedy at an early stage. As mentioned above this is particularly important in cancer cases, as usually stage 1 and 2 of a cancer is curable with surgery. Once you get lymph node metastases and distant metastases, the cancer is much more difficult to treat, if at all. This is a principle that is pretty much true for any disease. The prevention factor is huge. Make use of it!

Seven steps to live over 100 years – step 5: Lifestyle matters

Watch excesses like smoking (cut it out!), alcohol intake, and recreational drugs. Smoking causes heart attacks, strokes, and cancers, which shorten your life. Recreational drugs just interfere with your body chemistry and have side effects. Cut them out, if you cherish growing older than 100. Alcohol needs to be kept at a very low consumption, if you want to preserve your liver, which is your central metabolic organ. If you can’t handle moderation with alcohol consumption, cut it out. No one has died from not consuming alcohol.

Explanation: I have already explained why lifestyle choices matter. The alcohol question is one that will be discussed back and forth for centuries. There are cardiologists who tell you that men should drink 1 to 2 drinks per day and women 1 drink per day and we all live longer, because of prevention of heart disease. The wine industry makes sure that you will hear this cardiology rule. It is true that centenarians often drink one glass of red wine per day. But there are plenty of centenarians who never drank in their life. It is a matter of personal choice.

Seven steps to live over 100 years – step 6: Avoid obesity and diabetes

I did mention to avoid obesity under point 2 above, which is associated with metabolic syndrome and diabetes. Your ideal body mass index should be in the 21 to 22 range. You can achieve this by following the diets I mentioned above. You should cut out sugar and starchy foods.

Explanation: I have followed such a diet since 2001 and my body mass index is between 21 and 22. I grew up in Germany where an emphasis was put on sweets and starchy foods. Needless to say my modified Mediterranean diet deviates from the good old German diet significantly. I find healthy food very tasty.

Seven steps to live over 100 years – step 7: Sleep and hormones

Getting sleep regularly, having an optimistic outlook on life, and having good relationships help to keep the immune system strong and keep your hormones balanced. This in turn will keep you healthy emotionally and physically.

Explanation:

There are two comments I like to make. One is that when you have calm nerves, and your emotions are balanced, your stress hormones are controlled. We know that people who are laid back and easy going live longer. The type A personality is the one who gets a heart attack.

The other point is that hormones have running times. When they start missing, we get menopause or andropause. When we are in our 50’s it is time to have your hormones checked by a knowledgeable health practitioner (naturopath, anti-aging physician). At this point regular physicians are mostly uneducated about bioidentical hormone replacement. I mention this as in European studies it has been shown that replacement of missing hormones with bioidentical hormones resulted in more youthful lives. Life expectancy can be prolonged by 15 years using bioidentical hormones according to Dr. Hertoghe, an endocrinologist in Belgium. http://www.askdrray.com/life-extended-by-several-decades/

Seven Steps To Live Over 100 Years

Seven Steps To Live Over 100 Years

Conclusion

People have always been fascinated about the factors that lead to a healthy age above 100 years. I am suggesting that you concentrate on enjoying your life and keeping toxins out. Engage in some form of exercise or stay active all the time. Adopt a healthy diet. This is where perhaps most people go wrong. They think they can go on pouring junk foods and alcohol down their throats and never get heart disease or cancer. The truth is not quite like that. We do need to adopt a healthy diet like the Mediterranean diet. We also need to limit drinking to a healthy level. Replacing missing hormones with bioidentical ones will prolong your life as well. Given these recommendations, happy journey to 100 and beyond!

Aug
13
2016

Avoid BPA

After a lot of bad press as a hormone disruptor we know we should avoid BPA. Bisphenol A (BPA) is a synthetic compound that has been used since 1957 in plastic bottles and as lining inside cans, so they don’t rust.

Study showing why we should avoid BPA

Recently BPA has again hit the media as a new study has shown that there are things we can do to avoid high concentrations of BPA by changing our lifestyle.

This media report is based on a scientific study that Jennifer Hartl and coworkers have done. They followed patients who had consumed various items known to be contaminated with BPA and measured their urine BPA concentration 24 hours later. 9% of their study participants had consumed one can of food or more, while 2% had consumed 2 cans of food or more on the previous day. When one can of food consumed was compared to none, 24% of higher BPA concentration in the urine was found. With two cans of food consumed versus none 54% of higher BPA concentration was found in the urine tests.

When one or more specific types of canned foods were compared to none consumed, some interesting differences emerged. Canned vegetables and fruit showed 41% higher BPA in the urine test. Canned pasta measured 70%, but canned soup 229%. The researchers also tested canned beverages. None of them were associated with elevated BPA in urine tests.

What BPA does

93% of Americans 6 years and older have BPA in their urine indicating that it is in our bodies, and the body is attempting to get rid of it. It is known as an endocrine disruptor, but how effective BPA is as an endocrine disruptor remains to be seen. This link described that BPA is 800-times weaker as an estrogen blocking substance compared to soy products.

There are two mechanisms of action where BPA interferes with normal body function.

  1. BPA functions as a weak estrogen and binds to the nuclear estrogen receptor. This partially blocks the action of the body’s own estrogen function.
  2. There is also a membrane based estrogen receptor on body cells that is involved in cell signaling and gene expression. BPA can add methyl groups to DNA, which silences gene expression. This latter mechanism is much more sensitive to BPA (probably by a factor of 1000-times) than the traditional effect on the nuclear estrogen receptor.

It is these newer findings that are of concern with regard to fertility in males as this study on rats showed: It is important that babies are not fed using regular plastic bottles, but rather that BPA-free bottles or glass bottles are used to avoid BPA exposure. Babies and children are particularly vulnerable to the hormone blocking effects of BPA as well as the interference of brain development and maturation by BPA.

Manufacturing of BPA free plastic

In an attempt to avoid BPA in manufacturing of plastic bottles and food containers industry has used other chemicals, among other materials something called BPS. This stands for “Bisphenol S”. A research paper found that BPS is an endocrine disruptor as much as BPA is and causes fat cells to grow rapidly. According to the author of this publication it may be partially responsible for the obesity wave. The author of this study recommends using glass containers as much as possible to avoid transfer of either BPA or BPS to food that comes in contact with plastic materials.

Avoid BPA from receipts

Have you ever thought that you may be able to absorb BPA through your skin from receipts when you buy items at a store? Yes, the receipt that is printed on heat sensitive paper has BPA on it that gets absorbed through the skin. If you scratch the printed part of the paper and it leaves a dark mark, it is thermal paper.

In this study workers were handling thermal receipts for four hours and their urine was monitored for BPA the following day. Another group was handling thermal receipts for 8 hours. In the first group that was exposed for 4 hours the BPA concentration in the urine rose to three times higher than the base rate. The second group exposed for 8 hours had BPA levels that were five times higher than the base rate. For comparison another group was measured that was wearing surgical gloves and their BPA concentration in the urine showed no change from the baseline.

I have changed my way of shopping. I think about whether I would ever want to exchange the item I just bought. If not, I tell the clerk that I do not want a receipt and the receipt is thrown out.

How you can avoid BPA exposure

  1. Do not use plastic containers to heat food in a microwave, use glass containers instead.
  2. Avoid all plastic food containers that have a “7” printed in a triangle on the bottom. Among these is a significant number that will release BPA over time.
  3. Avoid canned soups, such as tomato soup or canned mushroom soup. The paper reviewed at the beginning of this review showed these led to the highest BPA readings in urine tests the following day.
  4. Keep in mind that 2 out of 3 cans in supermarkets are positive for BPA. Eat as much fresh or frozen food as you can, but avoid canned food.
  5. Many canned beverages (such as beer, soda, juice) are acidic; this means that their thermal processing requirement is much different requiring lower temperature where BPA does not leach from the bottle into the stored fluid. These drinks when tested were BPA free.
  6. Among drinking water containers the following have been tested: Aquafina, Dasani, Arrowhead, Fiji and Kirkland Signature bottled water from Costco. They were all BPA free. Most water companies have now switched to BPA free containers, but avoid the containers with the “7” in a triangle as already stated, as some of them may leach BPA into the bottle content.
  7. Use fresh, unpackaged foods as much as possible. For instance, fruit and vegetables can often be had unpackaged. If it is packaged, check the type of plastic it is packaged in and do not buy, if you are unsure.
  8. Whenever possible, avoid handling thermal receipts; if possible, get an email receipt instead to avoid BPA exposure through the skin.
Avoid BPA

Avoid BPA

Conclusion

There has been a silent revolution where more and more plastic and resins have entered our lives. With it came the exposure to BPA, which is an endocrine disruptor. This may have consequences regarding male fertility, change of fat metabolism in both sexes with weight gain as the end result. It also interferes with brain development in the fetus and in young children. BPA has to be considered as a poison.

In this blog I have shown ways to reduce exposure to BPA. We need to eat more fresh vegetables and fruit that are not sold in plastic, or if plastic is used for packaging, the containers must be BPA and BPS free. The labeling of containers needs to be made mandatory by the FDA and/or EPA. Whenever possible we need to return to glass containers that are guaranteed BPA free. Also bear in mind that heating plastics can release toxins. If you are heating food in a microwave, do not use plastic containers. Instead any use glass or ceramics, which are known to be safe!

Additional reference (Questions about BPA answered):

http://www.niehs.nih.gov/health/assets/docs_a_e/bisphenol_a_bpa_508.pdf

Incoming search terms: