Jul
01
2007

Waist line reduction scores in health prevention

By | Health, Hormones, Men's Health, Nutrition, Obesity, Prevention

To women waist measurement has always been of importance. Increased waist measurement and weight gain go hand in hand, and a poor fitting garment in the waist usually signals to cut out the junk food. In the past century extremely tiny waists became an unhealthy obsession, till common sense got the upper hand.

In the past males seemed to be unperturbed by a large girth and often ridiculed the opposite sex about their preoccupation with their waist lines. With more knowledge about the intricate play of metabolism increased waist circumference is a signal to health problems. It may be that a simple measuring tape can be one of the most helpful tools to predict a group of health problems in males. While type 2 diabetes, hypertension and high cholesterol and triglycerides are the problems that would first come to mind, there are more, namely coronary artery disease, prostate enlargement, a high prostate-specific antigen level, erectile dysfunction and ejaculatory dysfunction. Dr. Steven Kaplan, professor of urology at Cornell University, New York presented a study at the American Urological Association. Men with moderate to severe urinary tract symptoms were divided into groups based on their waist sizes, 30 to 36 inches, 36 to 40 inches and greater than 40 inches.

Waist line reduction scores in health prevention

Waist line reduction scores in health prevention

Results surprised even the researchers. Metabolic disorders like diabetes showed an incidence of 11.25% in the first group, 22.3 % in the next higher group and 37.8% in the group with waistlines over 40 inches. Erectile dysfunction was seen in 34.6%, 49.5% and 78.6 % respectively. The percentiles for hypertension showed 12.6% in the first group, versus 24.7% and 37.8 %. The researchers stressed that male pelvic dysfunction and the derailment of metabolic function, also known as the “metabolic syndrome” are closely linked.

More information about metabolic syndrome: http://nethealthbook.com/hormones/metabolic-syndrome/

Last edited November 2, 2014

Jan
01
2007

Prevent Type 2 Diabetes With Diet And Moderate Exercise

By | Diabetes, Hormones, Nutrition, Prevention

The almost epidemic proportions of Type 2 diabetes has raised grave concern, but healthcare providers agree that adult onset diabetes is not just a disease that strikes out of the blue. Patient education remains a basic concern, as there are factors that predispose people to the disease. There are known risks for those who are overweight and when inactivity is the main lifestyle. Family history plays a role and ethnic origin can make the patient more vulnerable to the development of diabetes. Population groups at risk are African-Americans, Native Indians, Pacific Islanders, Hispanic-Americans and Asian-Americans. There is a stage which is known as pre-diabetes. The blood glucose level is elevated, but it is not high enough that the condition is labeled as a full-blown diabetes. The good news is that with screening of the blood sugar the first signs of elevation can be detected with a blood sugar monitor at home. This way this condition can be picked up and the progression to diabetes can be avoided with proper diet and exercise.

In a large study of the Diabetes Prevention Program people who lost 7 % of their body weight and exercised 150 minutes per week cut their risk of developing type 2 diabetes by 58%. For patients in the age group over 60 the risk was reduced by 70%.

Prevent Type 2 Diabetes With Diet And Moderate Exercise

Diabetics need exercise and a proper diet

It is important that all persons who are at risk are screened. The laboratory tests involve fasting overnight, after which the fasting glucose levels are checked. A glucose tolerance test is the second test. After overnight fasting the patient receives a glucose-rich drink and blood sugar levels are monitored afterwards to establish how well the glucose is metabolized. These tests are inexpensive and are usually covered by health insurance.

More information about:

1. Diabetes type 2: http://nethealthbook.com/hormones/diabetes/type-2-diabetes/

2. Exercise (fitness): http://nethealthbook.com/health-nutrition-and-fitness/fitness/

Reference: Dec. 25, 2006/January 1, 2007 issue of U.S. News & World Report, page 55

Last edited November 2, 2014

Aug
01
2006

Non-Hormone Alternative Against Hot Flashes

By | Hormones, Women’s Diseases

Hormone replacement therapy has its positive and negative effects, and the proven risk of breast cancer has stopped many women from choosing hormone replacement for menopausal problems. Yet menopausal problems can be a source of suffering and frustration for those women who are affected. Menopausal hot flashes can be bothersome, and if they are severe, frequent and go on for years, women find it difficult to cope with this condition. Even if hormone replacement is not an option because of the risk factors, relief of those symptoms is very much needed. Herbal remedies are often not sufficient. As a result the day to day functioning of the patient is affected and even a restful night is interrupted by sweating.
Dr. Sireesha Reddy from the department of obstetrics and gynecology at the University of Rochester’s school of medicine and dentistry has led a study of 60 postmenopausal women. A medication called gabapentin was used in a randomized study. Three equal groups were observed: the first received gabapentin titrated to 2,400 mg per day. The second group received 0.625 mg per day of estrogen, and the third group was given a placebo. The gabapentin group and the estrogen group achieved similar results, namely a 71% reduction, versus 72% in the estrogen group. The placebo group reported a 54 % reduction of hot flashes.
Dr. Reddy states that gabapentin against hot flashes is a good alternative. It works for patients who only have these particular problems, as it does not address other indications where estrogen is prescribed.

Non-Hormone Alternative Against Hot Flashes

Non-Hormone Alternative Against Hot Flashes

Dr. Reddy also added that it might not be necessary to titrate to 2,400 mg gabapentin per day, because some women metabolize it at a higher rate than others.
Specific side effects such as headaches and dizziness occurred more frequently in the gabapentin group, but they were not statistically significant.

Reference: The Medical Post, July 18, 2006, page 4

Comment on Nov. 13, 2012: This is an example of symptomatic therapy for one symptom, in this case hot flashes, but the trade-off are side effects like headaches and dizziness, which were discussed away because they were “statistically not significant”. Women in menopause have a lack of estrogen and progesterone, which is sensed by the receptors for both of these hormones throughout the woman’s body. The solution is bio-identical hormone replacement with specific hormone measurements as discussed under this link.

Last edited December 6, 2012

Jan
01
2006

Prevent Foot Problems In Diabetics

By | Diabetes, Hormones, Prevention, Skin Disorders

Diabetes has reached epidemic proportions in North America. Two million Canadians (about 20 million in the US) have diabetes, and the number is expected to rise dramatically. At one time or another about 15-20% of patients with diabetes will need hospitalization with a diabetic foot complication. The conditions, which are of concern, are diabetic foot ulcers, severe infection and circulation problems in fingers and feet (peripheral circulation). Health budgets are stretched, as the cost of treating a single foot ulcer has been estimated at $2,183, so the total cost over the lifetime of current diabetics will exceed $650 million (about 6.5 billion $ in the US). Foot ulcers appear like a small item considering the fact that the need for amputation of a lower extremity is the next severe problem that can arise. The average patient who undergoes a below knee amputation will spend 84 days in hospital and another 38 days in rehabilitation.
To prevent the development of foot ulcers, it is important to screen diabetic patients for predisposing factors like the loss of protective sensation in the feet (diabetic neuropathy) as well as structural changes resulting in areas of increased pressure. A study conducted in southwestern Ontario found that only 15% of patients with type 2 diabetes were screened to identify those at risk for foot ulcers. Screening is the first step, after which a podiatrist will have to take over. Footwear prescribed by a podiatrist can be an avenue of prevention, but ongoing podiatric care as well. The small number of diabetic foot screenings shows that podiatric medicine has not been used as a tool to recognize and treat diabetic foot problems.

Prevent Foot Problems In Diabetics

Prevent Foot Problems In Diabetics

The proactive approach of seeking the input of a podiatrist early will translate into significant benefits for the patient with type 2 diabetes.

More information on complications of diabetes:  http://nethealthbook.com/hormones/diabetes/complications-diabetes/

Reference: Parkhurst Exchange, December 2005, page 162

Last edited October 30, 2014

Apr
01
2005

Hormone Replacement Worsens Incontinence

By | Hormones, Prevention, Women’s Diseases

Once hailed as the miracle pill for the aging woman, hormone replacement therapy (HRT) is now being approached with caution. The infamous Women’s Health Initiative study, which first disproved benefits of hormone therapy, first pointed out an increase of breast cancer risk and risk of cardiovascular disease. On re-analysis of the data the Journal of the American Medical Association has published a study in its issue of February 23, 2005, which shows some more reason for caution with HRT. The previous notion that hormone replacement would improve the symptoms of urinary incontinence has turned out to be a fallacy. Dr. Susan Hendrix and her colleagues from Wayne State Untiversity School of Michigan in Detroit analyzed the data from 23,296 women with urinary incontinence. In randomized trials they received either estrogen alone, estrogen with progestin (Prempro) or the placebo effect (“fake pills”). Among those who were continent at the baseline, both, estrogens alone as well as the combination therapy were associated with an increased risk of incontinence at one year. Estrogen (Premarine) alone produced the most marked effect: stress incontinence increased by a factor of 2.15, the combination therapy increase stress incontinence by a factor of 1.87. In addition, women who were already suffering of incontinence, tended to report a worsening of their symptoms after beginning hormone therapy. The Women’s Health Initiative trials were stopped because the treatment risks appeared to outweigh its benefits. These new findings tilt the scales even further against hormone therapy, the authors say in their study.

Hormone Replacement Worsens Incontinence

Hormone Replacement Worsens Incontinence

Reference: National Review of Medicine, Canada, March 15, 2005, page 28

Comments on Nov. 8, 2012: We have to keep these observations in perspective. The authors of that study were using the “regular” Big Pharma manufactured hormone substitutes that the body cannot read. There are no Premarin or Provera receptors in the tissue, only testosterone receptors, estrogen receptors and progesterone receptors. These artificial hormones cannot be metabolized in the woman’s body into testosterone as bio-identical estrogen and progesterone would, because they are structurally different from the bio-identical hormones. The sad truth is that an anti-aging physician could have treated these poor women with incontinence safely by prescribing small amounts of testosterone cream that would have had to be applied to the urethral opening. From there the body would have sent it to the bladder, the bladder sphincter and the testosterone receptors that control these tissues and would have taken care of the incontinence problem.  You do not need a clinical trial. This type of treatment has been used in Europe for decades and has been used in the US for maybe 10 to 15 years as well by some open minded urologists and anti-aging physicians. The heading for this post is only applicable for HRT in the conventional sense (using Big Pharma drugs), but none of this applies to bio-identical hormone replacement for menopause.

More info on bio-identical hormone replacement in menopause: http://nethealthbook.com/hormones/hypogonadism/secondary-hypogonadism/menopause/

Last edited October 28, 2014

Mar
01
2005

Metabolic Syndrome Threatens Mental Functioning

By | Health, Hormones, Mental Health

It used to be called syndrome of hyperinsulinism or syndrome X, but in the meantime the term Metabolic Syndrome stands for a derailment of the metabolism, which manifests itself in excessive weight, type 2 diabetes, high blood pressure and inflammatory processes in the body. The condition, which is largely preventable by healthy lifestyle choices, also paves the way for heart disease, stroke, arthritis and some cancers.
A study from the University of California at San Francisco by Dr. Kristine Yaffe points to yet another health problem that results from the metabolic syndrome and which mars the “golden years” of a large number of seniors: lack of cognitive function, short term memory loss, and forms of dementia.
The study was based on 2632 participants with an average age of 74 years. The likelihood to develop cognitive impairment was 20% higher in those participants of the study who had metabolic syndrome. Things were getting worse, if patients had metabolic syndrome and laboratory tests showed high inflammation with elevated blood levels of interleukin 6 and the C- reactive protein test: the likelihood to develop cognitive impairment rose to 66%.

Metabolic Syndrome Threatens Mental Functioning

Metabolic Syndrome Threatens Mental Functioning

So much for the bad news. The good news, however, is that lifestyle can be a powerful armor in the prevention of disability and disease.

Reference: The Medical Post, January 25,2005, page 45

Last edited October 27, 2014

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Dec
01
2004

Birth Control Pill Lowers Sex Drive

By | Health, Hormones, Women’s Diseases

Sexual dysfunction is often left untreated, as the topic may not be discussed at the doctor’s office. It can also be difficult to treat, since there can be physical or psychological reasons or a combination of both.

Studies by California researchers now show, that patients who were taking oral contraceptives (birth control pills) and stopped the pill show an increase of sexual function, more energy and fewer problems. Dr. Susan Sarajari from the Los Angeles Medical Center conducted this study and presented the results: About 15 % of women who take the birth control pill experience symptoms of sexual dysfunction from low libido, to low sexual arousal and vaginal dryness. Four weeks after discontinuing oral contraceptives, there was significant improvement. There was also a correlation between laboratory tests, which showed an increase in free testosterone after the pill had been discontinued. These findings are not entirely surprising, as it has been known for some time that androgens, or more specifically testosterone, increases sexual function in women.

In the past hormonal contraception has been overlooked as a culprit in sexual dysfunction. This study will likely serve as a wake-up call.

Birth Control Pill Lowers Sex Drive

Birth Control Pill Lowers Sex Drive

 

More info on BCP: http://nethealthbook.com/womens-health-gynecology-and-obstetrics/birth-control-options/contraception-birth-control-pill/

Reference: The Medical Post, November 9, 2004, page30

Last edited October 27, 2014

Aug
01
2004

Birth Control Pill Increases Strokes And Heart Attacks

By | Heart Disease, Hormones, Stroke, Women’s Diseases

At the recent 86th Annual Meeting of the Endocrine Society in New Orleans/Louisiana a Canadian delegation presented data from a meta-analysis of 14 trials regarding side effects of the birth control pill (BCP) when taken on a prolonged basis. The researchers were interested to know the risk of heart attacks or strokes that would be associated with the prolonged use of the low dose estrogen BCP. All of the studies between 1980 and October of 2002 were examined and 14 independent studies qualified for the meta-analysis. The strength of such a meta-analysis lies in the pooling of data and the fact that the data is derived from a much larger patient population, which generally makes the results more reliable. Dr. J. Baillargeon from the Centre Hospitalier Universitaire in Sherbrooke, Quebec/Canada, stated that they found a 1.85-fold risk for developing heart attacks with longterm use of the BCP and at the same time there was a risk of 2.54-fold of hemorrhagic strokes with longterm use of the low-dose BCP.

I have depicted these findings below in graph form where the risk is readily seen when compared to women who did not use any birth control pills. In discussions following this presentation the authors explained that with short-term use of the BCP using the modern low dose formulations heart attacks and strokes would likely not be noticeable.

Birth Control Pill Increases Strokes And Heart Attacks

Birth Control Pill Increases Strokes And Heart Attacks

But women should know that long-term use does have this risk. These decisions of whether to take the BCP and for how long needs to be discussed with the treating physician also in the view that other risks such as high blood pressure, diabetes or the metabolic syndrome would be added risks where heart attacks and strokes can occur more frequently. In these conditions the BCP likely should be avoided.

Risk of Developing Heart Attack or Stroke after Longterm Use of The Birth Control Pill
 Birth Control Pill Increases Strokes And Heart Attacks1

 

 

 

 

 

 

 

 

 

Dr. Ricardo Azziz, chairman of obstetrics and gynecology at the Cedars-Sinai Medical Centre in Los Angeles, California, stated that these findings from this meta-analysis would be very important because it was based on such a large data base and was measuring the effect of the BCP over a long period of time. He stressed that the benefits of any medication must always be weighed against the risks by the treating physician. In diabetic patients on the BCP, for instance, the benefits likely outweigh the risks as the metabolism is stabilized through an improved insulin sensitivity, improved managability of the diabetes and avoidance of the high risk pregnancies in diabetics.

More info on:

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

Strokes: http://nethealthbook.com/cardiovascular-disease/stroke-and-brain-aneurysm/

Reference: The Medical Post, Vol.40, July 20, 2004, page 20

Comments on Nov. 6, 2012: What was not discussed by these experts is the fact that the BCP contains a mix of two artificial hormones (estrogen and progesterone equivalents) that the body’s estrogen and progesterone hormone receptors cannot recognize. Bio-identical estrogen and progesterone creams on the other hand would be recognized by these receptors, but nobody has researched their use for BCP purposes, only for post-menopausal hormone replacement.

Last edited Oct. 26, 2014

Aug
01
2004

Too Much Fat Fuels Metabolic Syndrome

By | Heart Disease, High Blood Pressure, Hormones, Nutrition, Obesity

In a review article for physicians from the St. Michael’s Hospital of the University of Toronto (see reference below) Dr. Monge outlined some of the newer human research where links were found between the lining of the blood vessels and the hormones produced by fat cells that lead to the complications of the metabolic syndrome. In obese people there is a cluster of conditions such as high blood pressure, high blood sugar, high cholesterol, lipid abnormalities and high insulin levels, which is known as “metabolic syndrome”. Another name that was used for this condition in the 1990’s was “syndrome of insulin resistance”.

Dr. Monge pointed out that blood vessel health depends on the fine balance between two opposing forces. On the one hand there is a system that leads to blood vessel spasm, blood clotting, growth promoting, inflammation causing and oxidizing. On the other hand there is a system that is responsible for blood vessel relaxation, growth inhibition, blood clot dissolving, inhibiting inflammation and antioxidant activity. Complex changes occur in our metabolism when we put on pounds and accumulate too much fat. It is important to realize that fat is not just sitting there, but is composed of highly active fat cells that respond to insulin and growth factors and in turn produce a number of hormones and factors that affect the cells that are lining the blood vessels. Inflammatory cytokines are produced by fat cells that attack the blood vessels by producing atheromatous plaques, causing them to accumulate fat again and help in the processes that lead to rupture of the plaques.

Too Much Fat Fuels Metabolic Syndrome

Too Much Fat Fuels Metabolic Syndrome

The end result is that the deadly interplay between the fat cells and the endothelial cells lining the blood vessels tips the balance between the two systems mentioned above to the point where heart attacks and strokes suddenly occur.

There are two complex pathways that are involved in this process and that are linked to what was stated above. One crucial aspect of this involves nitric oxide, a small molecule that is normally produced by the endothelial lining cells and that is needed for normal circulation of the heart muscle, skeletal muscles and internal organs. This protective system is where much of the derangement of normal metabolism occurs with regard to the metabolic syndrome.

Dr. Monge pointed out that with these newer insights into the complex metabolic changes associated with the metabolic syndrome in obese people, there will be very practical results in the near future. Anti-inflammatory medications are already being utilized and some of the anti-diabetic medications have been shown to reduce the risk of heart attacks. It is hoped that sensitive tests will be developed to measure the hidden endothelial dysfunction at a time when preventative steps are still effective or early intervention can be done.

More info on the metabolic syndrome: http://nethealthbook.com/hormones/metabolic-syndrome/

Reference: Metabolic Syndrome Rounds (April 2004): J.C. Monge “Endothelial Dysfunction and the metabolic syndrome”

Last edited Oct. 26, 2014

Feb
01
2004

Kidney Disease, Another Complication Of Metabolic Syndrome

By | Hormones, Nutrition, Obesity, Prevention

The metabolic syndrome is a new disease entity that is known to be associated with obesity. In order to make the diagnosis of metabolic syndrome at least 3 of the 5 components listed in the table under this link (hypertension, hypertriglyceridemia, low high-density lipoprotein cholesterol level or LDL cholesterol, high glucose level, abdominal obesity) have to be present.

Dr. Jing Chen and colleagues of Tulane University School of Medicine in New Orleans, La., published an analysis of the Third National Health and Nutrition Examination Survey in the Feb.3, 2004 edition of the Annals of Medicine. Patients with chronic kidney disease were identified in this study where 3, 4 or 5 of the metabolic syndrome criteria were positive. Two criteria for chronic kidney disease were measured:

1. if there was a significant reduction of the filtration capacity of the kidney.

2. if there was critical leakage of blood protein into the urine.

Kidney Disease, Another Complication Of Metabolic Syndrome

Kidney Disease, Another Complication Of Metabolic Syndrome

Depending on how advanced the metabolic syndrome was (all 5 criteria of metabolic syndrome positive versus only 3 or 4) there was a higher or lower risk of developing chronic kidney disease.

I have depicted the results of this study in bar graph form here. It shows clearly that chronic kidney damage occurs in a dose-response curve pattern depending on how severe the degree of the metabolic syndrome is.

Risk of developing kidney disease with various degrees of severity of the metabolic syndrome
 Kidney Disease, Another Complication Of Metabolic Syndrome1

With 5 factors of the metabolic syndrome present the risk to develop reduction in filtration capacity of the kidneys is almost 6-fold. This is 3-fold higher than in a person with a milder degree of metabolic syndrome where only two factors are present. Such a person would only have a 2-fold risk for developing chronic kidney damage (dark blue shaded bars in graph). A dipstick urine test can measure protein in urine, which is an alternative way to measure kidney damage due to the metabolic syndrome. These values followed a very similar dose-response curve (light blue shaded bars in graph). The authors of this study believe that the kidney damage inflicted by the metabolic syndrome is different from that caused by high blood pressure or by diabetes. Future studies will have to establish whether this type of kidney damage can be repaired by treating the metabolic syndrome with a low glycemic, calorie restricted diet coupled with exercise.

Based on an article published in: Ann Intern Med 2004:140:167-174.

Last edited December 8, 2012