Aug
17
2013

Postpartum Depression

By | Mental Health, Prevention, Women’s Diseases

Recently there has been a lot of publicity around the topic of postpartum depression (PPD). Typically the reports originate from a case where depression led to catastrophic consequences. It is sad that it often takes a tragedy before a problem like this is publicly more acknowledged. But sadly reports are often one-sided and are missing vital information about pre-existing risk factors. The family doctor often misses the diagnosis of postpartum depression. There is often denial on behalf of the mother and family. The mother is getting no support from support groups, even though there are such groups.

Swift treatment often not given

And swift treatment that would be available is often not given. The results are finally making headlines. Once a mother is desperate and deeply depressed (“psychotic depression”) she is capable of killing the baby, herself and others who are close. PPD affects 15% of mothers (Ref.1); a small percentage of them may have postpartum psychosis, which is the most severe form of PPD.

Risk factors for postpartum depression

Ref. 1 reviews  several risk factors that can lead to postpartum depression. For instance, a history of a major depressive episode or anxiety attack during the pregnancy predisposes a young mother to develop PPD. However, there may also have been a history of dysphoria (intense feeling of discontent) before her periods in the past; stressful events during the pregnancy or right after birth. Often there is poor social support or a marital conflict. Other factors are low income, young maternal age or immigrant status with deprivation. A lack of support from the partner can also be a major factor.

Up to 85% of women experience postpartum blues within the first 10 days after the delivery of the baby. Symptoms such as mood swings, fatigue, confusion, tearfulness, mild elation and irritability are common during these initial days following her delivery.

Progesterone levels decreased up to 3 months

Researchers found a decrease in progesterone levels following delivery for at least one month, sometimes up to 3 months. This leads to sleep problems (insomnia), which coupled with the baby crying in the middle of the night causes more sleep disruption. Electroencephalography studies documented abnormal brain wave patterns in women following the birth of a child.

Only 1 in 500 mothers after birth develop what physicians call “postpartum psychosis”, which is a recognized psychiatric emergency.  The symptoms here are extreme mood swings with confusion, poor judgment, disordered thoughts (“delusions”), paranoia (where they think that someone is after them or it is the baby’s fault that they feel that way).

Erratic behavior and impaired functioning

Erratic behavior and impaired functioning are also part of this symptom complex. It is this state that needs to be monitored in a psychiatric unit as it is associated with a high suicide and homicide rate. A psychiatrist with experience in treating PPD needs to treat the patient.

Urbanization leads to a lack of support, which is particularly devastating to new mothers who need all the support they can get. This is reflected in a higher percentage of PPD in urban areas versus the percentage of PPD in more rural areas where there is more family support.

 

Postpartum Depression

Postpartum Depression

Hormone changes with postpartum depression

Some people do not understand why a woman who just had a baby would not be happy and content. Most women are. However, the stress from the pregnancy and from childbearing can be too much on her system. There can be a point where the hormones no longer are in balance and the young mother loses her coping mechanisms.

Serotonin concentrations in the brain of women during pregnancy are at a higher level due to higher estrogen levels that slow down the degradation of serotonin. Serotonin is the brain hormone that makes you feel good. Estrogens and progesterone are very high during the pregnancy, but this changes right after the baby’s delivery and during the time of recovery in the first few days and weeks. Studies showed that there was a 15% higher thyroid autoantibody rate in postpartum depression patients in comparison to controls without depression.

Patients with higher thyroid autoantibody rates respond to thyroid

Patients with thyroid autoantibodies associated weakly with postpartum depression and responded favorably to thyroid replacement therapy. Progesterone levels were much lower in patients with depression and in patients without depression following delivery. The reason for this likely is the fact that with the delivery the placental source of natural progesterone disappeared. Researchers replaced progesterone in a group of patients, but they die not observe any significant improvement of PPD. However, they did not explain whether the progesterone replacement involved bioidentical hormones or synthetic hormones.

Dr. Michael Platt described a case of a postpartum woman who was hypothyroid as well (Ref.2). She responded to hormone replacement with thyroid hormones and progesterone by shedding 60 pounds (she always had a weight problem) over 10 months changing from a size 20 to a size 4. She was able to wean herself off the anti-depressants.

Breast feeding women on bioidentical progesterone

In breast feeding women this could be a significant difference as women on bioidentical progesterone can breast feed and will positively influence their breast-fed child’s brain development (brain cells have a lot of progesterone receptors, which are stimulated by progesterone).

A recent Canadian study involving pregnant women and women after delivery of their babies showed that there was a significant drop of progesterone levels in saliva samples for several weeks, particularly with breast feeding. The authors explained that the lack of ovulation with a lack of progesterone synthesis in the ovaries was responsible for this. It takes several weeks for most women to regain regular menstrual cycles. It would follow from this that there is room for bioidentical progesterone replacement in the first few months of the postpartum period until the ovaries have resumed their normal cyclical hormone activity.

Conventional treatment for postpartum depression

With baby blues the symptoms are much less severe (in comparison to PPD) and are starting 2 to 3 days after childbirth, resolving spontaneously within 10 days after delivery. PPD occurs within 3 months following delivery and responds to treatment with antidepressants and psychotherapy such as cognitive behavioral therapy.  Breast feeding needs to be stopped, as it is known that metabolites of the antidepressants end up in breast milk. Typically, a less toxic antidepressant is used like paroxetine (Paxil), otherwise citalopram (Celexa), and fluoxetine (Prozac). In the rare cases where PPD is so severe that psychotic symptoms are present (postpartum psychosis) hospitalization is mandatory (Ref.3). Some of these cases may require electroconvulsive therapy (ECT) and/or lithium treatment for mood stabilization. Thyroid hormone therapy has also shown a beneficial effect in treating antidepressant-resistant cases of PPD (Ref.4).

Alternative treatment of postpartum depression

Although review texts of the treatment of PPD mention that estrogen replacement in postnatal women with PPD was beneficial, there is a warning that this could cause blood clots and anticoagulant measures would have to be combined with this to prevent deep vein thrombosis. Researchers suggested progesterone replacement, which is a treatment modality where blood clots are no danger. However, there are no formal trials yet, so most medical professionals ignore this suggestion. Here is forum of women who have taken postpartum progesterone with positive effects.

Dr. Katherina Dalton published a trial involving 30 PPD patients with a positive response rate of 95% when treated with natural progesterone.

Bioidentical progesterone treatment reduces symptoms of postpartum depression

Before treatment patients were suffering from an average of 7.57 symptoms, after the treatment only 2.1 symptoms remained. (Figures with details regarding this study under the above link).

There are many descriptive observations without controls like this where natural progesterone creams are part of a holistic approach to treating PPD. Dr. Mercola describes here how useful natural progesterone therapy can be. He also cautions that the woman should take bioidentical progesterone cyclically to mimic nature’s biorhythm to allow progesterone receptors to recover in between treatments.

There are many websites that have useful information about natural progesterone cream treatment for PPD, such as this.

Conclusion

It is common sense that a woman may need natural progesterone following a delivery. She just gave birth to her placenta, which was a virtual progesterone factory. It  protected her body and the baby’s brain all throughout the pregnancy. If women decided to use natural progesterone for 3 to 6 months, this would make a big difference.  The majority of women would not experience the baby blues or PPD. Eventually regular menstrual cycles return, the patient’s own ovarian progesterone production resumes and there no longer is a need for progesterone cream until after the birth of the next child or at the arrival of menopause. Medicine is full of examples where common sense was applied for effective treatment options despite missing randomized studies.

Natural progesterone treatment of PPD

Natural progesterone treatment of PPD is one such example. Physicians used bioidentical progesterone intuitively, but it worked in many patients. The progesterone receptors do not distinguish whether or not researchers did a clinical trial. But they do not like the synthetic versions of progesterone, as they block the receptors leading to progesterone deficiency.  The physician can combine natural progesterone treatment with traditional treatments of PPD.

More information on postpartum depression: http://nethealthbook.com/mental-illness-mental-disorders/mood-disorders/postpartum-depression/

References

1.Teri Pearlstein, MD, Margaret Howard, PhD, Amy Salisbury, PhD and Caron Zlotnick, PhD: “Postpartum depression” : American Journal of Obstetrics and Gynecology – Volume 200, Issue 4 (April 2009)

2. Dr. Michael E. Platt: The Miracle of Bio-Identical Hormones; 2nd edition, © 2007 Clancy Lane Publishing, Rancho Mirage, Ca/USA (p.53-55).

3. Bope & Kellerman: Conn’s Current Therapy 2013, 1st ed.© 2012 Saunders

4. Jacobson: Psychiatric Secrets, 2nd ed. © 2001 Hanley and Belfus

Aug
10
2013

Bioidentical Hormone Replacement

By | Alzheimer’s disease, Anti-aging medicine, Arthritis, Cancer, Diabetes, Fitness, Health, heart attack, Heart Disease, Hormones, Men's Health, Nutrition, Osteoporosis, Prevention, Stroke, Women’s Diseases

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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Jul
13
2013

Low Cost Cervical Cancer Screening

By | Cancer, Infectious Disease, Prevention, Women’s Diseases

Introduction

Recently a low cost cervical cancer screening method was developed in India. About 25% of all invasive cancers of the cervix in the world are contributed from India as screening for cervical cancer is not practiced there on a large scale. Many screening methods for cervical cancer became more elaborate over the years as I describe here.

However, these screening methods are expensive.  They require a doctor who does the Pap test (or takes a swab for DNA testing) and a cytological laboratory. In addition, this service requires a gynecology service back up for positive cancer cases. In the Western world these services are in place and are responsible for improved cervical cancer survival rates.

The American Cancer Society (ACS) guidelines

The ACS guidelines state that cervical cancer screening should begin 3 years after the initiation of sexual intercourse. Women benefit from  screening every year for the first 3 years. If 3 consecutive screening results were normal, then a Pap test once every 2 or 3 years would suffice. Because of the Pap test the incidence of cervical cancer has continually dropped in the Western world as seen in this image. Compare this to the next link, which shows India as the main part of the undeveloped countries as a graph on top of the graph for cervical cancer incidence of developed countries.

Cervical cancer is due to a chronic HPV infection

With the new insight that cervical cancer is due to a chronic HPV infection, mostly due to strains 16 and 18 there are shifts in screening methods even in the Western world as DNA tests for HPV can identify a high percentage of cases that would otherwise go on to develop cancer of the cervix. However, due to cost issues with regard to DNA testing for HPV the Pap test is still the method of choice in many Western countries including the US.

Low Cost Cervical Cancer Screening

HPV16 and HPV18 were very prevalent in the cervical cancers found, not only in premalignant lesions, but also in advanced cervical cancer as this study showed. The authors concluded that vaccination with the HPV vaccine (e.g. Gardasil) would have a significant impact on the prevention of cervical cancer, particularly in a country like India where a regular screening program is not yet in place.

An inexpensive test for cervical cancer screening

In 2009 there was a publication in the New England Journal of Medicine that investigated three screening methods for cervical cancer, the familiar Pap test (cytology testing), human papilloma virus (HPV) testing and visual inspection after staining with 3-5% acetic acid. In Western medicine the Pap test is done first and if suspicious cancer cells are detected, this is followed up with colposcopy where acetic acid staining is done and a biopsy is taken from the suspicious area. After this one-time test in 1999 the patients of this study received follow-up again (10 year follow-up).

The direct DNA test for HPV

The direct DNA test for HPV caused a 52% reduction of deaths from cervical cancer in comparison to the control group. The other two test methods, done as a single test (cytology testing and acetic acid visualization) did not result in reduced mortality when compared to the untreated control group after 10 years. However, a 15-year follow-up of a one-time screening with the acetic acid test showed a reduction of 31% in the cervical cancer death rate (reduction from 16.2 women per 100,000 to 11.1 women per 100,000) as reported recently at the annual meeting of the American Society for Clinical Oncology. Shastri and co-workers, the authors of this study, estimate that this would translate into prevention of 22,000 cervical cancer deaths annually in India and if instituted across the developing world it would save 73,000 lives annually.

Is cervical cancer screening effective?

A meta-analysis of several randomized studies regarding the effectiveness of cervical cancer screening in reducing mortality from invasive cervical cancer was published in May 2013 and found that cancer screening is indeed very effective.

In most studies Pap tests (cytology testing) or DNA tests for HPV led to a 62% to 65% reduction of mortality from invasive cervical cancer 10 to 15 years later. The protective effect from screening lasted about 5 years. However, the practice of doing Pap tests or DNA/HPV testing every 1, 2 or 3 years is safer than waiting 5 years between tests as there is a cumulative protection to the point of preventing almost 100% of cervical cancer over the years with regular testing.

Staining with 3-5% acetic acid and visual inspection

For India and other development countries the inexpensive visual inspection method to screen for cervical cancer after staining with 3-5% acetic acid is better than not doing any screening at all. A nurse can readily learn this type of screening. Only patients with positive or questionable screening results receive a referral to a treatment center.  The best results were possible through a combination of this screening method and vaccinating girls with an HPV vaccine. This leads to a more complete prevention program for cervical cancer in these countries that could otherwise not afford screening. The Bill & Melinda Gates Foundation is helping to reduce the cost of the HPV vaccine to about $4.50  from about $170 in the US, which will allow mass vaccination in development countries in the near future.

What other cervical cancer prevention is available?

As pointed out earlier it is now evident that most cases of cancer of the cervix are due to chronic HPV16 and HPV18 infections. Teens can acquire these and the HPV viruses linger on unnoticed within the affected cervical cells. However, 10 to 15 years later they can manifest themselves as cancer of the cervix . This long latency period allows the physician to screen for this before it becomes invasive and is more difficult to treat. What has become more evident only in the past few years is that other human tissues can get infected with papilloma virus as well and turn cancerous over the years.

Cancers that can occur from sexual contact

Oropharyngeal cancer, anal cancer, penile cancer, vulvar and vaginal cancer and even some forms of throat cancer and lung cancer can develop from intimate contact with a person who is HPV positive. Researchers confirmed that oral cancer is now more than 70% related to HPV infection rather than to cigarette smoking or alcohol as in the past. Sexual practices have changed over the past decades with oral sex being more common. This likely is the reason why HPV caused more oral cancers in recent years.

Finger pointing is not constructive

Finger pointing is not uncommon when it comes to a rational discussion of HPV transmission, but it has become apparent that males are often the ones who may be spreading HPV unknowingly through promiscuous sexual activities. Both heterosexual and homosexual activities will spread HPV. But the more promiscuous a woman is, the more she will also contribute to HPV infections in the population.

HPV vaccines Gardasil and Cervarix

When the pharmaceutical industry developed the HPV vaccines Gardasil and Cervarix many religious groups have spoken out against vaccination, as this would “encourage promiscuous behavior”.  I look at this question from the point of view that lives can be saved down the road by preventing several cancers as indicated, and that is what counts on the long-term. In this context it makes a lot of sense that not only females get a vaccination, but also males to interrupt the infectious chain and this trend can now be seen as it is adopted by several jurisdictions.

Conclusion

Cervical cancer screening is still very necessary doing a Pap test or a DNA/HPV test. Screening is necessary more often than every 5 years as pointed out. Most women need a Pap test every 2 to 3 years. HPV vaccination with Gardasil and Cervarix for boys and girls prior to sexual relations is very preventative, but still does not mean that screening should be stopped. Cervical cancer is the cancer that has the longest medical history of moving from a very prominent deadly disease (back in the 1960’s) to a cancer that can now be cured and prevented.

References

  1. Causes of cervical cancer: http://nethealthbook.com/cancer-overview/cervical-cancer/causes-cervical-cancer/
  2. HPV vaccine: http://www.mayoclinic.com/health/cervical-cancer-vaccine/WO00120
  3. Review of cervical cancer: http://www.nethealthbook.com/articles/cancer_cervicalcancer.php#topoftable

Last edited Nov. 7, 2014

Jun
29
2013

Aging And Lack Of Hormones Matter, Not Evolution

By | Anti-aging medicine, Cancer, Health, heart attack, Heart Disease, Hormones, Men's Health, Osteoporosis, Women’s Diseases

Aging and lack of hormones matter, not evolution. Recently a story went through the media regarding the findings of a research group from McMaster University, Hamilton/Ont. that described that as men were dating younger women evolution took fertility away from aging women. It sounds to me that this research, which included computer modelling  was mainly driven by sociological observations. Some older males may seek out female partners that have the same age as their daughters, which seems to be considered “socially acceptable”. Contrary to that successful relationships of older females with younger partners are often met with less tolerance!

Hormones are important for behaviors

It seems that medical facts like hormonal changes that are behind behaviors have not been taken into account. The following blog provides you with a background of hormonal changes for both sexes as we age. I also describes how to reset the clock for males and females alike to an age between 30 and 35, which creates a “level playing field”. It is a 101 on bio-identical hormone replacement.

Depleting hormones due to aging

Both men and women experience a slow decrease in hormone production beyond the age of 30, but the depletion occurs somewhat faster in women than in men. As a result women get menopause at the age of 45 to 55 (cessation of periods and postmenopausal symptoms) and men get into andropause (the male equivalent of menopause) at the age of 55 to 65. The main symptom of andropause is erectile dysfunction. These are acceptable simple physiological facts that endocrinologists knew since the 1950’s to 1960’s. Common sense would suggest that replacing missing hormones with bioidentical hormones should bring the body chemistry back to normal. However, this is not what conventional medicine has done.

Synthetic hormones are not bioidentical hormones

Instead, Big Pharma got wind of how powerful hormones were, and they developed hormone-like substances that could be patented and produced on a large scale. What they did not disclose initially was the fact that non-bioidentical hormones with side-chains and chlorine or fluoride atoms in the molecules would cause heart attacks, strokes and blood clots. An example of this is Premarin, an estrogen concoction that is derived from pregnant mares and Provera, a “progesterone-unlike” synthetic product, both of which were used for HRT (“hormone replacement therapy”).

Aging And Lack Of Hormones Matter, Not Evolution

Aging And Lack Of Hormones Matter, Not Evolution

Results of the Women’s Health Initiative (using synthetic hormones)

As there were conflicting reports about the benefit of hormone replacement after menopause in the medical literature, the National Institutes of Health funded a large study (the Women’s Health Initiative) to clarify what was going on with regard to side effects and effects of HRT. Unfortunately, the researchers used synthetic non-bioidentical hormone products in these studies (Premarin and Provera) instead of bioidentical estrogen and progesterone. The results of the Women’s Health Initiative were devastating. In 2002 doctors  were warned that Premarin and Provera used as HRT would cause increased heart attack rates and breasts cancer, which led to premature death.

Results of the Women’s Health Initiative confused hormone therapy

Overall, the placebo group did better than the experimental group and this is why the trial was prematurely stopped. Due the wide publicity regarding the negative results of the Women’s Health Initiative postmenopausal women feel confusion about what to do. Either they do not see their physician for hormone replacement. Or conventional doctors advise them that they should use only small amounts of Premarin. Their physician also tells them not to take HRT for more than 5 years for fear that it may cause breast cancer. Medico-legal considerations are at play and the whole issue of HRT after menopause has been politicized.

Facts about bioidentical hormone replacement therapy (BHRT)

The key with menopause or andropause is to accurately determine what the hormone levels are, which requires saliva hormone tests, not blood tests. The results are compared to what is normal for a 30- to 35-year-old person and missing hormones are replaced with bio-identical hormones as originally suggested by Dr. John Lee some time ago. Briefly, he mentioned 3 fundamental rules in bioidentical hormone replacement: first, only replace those hormones that are missing; secondly, use bioidentical hormones instead of synthetic hormones and thirdly, use the smaller doses that are enough to replace the normal hormone levels that the body had around your mid-thirties, don’t over treat. He also stated that there is a need to address lifestyle issues like poor diets, excessive alcohol intake, stress and insulin resistance (from obesity). His recommendations are still valid today, as hormone facts have not changed.

Replace hormones that are missing with bioidentical hormones

So, the physician or naturopath needs to use common sense and replace what is missing with bio-identical hormones (not with synthetic hormone-like drugs that make the patient sick). If people do this properly, a normal sex life persists in both males and females and both age at a much slower pace without the development of heart attacks, strokes or osteoporosis. When people rebalance hormones, adopt a proper diet and do regular exercises, diseases like diabetes, cancer, osteoporosis, heart attacks, strokes, arthritis or high blood pressure do not develop. In other words, this is a way to prevent disabilities and you are able to enjoy an active life in vibrant health.

More info on bioidentical hormone replacement

Eventually all of us, male or female succumb to the hormone deficiencies that come with aging. As long as males still produce testosterone, males will have a normal sex drive. But 10 or 20 years beyond the point where their partners entered menopause erectile dysfunction will eventually set in. Just taking Viagra is no substitute for the missing testosterone and other hormones. If we do not pay attention to hormone restoration, the biological clock is ticking and the diseases I mentioned above will start to occur and lead to premature death. On the other hand with male hormone restoration (bioidentical testosterone) the body chemistry and physiological functions return to how they were in his 30’s. The same is true for female hormone restoration (using estriol/estradiol and progesterone).

Bioidentical hormone replacement in Europe

The irony is that a small number of physicians back in the 1960’s and 1970’s in Europe used bioidentical hormone replacement. It was amazingly successful. One of these doctors is Dr. Hertoghe, an endocrinologist in Belgium. They were able to show then that women could regain their sexual desire and their vitality with bioidentical hormone replacement (BHRT). For some reason (could it be greed?) Big Pharma and various government agencies were able to get the upper hand and suppress this knowledge. They spread the word that hormones that come factories would be of “higher quality” than bioidentical hormone creams from compounding pharmacies. Fortunately, these lies have been exposed in numerous publications and the information is now more easily accessible through the use of the Internet.

Safety of bioidentical hormones

But Big Pharma still tries to intimidate and twist the truth! Here is a recently published prospective study over 3 years involving 300 women from Texas (Women’s Wellness Center, Tyler, Texas, USA) that showed anti-inflammatory effects and anti-anxiety effects with bioidentical hormone replacement. It also showed that no biochemical changes took place that would have caused changes in fibrinogen levels. Bioidentical hormones do not affect clotting, do not cause inflammation, heart attacks cancer. This confirms what Moskowitz had stated in 2006 about the safety of bioidentical hormones.

Testosterone is mostly bioidentical

Male testosterone products from Big Pharma are by and large hormone preparations  that are actually bioidentical testosterone. It is with women’s hormones that Big Pharma made substantial chemical modifications so that the final products did not fit the estrogen and progesterone receptors, causing heart attacks, blood clots and breast cancer.

Bioidentical hormone replacement and saliva hormone tests

Both women and men should get a saliva hormone panel test measuring DHEA-S (storage form of DHEA), estradiol, testosterone, progesterone and cortisol from one sample test tube when they become hormone deficient. Typically, the physician should test women first around the age of 35 to 40. Similarly, a man needs testing around the age of 45 to 55. This provides a baseline hormone level. The treating physician or naturopath can then decide, whether bioidentical hormone replacement is necessary. If so, only what is missing is replaced with bioidentical hormone creams from a compounding pharmacy. The hormone levels are titrated to the level around the age of 30 to 35. Thi is according to the principles by Dr. Lee. For A4M physicians this is a routine that is familiar. Your regular physician will likely feel uncomfortable, but many naturopaths will feel very comfortable doing this.

Discussion of the evolutionary study of McMaster University

It may sound intriguing to rationalize that older men like to date and marry younger women. In my medical opinion these researchers got it wrong. Hormone weaknesses manifest themselves perhaps 10 years later in men than in women. In some men testosterone production may even diminish only 20 years later. Older men may not find a sex partner the same age, if women do not use bioidentical hormone replacement. The McMaster team should have done their research including a control group.

Older women on bioidentical hormone replacement preserve their sex drive

This group should consist of men and women who used bioidentical hormone replacement. Researchers likely would notice that older women preserve their sex drive with bioidentical hormones. The sex drive of these older women would be comparable to women in their 30’s. Also, the “aging clock” would have slowed down in these women on bioidentical hormone replacement. This in turn would probably have resulted in a different behavior pattern among the older males.

References

1. Why choose bioidentical hormones: http://www.empowher.com/menopause/content/bioidentical-hormones-vs-synthetic-hormones-what-s-difference

2. Anti-Aging Medicine for Women and Men: http://www.nethealthbook.com/articles/antiagingforwomenandmen.php

3. Menopause: http://www.nethealthbook.com/articles/menopause.php

4. Andropause: http://www.nethealthbook.com/articles/malemenopauseandropause.php

5. 2009 Postgraduate Medicine article on the bioidentical hormone debate: http://www.ncbi.nlm.nih.gov/pubmed/19179815

Last edited June 29, 2013

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Jun
08
2013

Breast Cancer Due To Stress

By | Cancer, Health, Hormones, Stress management, Women’s Diseases

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

Mar
10
2013

March Is Colorectal Cancer Awareness Month, So Let’s Discuss Prevention

By | Cancer, Gastrointestinal Disease, Health, Men's Health, Prevention, Women’s Diseases

Introduction

March is colorectal cancer awareness month, so let’s discuss prevention. Only 40 years ago cancer of the cervix was one of the major killers for women, but with the introduction of the Pap test this has all changed.  For those women who get that screening done, there is no need for fear. The mortality rate from cervical cancer since the 1970’s has steadily decreased as shown in this link.

As far as cancer of the prostate is concerned, a lot of progress with regard to early detection has been made due to the introduction of the PSA blood test, which is used as a method of screening. As a result men are diagnosed earlier with prostate cancer resulting in more cures as the cancer found is at an earlier stage. Here is a link depicting the effect of the PSA test on mortality rates from prostate cancer in time.

March is colorectal cancer awareness month, so let’s discuss prevention

March is colorectal cancer awareness month as this article explains. The key is early detection and treatment as with any type of cancer. Specifically, with rectal and colon cancer there are mostly no symptoms, as blood in stool or any other symptoms occur only late into the disease. What we do know, however, is that there is a long latent phase where precancerous mucous membrane changes lead to polyps and these will degenerate in time into cancer of the colon or rectum.

Not everyone has the same risk of developing colon cancer or rectal cancer.  There are people with a higher rate of colorectal cancer, as they carry a susceptibility gene in their families. A healthy lifestyle can also reduce the risk of colorectal cancer.

March Is Colorectal Cancer Awareness Month, So Let’s Discuss Prevention

March Is Colorectal Cancer Awareness Month, So Let’s Discuss Prevention

Polyps are the precancerous precursors for colorectal cancer

It is now widely accepted that polyps are the precancerous precursors for colorectal cancer and colonoscopies done on everybody starting at age 50 (those with family risk factors much earlier) have already been shown to have decreased the frequency of the disease as the data from the CDC show. The problem is that the survival curves for colorectal cancer have only a swallow incline. A steeper decline would mean better survival of colorectal cancer patients. In the case of the mortality rates of cervical cancer and prostate cancer the slope showed a more rapid decline translating int much better survival rates.

Not enough colonoscopies are done

The incidence of colon cancer should have gone down to almost the zero point. All that has been achieved so far is a reduction of a portion of cases (those who went for colonoscopies early enough before it turned into colon cancer); this is by far not an elimination of colorectal cancer. The reason for this is the fact that in many cases people have colonoscopies too late when the polyp has already turned cancerous, or invasive colon or rectal cancer is already present at the time of the first colonoscopy.

Designating March as colorectal awareness month makes a lot of sense to me

I happen to come from a family where my mother died in 1980 from colon cancer at the age of 59. Because of this my doctor told me that I have a risk of about 3-fold higher than the population at large to also develop colon cancer. I have had colonoscopies since the age of 40 every 3 years. Ironically a few days ago right during the colorectal awareness month, I was getting my 9th colonoscopy. On three occasions polyps were removed, which tells me that the cancer-screening program works!

Why screen for colon cancer in regular intervals?

So why is it important to screen in regular intervals? One reason is that we are now exposed to more toxic chemicals in our environment and food than 100 years ago. So all cancers, but especially colorectal cancer rates have increased. We know the pathophysiology, which is the science that studies how an illness develops. We know that it takes several years between the occurrence of the first precancerous cells that form in the lining of the gut (called “mucosa”) and the formation of polyps. It takes another few years before polyps turn cancerous. This means that there is enough of a time interval to do screening. If we are not aware of this and ignore it (as unfortunately many people do), the process will run down the conveyor belt on an automatic program, which ends up in end stage colorectal cancer. The stages of colon cancer are depicted in this link.

Invasive colon cancer is deadly

As the table of my chapter on colon cancer staging shows, the invasive end stage colon cancer (stage IV or Duke D) has a 5-year survival rate of only 6%. Even when the cancer is limited to stage II (also called Duke stage B) there would be a 5-year survival of only 80% (see table in link).

What does screening really achieve? On an individual basis the gastroenterologist who does the colonoscopy can screen the whole colon for premalignant polyps and remove them during the procedure. This moves the potential cancer staging backwards to beyond any detectable cancer, as all of the potential early cancer cells would have been inside the polyp (called local “in situ” disease) and were removed by cauterizing the stalk (see above link). There is another potential factor that can help to reduce colorectal cancer incidence: Recently a connection was made between

Helicobacter pylori as a risk factor for colorectal cancer

Helicobacter pylori (H. pylori) infection of the stomach and polyps in the colon as well as colon cancer. In the past several smaller studies failed to show this correlation. It took 156,269 patients in this study to show that there was a correlation. As H. pylori is being tested for and treated more and more, this will also have a positive effect on lowering the frequency of colorectal cancer.

Mass colonoscopy screening

On a population basis with mass colonoscopy screening the incidence of colorectal cancer is reduced. The reduction of colon cancer would be much faster. Eventually it would turn into a disease similar to cancer of the cervix. Here it still matters whether you screen or not, but very few people have to suffer from it. Here is an image from a paper (look for Fig. 2, halfway down the page). It shows that survival benefits (longer lives) are registered only after 10 years or more following colonoscopy.

Colorectal cancer statistics

Every polyp that is removed will add up to the colon and rectum health of the nation at large. This shows statistically, when you sum up all of the colonoscopies done around the country year after year.  We need a nationwide and worldwide awareness that colorectal cancer screening is something worthwhile doing. This cancer is the third most frequent cancer in many parts of the world.

I am grateful that colonoscopy screening works, as I had polyps removed three times over a 29 year span and I did not have to go through all the surgical procedures that my mother had to endure. Had I lived 50 years earlier I may not have lived long enough to tell you how important colonoscopy screening is.

Here are the recommendations

      1. Let us assume there is no risk of colorectal cancer in your family. In this case screen once at the age of 50. This makes sure you are not one of the spontaneous colorectal polyp producers. If OK, screen every 10 years provided the colonoscopy is always negative.
      2. A family history of direct bloodline relative increases the risk for colorectal cancer. Direct bloodline relatives are: mother, father, brother or sister. If one of them had cancer of the colon or rectum, you have a higher cancer risk. In these individuals a gastroenterologist must do colonoscopies every 3 years.
Missed polyps during a colonoscopy
      1. There may be up to 15% of missed polyps during a colonoscopy. But with the next colonoscopy there is a high likelihood that the physician catches the abnormal polyp in time. The pathologist confirms that the subsequent screening caught them before they turn cancerous.
      2. There are special cases, families with genetic syndromes like the familial polyposis of the colon. In these families a gastroenterologist needs to screen children/young adults for polyps when they are still young. This is from the age of 20 to 25 years onwards.

Don’t complain, if you belong to category 1 or 2 as it could be much worse (category 3). Cancer is serious business. Remember, March is colorectal cancer awareness month.

More information about colon cancer.

Dec
11
2012

What a Wonderful World

By | Anti-aging medicine, Arthritis, Cancer, Diabetes, Heart Disease, Men's Health, Nutrition, Prevention, Stroke, Weight loss, Women’s Diseases

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/

Nov
22
2012

New Breast Cancer Treatment

By | Cancer, Health, Women’s Diseases

For decades the dogma in medicine has been that any kind of cancer, including breast cancer would be treated with surgery, radiotherapy and/or chemotherapy. However, the 5-year survival rates were disappointing as this table shows. In the 1980’s the idea of adjuvant treatments for cancer came up and one of the popular methods was hyperthermia treatment. Cancer cells of a variety of cancers were found to be very heat sensitive, but the limiting factor in treating with hyperthermia systemically was the fact that   bone marrow cells were found to be very heat sensitive, which limited this application. With respect to breast cancer a review of data pooled from 5 trials showed that there was an 18% survival advantage due to the added step of hyperthermia in addition to radiotherapy. With radiotherapy alone a group of advanced breast cancer patients had a 5-year survival of 41%, but a comparable group treated with a combination of radiotherapy and hyperthermia had a survival of 59%.

Let’s back track for a moment and ask what breast cancer is. In the past we thought it developed out of one mutated cell, a breast cancer cell that would multiply into a clone of cells, which would first grow locally and then spread as metastases throughout the body at a later time. Unfortunately further research has shown that breast cancer can simultaneously occur in several spots in one breast or even in both breasts. The spreading of the cell clones to distant areas can occur very early on, but cells can lay dormant for years and start growing again at a time when the immune system is weak. With these facts in mind it can readily be seen that surgery cutting out a “local breast lump” will not be successful in the long term as a treatment of breast cancer, even when radiotherapy treatment is added to sanitize the local lymph glands of local cancer metastases.  Adding chemotherapy to eradicate distant metastases may  sound like a good idea, but chemotherapy is very toxic to bone marrow cells and to the immune cells that are supposed to kill the last breast cancer cells. As a result, chemotherapy has its own problems. Medical researchers had to start thinking outside of the box to discover a breakthrough in breast cancer treatment.

Fast forward to 2012. We still need a breast cancer treatment method that is non-toxic, that kills the breast cancer cells and that ensures that there will be no recurrences in the future.

New Breast Cancer Treatment

New Breast Cancer Treatment

This new treatment method is called “laser-assisted immunotherapy“, and it is being studied in a pilot study right now. 62.5% of end stage breast cancer patients had a response rate, something that has never been achieved before. The systemic side-effects of hyperthermia are overcome by heating only locally and directing the laser beam to the diseased tissue. The quality of the Laser beam is close to the infrared frequency of light . This is amplified by injecting the FDA approved compound indocyanine green, which absorbs more heat from the laser beam right in the cancer cells where it is needed for local hyperthermia treatment. The immune cells and the bone marrow cells are not harmed. The killed cancer cells release the cancer antigens that the immune system could not recognized before, as the immune cells were suppressed by suppressor T lymphocytes. With this added immune booster which is called “glycated chitosan” the cancer patients’ immune cells(called “killer T lymphocytes”)  are now being stimulated and are in a position to eradicate the last trace of cancer cells anywhere in the body. This is similar to a vaccination procedure that takes place within the body of the cancer patient. The T lymphocytes remember the surface antigen of the cancer cells that were killed. As a result the same type of tumor will never reoccur in that person’s life. It also takes care of the dilemma of the past that sometimes more than one cell type clone was found among the biopsy material of a cancer patient.

At this point the trial has not reached the 5 year mark of survival. Only 15 patients of the total of 45 patients have so far been enrolled. But 80% of the 15 patients have survived 2.5 years, which is unheard of with stage IV (late stage) breast cancer. In an experimental breast cancer model in rats where laser assisted immunotherapy was first shown to be effective, there was 100% survival of the treated group. However, it was noted that it was essential that all three components of the new treatment modality were followed. The protocol for the human pilot study therefore is as follows:

1. After placement of an anesthetic in the tumor area the indocyanine green is injected into the tumor (placement of the photosensitizer).

2. The laser beam near infrared frequency of light is applied in the tumor area (or over the palpable metastases). This application takes about 10 to 12 minutes and two courses are given over two weeks. An option of a third course within one year may be considered, but did not have to be done so far.

3. The adjuvant immune booster (glycated chitosan) is injected into and underneath the tumor right after the laser treatment is finished.

This triple therapy is the secret to the success of the new breast cancer treatment as each step is augmenting the other steps resulting in a complete destruction of the breast cancer and an active immunization against any of the residual cancer cells.

At this point the offshore Caribbean breast cancer treatment pilot study has been chosen to bypass frustrating FDA slow-downs in the US. But I suspect that proper protocols in a much bigger randomized US based study will follow the obvious successes in these late stage breast cancer cases. New cancer therapies are urgently needed. They are typically introduced by treating “incurable” (late stage) patients first. We are about 2 1/2 years away from the completion of this pilot study so that 5-year cures rates can be compared to older studies with the conventional cancer treatment approach. I am convinced that this new approach will not only help breast cancer patients,  but will also help prostate cancer patients and pancreas cancer patients (these three come to mind as they all are glandular cancers). Surgery for the removal of lymph gland metastases in prostate cancer patients and breast cancer patients using laser assisted surgery with indocyanine green stained lymphatic tissue has already been pioneered. It also opens up possibilities of modifying the method to suit other types of cancers.

More information about breast cancer: http://nethealthbook.com/cancer-overview/breast-cancer/

Last updated Nov. 6, 2014

Dec
01
2008

Climb Stairs And Stay Healthy

By | Fitness, Health, Heart Disease, High Blood Pressure, Men's Health, Prevention, Women’s Diseases

Everybody knows that walking from the TV to the fridge does not qualify as exercise, and those few steps to the mailbox don’t do the trick either, when it comes to staying fit. But by the same token it is also a fallacy to believe that only the work-out in the gym will reap benefits and improve aerobic capacity. According to Dr. Philippe Meyer and colleagues at Geneva University Hospital in Switzerland, the mundane task of taking the stairs can show statistically significant changes in aerobic capacity, decrease in body weight, decrease in fat mass, waist circumference, decrease in diastolic blood pressure and increase in heart healthy HDL cholesterol. Dr. Meyer asked 77 healthy hospital workers including 20 physicians to exclusively use the stairs at the 12-storey hospital. During this 12 week quest for more fitness promotional signs encouraged stair climbing. All of those 77 participants were a sedentary group of individuals. Nevertheless they had to walk…the cafeteria was on the twelfth floor! At the baseline the participants walked up and down an average of 4.5 storeys per day, and at the end of the twelve weeks they were walking about 20.6 storeys per day.

Climb Stairs and Stay Healthy

Climb stairs and stay healthy

The tangible results showed that aerobic capacity and fat mass remained significantly improved, even though the participants walked less storeys after 12 weeks. It seems that initial change of habits-walking instead of taking the elevator- had made the difference in the transformation from couch potato to more active individual.

Stair climbing is an excellent exercise for healthy individuals in the general population. This high intensity exercise cannot be recommended to heart patients that are not entirely stable or to a patient who has angina. In these cases caution and a supervised exercise program is needed.

More information about fitness: http://nethealthbook.com/health-nutrition-and-fitness/fitness/

The Medical Post, November 18, 2008, page 17

Last updated Nov. 6, 2014

Dec
01
2008

Fifty Percent of US Population Do Not Take Enough Calcium

By | Heart Disease, High Blood Pressure, Nutrition, Osteoporosis, Women’s Diseases

Even though supermarket shelves are stocked to the hilt with a wide assortment of groceries, not all is well in the USA. At the annual meeting of the American College of Nutrition Theresa A. Nicklas, D.P.H. summed up the current situation in the following statement: “The American population is overweight but undernourished.” Results from a study of more than 25,000 people showed, that half the population does not get enough calcium, magnesium and potassium.

Many people consume more calories than they need, but nutrients like the ones mentioned before and which are essential for functions such as immunity, bone health and blood pressure are falling short of the recommended amounts. The only age group in which the recommendations for calcium intake were met was the age group up to 8 years. In adults the needs were not met, and more females than males were deficient in all of the three nutrients.

Fifty Percent of US Population Do Not Take Enough Calcium

Calcium intake prevents osteoporosis

 

 

The situation could be corrected by consuming 3 to 4 equivalents in the dairy group. It should be added that not only dairy foods are rich in calcium. For individuals who do not consume dairy foods, soy products are rich in calcium, as are almonds, almond butter and nuts. Legumes (beans) as well as green vegetables (bok choi, collard greens, turnip greens) are calcium sources that should be incorporated in a nutrient rich diet.

More information about osteoporosis: http://nethealthbook.com/arthritis/osteoporosis/

Annual Meeting of the American College of Nutrition

Last updated Nov. 6, 2014