May
10
2014

The Full Story About Testosterone

Much has been written about what happens when women get into menopause. This begs the question: do men experience a change of life? As a matter of fact, they do. It is called “andropause”, and they can experience problems as a result. Here is a study from the Massachusetts General Hospital in Boston, MA, which was published in the New England Journal of Medicine (Sept. 2013) describing in detail what happens when men get into andropause (the male equivalent of the menopause).

We know from other studies that in obese men testosterone is converted into estrogen because of the enzyme aromatase that converts testosterone into estrogen resulting in erectile dysfunction and loss of sex drive. In lean men above the age of 55 there is a true testosterone reduction because the testicles produce less testosterone. This results in less sex drive, moodiness and lack of energy. But these men will do well with bioidentical testosterone replacement.

Main findings of the Massachusetts General Hospital study:

  1. Testosterone was responsible for thigh muscle development and leg press strength, for erectile function and sexual desire.
  2. Surprisingly, estradiol (the main estrogen component in both sexes) plays a significant part in sexual desire in the male. This became particularly apparent in the post-andropause male who desired hormone replacement. When bioidentical testosterone is used to replace what’s missing there was no problem with sexual desire or erectile function as a small amount of the testosterone was aromatized into estradiol. The researchers were able to measure both testosterone and estradiol levels.
  3. Here is a surprising fact: a lack of estrogen leads to abdominal obesity. This could also be verified by hormone measurements.
  4. In the past doctors used synthetic testosterone products like methyltestosterone, danazol, oxandrolone, testosterone propionate, testosterone cypionate or testosterone enanthate. The problem with these synthetic testosterone products is that the body cannot metabolize a portion of them into estrogen that is desirable for a normal sex drive, so the testosterone compounds alone are not doing their job as well as the bioidentical testosterone that the body can aromatize.

In obese men the problem is that there is too much estrogen in the system, which leads to a disbalance of the hormones in the male with a relative lack of testosterone. Overweight and obese men produce significant amounts of estrogen through aromatase located in the fatty tissue. Aromatase converts testosterone and other male type hormones, called androgens, into estrogen. Excessive levels of estrogen cause breast growth, muscle weakness, lead to abdominal fat accumulation, heart disease and strokes. Dr. Lee described what happens in men who enter andropause years ago as indicated under this link.

The Full Story About Testosterone

The Full Story About Testosterone

Testosterone to estrogen ratio:

Dr. Lee indicated that in his opinion saliva hormone testing is more reliable than blood tests (Ref. 1). One of the advantages of doing saliva hormone tests of estrogen and testosterone is that you can calculate directly the ratios of these two hormones. In hormonally normal younger males the testosterone to estrogen ratio is larger than 20 – 40 (Ref.2). The testosterone to estrogen ratio in obese men is typically less than 20 meaning it is too low. But lean men in andropause produce too little testosterone and their testosterone to estrogen ratio is also less than 20, because they may still have enough estrogen in their system from aromatase in the fatty tissue, but they are lacking testosterone due to a lack of its production in the testicles (Ref. 1 and 2).

When a man in andropause is given bioidentical hormone replacement with a testosterone gel or bioidentical testosterone cream this is absorbed into the blood and body tissues and then partially metabolized into a small amount of estrogen. This can be seen when saliva hormone tests are done; a higher level of testosterone is detected and much lower estrogen level so that the testosterone to estrogen ratio is now 20 to 40 or higher and the affected person will no longer be the “grumpy old man” that had been a source of distress to his partner before.

This New England Journal of Medicine study is important because it confirmed what anti-aging physicians had been saying for years: a small amount of estrogen is necessary for the male for bone health as estrogen receptors will regulate the bone density, it also helps for a normal sex drive. The same is true for women: a small amount of the opposite hormone (testosterone) will help a woman’s sex drive, but she needs the right mix of progesterone to estrogen (a progesterone to estrogen ratio of 200:1 using saliva tests) to feel perfectly normal as a women.

Health and well-being of a man depend on normal testosterone levels:

It is important to realize that testosterone is not only supporting a man’s sex drive and libido, key organs like the heart, the brain and blood vessels contain testosterone receptors as well. The body of a man was designed to respond to testosterone all along. It is when testosterone production is no longer keeping up that premature aging becomes apparent, as the target organs do no longer receive the proper signals.

A healthy heart in a man depends on regular exercise and testosterone stimulation whether he is young, middle aged or old. The same is true for the lining of the arteries where testosterone receptors are present to help with the normal adjustment to exercise and relaxation. The brain cells have receptors for all of the sex hormones and in a man they are used to higher levels of testosterone and lower levels of progesterone and estrogen. If you take the balance away, the aging man will feel miserable and grumpy. Depression will set in. Here is a brief review how one man’s life has been changed by testosterone replacement.

So, bioidentical hormone replacement is not just a matter of replacing one hormone, you need to pay attention to all of the hormones. Lifestyle issues enter the equation as well. I have reviewed the issue of bioidentical hormone replacement for women and men in this blog.

Conclusion:

When a man reaches the age of 55 or older there comes a point where a lack of testosterone and estrogen sets in. It is wise to start doing intermittent blood or saliva hormone tests before this point is reached in order to gage when bioidentical hormone replacement treatment should be given. Along with an assessment regarding the hormone status it would be wise to also assess lifestyle issues as often other factors play a role in premature aging. I have reviewed these factors systematically in a recent publication (Ref. 3). It is best to combine bioidentical hormone replacement with life style interventions to achieve optimal preservation of a man’s health.

More information about male menopause (=andropause): http://nethealthbook.com/hormones/hypogonadism/secondary-hypogonadism/male-menopause/

References:

  1. John R. Lee, MD: “Hormone Balance for men- what your doctor may not tell you about prostate health and natural hormone supplementation”. 2003 by Hormones Etc.
  2. George Gillson, MD, PhD, Tracy Marsden, BSc Pharm: “You’ve Hit Menopause. Now What?” 2004 Rocky Mountain Analytical Corp. Chapter 9: Male Hormone Balance (p.118-148).
  3. Dr.Schilling’s book, March 2014, Amazon.com:“A Survivor’s Guide To Successful Aging: With recipes for 1 week provided by Christina Schilling”.

Last edited Nov. 8, 2014

Dec
07
2013

Slow Down Aging And Prevent Disabilities

You have seen it many times before: a man or a woman retires at age 65; for a while you see them around at social functions; then they are not seen any more and they return in a wheel chair only to die prematurely. You ask yourself: what can I do better to avoid this death trap?

There are several aspects to this equation: first, we would like to slow down the aging process. Part of this is to retain our physical functioning. In the following I am discussing the ingredients that are necessary to achieve the goal of aging in dignity, but avoiding disability.

It starts with a healthy mind set

You need to be optimistic and have a mindset of believing in yourself that you can do it. With a negative attitude, you will manage to find something to complain about, no matter how perfect the day has been. Negative thinking is rampant, and depression tends to be higher in the older population. If you suffer from depression or you had negative events such as accidents or abuse in the past, it is important to do some house cleaning. Do not be hesitant seeking professional help and counseling from a health professional to help you build up your self-esteem.

Regular exercise is important

A regular exercise program helps you to get your day organized. If you think that you are too busy to find the time to exercise, you are sacrificing your wellness and in fact you sabotage your health. It’s time to rethink your lifestyle! The reason you need exercise is to set the automatic pilot on staying healthy and active. If you are accustomed to sitting down in front of the computer or television set for hours, your muscles do not get the exercise they need. Fast-forward several decades and you will be one of those who rely on walkers, wheel chairs and assisted living establishments. Without training your muscles you are more prone to falls and injuries. Your balance organ is not getting the impulses it needs on an ongoing basis to prevent you from falls later in life. People in their 80’s are often stable up to the point where they trip and fall. I have seen many patients like this arrive in an ambulance where I was doing my shift as the emergency physician in a community hospital. When I summarize the fate of all of the people in their 80’s who had falls and broke their hips over the years, 50% of them made it through the surgery and went back home (often with a walker or in a wheel chair) or ended up in a nursing home; the other 50% died from complications of the surgery, often from heart attacks during the surgery or from clots in their pelvic veins or in the leg veins that dislodged and turned into pulmonary emboli. A fracture and in particular a hip fracture in your 80’s is a serious, potentially deadly accident. So, you need strong muscles and joints and you need strong bones. All of this comes free to you from years of regular exercise in your 60’s and 70’s.

Slow Down Aging And Prevent Disabilities

Slow Down Aging And Prevent Disabilities

You guessed right: good nutrition is important!

Eat right and your body will function right. This is where a lot of people are sent on the wrong path due to clever advertising from the Agro Industry, Big Pharma, the American Dietetic Association and the United States Department Of Agriculture. So they preach that wheat and wheat products are good for you, but the lab tests show that it induces hyperinsulinemia and leads to diabetes. The genetic changes of wheat (“accomplished” through forced chemical hybridization in the 1970’s) are responsible for the metabolically very active wheat belly (accumulation of visceral fat) that Ref. 1 has described in detail. But others have researched this topic as well. Ref. 2 for instance confirms that gliadin, the glue in wheat, which allows dough to stick and makes it easy to create bread, bagels and pasta, is responsible for neurological issues like numbness of fingers and feet (peripheral neuropathy), balance problems and cognitive decline all the way to Alzheimer’s disease. If you continue to eat wheat and wheat products (all contained in conveniently packaged “processed” foods), you may very well find that your balance and muscle control will deteriorate by the time you are in your eighties. This condition is not new: one of the lecturers I listened to at McMaster University in Hamilton, Ontario in 1977 referred to those unfortunate individuals who were severely disabled as the “tea and toasters”. The tea in this case was probably the lesser evil, but the wheat induced malabsorption and malnutrition was a reality already in the mid and late 1970’s.

However, if you start eating organic foods to avoid the chemicals and estrogen-like xenoestrogens from pesticides, and you cut out sugar, high-density carbs and wheat products, you will no longer have problems with weight control and you will maintain your muscle, brain and nerve function. This is not what you learn from the regular agencies mentioned at the beginning of this paragraph, but Ref. 1 and 2 will fill you in on the details. Essentially, I follow a Mediterranean diet without sugar, starchy foods and wheat or wheat products. Ref. 2 stressed the importance of enough saturated and healthy fat (omega-3 fatty acid rich oils) in a balanced diet consisting of 20% protein and low carbs. No specific numbers were given regarding the %-age of fat. I would say that a limit of about 25 to 35% for fat would be reasonable except for the Inuit who are used to a fat content in their diet of 80%. The new thinking is that healthy fats are good for your brain and heart. Healthy fats are omega-3 fatty acids (EPA and DHA) derived from fish oil as they are very protective (anti-inflammatory) oils, so is olive oil and coconut oil. These latter two are anti-inflammatory monounsaturated fatty acids. Keep in mind that you want to change the ratio of omega-3 to omega-6 fatty acids (the ratio in this link is cited as omega-6 to omega-3) more in the direction of omega-3 fatty acids, so that the ratio will be between 1:1 and 1:3. Most Americans are exposed to ratios of 1:8 to 1:16 (too many omega-6 fatty acids in fast food and processed foods), which leads to inflammation of the arteries as well. Omega-6 fatty acids, found in safflower oil, sun flower oil, grape seed oil and canola oil are bad for you when not balanced by enough omega-3’s (flax seed oil and fish oil) as they lead to inflammation through the arachidonic acid system in the body. It may be a surprise to you that saturated fats are OK: animal fat like butter, lard, cream, ghee (clarified butter), and other animal fats provided they come from clean (not antibiotic or bovine growth hormone treated) animals. Buy organic and buy organic meats as well such as grass fed beef and bison, chicken and turkey.

Here is an example of what a day would look like nutritionally in terms of a breakfast, lunch and dinner (recipes by Christina Schilling):

Breakfast:  Great Greens Omelet

(2 servings)

1 tablespoon olive oil or coconut oil

3 chopped green onions

3 cups spinach leaves or a mix of greens: kale, spinach, Swiss chard

1 red pepper cut into strips

3 eggs and 3 egg whites

2 tablespoons grated Parmigiano

In non-stick pan sauté green onion, greens and pepper strips in oil, stir eggs and egg whites and pour over the vegetables, sprinkle with Parmigiano. Cook on medium heat, till the egg mixture has started to set. Turn over and briefly let cook. Remove from pan, divide into two portions and sprinkle with a bit of salt (optional). Serve with salsa and guacamole.

Lunch: Oriental Salad

(2 portions)

1 small Sui choy cabbage (Napa cabbage)

2 cups mung bean sprouts

1 small daikon radish, shredded to yield 1 cup

1 red pepper, cut into thin slices

3 green onions, chopped

1 medium sized carrot, cut into matchstick size pieces

1 can sliced water chestnuts, rinsed.

Dressing: 2 tablespoons sesame oil,

2 tablespoons rice vinegar,(light balsamic vinegar works too)

1-tablespoon tamari soy sauce

1 tablespoon Thai sweet chilli sauce

1-teaspoon fresh grated ginger

3 tablespoons chopped fresh cilantro

Prepare all vegetables and put into salad bowl. Stir all dressing ingredients together and pour over vegetable mix. Stir gently, cover and refrigerate. This salad can be consumed immediately or kept refrigerted for a day. To complete the salad with a protein portion add your choice of 6 oz. cooked shrimp or the same quantity of cubed or sliced grilled chicken.

Dinner:  Florentine Chicken

(2 servings)

1 large boneless chicken breast

1 tablespoon of chopped fresh basil-alternatively use 1 teaspoon dried basil.

1 tablespoon grated Parmigiano

4 thin slices prosciutto

1 tablespoon olive oil

2 tomatoes- cut into halves

3 chopped green onions

2 cups baby spinach leaves

pinch of salt

Spread chicken breast flat and top it with the basil, Parmigiano and prosciutto slices. Fold into half an hold the stuffed chicken breast together at the edges with a toothpick or two. Heat olive oil in frying pan, add onion and tomato slices and put the chicken breast on top. Put lid on the pan, and cook at medium heat till the chicken is cooked through. If you test with a fork, the juices will be clear. Remove vegetables and chicken from pan, put on serving plate and keep warm. Remove toothpicks from meat, and cut chicken breast into two portions. Put spinach into pan and let the leaves wilt at medium heat (cover with lid). Put spinach on the side of the chicken and tomatoes, and sprinkle with a bit of salt.

Dessert after dinner: Berry Sorbet

(2 servings)

2 cups of deep frozen berries (strawberries, blueberries or a berry mix, no sugar added)

¾ cup of organic yogourt or goat’s milk yogurt

a few drops of liquid stevia or small amount of powdered stevia-to taste.

Put into blender and process till smooth. You will have to open the blender jar to stir the contents in between. Serve with a dollop of whipped cream,  if desired.

What about the “slow down” of menopause and andropause?

It is a fact that as we age, our hormone glands do not produce as much hormones as when we were in our 20’s and 30’s. But if you find a health care provider who is interested in anti-aging medicine (there are about 26,000 physicians, chiropractors and naturopaths who are members in the A4M), your hormones can be measured accurately from saliva and blood tests. This will tell whether you are hypothyroid, deficient in sex hormones and whether you should be supplemented with the missing hormones in adequate doses through bio-identical hormones. For instance, women are often deficient in progesterone in menopause and men deficient in testosterone. Treatment needs persistence and patience, as it often takes months for the patient to feel better and up to 2 years, to find the exact balance for you where the hormones are re-balanced and your symptoms of tiredness, insomnia, hot flushes etc. disappear. All our body cells have hormone receptors that require stimulation for the cells to function normally. Your health professional needs to pay attention to this and not just treat your symptoms symptomatically. When your hormones are in balance and you take a few supplements, your bones will be strong (no osteoporosis), your brain will be clear, your hearing perfect, and your balance great. You will be much less likely in your eighties to fall and break a bone and your mind will be clear and sharp.

Stress management

As the baby boomers age, they need to be aware of the stress in their lives. You may have been accustomed to having lots of energy when you were in your child rearing years or in your active professional career. Often we do not even notice that there may be stress in our lives. But your adrenal glands know. This is really a subpart of what I said of hormones: they need to be in balance. But cortisol, which is produced in your adrenal glands, is different from the menopause/andropause hormones. Corticotrophin-releasing hormone (CRH) from the hypothalamus and adrenocorticotrophin hormone (ACTH) from the pituitary gland are the rulers of the adrenal glands. And it is how you handle stress when you are in your 40’s, 50’s and 60’s which will determine whether you come down with adrenal fatigue, various degrees of adrenal insufficiency or not. Ref. 3 is a whole book that deals with this topic. Here I like to mention only that the best test to diagnose adrenal problems is a four-point saliva hormone test for cortisol. You connect the four points and get a curve where the cortisol level is expressed as a function of time. If this curve is below the lower normal range, which the laboratory provides for you, you need to be managed by a knowledgeable health care professional in order to build up the reserves of your adrenal glands. Yoga, meditation, deep prayer, self-hypnosis and enough regular sleep are all proven methods to overcome any stress related issues. Sometimes more effort is needed to rebuild the adrenals by specific herbs or porcine adrenal gland cortex extracts. Your health care provider can tell you more regarding this.

Useful supplements

1. On March 17, 2013 I wrote in a blog about prevention of osteoporosis the following summary:

“The best combination is 1000 mg (or 1200 mg as per National Osteoporosis Foundation recommendation) of calcium per day together with 400 to 800 IU of vitamin D3 (for cancer prevention you may want to take 4000 IU to 5000 IU of vitamin D3 per day instead monitored by a 25-hydroxyvitamin D blood level test through your physician) and 100 micrograms of vitamin K2 (also called MK-7). In the age group above 50 missing hormones such as bioidentical testosterone in men and bioidentical progesterone/estrogen combinations in women should be given as well. This works best, if you also watch your weight, cut down your alcohol consumption to a minimum (or better cut alcohol out altogether), exercise regularly (this builds up bone and muscle strength) and stick to a balanced diet resembling a Mediterranean or zone type diet (low-glycemic,  low fat, wheat free and no sugar).” I would add in view of Ref. 1 and 2 that “low fat” should now be replaced by “balanced fat diet”. With this I mean that nuts, almonds, olive oil, unsalted butter are allowed within reason. Lately there have been new insights that some cholesterol is needed for normal hormone production. What needs to be cut out are omega-6 fats and trans fats.

2. Omega-3-fatty acid supplements from molecularly distilled fish oil at a good dosage (3 to 6 capsules a day) will prevent chronic inflammation that often causes arthritis. Chicken cartilage (UC-II) from the health food store will desensitize your system in case you have rheumatoid arthritis or osteoarthritis. This will prevent crippling arthritic disease down the road.

3. Mitochondrial aging (the mitochondria are the energy packages in each body cell) is slowed down by the two supplements ubiquinol (=Co-Q-10, take 400 mg per day) and 20 mg of PQQ (=Pyrroloquinoline quinone). Co-Q-10 repairs DNA damage to your mitochondria and PQQ stimulates your healthy mitochondria to multiply. Between the two supplements you will have more energy.

4. Vitamin C 1000 to 2000 mg per day and a multivitamin supplement help to support the rest of your metabolism. Some may want to add PS (Phosphatylserine) 100 to 200 mg per day, which works together with vitamin D3 for Alzheimer’s prevention.

Conclusion

By now you noticed that nothing comes from ignoring the fact that we are aging. We need to pay attention to our body functions and think about what we can do to make us stronger. In the end we are our own caregivers. When we are in our eighties, we should still be active and our brains should function with a lot more experience than in our past. Our bones will be strong and our balance should prevent us from falling. I do not want to use assisted living and I do not like the confinement of a wheel chair. In the meantime I am going to carry on dancing.

More information on:

1. Fitness: http://nethealthbook.com/health-nutrition-and-fitness/fitness/

2. Nutrition: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/

3. Vitamins, minerals and supplements: http://nethealthbook.com/health-nutrition-and-fitness/nutrition/vitamins-minerals-supplements/

References

1. William Davis, MD: “Wheat Belly. Lose the Wheat, Lose the Weight, and Find Your Path Back to Health”. HarperCollins Publishers LTD., Toronto, Canada, 2011.

2. David Perlmutter, MD: “Grain Brain. The Surprising Truth About Wheat, Carbs, And Sugar-Your Brain’s Silent Killers.” Little, Brown and Company, New York, 2013.

3. James L. Wilson, ND, DC, PhD: “Adrenal Fatigue, the 21sty Century Stress Syndrome – what is it and how you can recover”; Second printing 2002 by Smart Publications, Petaluma, Ca, USA

Last edited Nov. 7, 2014

Oct
19
2013

Healthy Choices Start In Your Brain

You may have seen the CNN heading “Where is self-control in the brain?”  If we want to make any healthy choices in life including sound financial choices, we need a balanced brain that makes the right decisions for us.

Researchers at the Caltech in Pasadena, CA have examined this question in detail using functional MRI scans and found out that there are two loci on the frontal lobe of the brain that control your impulses: the “ventral medial prefrontal cortex” (red in this link) that processes your initial image (like seeing a delicious ice cream cone”) and the “dorsolateral prefrontal cortex”(green in this link), where you decide that this is not healthy for you because it has too much sugar in it. The Caltech researchers found a group of volunteers who were impulsive and made the wrong choice simply based on their taste buds without consideration for their health in general. An equally large group of volunteers was also found who had functional activity in the ventral medial prefrontal cortex and the dorsolateral prefrontal cortex, the latter of which modified the final decision into the healthy choice. The impulsive group made their decision to buy simply with the activation of only the ventral medial prefrontal cortex.

The researchers think that it is this kind of lack of balanced thinking that decides whether we are going to make the right or wrong health choices for ourselves. The sad part is that ultimately, the summation of bad health decisions during life can become the cause of developing dementia, such as Alzheimer’s disease. The good news is that many of the causes of dementia can be avoided, which means that the average person could prevent dementia. I will discuss this in detail here.

Causes of dementia

It is interesting to study patients with various forms of dementia as it is often in the frontal and temporal portions of the brain where brain cells are dying off resulting in impulsive buying, impulsive behavior and lack of recent memory. It is also important to recognize that a number of conditions or factors can cause dementia:

1. Genetic causes

Here is the

There are two types of frontotemporal lobe dementias, a tau-protein positive FTD and a ubiquitin-positive FTD, which has been shown to be due to a deficiency in progranulin. Both of these genetic defects are located on chromosome 17. In Alzheimer’s dementia, which occurs later in life there can be genetic defects at chromosomes 21, 14 or 19. Epigenetic factors like exercise, avoidance of alcohol, and taking omega-3 supplements can even partially prevent or postpone the onset of dementia from genetic causes.

Healthy Choices Start In Your Brain

Healthy Choices Start In Your Brain

2. Toxins like alcohol

Another example of how people can get dementia is through the effect that regular alcohol consumption has on our brains and bodies. This image of an MRI scan shows a normal brain for comparison on the left and  the MRI scan of the brain of a chronic alcoholic on the right.  When a chronic alcoholic has severe atrophy of the brain a psychiatric condition, called Korsakoff’s syndrome can occur. This psychotic condition as a result of the brain having been poisoned by regular alcohol intoxication. Essentially the toxic effect of high daily doses of alcohol have shrunk not only the surface of the brain, but also the deeper substance of the brain. The patient is psychotic, has loss of memory and is unable to care for him/herself.

3. Vascular damage to the brain

Strokes can cause vascular dementia that leads to Alzheimer’s disease-like memory loss. This link points out that diseases like hypertension, obesity, diabetes, atrial fibrillation, ischemic heart disease and dyslipidemia all predispose you to possibly get a stroke with subsequent dementia.

4. Traumatic head injuries

In boxers, football players and combat soldiers brain cells can get lost from repetitive head trauma leading to dementia (in this case it is called “dementia pugilistica”).

5. Infectious dementia

HIV in AIDS patients can affect the brain and cause an HIV-associated dementia. Bacterial meningitis and viral meningitis can kill brain cells and cause a form of dementia as well.

6. Immune disorders

We know that MS can go on to develop dementia as a late complication. In MS there are autoantibodies against myelin, the insulation material that surrounds nerve fibers. An important category of immune disorders is autoimmune disease that can cause dementia. The cardiologist, Dr. William Davis, has presented compelling evidence that wheat allergies can cause dementia, but if detected early and treated by a gluten free diet, this clears up the mind and stops further development of dementia (Ref.1 describes wheat allergies causing dementia; a wheat free diet is described in Ref.2).

7. Hormone deficiencies

A classical example is hypothyroidism, which in the past before thyroid medicine was available, often led to dementia. A simple blood test, TSH (thyroid stimulating hormone) can detect whether or not you are hypothyroid. The A4M recommendation for a normal level is below 2 (not below 5 as often reported by official lab value reports).

8. Lack of vitamins

Thiamine (=vitamin B-1) is often missing in alcoholics. If you are missing vitamin B-6 and vitamin B-12 in your diet, this can predispose you to develop dementia as well. Aging people lose a factor from the gastric mucosa (the intrinsic factor) that is essential to absorb vitamin B-12 in the mall bowel, which predisposes them to develop pernicious anemia and dementia. A simple vitamin B-12 injection can prevent this from happening.

9. Too much sugar consumption

Sugar consumption has skyrocketed in the 1900’s and keeps on going up in the new millennium as well. Here is a review that discusses the possibility that Alzheimer’s can be triggered by overconsumption of sugar. The higher the blood sugar levels in diabetics, the higher the risk for developing Alzheimer’s disease. A study in Seattle has confirmed this. High insulin levels are found in type 2 diabetes; they are responsible for making brain cells stimulate the production of the gooey substance amyloid that causes Alzheimer’s disease. The authors of this study showed this to be true both in humans and in animal models.

10. Lifestyle issues like lack of exercise, excessive weight (obesity, being overweight) and poor diet (fast foods) play an enormous role in terms of causation of dementia in addition to the other factors mentioned. On the other hand organic foods Lack of toxins) and a Mediterranean type diet will preserve your brain cells.

Treatment of dementia

At present treatment of dementia is very limited, as we do not have a complete understanding of dementia at this point. The traditional treatment of dementia outlined here will only marginally delay further deterioration of dementia, but ultimately fail. In my opinion this is because the medical profession has been concentrating on fighting the symptoms of dementia rather than the cause.

Given the list of known causes above, I like to give you 6 recommendations that will help you to prevent Alzheimer’s disease and dementia in general.

  1. I would suggest that you cut sugar out of your diet and replace it with stevia. This also includes dates, grapes, bananas; also wheat and wheat products and starchy foods like pasta, potatoes, rice and bread (see Ref. 1 and 2 for details). The manufacturers of soda drinks, pies and cakes will not be happy about this recommendation, but it will please your brain cells. You will also be surprised how easy it is now to lose weight, which will please you (this also lowers your risk for heart attacks and strokes).
  2. Severely limit your alcohol consumption to less than 1 drink for women and 2 drinks for men per day (better still would be to stay sober) unless you want to become part of the hospital population mentioned in one of the links at the beginning of this blog.
  3. Have your hormones checked, particularly your thyroid hormones, but also estrogen and progesterone levels in women and testosterone in men. Our brain cells have hormone receptors for a reason. They need to be stimulated by our hormones, even in menopause or andropause. Replace the missing sex hormones with bioidentical hormone creams and missing thyroid hormones with thyroid tablets (Armour is the best mix of T3 and T4 thyroid hormones, not Synthroid).
  4. Prevent repetitive brain injuries before it is too late. Rethink whether you really need to box, street fight, play football, rugby or hockey.
  5. Use vitamins for prevention of dementia: The B complex vitamins like B-2, B-6, B-12 (by injection); vitamin D3 has recently been shown to be effective in slowing down Alzheimer’s disease. Vitamin D3 is low in Alzheimer’s patients and vitamin D3 supplements will slow down this disease. Although vitamin C showed equivocal results, it does have some neuroprotective qualities and decreases β-amyloid production and acetyl cholinesterase activity. A Mediterranean-type diet (Ref.2) is also helpful in preventing dementia.
  6. Exercise daily. It will discipline you to stick to the other points mentioned above. It gives you some extra endorphins and will make you feel good about yourself.

Conclusion

Although we do not yet have a complete picture regarding Alzheimer’s disease and dementias, we do know enough to reduce our risk of getting them. When you cut out wheat and wheat products, autoimmune antibodies against your brain cells will not be produced, your opiate receptors in the brain will not be seduced to eat more and more sugar, starchy foods or high fructose corn syrup, so you will have no problem in cutting out high glycemic index foods (Ref.1). This will reduce insulin and reduce IGF-1 growth factors that would have made you vulnerable to produce the gooey amyloid substance that makes you lose your memory. The orbitofrontal part of your brain (particularly the dorsolateral prefrontal cortex) will be reminding you what you read here: healthy lifestyle choices start in your brain.

References

1. William Davis, MD: “Wheat Belly. Lose the Wheat, Lose the Weight, and Find Your Path Back to Health”. HarperCollins Publishers LTD., Toronto, Canada, 2011.

2. William Davis, MD: “Wheat Belly Cookbook. 150 Recipes to Help You Lose the Wheat, Lose the Weight, and Find Your Path Back to Health”. HarperCollins Publishers LTD., Toronto, Canada, 2012.

Last edited Oct. 19, 2013

Sep
21
2013

In Vitro Fertilization As A Last Resort To Get Pregnant

Since its invention in 1978 there have been 5 million babies born through in vitro fertilization (IVF). According to the World Health Organization there are about 120 to 160 million couples worldwide struggling with infertility problems.

Assisted reproduction technology (a fancy name for artificial insemination) has been helped a lot by the breakthrough discovery in the US with regard to ultrasound identification of mature follicles in the ovaries. The second technical breakthrough, another ultrasound method done trans-vaginally to recover eggs from the identified mature follicles, has also helped the IVF technology (Ref.1).

When all of the cases of infertility in the United States are broken down into what causes them, the following was found (Ref. 2):

20% of cases of infertility were caused by anovulation, about 35% were due to abnormal semen production in the male, 30% by pelvic disease (fibroids, tubal blockage, polycystic ovaries), and 15% of cases were unexplained.

Process of artificial insemination

There are a number of steps that have to be followed to be successful with IVF.

a) Hormonal stimulation of the ovaries: The first step in getting eggs from a woman who desires IFV is to stimulate her ovaries to produce several mature follicles. This is achieved with gonadotropins, which are hormones that lead to ovarian overstimulation. Over the years this has been fine tuned with gonadotropin-releasing hormone (GnRH) analogues given first (stimulating release of LH and FSH from the pituitary gland). Subsequently follicle-stimulating hormone (FSH) is given, which causes the ovaries to produce follicles that can be identified on a TV screen using ultrasound technology. When follicle maturity is established with the ultrasound method, human chorionic gonadotropin can be given to trigger ovulation. However, when this is done and combined with artificial insemination through depositing sperm via a catheter into the uterus, the pregnancy rates judged by today’s standards to be too low (in the order of 15 to 20% per cycle).

b) Harvesting of eggs:

Nowadays the 2 or 3 follicles that have been identified as mature by ultrasound are used for follicular aspiration. With transvaginal sonography and a long needle that comes out from the ultrasound probe, the specialist will be able to harvest the mature eggs from the follicular cysts.

c) In vitro fertilization methods:

There are basically two methods for fertilization. First the standard IVF method is simply to add sperm to the eggs in a Petri dish with growth medium. After spontaneous fertilization the eggs undergo cell division. Compared to this standard IVF the success rates have been found to be higher with a newer method, called intracytoplasmic sperm injection (ICSI). In this case a single sperm is injected through a fine needle into the egg. On the 2nd or 3rd day of in vitro culture with either of these methods of fertilization the embryos consist of 6 to 8 cells. The embryos (typically one or two) are now introduced into the uterus of the mother by the specialist.

In Vitro Fertilization As A Last Resort To Get Pregnant

In Vitro Fertilization As A Last Resort To Get Pregnant

Success rates of in vitro fertilization (IVF)

Approximately 10% of all U.S. couples with women of the reproductive age are infertile, approximately more than 7 million women; the incidence of infertility steadily increases in women after the age of 30. Among fertile couples who have sex during the week before ovulation, about 20% achieve a pregnancy.  If regular unprotected sex does not lead to a pregnancy within one year, the couple is considered infertile (that is the medical definition of infertility). With infertile couples using intrauterine insemination there is a pregnancy success rate of about 8 to 9% per cycle. However, IVF has a success rate of 30% per cycle. The chance of a pregnancy after six cycles of IVF is 72% provided the woman is in close contact with the IVF specialist and follows all of the instructions carefully. If the woman does not adhere to the program (this includes some dropouts), the pregnancy rate for IVF is only 51% in 6 months (Ref.2).

In 2010 the Nobel Prize for Physiology and Medicine went to Bob Edwards for his outstanding work on IVF. His work has improved the success rate for pregnancy of infertile couples significantly.

Costs of in vitro fertilization (IVF)

The conventional IVF cost is about 60,000$ to achieve a successful pregnancy; a newer, simplified IVF version costs only 265$, a method which has been developed for development countries. In the simplified version fertility drugs are given as generic tablets. The pregnancy rate for IVF is about 34% in this study from Belgium involving 100 infertile couples so far with the women being under the age of 36.

Gender selection and genetic abnormalities

Gender selection is highly controversial and is not being practiced. However, there are gender specific genetic abnormalities that can be identified in the 2 to 3 day old embryo after a few in vitro cell divisions. If DNA analysis shows an X-linked abnormality, this genetic abnormality would not be implanted into the womb. An embryo with a normal DNA test would be implanted instead (male or female). There are obvious ethical guidelines that have to be followed and these have been in place for a number of years.

The following overview of IVF contains a mini video showing a single sperm injection into an egg (the intracytoplasmic sperm injection method or ICSI). This is the latest in IVF technology, but also the most expensive option.

Complications with in vitro fertilization (IVF)

A review article in the Journal of Obstetrics and Gynecology in March of 2004 (Ref. 3) compared the complications and outcomes of single baby pregnancies (=singletons) that were either conceived normally (control group of 1.9 million spontaneous singletons) or conceived by IVF (12,283 IVF singletons pooled from 15 studies). Compared to normally conceived babies the group of IVF conceived babies had a perinatal mortality rate, which was 2.2-fold higher, the rate of preterm deliveries was 2.0-fold higher, low birth weight was 1.8-fold higher, a very low birth weight was 2.7-fold more common and the classification of “small for gestational age” based on birth weight was 1.6-fold higher. The medical researchers found a number of reasons for this: compared to normally conceived babies, the rate of IVF conceived babies had a higher rate of placenta previa, early preterm delivery, spontaneous preterm delivery, gestational diabetes, preeclampsia, and neonatal intensive care admissions were also significantly more common.

Other observations

If anovulatory cycles are the reason for infertility, clomiphene treatment can often restore regular menstrual cycles, but according to Ref. 2 there is an 8% risk for multiple gestations (twins, triplets) with a higher infant mortality rate.

For women with tubal obstruction IVF is better than attempting to do tubal reconstruction.

Women with unexplained infertility (no cause found despite thorough investigations) are treated by controlled ovarian stimulation as mentioned above and by inserting semen from the husband into the uterine cavity through a small plastic catheter (intrauterine insemination). With this combination pregnancy success rates of 10% per cycle can be achieved and this should be the first approach to cases of unexplained infertility (Ref.2)

Fibroids in the uterus are from estrogen dominance, so are polycystic ovaries. Replacement of missing progesterone with bioidentical progesterone cream will often shrink or melt the fibroids away, cure the ovaries of polycystic disease and restore fertility (this is not taught in medical schools and will not be told to most women attending fertility clinics). There are countless numbers of women attending fertility clinics needlessly; had they only checked their hormone status with saliva hormone tests and corrected the hormone imbalances with bioidentical hormones.

In vitro fertilization with or without ICSI has a pregnancy success rate of 50% per cycle for women less than 30 years of age. Above the age of 30 these numbers are lower and genetic abnormalities are higher necessitating the more expensive ICSI fertilization method. The pregnancy rate is also directly related to how many embryos are transferred into the womb. Usually 1 or 2 embryos are inserted. Twins are not uncommon with IVF.

Conclusion

In 35 years in vitro fertilization has developed into a sophisticated tool that helps women who previously were considered to be permanently infertile to conceive a normal pregnancy. Despite these technical advances we should not lose sight why infertility is such a problem today. Two main factors come to mind: sexually transmitted diseases can scar up the Fallopian tubes making it impossible for the sperm to reach their goal, the fertile egg. Men can also get scarring of their collecting ducts for the sperm (from epididymitis) from Chlamydia and other VD. Secondly, couples are settling into marriage much later in life, often well beyond their 30th birthday. Ideally a woman should have her first pregnancy between 20 and 25, when she is most fertile. If these things don’t fall into place, there is a cost to IVF and there are the associated risks discussed.

More information on infertility: http://nethealthbook.com/womens-health-gynecology-and-obstetrics/infertility-php/

References

1. Adam: Grainger & Allison’s Diagnostic Radiology, 5th ed. © 2008 Churchill Livingstone, CHAPTER 53 – Imaging in Obstetrics and Infertility.

2. Lentz: Comprehensive Gynecology, 6th ed. © 2012 Mosby: Treatment of the causes of infertility.

3. Review article in the Journal of Obstetrics and Gynecology in March of 2004 (March 2004, Volume 103, Issue 3: pages 551-563) examined the complication rates of IVF.

Last edited Nov. 7, 2014

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Aug
10
2013

Bioidentical Hormone Replacement

In many previous blogs I have mentioned that bioidentical hormone replacement prolongs life. Here is a more detailed look at what such hormone replacement looks like for both women and men. Before I get into details I want to stress that I am talking about replacing what is missing and replacing only with natural hormones, not some artificial hormone derivative produced by a drug company. The reason this is immensely important is that hormone receptors in the body are distributed all over our vital organs including bones, blood vessels and the nervous system. If there is no lock and key fit (bio-identical hormone fitting the hormone receptor), there is trouble as the Women’s Health Initiative in 2002 has shown. Unfortunately they had used synthetic hormones for HRT that were not fitting the hormone receptors, and this caused many problems (heart attacks, strokes, osteoporosis, cancer).

Physiology of aging

As we age, we gradually produce fewer hormones in our hormone glands, but the various hormone glands deteriorate in their functions at different rates. Beyond the age of 30 we produce less melatonin and less growth hormone. As a result our sleep pattern may change, as melatonin is necessary for a deep sleep. The decreasing growth hormone production means that we are losing some of our muscle mass and accumulate more fat in the subcutaneous tissues. Our adrenal glands produce less DHEA at the age of 35 to 40, a hormone that is a precursor to our sex hormones in males and females. The gonads (testicles and ovaries) also produce fewer hormones, a process which already starts 5 years before menopause and about 5 years before andropause (the male menopause equivalent).

Typically a woman will get into menopause at the age of 45 to 55 at which time the periods stop and postmenopausal symptoms are interfering with her well-being.  Men get into andropause (the male equivalent of menopause) at the age of 55 to 65 at which time erectile dysfunction occurs and often the individual will become the “grumpy old man”.

Other hormones such as thyroid hormones are also affected by the slow down. Hypothyroidism is common in people above the age of 50.

Bioidentical Hormone Replacement

Bioidentical Hormone Replacement

Baseline laboratory tests

In order to know what is going on, the physician or naturopath needs to order a number of tests to assess whether there is inflammation, how your key hormone levels are; the cardiovascular system markers should also be checked, the liver enzymes and vitamin D3 level. Inflammatory markers are fasting insulin levels and C-reactive protein (CRP). Fasting cholesterol and subfractions (HDL, LDL, VDLP, small LDL) and fasting triglycerides are also measured. Thyroid hormones (T3 and T4, TSH) are measured to rule out over or under function. Typically hypothyroidism is found, which would have to be rectified by taking Armour (a mix of T3 and T4 thyroid hormones).

At this point I need to explain that long time ago the research by Dr. Lee has shown that progesterone hormone levels are notoriously unreliable when blood tests are done. All of the other sex hormones, and cortisol are also not that reliable with blood tests. For this reason the saliva hormone tests have been invented that conveniently report a panel of 5 hormones from one saliva sample: DHEAS (which is the storage form of DHEA), estradiol (the major estrogen in a woman), progesterone, testosterone and cortisol. The saliva hormone tests correlate very well with the actual tissue hormone levels. You can order the saliva tests through Dr. Lee’s website. Another longstanding lab in the US is Dr. David Zava’s lab. In Canada the Rocky Mountain Analytical Lab can process your saliva tests.

Women’s hormone replacement

Let us assume that a woman is getting postmenopausal symptoms and bioidentical hormone replacement is being discussed. The physician will want to first rule out that insulin resistance is not present by ordering a fasting insulin level. If this is normal and the other baseline tests are normal as well except for missing estrogen and progesterone, the physician will usually start to replace progesterone first using a bioidentical hormone cream to be applied once or twice per day. If estrogen levels were also low, the next step in 4 weeks or so is to add Bi-Est, a bioidentical estrogen replacement cream. After 8 weeks of hormone replacement the saliva hormone test is repeated to see whether the estrogen and progesterone levels have come up and also, whether the ratio of progesterone to estrogen is at least 200 or more. Dr. Lee has extensively researched this and found that women with a ratio of less than 200 to 1 (progesterone/estrogen ratio) were more prone to breast cancer. He also stated in this link that there are 3 basic rules with regard to bioidentical hormone replacement:

1. only replace hormones, when they were measured to be low.

2. use only bioidentical hormones (never synthetic hormones) and

3. only replace with low doses of bioidentical hormones to bring hormone levels to physiological levels (body levels that were experienced to be normal before).

Many women who are not replaced in menopause have estrogen dominance meaning that the progesterone/estrogen ratio is less than 200:1, which puts these women at risk of developing breast cancer. Women who are overweight or obese also are estrogen dominant (from estrogen produced in excess through aromatase in the fatty tissue, explained further below), which makes them more prone to breast cancer, uterine cancer and colon cancer. Without bioidentical hormone replacement inflammatory processes take place in the joints (causing arthritis), in the nervous system (causing Alzheimer’s and dementia) and in the blood vessels (causing heart attacks and strokes). Rebalancing your hormones to a youthful state by paying attention to the hormone levels and the hormone ratios mentioned will remove the inflammatory reactions and reduce the risk for cancer.

Men’s hormone replacement

Males enter andropause 10 to 15 years later than women are entering menopause. Typically testosterone production slows down leading to hair loss, erectile dysfunction, loss of muscle mass, osteoporosis and Alzheimer’s/dementia. Blood tests (bioavailable testosterone) or saliva tests are both reliable in determining a deficiency. Replacement with bioidentical hormone creams once per day is the preferred method of treatment. Overweight and obese men produce significant amounts of estrogen through an enzyme localized in fatty tissue, called aromatase.

Aromatase converts testosterone and other male type hormones, called androgens, into estrogen. Estrogen causes breast growth, weakens muscles, and leads to abdominal fat accumulation, heart disease and strokes.

Similar to women, where the progesterone/estrogen ratio is important, there is another ratio for men, called testosterone/estrogen ratio. This should be in the 20 to 40 range for a man to feel good and energetic. Unfortunately many men above the age of 55 have testosterone/estrogen ratios much smaller than 20. This makes them more prone to heart disease and prostate cancer (Ref.1).

However, a male also does need a small amount of estrogen and normal thyroid hormones as well as all of the other hormones for his “hormonal symphony” (mentioned in Ref. 2) to function at his best.

Safety of hormone replacement

There are still otherwise reputable websites that state that bioidentical hormones are not safer than standard synthetic hormones. This confuses the consumer and does not serve the public well. I much prefer the text of the Wikipedia, which is a more thorough review regarding safety of hormone replacement and explains what the issues are.

In the US there is a collective experience of about 25 years on thousands of patients, but there have not been any randomized studies, as Big Pharma that would have the money to finance such studies is not interested in proving that bioidentical drugs would be safer than their distorted synthetic hormone copies that will not fit the body’s hormone receptors. There are some noble exceptions as Big Pharma is producing bioidentical insulin and human growth hormone that had toxicity studies done and showed safety. In Europe bioidentical hormones have been used since the 1960’s, on a larger scale since the 1970’s. So the European experience of safety of bioidentical hormones is presently about 40 to 50 years.

The FDA is contributing to the confusion of the public as can be seen from this publication. One example where the FDA is confusing the consumer, is the progesterone product Prometrium, a bioidentical micronized progesterone capsule that can be taken by mouth. By law the manufacturer had to put a warning label on the package identical to progestin, which is the synthetic, non-bioidentical hormone having been shown to have severe side effects. As is explained in this last publication Prometrium should not have been required to have a warning label in it ; the paper explains what I have already stated above, namely that bioidentical hormones are the safest form of hormone replacement and administered in the right ratios will actually prevent cancer and prevent premature cardiovascular and joint deterioration. In other words, bioidentical hormone replacement can add many years of useful life when started early enough before permanent organ damage sets in from the aging process (which would be due to missing hormones).

Why bother about hormone replacement?

Nature has a plan of “knocking us off” to make room for the next generation. The only way that you can change nature’s plan of killing us prematurely through cardiovascular disease, arthritis, dementia and loss of your sexual life is by bioidentical hormone replacement. Of course you also need the other ingredients of known life prolongers such as healthy (preferably organic) foods, exercise and detoxification. Many women are scared to treat the hormone deficiencies that cause their menopausal symptoms because of the Women’s health Initiative results with synthetic hormones. Men who would benefit from testosterone are often anxious that they may get prostate cancer, when in reality it is the exact opposite: testosterone prevents prostate cancer (Ref.3).

Conclusion

I wrote this blog about bioidentical hormone replacement in order to clarify this often-misunderstood topic. Don’t get confused by the FDA, by highbrow medical websites (such as the likes I mentioned). Big Pharma has a powerful lobby that attempts to keep the medical profession in the belief that their products are better than those that nature has provided (I call it “defend your patent rights”). We are still in a flux state where anybody who tells the truth about hormones gets much criticism. In another few decades it will be an accepted fact and people will wonder why the Women’s Health Initiative was done without a control with bioidentical hormones. With bioidentical hormone replacement you can add about 20 years of youthful life without disabilities to the normal life expectancy. Exercise, detoxification and organic food with avoidance of wheat, starch and sugar can add another 5 to 10 years to your life. The baby boomers are lucky that they have this new tool to prolong life. I wonder whether they will put it to good use.

More information about bioidentical hormone replacement: http://nethealthbook.com/hormones/anti-aging-medicine-women-men/

References:

1. John R. Lee: “Hormone Balance for Men – What your Doctor May Not Tell You About Prostate Health and Natural Hormone Supplementation”, © 2003 by Hormones Etc.

2. Suzanne Somers: “Breakthrough” Eight Steps to Wellness– Life-altering Secrets from Today’s Cutting-edge Doctors”, Crown Publishers, 2008

3. Abraham Morgentaler, MD “Testosterone for Life – Recharge your vitality, sex drive, muscle mass and overall health”, McGraw-Hill, 2008

Last edited Nov. 7, 2014

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Jun
08
2013

Breast Cancer Due To Stress

The medical profession is of the opinion that breast cancer is multi-factorial, where genetics, body weight, hormonal and other factors play a role in causing it (details see Ref. 1). The Wisconsin Longitudinal Study (United States) showed in May 2012 that girls from families of lower socioeconomic status have a higher risk of breast cancer later in life. The study also showed that girls from families with a higher socioeconomic status had a low risk of breast cancer later in life.

The same cohort of women was the subject of another study, which was just published in April of 2013. In this study the question was asked whether stress in career women could cause a higher rate of breast cancer. Using 1957–2011 data showed that 297 of the 3682 White non-Hispanic women of the Wisconsin Longitudinal Study developed breast cancer. Details of the study showed that the peak of the age for breast cancer to develop was around 55 to 65. Women working with the lowest job authority had the lowest rate of breast cancer. High job authority, being the “boss”, was associated with a 1.57-fold (range 1.12 – 2.18-fold) increase in breast cancer. There was also a striking difference between the lengths of job stress exposure, 5 years versus 15 years with both groups, high and low job authority. The lowest risk of breast cancer was for the low stress group of women who worked under these conditions only for 5 years, followed by the same group who had worked there for 15 years. Slightly above that latter group was the breast cancer risk for the 5-year employed high job authority. The highest group of breast cancer risk, rising above all other groups, was the group with high job authority, exposed to this for type of stressful situation for 15 years (see Fig. 1 of the above link). The researchers interpreted their data to say that the majority of the breast cancer risk in these groups of women was due to the stress hormone (cortisol). Minor contributions were thought to be due to the carcinogenic effect of estrogens.

Breast Cancer Due To Stress

Breast Cancer Due To Stress

 

Review of the literature regarding this study

Dr. Lee had been publishing about estrogen dominance for many years (Ref. 2 and 3). When women age, their ovaries do not produce as much progesterone during the luteal phase as in younger years and above the age of 30 to 35 anovulatory cycles are common. During anovulatory cycles ovulation (=release of an egg) does not occur and there is no formation of a corpus luteum that would produce progesterone for 2 weeks. The end result is that there is a lack of progesterone as a woman ages. This has been discussed in detail in Ref. 3. Dr. Lee called this disbalance of estrogen and progesterone “estrogen dominance”. This is one of the important causes of breast cancer as explained in Ref.2. This can be caused by aging, xenoestrogens from exposure to artificial fertilizers, insecticides and cosmetics, but also taking the birth control pill for prolonged periods of time. However, stress by itself can also produce a state of estrogen dominance. Dr. Lee explained (page 180 of Ref. 2) that the cortisol-binding globulin (CBG), which binds both cortisol and progesterone, is a storage form for both of these hormones. As a person is under chronic stress the CBG is increased binding both cortisol and progesterone. This means that less of these hormones are preliminarily available in their free form for body consumption as CBG binding is a storage form for these hormones. The free progesterone, which is the only biologically active progesterone portion, is lowered as a result of stress causing estrogen dominance. If estrogen is not opposed by progesterone, it is cancer causing for breast tissue and the uterine lining, which translates into being at risk for breast and uterine cancer. Only supplementation with bioidentical progesterone cream as described in Ref. 3 will rebalance the hormones (progesterone/estrogen balance) and reduce the cancer risk. The symptoms of estrogen dominance according to Ref. 4 (p. 29) are fatigue, weight gain, less ability to handle stress, headaches, mood swings, loss of sex drive, irregular periods, uterine fibroids, fibrocystic breasts, fluid retention (particularly around the ankles), irritability and depression.

Practical recommendations for women in stressful jobs

Above the age of 35 it is wise to have a saliva hormone test done, checking the levels of 5 hormones (cortisol, DHEAS, estrogen, progesterone and testosterone). This establishes the baseline values for these hormones. The relationship between the levels of these hormones determines whether they are balanced or not. For instance, if the ratio between progesterone and estrogen (divide the level of progesterone by the level of estrogen) is less than 1 in 200 the patient has estrogen dominance (see Ref. 5). You may need to get a naturopathic physician or an A4M physician who is knowledgeable in interpreting these results and treating the patient with bioidentical hormones. Some women may need to start bioidentical hormone replacement at this point if a hormone deficiency is noticed.

In order to counterbalance stress you need to schedule some time for yourself regularly where you can relax, do yoga exercises, meditation, and/or self-hypnosis. Make sure you get enough sleep. Avoid alcohol, if you can as it interferes with a restful sleep, or reduce alcohol to the absolute minimum. Alcohol causes decreased hormone production of both ovaries. It also weakens the adrenal glands contributing to hormone disbalance. Usually the first hormone to show a decline with stress and aging is progesterone. It has to be measured by the saliva test. Ref. 2 and 3 explain why: progesterone is fat-soluble and is transported through the blood in its free form through red blood cells. However, a progesterone blood test measures the serum progesterone level after the red blood cells have been spun down in the centrifuge, which leads to misleading results; only the saliva test gives reliable results in terms of bio-available progesterone levels. Many conservative physicians blindly insist on blood progesterone levels, which will lead to false results. This is why you need a naturopathic physician or A4M physician to help you with the proper interpretation of the test results.

If saliva progesterone levels are low, progesterone cream (bio-identical, as explained below) is applied daily in a concentration that will normalize the levels. Physicians who have been influenced by drug company representatives may suggest to use Provera (or another progestin, which are synthetic hormone substances) as a “supplement”, but this is known from the Women’s’ Health Initiative to cause breast cancer, heart attacks and strokes.

Do the proper monitoring tests with saliva testing and only substitute what is missing with bioidentical hormone creams. Otherwise a low fat, low refined carbohydrate diet, exercise and other good health habits as I have summarized in this link will be very beneficial to prevent stress as a cause of breast cancer. Ref. 6 is also a useful text written for the layperson explaining what to do when stress leads to adrenal fatigue.

References

  1. A review of the causes of breast cancer: http://www.nethealthbook.com/articles/causesofbreastcancer.php
  2. Dr. John R. Lee, David Zava, Ph.D. and Virginia Hopkins: “What your doctor may not tell you about breast cancer”. 2002 Hachette Book Group, New York,NY, USA.
  3. Dr. John R. Lee: “Natural Progesterone”.  2nd edition. Jon Carpenter Publishing, 1999 Charlbury, England.
  4. George Gillson, M.D., Ph.D.: “You’ve hit menopause. Now what? 3 simple steps to restoring hormone balance” 2nd edition, 2004, Rocky Mountain Analytical Corp., Calgary, AB, Canada.
  5.  John R. Lee, M.D. and Virginia Hopkins: “Dr. John Lee’s Hormone Balance Made Simple- The Essential How-to Guide to Symptoms, Dosage, Timing, and More”. Wellness Central Hachette Group USA, New York, NY 10017. Published 2006. Page 57 discusses saliva testing and states: “The healthy ratio of progesterone to estradiol is at least 200 to 1 and can go up to 1,000 to 1 in women using transdermal (delivered through the skin with cream, gels, oils) progesterone.”
  6. James L. Wilson, ND, DC, PhD: “Adrenal Fatigue, the 21sty Century Stress Syndrome – what is it and how you can recover”; Second printing 2002 by Smart Publications, Petaluma, Ca, USA

Last edited Nov. 6, 2014

Jan
03
2013

Thinking Of Health In The New Year

As we start a New Year it is a good time to reflect on our health, what makes us healthy, what keeps us healthy and what makes us age less quickly.
Here are a few thoughts, partially my own, partially influenced by the 20th Anti-aging conference in Las Vegas in December of 2012.

1. We know that cigarettes are no longer in, but in the casinos of Las Vegas and outside of restaurants a lot of people are still smoking! Here is a website that tells you why you should quit.  Cigarettes cause lung cancer, hardening of the arteries, strokes, and often reduce life expectancy by 10 to 15 years. So, if you are smoking do anything to quit this habit! Acupuncture helps, Nicorette assists you in overcoming the addiction part of smoking. Self hypnosis discs are also helpful.

2. Reduce toxins in your life: you may think that toxins consist of lead, mercury and other heavy metals and that only people in certain industries would be exposed to those. Not so. It is in the air we breathe. Your tooth fillings (silver amalgam fillings)may leech out mercury, old paints at home could still expose you to lead, as would fashion jewelry made in China. Various foods contain toxins in them in form of residues from herbicides and insecticides. How do we detoxify? Vitamin C is a good start. It can be taken as a daily vitamin supplement (see below). Detoxification can be done intravenously, if urine and blood tests show high levels of toxins. This is something an anti-aging doctor or a naturopathic doctor can help you with. Glutathione and vitamin C can be given intravenously for chelation treatment with the least side-effects. Here is a link that tells you more about chelation in general.

3. Cut out wheat and other genetically modified foods: What’s the thing about wheat? Read my blog about this.
All of the wheat we get today in bread, cereals, pasta, pizzas etc. has been genetically modified and has about 7 times the gliadin concentration that the original wheat species had before BASF did the chemical modification of  wheat in the 1960’s and 1970’s. Today practically all of the commercial wheat is this type.
As a result I have avoided wheat in my food intake since 2001. When you avoid wheat and sugar, which is another culprit (sugar is simply too strong for your body to handle and leads to hyperinsulinism and diabetes) you will likely loose whatever weight is too much for you without any effort.

Thinking Of Health In The New Year

Thinking Of Health In The New Year

4. Eat only organic food , if you can afford it. Or grow your own vegetables and lettuce in your vegetable garden, if you can. Because of what I said under point 2 above, I stay away from regular vegetables and lettuce that are sold in super markets as they contain residues of round-up (herbicides) and insecticides on them. Organic food nowadays is affordable as enough of us demand it. Even Wal-Mart has some organic foods! Keep an eye on your body weight and aim for a body mass index between 21.5 and 23.0. Several long-term studies have shown that the BMI is worth observing in order to reduce mortality.

The Singapore Chinese Health Study: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0014000

The Buffalo Health Study:  http://aje.oxfordjournals.org/content/146/11/919.full.pdf+html

5. Exercise regularly 5 to 7 times per week. Perhaps one of the most important points is regular exercise. If you engage in ½ hour of vigorous exercise three times per week you will reduce your probability of coming down with a serious illness that could kill you by 15%. If you exercise 5 to 7 days per week for 30 minutes or more this percentage goes up to about 40%. If you exercise 60 minutes 6 to 7 times per week in a gym, you reduce mortality by about 50 to 60%. Here is an interesting graph that shows that older adults benefit more from exercise than younger adults do.

6. Have a yearly check-up including a check-up of your hormone status: As we age, our hormones reduce in a characteristic patterns with melatonin and growth hormone production going on a downhill slope after the age of 30, followed soon by DHEA and cortisol. Often by the time a woman reaches menopause at the age of 35 to 50, there is a lack of estrogens, progesterone, and often also of thyroid hormones. In a man this decline (andropause) may take longer until the age of 55 to 65 before he experiences a lack of energy, erectile dysfunction and muscle weakness from testosterone deficiency. Sex hormones are best measured in saliva samples, the remaining hormones in blood samples. Here is a website that describes the various hormones that often need replacement (note that I am not endorsing this center, just citing it as an example of what to look out for).

7. Replace hormones only with bioidentical hormones: When there is a hormone deficiency, a doctor would usually replace the deficiency with synthetic hormones from Big Pharma. This was good for the profits of the companies, but bad for people as the Women’s Health Initiative has shown.
As a result of this study (showing heart attacks, strokes, breast cancer) a lot of American women and women around the world were unjustly horrified of hormone replacement. However, many trials with bioidentical hormones around the world have proven that bioidentical hormone replacement with hormone creams from compounding pharmacies add years of life expectancy as these hormones restore all body functions back to normal. No breast cancer, no heart attacks and no strokes were noted on these natural hormones. The key is to replace with low doses and slowly under the supervision of a naturopathic physician or anti-aging physician.
Here is a site that explains bioidentical hormone replacement (note that I am not endorsing this center, just citing it as an example of what to look out for).

8. Have hobbies, cherish friendships. Social networking is good for your emotional health. It reduces stress, re-balances your hormones, reduces your risk of heart attacks and strokes.

9. Don‘t neglect your spirituality. Be part of a church community that builds you up, if you are religious. For those who no longer belong to a church group, meditate instead, use yoga, do self hypnosis or read an inspiring book. Music can energize you or contribute to relaxation.

10. Use vitamin and mineral supplements. There are a number of vitamins and minerals that have anti-oxidative effects. They help to detoxify your body and protect you from some of the environmental challenges. I have discussed them elsewhere in more detail under this link.

So, here they are, the 10 steps to a healthier 2013. Review what you are doing in your life . You may need to only modify the one or the other point. Otherwise, if you have identified several points you want to change, just start with the ones you feel can be achieved the easiest first and then gradually tackle the rest. You will be rewarded with more energy and you will probably find it difficult to hide your successes from your friends.

Last updated January 3, 2013

Dec
11
2012

What a Wonderful World

Recently I traveled from Palm Springs to the Caribbean and back and I had to think: what a wonderful world! There were connecting flights and there was waiting at various airports. I had lots of time to watch people and to observe what was happening around me.  Louis Armstrong’s song (1967) “What a Wonderful World“ came to mind. I thought that this would be a fitting title for this Blog. Earlier we had come from Canada escaping the winter. The deep blue sky of Southern California and the sight of palm trees (instead of pine trees) is something that makes our hearts beat faster.

The desert is a special place

The desert is a special place. We had friends join us for a week and we had visited Joshua Tree Park with the grotesque looking rock formations. During the flight it was interesting to see the landscape, as we crossed the desert areas of Arizona and New Mexico, seeing what difference people make when large areas are irrigated and the desert transforms into lush, green areas. It is also very visible, where the desert has taken back the land that no longer is irrigated.

Travel to Dallas Fort Worth and Miami

We came to Dallas Fort Worth and the sky was clear. We traveled on to Miami and the sky was showing signs of pollution, although it was a sunny day. After our take-off from Miami we saw the ocean. I have flown over that region many times before, but this time I detected oil slicks on the surface of the ocean of the Gulf of Mexico, leftovers from previous oil spills. So, the Armstrong song of a “wonderful world” came back to me in a different context. I looked at the landscape and what industries can do to it. Erroneously we had just seen several BP commercials while waiting for our plane at the airport where BP was congratulating itself for the role it plays in cleaning up the environment having spent several billion dollars. But there are still oil slicks…

What a Wonderful World

What a Wonderful World

Watching people on the plane

I looked at the people around me in the plane. More than 35% of them were obese; many of their faces looked sagging and prematurely aged, particularly in women. Males, even middle aged ones looked like they were pregnant (abdominal fat) and often their hair was receding, thinning on top and quite a few were bald. All of the texts I had read about anti-aging medicine came back to me. Too bad that people were eating the wrong foods and obviously did nothing to counter their built-in aging clock from depleting hormones as we age.

Menu of the airline

I looked at the menu of the airline. I won’t mention the name of the airline, but I can assure you that 10 different airlines would have almost the same menus. There would only have been one chicken salad that I could have eaten. In the past I tried to order this and I was told that due to popular demand this item was sold out. Instead they wanted to offer me potato chips, cheese and crackers. My wife and I had anticipated this scenario and we had bought a chicken salad and water before we boarded the plane. We also had packed healthy organic energy bars and a trail mix consisting of nuts and raisins to use as snacks during the trip.

Cutting out starchy foods, eating fresh vegetables and lean meat instead

While travelling we stuck to the same principal of cutting out starches, bread, rice, pasta and only eating fresh vegetables, salads and lean meat (chicken, grass fed beef, ribs, lean pork and veal), which we always do since the fall of 2001.  We also avoid all alcoholic beverages and sugar containing sodas. When we returned to Southern California we were delighted to see that our body compositions when measured with the body composition scales were identical to what they were before the trip.

I think we can all contribute to this wonderful world, if we participate in whatever we can do such as these steps.

End wars

End wars because on the long-term they do not lead anywhere to solve conflicts (in my lifetime I am thinking about the Vietnam war, long-winded Ireland crisis, the Korean war and the German reunification at the end of the Cold War). Right now there is the Middle East conflict, which screams for a peaceful solution. As we are conscious about the devastation that is caused by wars, we have to start with ourselves. We have to resolve our own conflicts that may be present in our own lives. Tolerance, acceptance and forgiveness are the tools.

Address pollution 

Pollution needs to be addressed by the US and all of the world’s countries (including Canada where I live most of the time). This means that anti-pollution devices need to be installed in industrial plants and chimneys. Recycling needs to be done on a larger scale. China and India and other emerging market countries need to be taught how these new anti-pollution measures work. This is an ongoing project, but we need more co-operations between government, industry and countries all around the globe. Also we have to start with our own behavior: we can become more aware of reusing and recycling instead of creating more waste in our landfills.

Become better caretakers of our bodies

What can we do to make us part of this wonderful world? We need to become better caretakers of our bodies. Instead of looking at quantity we must look at quality in choosing  natural food wherever possible. Growing up in Germany after the Second World War in the 1960’s and early 1970’s made me witness that high consumption of fat, sugar and starchy foods (potatoes, pasta and bread) caused people to age prematurely and get heart attacks, strokes, high blood pressure, arthritis, obesity, diabetes and cancer. At that time the “Wirtschaftswunder” (translated into English it means “economic miracle”) had propelled Germany into a nation of  high consumers. During the war they had been poor and often went hungry, they were slim and heart attacks were at an all-time low.

Unhealthy foods and snacks

After the war they made up for times of deprivation and overindulged:  pretzels, buns, bread, butter, French fries, sweets, cakes, cookies, jams, chocolates, pralines-everything was consumed with gusto!  What happened to Germany in the 1960’s and 1970’s is happening again right now in front of our eyes with the obesity wave in the US, Canada and all the other civilized countries around the world. Food companies have been very successful with their advertising through the media. Already kids get hooked to the wrong foods! Hyperinsulinism will ensure that we get hungry every two or three hours. Refined carbs and extra calories are turned into fatty acids by the liver and stored as fat. It shows that we have to resist the wrong food temptation and cut out all refined carbs.

Healthier alternatives

It is healthier to stick to salads and vegetables like broccoli, cauliflower, asparagus, and spinach and eat a small piece of lean meat with it. Have probiotics as plain yoghurt (0% to 2% fat). If you need a sweetener, use a small amount of Stevia, which is a natural sweetener that leaves your body chemistry untouched. Have some fruit as a dessert like blueberries, cherries or strawberries. Eat an apple, the occasional grape. Drink lots of purified water or mineral water.

Buy organic food

Buy ORGANIC food whenever possible. Farmers treat most of the vegetables and fruit with insecticides, which contain residuals in them. When these are ingested, they act like estrogenic substances causing breast cancer in women and prostate cancer in men. The safest in our society is to stick to organic foods. More expensive, but the best insurance against future disease. Question politicians whenever possible to make yourself heard. You want unadulterated food and water. And as I’m writing about water, have a water filter under the kitchen sink with a carbon filter. In addition, it is good to have reverse osmosis to get rid of chloride or fluoride from the city water. This is what you use to cook your food. You may want to take an iodine tablet once or twice a day to counteract the negative effects of chlorine from having a bath or shower (the skin absorbs chlorine). Why? Because chlorine and fluoride can displace the iodine of the thyroid hormones and make you hypothyroid.

Regular exercise

Exercise every day. Nobody gets fit in their muscles from sitting in front of the TV for hours. You also don’t get fit from spending hours and hours of computer work. If you have to, counterbalance this with an exercise program of 1 hour per day. Walk 30 minutes on a treadmill and do 30 minutes of weights or use specific exercise machines in a gym to strengthen your upper and lower extremity muscles.

Replace missing hormones with bioidentical ones

Did I mention hormones? Yes, I did above when I mentioned depleting hormones as we age. We know for some time that each hormone of the body has its own peak in life and then it declines in production as we age. Or should I rather say, we age when these hormones decline? I like the latter way of wording it, because we can measure hormone levels and when one of the hormones is too low, we can replace it with a bio-identical hormone and the person’s energy comes back and whatever function was missing is restored. This is in essence what anti-aging medicine does. Many conservative physicians and clinics do not like to hear this. Big Pharma does not like to hear this when I am talking about replacing hormones in the body with bio-identical hormones. But the patented cheap copies that are mass manufactured and sold at inflated prices are no fit to the hormone receptors in the body and therefore are dangerous. The artificial drugs cause heart attacks, strokes and cancer as the Women’s Health Initiative has shown in 2002.

What people need to do

What did I think the people I watched on the plane should have done? Their physicians should have tested the hormones of many of them. Many of the overweight or obese patients would likely have had high fasting insulin levels. The extra fat does not just sit there; it is a hormone producing factory for inflammatory compounds and estrogen-like substances. This causes heart attacks and strokes in women. It causes prostate cancer and hair loss in males as well as impotence (“erectile dysfunction”). What I said above would help these people that I met. When you lose fat through changes in the diet and when you start an exercise program, the body mass index slowly comes down as fat melts away. The estrogen production comes down, the inflammatory substances abate. The person feels more energetic and may even think straighter. This is when you realize what a wonderful world it is.

Saliva hormone test

One special test is a saliva hormone test that looks at 5 steroid hormones: DHEA-S (storage form of DHEA), testosterone, estradiol, progesterone and cortisol. Every man and every woman needs a certain balance between these hormones and this test should be done when there is a change in energy or appearance (hair loss) somewhere when we are 35 to 40 years. In women it is important that the progesterone level is 200 times fold higher than the estradiol level (progesterone/estradiol ratio) or she is at risk of developing breast cancer and other cancers (ovary, colon etc.). In a man it is important that his testosterone to estradiol ratio is higher than 20 to 1. This protects him from cancer of the prostate or other cancers.

Bioidentical hormone creams

The physician or a knowledgeable naturopath can prescribe whatever hormones are missing. The health care provider needs to be familiar with the use of bio-identical hormone creams. This program can prevent diseases like osteoporosis, diabetes, cancer and arthritis. It also prevents disabilities.

With this I leave 2012 behind and I am looking forward to a new year (2013). I am looking forward to the time when more people can see Louis Armstrong’s vision of a “What a wonderful world”.

More information on:

1. Pollution: https://www.askdrray.com/protecting-yourself-from-environmental-toxins/

2. Obesity: https://www.askdrray.com/stop-obesity/

3. Processed food: https://www.askdrray.com/caution-processed-food-ahead/

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