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.

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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

May
14
2016

Hormone Replacement Therapy In Menopause

Back in the 1980’s many physicians were hopeful that hormone replacement therapy in menopause (HRT) could extend the lives of postmenopausal women by approximately 10 years, if HRT would be started early enough. But the HERS study (Heart and Estrogen/progestin Replacement Study) in 1998 and the WHI study (Women’s Health Initiative) of 2002 changed things dramatically.

The HERS study did not show any benefit with regard to prevention of heart disease. Instead it showed more gallbladder disease (1.38-fold) and blood clots (2.89-fold) develop in the experimental group versus the placebo.

The WHI study was complex and had several arms. There also were some methodological errors in the study as pointed out here.

Instead of a decrease in heart attacks, there was an increase, when estrogen and progestin was combined. There were more cases of colon cancer, more blood clots and heart attacks in the placebo groups compared to the experimental groups. It seems that something went wrong with these trials.

Unknown facts about hormone replacement therapy in menopause

  1. Both clinical trials used the wrong hormones to do the trials. If you use the wrong hormones in a trial, you would expect to get the wrong test results. Horse derived estrogen (equine estrogen) is hardly a match for bioidentical, human estrogen in women. But decades ago the drug manufacturer had decided that estrogen was easiest to manufacture on a large scale when urine from pregnant mares was used. The product contains conjugated horse estrogen and is known by the name Premarin. Premarin is not bioidentical to human estrogens.
  2. The other hormone, medroxy progesterone (MPA) is a progestin, a bad copy of the bioidentical progesterone that a woman’s corpus luteum of one of her ovaries produces. This is in the second half of her menstrual cycle. During pregnancy the placenta produces lots of progesterone to protect the pregnancy. As Dr. Masley, a cardiologist stated synthetic progestins cause heart attacks, while progesterone does not. Masley said: “Medroxy progesterone (MPA) increases the risk for heart disease and for breast cancer. I can’t understand why any physician would recommend medroxy progesterone during menopause, but it is still in use.”
  3. Next there is the question whether the liver changes the composition of an oral hormone tablet metabolically or not. The answer is: yes! Dr. Masley stated in the link above that oral estradiol, when compared to estrogen rubbed onto the skin, increases levels of inflammation by 192%. The C-reactive protein (CRP),can be measure with a blood test.The risk for a blood clot increases by 400%. A woman using estrogen should always use the estrogen patch or an estrogen cream with bioidentical estrogen to avoid these complications.
  4. Measure hormones – don’t estimate: Hormones are constantly changing and if you don’t measure, you don’t know what you are dealing with. Dr. 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, you use only bioidentical hormones to replace and you replace only as much as is needed to normalize the levels. This is also the level where postmenopausal symptoms disappear. 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.”
  5. The elusive progesterone: when progesterone is measured as a blood test it may come back as high while it can be low in a saliva hormone test in the same woman. Dr. Lee has pointed out that studies have shown that progesterone levels in tissue are usually higher by several factors when compared to blood levels and that blood levels are not reliable predictors of tissue levels (Ref.1). On the other hand he found that saliva levels have a good correlation with tissue levels in organs like the ovaries or the uterus. Dr. Lee preferred saliva hormone tests for this reason. When it comes to progesterone levels you can trust saliva test, but you cannot trust blood tests. Many physicians ignore that fact and strictly order blood progesterone levels coming to false conclusions.
  6. We know that estrogen and progesterone must be balanced to avoid troubles of developing heart attacks or cancer. In the link under point 4 above Dr. Lee stated that women without breast cancer have saliva progesterone hormone levels that are more than 200-fold higher than the saliva estradiol levels. On the other hand women with breast cancer have a ratio of less than 200 to 1 with respect to progesterone to estradiol saliva levels. There is a similar ratio in men where the ratio of testosterone to estradiol must be larger than 20 to 1 or he is at a higher risk of developing prostate cancer. Unfortunately many older men, when overweight or obese, have high estrogen levels and the ratio is less than 20 to 1.
  7. Masley has mentioned that in the first 6 years after menopause using a topical form of estrogen and micronized progesterone as tablets can minimize the risk of future heart attacks and strokes. But after 10 years it is less obvious what is the best solution. The question is what type of estrogen application is used. Is it estradiol or is it Bi-Est or Tri-Est, which are other topical estrogen applications. Tri-Est is 80% estriol, 10% estrone, and 10% estradiol while Bi-Est is 80% estriol and 20% estradiol. Tri-Est in particular would be very close to the natural composition of estrogens in a woman’s body.

What to do after 10 years of hormone replacement therapy in menopause

Given the insecurity what to do after 10 years of menopause, my suspicion is that there are other factors that play a role with respect to hormone replacement. A lot of women have extra pounds accumulated. Fatty tissue contains an enzyme called aromatase.

This makes estrogen from androgenic hormones including testosterone. The adrenal glands situated above the kidneys produce these hormones in menopause. The more overweight or obese a postmenopausal woman is, the higher the estrogen levels in her blood because of the action of the aromatase. Most physicians have not measured hormones in the past, but just replaced hormones monitoring only postmenopausal symptoms. This is changing. What I said under point 4 above is happening more. Naturopaths tend to be more comfortable with bioidentical hormone replacement the way I have described it. If you did hormone tests (preferably saliva hormone tests) you would pick up higher estrogen levels and low progesterone levels with unfavorable progesterone to estrogen ratios as mentioned. These women do not need estrogen (they have it already in their systems). They need progesterone replacement only. Progesterone can be taken as micronized bioidentical progesterone capsules at night or as progesterone bioidentical cream to be applied to the skin. Here is another take on the use of bioidentical hormones.

Hormone Replacement Therapy In Menopause

Hormone Replacement Therapy In Menopause

Conclusion

Bioidentical hormone replacement is complex. It requires some basic knowledge of the facts mentioned above. I find it surprising that two separate research groups could not free themselves of the Big Pharma grip. In not doing so they unwillingly produced studies showing all of the undesirable side effects of using artificial hormones. When manufacturers modify natural hormones with unnatural side-chains, the end products are synthetic hormones. These do not fit the appropriate natural hormone receptors. The anti-aging community as represented by the A4M group (American Academy Of Anti-Aging Medicine) with more than 25,000 physicians worldwide has been saying this all along. Now we know that it is really true. Use hormone replacement knowledgeably and use bioidentical hormones!

References

  1. Dr. John R. Lee: “Natural Progesterone – The remarkable roles of a remarkable hormone”, Jon Carpenter Publishing, 2nd edition, 1999, Bristol, England.

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Apr
16
2016

Sleeping Habits

When you are a child or a youngster sleeping habits are rarely a problem. But as people age, they tend to have problems falling asleep and sleeping through the night. Older people may also have certain hormone deficiencies, which can contribute to a change in sleeping habits.

Some basics regarding sleeping habits

There are a couple of facts that everybody should know about sleep, so you work with nature, not against it.

  1. The way our bodies are hardwired, we need 7 to 8 hours of sleep and we need to fall asleep between 10PM and 11PM.
  2. The reason for the relative rigid sleeping schedule time wise is the diurnal hormone rhythm. This is also known as the circadian clock that is dictated by the light of the sun (24 hour cycle). Light going into our eyes in the morning inactivates melatonin. But in the evening the pineal gland releases melatonin after sunset. This is what keeps the internal clock on time. We all know how we derail when we fly east or west. There are differences. I find that I am more affected when I fly west than east. The readjustment for me often takes one or two weeks for a 9-hour time zone difference.
  3. Melatonin is gradually produced less as we age. The highest melatonin production occurs around 10 years of age. From then on melatonin production declines. This likely is the reason why older people more often have insomnia problems.
  4. There is interplay between melatonin and cortisol. These two hormones complement each other. When you sleep melatonin governs and resets the hormones to be ready in the morning. This involves an early testosterone peak for the male and cortisol, which has to be ready the moment you wake up. It is cortisol coming from the adrenal glands that rules during the day and is giving us energy. Thyroid hormones also give you energy during the day. As I will explain below, human growth hormone is an energy-giving hormone as well that also clears your mind.
  5. What is not as much known is that human growth hormone (GH) provides energy for us. Growth hormone is released as a spurt between midnight and 3 AM, when you’re deep asleep. The purpose of that is to get you ready with regard to energy for the next day. If you drink alcohol after 5PM the afternoon before, you will miss most of that GH spurt during the night and have a hangover (lack of energy the following day).  At the 23 rd Annual World Congress on Anti-Aging Medicine on Dec. 13, 2015 in Las Vegas the endocrinologist, Dr. Thierry Hertoghe from Belgium gave a talk about GH and said that even one drink during the evening before you go to sleep will cancel 75% of the GH spurt causing a lack of energy the following day. When you have alcoholic drinks evening after evening as many people do, you interfere with your deepest sleep, creating a fitful sleep and you can develop GH deficiency, which can be measured with blood and urine tests. GH deficiency leads to premature signs of aging, such as wrinkles, musculoskeletal problems, muscle weakness and dementia. Many people in their 80’s look “old”. In fact they may be growth hormone deficient and could be treated with human GH, if GH deficiency were confirmed by tests. Part of the aged appearance is reversible in cases of growth hormone deficiency by treating with daily GH injections.
  6. As we age, we produce less melatonin and less growth hormone. All of these hormone levels can be determined. If they are low, they should be replaced with small amounts of whatever hormone is missing.
  7. There are other hormones that are important for energy: cortisol from the adrenal glands, thyroid hormones and DHEA from the adrenal glands. When people get older there is a problem with melatonin production and an evening dose of melatonin supplement of 3mg is advisable. People beyond the age of menopause (females) and andropause (males) need bioidentical sex hormone replacement. Once they have sufficient hormone levels, they will also have more energy. It is advisable to get all of these hormones tested using a saliva hormone test. Growth hormone is a bit more difficult to assess, but IGF-1 levels give a first indication what your growth hormone levels are doing. The newest test is a 24-hour urine collection or an overnight urine sample looking for growth hormone metabolites. If levels are found to be low, daily replacement of growth hormone using a pen similar to insulin injections in diabetics can be given, using pure human growth hormone. You would need to seek the advice of a knowledgeable naturopath.

What does insomnia do to you?

From a psychological point of view performance is slower, there is a slower reaction time and there is a risk of developing anxiety or depression. The immune system gets weakened, high blood pressure can develop and there is a risk of developing heart disease, diabetes and cancer. It is common to gain weight becoming overweight or obese. Even your telomeres, the caps of chromosomes in every cell get shortened from too much stress and too little sleep. Shortened telomeres mean a shortened life span.

How to improve sleeping habits

Set your alarm clock for 8 hours later when you go to sleep. Make sure your bedroom is dark, but wake up to the alarm clock after 7 to 8 hours of sleep. Don’t sleep longer than 8 hours per night. Your internal diurnal hormone rhythm will thank you for regulating your sleep/wake rhythm by giving you the energy you want. I enjoy mine.

Sleeping habits include problems falling asleep or sleeping through

Falling asleep: As we mostly have a lack of melatonin, the first step is to take 3mg to 5mg of melatonin at bedtime. But it should be taken during the window of opportunity fitting into the diurnal hormone rhythm as mentioned above: between 10PM and 11PM. It takes 20 to 30 minutes for melatonin to take effect. If you do not fall asleep within that time frame, you are likely thinking too much. If that were the case, I would recommend taking 1 or 2 capsules of valerian (500 mg strength) from the health food store. This combined with melatonin should help in more than 80%-90% of insomnia cases.

Not sleeping through: Some of you, particularly if you are elderly, may wake up at 3 or 4 AM and have a hard time falling asleep again. At that time it would be safe to take another 3mg of melatonin and if this does not work within 20 minutes add another 500mg valerian capsule.

If you continue to have insomnia problems, see your physician. You may need sleep studies done or you may have problems with your thyroid gland (hypo- or hyperthyroidism), which needs to be checked. Other medical problems including depression have to be checked out as well. Melatonin and valerian are safe. Other sleeping pills have multiple side effects including memory problems.

Part of good sleeping habits is to provide a quiet, comfortable bedroom

The following points are good checklist for a comfortable sleep environment (Ref.1).

  • Ensure your bedroom is dark, soundproof, and comfortable with the room temperature being not too warm, and you develop a “sleep hygiene”. This means you get to sleep around the same time each night, have some down time 1 hour or so before going to bed and get up after your average time of sleep (for most people between 7 to 9 hours). Do not sleep in, but use an alarm clock to help you get into your sleep routine.
  • Avoid caffeine drinks, alcohol, nicotine and recreational drugs. If you must smoke, don’t smoke later than 7PM.
  • Get into a regular exercise program, either at home or at a gym.
  • Avoid a heavy meal late at night. A light snack including some warm milk would be OK.
  • Do not use your bedroom as an office, reading place or media center. This would condition you to be awake.  Reserve your bedroom use only for intimacy and sleeping.
  • If you wake up at night and you are wide awake, leave the bedroom and sit in the living room doing something until you feel tired and then return to bed.
  • A self-hypnosis recording is a useful adjunct to a sleep routine. Listen to it when you go to bed to give you something to focus on (low volume) and you will find it easier to stop thinking.
Sleeping Habits

Sleeping Habits

Conclusion

We need to be aware how important a proper hormone balance is when it comes to a healthy sleep pattern. Thyroid hormones and sex hormones are easy to measure. Bioidentical hormone replacement is needed, if one of the hormones is low. GH needs to be checked by an IGF-1 level and/or metabolites of GH in a 24-hour urine sample as explained above. Melatonin deficiency in older age is replaced the way I summarized above. With these measures sleeping habits improve, and you will get your 7 to 8 hours of restoring sleep. Forget the notion of the past that older people would not need as much sleep. Especially for an aging individual it is important to have a good night’s sleep in order to feel well and energized every day.

References

Ref.1: Jean Gray, editor: “Therapeutic choices”, 5th edition, Chapter 8 by Jonathan A.E. Fleming, MB, FRCPC: Insomnia, © 2008, Canadian Pharmacists Association.

Apr
09
2016

Treating Lack Of Sexual Arousal

A few years back lack of sexual arousal was not discussed that much. But since Viagra has been such a success in males, the search was on for a similar drug for females who have a lack of sexual arousal. The new drug, the “Viagra equivalent for women” is flibanserin under the trade name Addyi.

The news about this new drug has been noted in the media.

How flibanserin works

How does flibanserin work? It stimulates 5-HT1A receptors in the frontal brain to produce more serotonin and dopamine. Due to these substances a premenopausal woman with a lack of desire for sex becomes more arousable. It may sound reasonable at first, but when you look at the many other effects that a stimulation of 5-HT1A receptors can produce, I find it surprising that the FDA gave approval to this drug.

Flibanserin can cause opening up of skin veins leading to hypothermia and fainting due to a lowering of blood pressure. It has some pain relieving properties. Flibanserin can also interfere with learning and inhibit some aspects of memory. Some positives are decrease in aggression, increase in sociability and decreased impulsivity.

Here are a few points that need to be discussed regarding this new drug.

Treating a symptom rather than the cause

Premenopausal women have a lack of progesterone, as their ovaries do not ovulate as regularly as they did in the past. When the last ovulation has occurred, the woman’s periods stop for good. She is said to have entered menopause. There is a profound lowering of estrogen and progesterone levels, which also leads to a lowering of the testosterone blood level. In women the percentage of testosterone is minute compared to men, but testosterone is essential for normal libido. About 5 years before a woman gets into menopause testosterone levels and progesterone levels may already be getting reduced. It is this low testosterone level, which is the cause of the lack of sexual arousal. So, why are we suddenly treating these symptoms with a poorly understood drug? Why are we not treating the cause? The causes for a lack of sexual arousal are premenopausal hormone changes: mostly lowered progesterone and including lowered testosterone levels as well.

Alternative treatment of lack of sexual arousal

Dr. Lee has written several books that became famous. He treated hormone deficiencies in people with replacement of bioidentical hormones, which resulted in feeling renewed energy and losing the symptoms for which the patients were seen. With regard to premenopausal symptoms Dr. Lee wrote the following in one of his books.

It is interesting that these premenopausal women were all helped with progesterone cream, and their sexual arousal returned as well as a tiny amount of bioidentical progesterone is metabolized into testosterone, which is known to increase libido in women.

It is clear that Dr. Lee would have done what any anti-aging physician today would do: measure hormone levels and add back the hormones that are missing. In the case of premenopausal women it is mostly progesterone that is missing.

What is better: using a chemical or using a natural hormone?

We need to come to terms with the question: is a chemical like Viagra better for a male to get an erection or natural testosterone?

Viagra and others of that type are drugs that are a foreign substance to the body. There are a significant number of side effects with this medication such as headaches and clotting problems that limit the use for certain patients. Bioidentical testosterone replacement therapy, which can stimulate libido significantly, can often eliminate the need for Viagra type drugs. In the past, with the use of synthetic testosterone, hepatic toxicity and with long-term use the risk of liver cancer existed. Dr. Morgentaler has shown that prostate cancer is not a risk with long-term use of bioidentical testosterone. Also, with synthetic testosterone blood could get thickened (secondary polycythemia), which could cause a stroke. Patients on synthetic testosterone need to be monitored for these side effects accordingly, but not on bioidentical testosterone.

If a male with erectile dysfunction is found to have a low testosterone blood level, this is the cause of erectile dysfunction and therefore treatment consists of bioidentical testosterone replacement therapy, NOT a drug like Viagra. Testosterone is well tolerated with no side effects. Instead the man experiences a profound feeling of wellbeing.

The same reasoning is true for a premenopausal woman with a lack of sexual arousal. If she is deficient in progesterone hormone, she needs bioidentical progesterone cream, not a new drug called flibanserin with a myriad of side effects.

Evidence of efficiency of flibanserin in treating sexual arousal

Evidence based medicine scrutinizes research papers to calculate the numbers of patients to be treated before there is one positive therapeutic effect. A good medical treatment is one where there are only 50 or less patients needed to treat before one therapeutic success occurs.

The observation from the studies on flibanserin was that satisfying sexual events rose from 2.8 to 4.5 times a month. However, women receiving placebo reported also an increase of satisfying sexual events from 2.7 to 3.7 times a month. There was only a difference of 0.8 times per month that a satisfying sexual event occurred compared to the placebo! If the average American couple has sex 2 to 3 times per week (2.5 times per week), this translates to 10 times per month. We just heard that 0.8 times of these 10 times per months a satisfying sexual event occurred on flibanserin. Flibanserin is taken as one tablet at bedtime.

Compared to the placebo group, it would take 12.5 episodes of sex to generate one event of success (satisfying sexual event), which can be attributed to taking flibanserin daily. The NNT (number needed to treat) is 12.5. However, if the number of days of taking tablets is used, it would take 37.5 days of taking flibanserin to create one satisfying sexual event, so the NNT=37.5. Nevertheless, both numbers would still be acceptable as a moderately effective medicine, as they are below 50.

But I think that we have to be much more cautious in this case as the side effects are considerable and an alternative with no side effects and much more effect exists (bioidentical progesterone replacement).

Consumer education needed

Should the patient trust a physician’s prescription? Should the patient put up with side effects like nausea, tiredness, and difficulty falling asleep or staying asleep, a dry mouth, constipation or excessive sleepiness? Should the patient insist to be educated about bioidentical hormone replacement therapy?

From an evidence-based medicine view bioidentical hormone replacement with a number needed to treat (NNT) of 2 to 5 has a much higher efficiency than flibanserin. In other words, many women would experience the satisfying sexual event a lot more commonly, namely after having had sex 2 to 5 times instead of 12.5 times. This is what you expect when a similar hormone environment is provided like in the time when the woman was younger. It is the responsibility of the physician to explain to the premenopausal woman that bioidentical progesterone replacement is a much safer treatment option with no side-effects as progesterone as a hormone from the ovaries has been part of the woman’s  menstrual cycle all along. It is also important for the woman to educate herself about bioidentical hormone replacement and ask questions. Some physicians are of the old conservative school and may refuse this type of approach. In this case it is time to seek out a naturopathic physician.

Treating Lack Of Sexual Arousal

Treating Lack Of Sexual Arousal

Conclusion

Nobody would suggest to treat depression associated with hypothyroidism with antidepressants. Instead the physician treats hypothyroidism with thyroid hormones and the depression disappears.

Similarly, lack of arousal, a symptom associated with premenopausal syndrome is due to progesterone deficiency and should be treated with bioidentical progesterone cream. It does not make sense to treat symptomatically with flibanserin and risk all of the side effects mentioned. It makes more sense to treat the cause (low progesterone) rather than the symptoms. See a naturopath or a physician who understands natural hormone therapy to get the best results.

Mar
26
2016

Heart Attacks Can Kill

We rarely hear that heart attacks can kill; we are more likely to hear that a person was brought to the hospital with a heart attack. The doctors placed a stent or two and the person left the hospital two or three days later, fully recovered.

What silent changes occur before a heart attack?

A heart attack does not happen out of nowhere. There can be one or several risk factors present before, like smoking, a lack of exercise, being overweight or obese from eating too much sugar, consuming sugary drinks and eating lots of starchy foods. This will have changed the cholesterol fractions with the bad LDL cholesterol being high and the good HDL cholesterol being low. Triglycerides in this setting are also usually high. The end result is that the lining of the body’s arteries, including the coronary arteries are thickened to the point where blood has a harder time flowing through the opening of the coronary arteries. One day the heart muscle reports severe pain from a lack of oxygen and nutrients. There are essentially three coronary arteries that supply oxygen and nutrients to the heart muscle. For details follow this link.

Often people have 50% to 60% of coronary artery narrowing, but do not know about this. There are tests available that a person could do to check the amount of hardening of the arteries (for instance the IMT test, see below).

What happens after stent placement?

The interventional cardiologist inserts a catheter from a wrist artery or elbow artery backwards through the aorta and from there into each of the openings of the coronary arteries. By injecting a dye X-rays can be made that show the condition of each of the coronary arteries. If a blockage is identified, this can be overcome through angioplasty, where an instrument is used to pierce through the atheromatous deposits and reopen the coronary artery. To prevent re-stenosing, the cardiologist places a wire mesh stent that opens up upon withdrawal of the instrumentation. The end result is that the previously closed off coronary artery is fully functioning again and the stent keeps the previously narrowed coronary artery open. The cardiologist may have to place two or more stents during the same procedure.

A 5-year follow-up study summarized the outcome after stent placements in 1095 patients with 3-vessel coronary artery disease. Percutaneous coronary intervention, a fancy name for saying “angioplasty combined with stent placement” had a 5-year mortality rate of 14.6%, 9.2% heart attack rates and 24.4% reoccurring blockages requiring repeat procedures to reopen the coronary arteries. There were 3% strokes over 5 years demonstrating that not only heart vessels, but also brain vessels were affected by the hardening of the arteries.

What is heart failure?

You may think that the heart would now be entirely back to normal. But this is a gross simplification. The heart functions like a pump, and we know that pumps can fail. In the past when the heart stopped functioning, the person would die. This was the case because there was a complete irreversible closure of one or more coronary arteries. As a result the muscle of one part of the heart, typically involving the left heart chamber would stop functioning. This part of the heart is supplied by the left anterior descending coronary artery. The left heart chamber is the main pump that pushes blood out into the aorta and from there through the whole body. We need the left anterior descending coronary artery to be open and supply nutrients and oxygen to this vital heart pump all the time. When there is a 70% to 80% narrowing of this artery and the heart is not yet failing, there can be life threatening irregular heartbeats, called ventricular fibrillation from a lack of oxygen. This makes the heart muscle contractions no longer effective, as they are no longer synchronized making the heart muscle beat as one unit. This causes acute pump failure and the patients dies. The other possibility is that the patient has a massive heart attack that kills a large portion of the heart muscle off (called myocardial infarction or heart attack). If the patient is not lucky to have immediate access to a hospital with an interventional cardiologist waiting for him or her, even angioplasty and stent placement will not revive the dead portion of the heart muscle and the patient will not survive.

Using a echocardiography the ejection fraction can be determined. This is a measure of how well your heart empties with each heartbeat. Normally it would be between 50 and 70. Below 50 indicates that heart failure is present.

Patients who had a mild heart attack may only have an ejection fraction of 40 and get short-winded with mild activity. Other reasons for mild heart failure can be atrial fibrillation, a common chronic condition in older patients where the atrial chamber is not contracting properly, but fibrillating. Another cause can be inadequate treatment of high blood pressure, so the heart muscle has a hard time keeping up the blood flow against an abnormally high pressure gradient.

Many patients who had a heart attack and were quickly treated with angioplasty and stent insertion have had some minor persistent damage to the heart muscle resulting in abnormal echocardiograms with lowered ejection fractions. In the past without the acute intervention they would likely not have survived. Now due to modern medical technology these patients did survive, but they are left with a mild degree of heart failure, as a certain portion of their heart muscle has died off.

What kills the patient with a heart attack?

As explained above, when the heart muscle no longer is able to function as a pump, the patient dies. This can come from irregular heartbeats, particularly ventricular fibrillation that does not respond to emergency treatment with a defibrillator. This is an electrical device that resets  The reason can also be a heart attack that kills a significant part of the heart muscle. Ventricular fibrillation often occurs when not enough oxygen reaches the heart muscle and the special nerves that coordinate that heart muscle fibers to contract as one unit. Regular monitoring of the carotid intimal-medial thickness (IMT) by ultrasound will give a fairly accurate test for coronary artery hardening as the two are closely related.

A patient in danger of getting into trouble can be referred to a cardiologist and angioplasty and stent placement can prevent further deterioration for the time being. It is much safer to do these procedures electively rather than during an emergency when the patient is in distress.

Prevention of heart attacks, any volunteers?

Following the overview above it becomes apparent that prevention to not get heart disease is the best approach with regard to hardening of the arteries. This can be achieved by doing the following:

  1. You must abandon the Standard American diet. This means no processed food, no refined sugar intake, avoid as much starchy foods as possible. Adopting a Mediterranean diet or a DASH diet is a first step. The DASH diet was developed to help patients with high blood pressure to reduce their blood pressure through the use of this diet. Reducing blood pressure will also reduce the risk of heart disease.
  2. Avoid excessive alcohol intake (more than two drinks per day for men and more than one drink per day for women) as the toxic effect of alcohol kills heart muscle cells. This in turn leads to heart failure.
  3. Regular physical exercise will condition your lungs and heart and improve your cardiac output. By having bigger reserves the person becomes more resilient to developing a heart attack.
  4. Increasing your fiber intake to 30 to 35 grams per day using vegetables and fruit and additional fiber supplements. Common fiber supplements consist of psyllium husk and/or others from the health food store. Take it in the morning with breakfast and with lunch. By avoiding extra fiber at dinnertime you sleep better at night. It turns out that fiber intake is very important to lower LDL cholesterol and triglycerides by interfering with the enterohepatic pathway that leads to recirculation of bile salts rich in these fatty substances. The net results are lower LDL cholesterol and triglyceride levels and higher HDL cholesterol (the good cholesterol) levels.
  5. Take some vitamins and supplements. Vitamin B2, B6, B12 and methyl folate will support methylation pathways. Vitamin D3 in a good dose like 5000 IU per day or more and vitamin K2, 200 micrograms per day will remove calcium out of the arteries and transport it into the bones; this effectively prevents hardening of the arteries and prevents osteoporosis at the same time. Omega-3 supplements (EPA/DHA) are very useful to keep inflammation under control and delay hardening of the arteries; it helps to lower LDL and increase HDL.
  6. Have your hormones checked. Some doctors do not feel comfortable doing this; maybe you want to see a naturopath about it instead. Your body needs the hormone receptors satisfied by adequate bioidentical hormone levels; otherwise you age prematurely and give up body functions that you would rather keep. Normal hormone levels prevent osteoporosis, premature hardening of the arteries, Alzheimer’s, erectile dysfunction and premature wrinkles. The essential hormones involved in cardiovascular disease prevention are thyroid hormones, sex hormones and in some aging people also human growth hormone.
  7. Once every 2 years it would be good to measure your heart function as is outlined in this blog.
  8. There are many more factors that have been identified by researchers to contribute to hardening of the arteries.  It is useful to read this and think about which of these factors may apply to your case.
Heart Attacks Can Kill

Heart Attacks Can Kill

Conclusion

I have explained that hardening of the arteries is the cause of heart attacks. This is caused by a multitude of factors including sugar and processed food overconsumption, smoking, excessive alcohol intake, obesity, undertreated high blood pressure and diabetes. Simply doing angioplasties and placing stents will not stop the process of what led to the heart attack in the first place. Almost 15% died within 5 years following those procedures and 9% got another heart attack. They did not change their diets and stayed inactive. There is another sad aspect about clogging of coronary arteries: the more coronary artery flow we lose through hardening of the coronary arteries, the lower our ejection fraction of the heart as a pump has become. When we reach the point of less than 50% of ejection fraction, we enter disability country with clinical heart failure, forcing us to wear continuous oxygen masks and being unable to exercise or walk. Heart failure is as deadly as terminal cancer having a very high mortality rate.

Concentrate on prevention now, because heart disease remains the number one killer. Remember that we can largely prevent heart disease when we follow the steps mentioned above!

More info about heart attacks: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/

Mar
19
2016

Book Review: “Healing Gone Wrong – Healing Done Right”, By Ray Schilling, MD

This book entitled “Healing Gone Wrong – Healing Done Right” (Amazon, March 18, 2016) is dealing with the practice of medicine then and now. Medical errors, false diagnoses and wrong treatments are nothing new in the history of medicine. It happened in the past, and it is happening now. My first book dealt with anti-aging and was entitled “A Survivor’s Guide to Successful Aging” (Amazon 2014).

Book overview

Chapter 1 describes that famous people like President Kennedy, Elvis Presley, Churchill, Beethoven or more recently Michael Jackson have something in common: all of them suffered the consequences of blatant medical mistakes. In Beethoven’s time lead containing salves to plug the drainage holes from removing fluid from his abdomen caused lead poisoning. In this chapter I review also how the illnesses of the above-mentioned celebrities were treated, but then ask the question: “What could have been done better to prevent some of the disastrous treatment outcomes?”

Chapter 2 deals with how modern drugs seem to come and go. We learn that twenty-first century medications that are touted as the latest therapeutic agents are having their potentially deadly consequences too: COX-2 inhibitors, the second generation of “improved” arthritis drugs cause strokes and heart attacks! Your doctor may still prescribe some of these dangerous drugs for arthritis now.

Chapter 3 deals with the fact that medical treatments for people’s diseases may be inappropriate when the doctor treats only symptoms, but nothing is done about the causes of their illnesses. This is a scary thought.

Chapter 4 asks the question whether we could learn something from these poor health outcomes in the past, so that we will be able to prevent any disastrous outcomes pertaining to our own health care in the present and future. As we will see, the problem today is still the same as it was in the past, namely that many physicians still like to treat symptoms instead of the underlying cause of an illness. Even though Big Pharma has the seducing concept of a pill for every ill, it is not always in your best interest, when these medications have a slew of side effects. “Gastric reflux” means a mouthful of stomach acid. This is a fact the suffering patient knows already! Big Pharma simply offers the patient with the symptom of gastric reflux a multitude of medications to suppress this symptom. But it is more important to dig deeper to find the reason for the illness and treat the underlying cause.

Chapter 5 concentrates on the brain and how we can keep our brains functioning optimally until a ripe old age. This review spans from prevention of head concussions to avoiding type 3 diabetes (insulin sensitivity from overconsumption of sugar). It manifests itself in Alzheimer’s disease. It is a form of diabetes of the brain that leads to deposits of a gooey substance. Prevention of this condition is also reviewed .

Chapter 6 reviews what we now know about how to keep a healthy heart. Certain ingredients are necessary such as regular exercise, a healthy Mediterranean diet, supplements etc. The good part is that what is good for the heart is also good for the brain. You are preventing two problems (brain and heart disease) at the same time.

Chapter 7 delves into the question why healthy food intake matters. Without the right ingredients of our body fuel, the body machinery will not work properly. The Mediterranean diet is an anti-inflammatory diet that is particularly useful.

Chapter 8 talks about healthy limbs, bones and joints. We are meant to stay active in our eighties and nineties and beyond. No osteoporosis, no joint replacements, no balance problems that result in falls! Learn about how to deal with problems like these in this chapter.

Chapter 9 deals with detoxification. What do we do as we are confronted with pollution, with radiation in the environment and poisons in our daily food? A combination of organic foods, intravenous chelation treatments and taking supplements can help us in that regard.

Chapter 10 deals with reducing the impact of cancer in our lives. A lot of facts have come out in the past 10 years telling us that reduction of sugar and starchy food intake reduces cancer. Curcumin, resveratrol and vitamin D3 supplements also reduce cancer rates as does exercise and stress management. All of this is reviewed here.

Chapter 11 checks out your hormone status. Women need to avoid estrogen dominance; both sexes need to replace the hormones that are missing. By paying attention to your hormonal status and replacing the missing natural hormones with bioidentical ones, most people can add 10 to 15 years of useful, active life!

Chapter 12 is refining some of the thoughts about anti-aging. You will learn about the importance to keep your mitochondrial DNA healthy. Apart from that there are ways how to keep your telomeres longer; certain supplements that are reviewed will help. Also your lifestyle does make a big difference in how old you can turn.

Chapter 13 investigates the limits of supplements. Many supplements are useful, but you do not want to overdo it and get into toxic levels. More is not necessarily better!

Chapter 14 reviews an alternative approach to treating ADHD. Attention deficit and hyperactivity disorder has been over diagnosed, has been neglected and has been over treated with dangerous drugs. An alternative treatment plan is discussed, which includes a combination of therapeutic steps.

Chapter 15 gives you a brief summary of the book.

Kirkus Review

Kirkus Reviews reviewed the book on March 17, 2016: “A retired physician details how various preventative measures can fend off disease and disability in this consumer health guide. Schilling (A Survivor’s Guide to Successful Aging, 2014) had a family medicine practice in Canada for many years before retiring. Although Schilling ventures into some controversial territory in his latest book, it’s generally an engaging, helpful synthesis of ideas that draws on reputable research from the Mayo Clinic and other sources. Overall, it serves as an intensely detailed wake-up call to the importance of preventative health. He largely brings an accessible and even-tempered tone to his narrative, warning readers, for example, that preventative health measures can only aid in “a delay of aging, not ‘eternal living.’ ” A thought-provoking, impassioned plea to be proactive about one’s health.”

Healing Gone Wrong – Healing Done Right

Healing Gone Wrong – Healing Done Right

Conclusion

In this book it becomes evident that it is better to prevent an illness whenever possible rather than to wait for illness to set in and cause disabilities or death. You heard this before: “Prevention is better than a cure” or “an ounce of prevention is better than a pound of cure”. I will give an explanation, based on scientific data that there is indeed evidence to support these notions on a cellular level. The mitochondria, the energy packages within our cells, are the driving force that keep people vibrantly healthy well into their nineties. All this can only happen when the mitochondria function properly. If the mitochondria are poisoned and as a result of toxins malfunction, we are not looking at a person with vibrant health. Instead sixty or seventy year-olds may be confined to a wheelchair. If you want a life without disabilities, a life without major illnesses and enjoy good health to a ripe old age, you are reading the right book.

The book is written in American English.

Available in the US: http://www.amazon.com/gp/product/1523700904

In Canada: https://www.amazon.ca/Healing-Gone-Wrong-Done-Right/dp/1523700904/  

In other countries the book is available through the local Amazon websites.

Feb
06
2016

Effects Of Hormones On The Heart

Since February is heart month, I believe that this is a timely topic to understand how we can protect ourselves from heart disease. During the 23rd Annual World Congress on Anti-Aging Medicine on Dec. 11-13, 2015 in Las Vegas Dr. Ron Rothenberg gave a talk entitled ”Hormones And The Heart”. He stated that he wanted to give an overview of the effects on the endocrine system and on the cardiovascular system, in particular the effect of testosterone and estrogen. Also discussed were the effects of thyroid hormones, growth hormone, vitamin D and melatonin. In the following I will summarize what he explained in detail.

Testosterone treatment in men

He stated that there has been some confusion about the protective effect of testosterone on the heart in men. But Dr. Sharma and colleagues who investigated 83,010 male veterans with documented low testosterone levels clarified this confusion with this large study.

One group was given testosterone replacement therapy, another was not given replacement therapy and one group was given replacement with testosterone, but normalization of testosterone levels was not achieved.

The various groups were followed for between 4.6 years and 6.2 years. The results were astounding: When results between testosterone treated men were compared to non-treated men there was a 56% reduction of all cause mortality, a reduction of heart attacks by 24% and a reduction of strokes by 36%. There was no difference between the non-treated control group and the partially treated testosterone group where the testosterone levels did not come up. It is clear from this that with proper testosterone replacement where testosterone levels are monitored and corrected, significant reductions in strokes and heart attacks can be achieved. The explanation for these findings is simple: both, brain cells and heart cells in males, have testosterone hormone receptors that need to be stimulated for full function.

Hormone replacement in women

This topic has been clouded for many years because of the insistence of the medical profession to use horse derived estrogen (Premarin) and synthetic Provera (instead of bioidentical progesterone). These artificial hormone-like substances were used in the much-discussed Women’s Health Initiative (WHI).

Dr. Rothenberg said about this study that investigators used the wrong estrogen, the wrong progesterone, the wrong route of administration of estrogen (oral estrogen causes inflammation), and the wrong women at age 63 who already had cardiovascular disease and breast cancer.

One important aspect that was learnt by re-interpreting the WHI was that when estrogen replacement was initiated right away when menopause started, the heart attack risk went down by 34%. Estrogen and Provera together reduced the risk only by 28% (Provera being the wrong hormone). Again, the explanation for this findings is simple: women have both estrogen and progesterone receptors in heart and brain cells, which want to be stimulated with the natural hormones. When estrogen is missing, women need bioidentical replacement of what is missing with estradiol transdermal creams. When progesterone is missing, replacement with bioidentical progesterone transdermal cream or with micronized progesterone orally is needed.

Estrogen

With regard to estrogen replacement the KEEPS study has shed a new light on what is going on with hormone replacement in women.

This study was done on 700 women in early menopause. They were treated with 0.45 mg of Premarin (still the wrong hormone) or 50 micrograms of transdermal estradiol (the right active human estrogen). Women also received 200 mg of micronized progesterone (Prometrium, the real human progesterone) for 12 days each month. After 4 years of observation there was no case of breast cancer, uterine cancer, heart attack, transient ischemic attack, stroke, or blood clots in veins between the three groups. Both Premarin and transdermal estrogen had slightly reduced coronary artery calcifications on CT scans compared to the placebo group without hormones. The Premarin group increased the triglyceride and the CRP (a measure of inflammation) levels while the transdermal human estrogen did not do that.

Another study showed that due to the WHI study with the wrong synthetic hormones many women were fearful of starting estrogen replacement. The lack of hormone replacement with nature-identical hormones is responsible for the death of many women, who did not have the beneficial effects. They died of cancer and heart disease.

Dr. Rothenberg explained that this study and others have shown the following:

  1. Bioidentical hormone replacement must be started immediately at or before menopause to have the best results in terms of cardiovascular and neuroprotective (Alzheimer’s) prevention.
  2. Oral estrogen induces inflammation, which causes heart attacks, strokes and venous thromboembolism (blood clots). To prevent this, estradiol must be given as a transdermal cream. This will avoid the first pass effect through the liver, which is the cause for inflammation. Transdermal estradiol does not have the first pass effect. Inflammatory cytokines are implicated in autoimmune processes, initiation of cardiovascular disease, osteoporosis and Alzheimer’s disease.
  3. If estrogen replacement is not done right away with the start of menopause, the estrogen receptor may get damaged, which means that when estrogen replacement is started at a later date, it is no longer effective.

Progesterone

Progesterone is the other female hormone that is often overlooked. It balances the effects of estrogens, but it can also be metabolized into estrogen or testosterone. Tiny amounts of testosterone are necessary for normal libido. Progesterone production from the ovaries is already reduced when the woman is premenopausal and should be replaced by transdermal bioidentical progesterone cream.

Estrogen dominance needs to be treated with transdermal progesterone (or micronized oral progesterone). Both estrogen and progesterone can be accurately determined using a saliva hormone test. Blood tests are accurate for estrogen levels, but not for progesterone levels.

Thyroid replacement

Not infrequently thyroid tests are low (hypothyroidism) and cholesterol levels rise. This can lead to heart attacks and strokes. For instance, a slightly elevated TSH of 5.5 is associated with a total cholesterol level of 209 mg/dL, and a TSH level of 7.0 is associated with a cholesterol level of 270 mg/dL (normal less than 180 mg/dL). It is very important to detect hypothyroidism early and to treat it effectively to prevent cardiovascular disease. The active thyroid hormone is T3. Thyroid replacement has a stabilizing effect on the heart rhythm. It works together with testosterone in men and estrogen in women to stabilize metabolism of all cells, but in particular the heart muscle cells and brain cells. Hypothyroid patients are often depressed, but thyroid replacement lifts the depression. Cognitive deficits in patients with hypothyroidism are also remedied with thyroid treatment.

Growth hormone replacement

Growth hormone (GH) is important in childhood for bone growth and growth of all the organs. But GH still has an important function later in life. GH improves cardiac performance; it does so by thickening the wall of the left heart chamber, the main pump of the heart muscle. GH improves the contractility of the heart muscle, reduces the stress on the heart muscle wall and decreases vascular resistance. In animal experiments it was found that GH plays an important role in remodeling the heart after a heart attack.

GH deficiency occurs with aging; it leads to high LDL (bad) cholesterol and high triglycerides in the blood and increased fibrinogen, which causes blood clots. All of this increases the risk for heart attacks and strokes.

When people age, they lose GH production, which puts them at a considerable risk to get heart attacks and strokes, but they are also at a higher risk of serious falls due to muscle weakness and balance problems. When the doctor detects low IGF-1 levels in the blood and confirms low GH metabolites in a 24-hour urine sample, the time has come to do daily GH injections with human GH. This can be done using a similar pen that is used for insulin injections. The dosage is only between 0.1 mg and 0.3 mg per day, given before bedtime. This is remarkably effective not only for heart attack and stroke prevention, but also to treat muscle weakness, lack of mental clarity and general well being. Patients report that their joint and muscle aches disappear and they can engage in physical activities again.

Melatonin replacement

Melatonin is a hormone that is mostly thought of as the “sleeping hormone”. It is released by the pineal gland and rules overnight giving you a refreshing sleep. In the morning and during the day the light that enters your eyes inactivates it.

Melatonin is a powerful antioxidant, stabilizes the heart’s rhythm (anti-arrhythmic activity), is anti-inflammatory, anti-hypertensive and protects against heart attacks and strokes. People who have heart disease are usually found to have very low blood melatonin levels. Melatonin can be used intravenously in patients who have heart attacks to reduce the amount of damage to the tissue and stabilize the heart rhythm.

Like with GH, the production of melatonin deteriorates significantly beyond the age of 40. Blood levels of melatonin can be easily ordered, and replacement is easy to do. 3 mg of melatonin taken at bedtime will be a sufficient dose for most people. Another 3 mg can be taken, if you wake up in the middle of the night. It will wear off within 3 to 4 hours.

Vitamin D replacement

The history of vitamin D3 is interesting. Vitamin D3, the active form of vitamin D has many actions: it stimulates the immune system and reduces the risk of infection, it reduces blood pressure, it reduces inflammation by reducing circulating cytokines, and it increases insulin sensitivity making insulin receptors more responsive.

Vitamin D3 binds to the vitamin D receptor, which is contained on all cells.

Many middfle-aged and older people are deficient for vitamin D.  A lack of it leads to higher mortality. Vitamin D helps to restore circulation in patients with ischemic heart disease. Vitamin D insufficiency causes high blood pressure, diabetes and metabolic syndrome, enlargement and thickening of the wall of your heart’s main pumping chamber, heart failure and chronic vascular inflammation.

A prospective 7.3-year study looked at the hazard ratios of the Third National Health and Nutrition Examination Survey (NHANES III) and linked mortality files with lower 25-hydroxyvitamin D levels. There were 33,994 persons part of the survey, of whom 1,493 died.

Below 10 ng/ml of 25-hydroxyvitamin D level the mortality was 2.5 fold for all causes and 3.08-fold for cardiovascular causes compared to those with levels of 100 ng/ml or higher.

The recommendation presently is to maintain serum levels at 60-80 ng/ml of 25-hydroxyvitamin D to prevent cardiovascular disease.

Effects Of Hormones On The Heart

Effects Of Hormones On The Heart

Conclusion

The following is important to remember regarding prevention of heart disease.

  1. Never smoke or if you do, quit smoking.
  2. Have your thyroid hormones checked as thyroid hormones are important as an energy source for your heart muscle, and they lower LDL cholesterol levels.
  3. Your sex hormones matter: in men it is testosterone, in women estrogen and progesterone that support your heart.
  4. Vitamin D is not only important when we grow bones as youngsters, but it continues to be important when we are older. It supports our heart and other body functions. It is an essential team player, as it prevents premature deaths. Blood levels of vitamin D are easy to measure.
  5. Two hormones leave us rapidly as we age: melatonin and human growth hormone. However, levels of both hormones can be measured and if low, they can be replaced.
  6. There are only two more things you need to do: eat a Mediterranean type diet and exercise on a regular basis. This will ensure your heart is still healthy in years to come.

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Jan
23
2016

Life Extended By Several Decades

Have you ever thought about the possibility to prolong your “Freshness Date”? At the 23rd Annual World Congress on Anti-Aging Medicine on Dec. 13, 2015 in Las Vegas the endocrinologist, Dr. Thierry Hertoghe from Belgium gave a talk about “How to extend the human lifespan by 40 years”. Dr. Hertoghe explained that it is possible to extend life by paying attention to the factors that prolong life and combining them as an anti-aging type lifestyle. He made a distinction between

  1. normal aging: up to age 82
  2. healthy aging: up to age 100
  3. anti-aging medicine: up to age 122
  4. reversing aging medicine: much more than 122, perhaps to age 150 or more.

Normal aging (up to age 82)

When you live without any interventions your life expectancy on average is about 82 years. From the age of 50 to 60 onwards you may encounter problems with increased cholesterol, high blood pressure leading to heart attacks and strokes. Coronary artery by-pass surgery may extend an individual’s life by 10 to 15 years. But hardening of the arteries in the general circulation will eventually cut down the blood supply to vital organs leading to premature death that could have been avoided.

Around the mid 60’s to mid 70’s 12.4% of African Americans or 2.9% Caucasians get Alzheimer’s disease. These figures worsen rapidly with further aging: in their mid 70’s to mid 80’s 32.5 % of African Americans and 9.8% of Caucasians suffer from Alzheimer’s disease. At the age of 85+ years 54% of African Americans and 27% of Caucasians have Alzheimer’s disease. Particularly with normal aging Alzheimer’s has already increased, and this trend is likely going to continue.

Memory loss also leads to a shortened survival curve; people with memory loss live two years less on average than compared to a group with no memory loss.

Add to this loss of life because of depression, which is common in older age. Compared to a non-depressed group of older people the depressed group lived 30% shorter over a period of two years.

Musculoskeletal pain is reported in younger age (18-44) to be 38%; the next demographic group aged 45-64 reported 61% of musculoskeletal pains; seniors between 65 and 74 had 68% of musculoskeletal pain, and in the demographic group of 75 and up 71% of persons suffered of musculoskeletal pain. As we will learn later there may be hormone deficiencies behind these neck and back pains that, if left alone. lead to falls, fractured hips and premature loss of life. Those who survive accidents will often become wheel chair bound and get admitted to nursing homes.

One specific subgroup of patients with musculoskeletal pain are rheumatoid arthritis sufferers. After 10 years of having rheumatoid arthritis patients will have a survival of only about 50%; if more than 30 joints are involved (more severe form of the disease) only about 40% will survive. In other words, rheumatoid arthritis is an important factor for lowering people’s life expectancy.

At an age of 65 to 74 men have 23% of disabilities, while woman have 27.5% disabilities. This increases between the ages of 75 or older to 40% for men and 44.5% for women. At the age of 65 disabled men have a 3.5% higher death rate than the average population; disabled women’s death rate is 2.5% higher than the normal population. In other words, disability kills.

Urinary urgency and incontinence leads to a 3.13-fold higher mortality rate than a control group of men who do not have these symptoms.

65% of men and 85% of women above the age of 50 have abdominal obesity. This is not just a harmless condition. It is associated with increased triglyceride levels and increased mortality due to cardiovascular disease and diabetes.

By the age of 65-74 heart disease has a frequency of 32% in men and 23% in women. At the age of 75 years and older this jumps to 44% in men and 32% in women. Once heart disease is established, it causes a lot of premature deaths: on average persons with heart disease live 10 years shorter than those who do not have heart disease!

Healthy aging (up to age 100)

If we look at normal aging, we realize that all these diseases and disabilities we discussed are eventually killing us. In order to live longer we have to take steps that are known to interfere with some of these factors. For instance, quitting smoking will prevent heart disease, several cancers and chronic obstructive lung disease (emphysema). Positive thinking, social support and transcendental meditation will increase survival by preventing mental illness and depression, which in turn will prevent suicides. A healthy diet such as the Mediterranean diet or the Pegan diet will avoid cardiovascular disease and cut down cancer rates. One dietary change called the “polymeal” would contain fish, fruit, vegetables, garlic, almonds, a moderate amount of wine and dark chocolate. Compared to the Standard American diet this type of diet would add 9 years for men and 8.1 years for women regarding their life expectancy. For instance, prostate cancer showed a 7-fold increase in a group of men who ate a lot of pickled vegetables, fermented soy products, salted fish and preserved meats, when compared to a control group who did not include these foods. In a group of women who had their meat well done and ate three servings of beef per week, breast cancer risk was 4.62-fold higher that the risk of women who had their meat done rare or medium rare.

Overall cancer and cardiovascular mortality dropped by 35% in a study where 5 or more servings of fruit and vegetables were eaten per day.

A regular exercise program will strengthen the heart and lungs, keep your weight stable, reduce heart attacks and strokes and reduce the probability to develop cancer. A group of men between 61 and 81 were observed over 12 years and divided into those who did not exercise versus those who walked more than 2 miles per day. The exercising men had 19% less mortality compared to the sessile men. Vitamin C from fruit and vegetables or from taking supplements reduces global mortality from all causes by 46% compared to controls that did not. Similarly taking omega-3 fatty acid supplements (fish oil) daily reduced all cause mortality by 20%.

Dr. Hertoghe calls this “healthy aging” and this would allow you to be able to reach an age of about 100 years.

Anti-aging medicine (up to age 122)

Dr. Hertoghe told the audience that further attention to anti-aging factors could reduce mortality even further. In particular, he found over the years that paying attention to correcting hormonal weaknesses would have profound effects on how old a person becomes. Thyroid hormone replacement has been one of the steps that have helped people to experience more energy and less musculoskeletal problems (less muscle pain, less falls, less fractures and complications). This translates into more energy and longer lives.

One slide showed that a low free T3 level (low thyroid) was associated with a 3.6-fold higher death rate. A low free T3 level predicts of cumulative death rate in cardiac patients most accurately.

T3 is also important for the maintenance of the immune system, which shows in patients with tuberculosis: the one-year mortality rate in thyroid deficient patients with low T3 levels was 75%, while patients with a normal thyroid had a mortality from tuberculosis of only 7%.

Secondly, replacing missing sex hormones can add more life because cardiovascular disease is postponed (less heart attacks, less strokes), there is less cancer and better cancer survival, if a person comes down with cancer. Many statistics were quoted.

One interesting slide showed the longitudinal survival follow-up of congenital dwarfs in comparison with their normal brothers or sisters. Untreated male dwarfs turned only 56 years on average, while their unaffected normal brothers turned 75 years on average (19 years longer). With female dwarfs the difference is even more striking: untreated females dwarfs turned 46 years on average, while their normal sisters turned 80 years on average (a difference of 34 years).

Another publication showed that the heart attack risk was 3.8-fold higher in a group of patients with hypopituitarism (under function of the pituitary gland), but the treatment group (treated with GH) had a normal rate of heart attacks.

11606 men aged 40 to 79 years were followed for between 6 and 10 years. The group who had the top 25% range of testosterone had a 19% lower mortality rated from heart attacks or cancer.

Older women, particularly aged 100 in Okinawa had 2.3-fold higher testosterone levels than women in the US at age 70. On the other hand 70-year old Okinawan women had 2.7-fold higher estrogen levels than US women.

Bioidentical hormone replacement therapy (BHRT) prior to developing breast cancer showed a 27% longer survival among 984 breast cancer patients in Sweden compared to those without prior hormone treatment.

In another group of breast cancer patients (2755 patients) aged 35 to 74 who were treated with bioidentical hormone replacement after their breast cancer diagnosis, 50% had a lower recurrence rate (compared to no-BHRT treatment) and there was a reduction of 66% of mortality from breast cancer compared to controls without BHRT treatment. Another study showed that breast cancer patients would have a mortality rate of 33.3% without hormone treatment, 12.5% mortality rate after non-estrogen hormone use and 6% after estrogen/progesterone use.

This shows the healing results of the various natural hormones.

A group of 280 men and women around the age of 50 were treated with anti-aging hormone replacement for 2 or more years. In the beginning there were 34% of women and 15% of men with coronary artery disease. There were also 36.4% of women and 34.1% of men with high blood pressure. After replacing all of the missing hormones with bioidentical hormones for more than 2 years, coronary artery disease had dropped to 1.6% of the women and 1.08% of the men; high blood pressure had dropped to 2% of the women and 3% of the men. No drugs, just hormones! Of course, initially there were drugs used to stabilize their condition, but they could gradually be dropped safely, because the underlying hormone deficiency, which was the cause of cardiovascular disease, had been treated (treating the cause rather than the symptoms).

Dr. Hertoghe presented data of 6.38-year follow-up of 286 consecutive patients using anti-aging medicine (replacement of missing hormones with bioidentical hormones). These patients had an overall cancer rate of 2.1%, which compared very favorably to the 3.2% cancer rate among US women, 3.1% French women and 3.1% Belgium women on no hormones. This is the type of information that is needed following the Women’s Health Initiative (WHI) that scared women into the false belief that hormones would be “poisonous”. In the WHI synthetic hormones were used causing cancer and heart attacks; the reason for this was that synthetic hormones are not the identical shape as the natural hormones. But hormones and hormone receptors have to fit like a key into a lock; otherwise they are not effective or even block the natural life prolonging action of the natural hormone. This is why in the WHI study the outcomes were poor. Using bioidentical hormones heart attacks and strokes are prevented and they are also cancer-protective.

Reversing aging medicine (much more than 122, perhaps to age 150 or more)

General medicine has the goal to make patients as healthy as possible. With reversing aging medicine the goal is to make patients as young as possible so that they are at their healthiest and feel younger again.

With anti-aging medicine using a healthy diet, exercise and bioidentical hormone replacement therapy the patients can add 15 years of good life. Add to these organ transplants, if necessary, telomerase activators and stem cell therapy and you can add another 25 years of life expectancy to a total of 40 years.

Growth hormone deficiency is the one factor that has been underestimated. We have seen in the discussion of dwarfs in comparison to their healthy brothers and sisters that normal growth hormone production can add between 19 and 34 years (average 26.5 years) of life. Dr. Hertoghe has done blood tests (IGF-1) and lately also 24-hour urine metabolite tests of growth hormone on aging patients and found that many are deficient with regard to GH production. These were patients who already had their thyroid hormones replaced, if abnormal and had their sex hormones replaced when they were found to be low. But they lost hair, developed old looking faces with wrinkles, loss of subcutaneous fatty tissue giving the face a hollow appearance. They also had muscle and joint pains and thin skin, particularly over the back of their hands. He replaced their missing GH using daily GH self-injection with a tiny needle (similar to diabetes injections) and within 1.5 to 3 years the wrinkles disappeared, the faces started to look younger and patients did feel younger. Their muscle and joint pains had disappeared and their hair grew back. The dosage range is between 0.1mg and 0.3mg, a tiny amount of GH daily. This is not inexpensive, but some health care plans pay for this, as a lack of GH is a true hormone deficiency.

Often it is a single limiting organ that determines when we die, typically the heart, lungs, brain, liver, kidneys, small bowel, pancreas or bone marrow. Organ transplants can add years of life, but it can be cumbersome to find a suitable donor. Another limitation is, as one study showed, that only 40% to 60% of organ transplants are surviving 8 years after doing the transplant surgery.

Stem cell therapies are other ways to prolong life. More research is needed to perfect this, but essentially 220 different cell types could be derived from stem cells in the future to replace malfunctioning organs.

Life Extended By Several Decades

Life Extended By Several Decades

Conclusion

The dream of staying younger for longer can be a reality today, if you are willing to discipline yourself to watch what you are eating (Mediterranean type diet), exercise regularly and have a positive psychological attitude. If the outdoor air is poor where you live, you may want to consider moving to a place with good air quality. Sleep well for 7 ½ hours every night and retire not later than 10 to 11PM. You need to be asleep between midnight and 3AM as the growth hormone peak occurs at that time. Take supplements that contain longevity micronutrients (magnesium, vitamins A, C, D, E, B6, B12, Co-Q-10, selenium, zinc, iron in premenopausal women etc.). Replace all missing hormones with bioidentical ones, like thyroid hormones (T3 and T4), sex hormones, DHEA and GH. Stem cell therapy and telomerase activators for cell rejuvenation will also have more of a place in the future.

Even, if you do only part of this reversing aging program you will slow down aging.