"Treat the disease, you win some, you lose some. Treat the patient, you always win."
~Patch Adams~

Wednesday, March 30, 2011

FDA Allows De Facto Generic of Pricey Preemie Drug Makena

As most of you know, I am not a fan of the FDA (Food and Drug Administration)---and conversely, they are not a fan of bioidentical hormones. However, I am cheering their recent decision to refuse to punish compounding pharmacies who make the progesterone shots that some pregnant women need to prevent preterm births. KV Pharmaceuticals (who are now on my list of companies I do not like) has tried to patent these shots and sell them for approximately 1000% the cost of what they are from the compounding pharmacy. That is, in my mind, criminal. Click here to read the story from ABCNews.com.

Sunday, March 27, 2011

Cellulite and menopause

I know, the dreaded cellulite. I have it on my upper thighs, and it's still noticeably even with the weight loss. Good article to share from BellaOnline.com about what cellulite really is, why it becomes more noticeable during the peri/menopause transition, and how to deal with it.

Multiple Sclerosis no match for Vitamin D and sunshine

I'm choosing a gray, cloudy and cold day here in NC to share a Vitamin D article with you from FYILiving.com. Studies have been and are currently being done on the relationship between Vitamin D levels and the risk of developing multiple sclerosis. I'm very much hoping that none of my readers are dealing with MS, but I thought the article was worth sharing with you so that you could pass it on to anyone who know who might be dealing with this disease. It's also a good time to remind you to take your Vitamin D supplements, and if you have not had your Vitamin D levels tested, to talk to your health care provider about it at your next visit.

Saturday, March 26, 2011

Chemicals Linked to Early Menopause

Study Suggests Exposure to Chemicals Called PFCs May Be Associated With Earlier Menopause.....

There may be a link between high levels of perfluorocarbons (PFCs) in a woman's blood an early onset of menopause, according to a recent study. Read more about this on WebMD.com. Besides affecting fertility, early onset menopause can raise the risk of osteoporosis and heart disease.

Tuesday, March 22, 2011

Workout myths: Fooling the fitness buffs

Today's article is from my own "backyard"...the Charlotte Observer.

I do weights for bone health----I hate them, but I do them. I am in the process of reworking my workout routines, for several years I have been doing water aerobics but it is no longer enough of a challenge. I am planning to travel back out to CA this spring to have a fitness consult with Dr. Carr's son Jason, who will be able to design a fitness routine for me taking into acccount my level of fitness and my back and hip problems. I will keep you updated!

Monday, March 21, 2011

Always go to the expert!

I have been to several seminars recently on menopause, women's health, etc. and I get so frustrated that every time the subject of bone health and calcium comes up, the presenter makes a blanket statement to the effect that all women need to take calcium for bone health. That's simply not true, and a discussion that every woman should have with her doctor. I have never taken calcium, and I was able to cure myself of osteopenia with hormonal balance and Vitamin D (I take 5000 IUs daily......talk to your doctor about the amount right for you). I asked Dr. Carr (my own physician in CA) to address the issue of calcium and bone health on his Facebook page (and if you are on Facebook, click here to become a fan of his page, some great information), and this is what he wrote:

The question of whether to take supplemental calcium to treat or prevent osteoporosis is discussed often in the media and in my practice. The current dogma is that since bone contains alot of calcium, if you lose bone (osteopenia or osteoporosis), then supplementing with calcium will correct the problem.

The truth is that bone loss do...es NOT represent a calcium deficiency. The only reason to take extra of anything is if the body is deficient in the substance. The reason that most women ( and a growing number of men) lose bone is primarily because they lose the hormones necessary to grow bone, especially testosterone.

Testosterone is the most important bone building hormone in the human body. The primary reason that bone loss occurs in peri-menopause and beyond is not that women suddenly stopped ingesting enough calcium. It is that the production of the bone building ovarian hormones (i.e. testosterone, estradiol and progesterone) diminishes significantly during this time period, causing the rate of bone loss (osteoclastic activity) to exceed the rate of bone building (osteoblastic activity).

In addition to the loss of hormones, with advancing age there is usually a decrease in physical activity necessary to build bone. Despite the current recommendations, walking is just not enough. Bone, like muscle, grows in response to resistance training (weight training). Walking, though better than sitting on the couch, is not a sufficient enough stress on the bone to cause the osteoblasts to lay down new bone.

Adequate vitamin D is necessary for absorption of dietary calcium from the gut and in the formation of bone. Vitamin D is the most common deficiency I see in my practice. How much vitamin D should you take? Nobody can answer that without testing blood. I have seen patients on the golf course all day in sunny Southern California still significantly deficient in vitamin D ( we lose the ability to convert sunlight to vitamin D with age). One patient in particular golfed 6 days per week, was taking 21,000 units of vitamin D daily, and his blood tests showed he was still deficient!

Remember that taking supplemental calcium is not without risks. Many of you will remember the media hype about a medical report last summer suggesting that calcium supplementation may increase the risk of heart attacks. The report was from the British Medical Journal which reported on a survey of fifteen trials in which participants (all over age 40) were given at least 500 mg of elemental calcium per day. The researchers concluded that calcium supplements increase the risk of myocardial infarction by about 30% over five years.
I have read the full study and although there are some flaws in the study design, my belief is that the authors conclusion in theory is correct.

Remember that calcium is part of plaque, the hard material that builds up in the lining of our blood vessels. You may have heard of a test called a Coronary Calcium Score, which is a CAT scan test that detects the amount of plaque in the blood vessel walls. Where there is calcium, there is plaque. If there is too much calcium in the blood, it can stick to blood vessel walls.

Many patients do not understand that the calcium level detected in blood tests is NOT a reflection of the amount of calcium in the bone. There is a very narrow range of calcium that the body needs in order to be healthy (approximately 8.5 to 10.2 depending on the lab). Ingesting a few thousand milligrams of calcium in a pill is too much to be taken up by the bones rapidly enough. The excess calcium will stick to tissues, including the lining of blood vessels, and contribute to plaque formation.

So how much extra calcium should one take? That is like asking what size shoe should one wear-it depends completely on the individual. In the active person with good vitamin D and hormone levels (as tested and followed with blood tests), the answer is none. You didn't need calcium supplementation in your 20's because you had optimal levels of bone building hormones, were likely more physically active, and still youthful enough to convert sunlight to vitamin D. Age should not be an excuse for not having everything necessary to build bone. As far as using drugs for bone loss, I never prescribe them. You don't develop a Fosamax deficiency, so why take drugs that have nothing to do with the normal, healthy bone buidling process, and can have serious side effects.

Saturday, March 19, 2011

Defining Perimenopause: What it Is and How to Deal

Menopause is actually a moment/day in time. For women with a uterus, menopause occurs when they have gone one year without a menstrual period. For those of us without a uterus, menopause occurs when the FSH (follicle stimulating hormone) is above a certain number and the estradiol level is below a certain number. The numbers are different for each lab, Lab Corp defines post menopausal as an FSH above 25.8, and as of October 2010, mine was 34.0. Estradiol levels are postmenopausal when they are less than 54, mine is 40.

While I obviously do not agree with the suggestions about hormonal therapy and/or antidepressants discussed in this article from AOL.com, there is some good information about the perimenopausal transition. The article is worth a read.

Menopause symptoms: searching for real relief

It's a good thing I don't have hot flashes anymore, because articles like this one in Boston.com make my blood boil. Seriously----read the article, and then scroll to the bottom and you will see I have commented on it. A couple of my favourite passages:

"He also recommends the herbal remedy black cohosh, which some women swear provides hot flash relief even though studies haven't found this to be the case. "Neither is terribly effective," he admits." If it's not effective, why is he recommending it?

"Some prescription drugs like the antidepressant Paxil and the pain reliever/anti-seizure drug Neurontin also appear to help alleviate hot flashes, though neither is approved by the US Food and Drug Administration for that purpose and both have side effects." I'm not a fan of the FDA, so I am not too concerned that they have not approved Neurontin or antidepressants for hot flash relief. However, Neurontin and antidpressants have numerous side effects, including weight gain, insomnia, loss of libido, lethargy. Don't those sound like the same side effects of menopause? C'mon, I'm not a doctor and even I can figure out that women have a hormone deficiency that needs to be addressed, not a pharmaceutical deficiency.

Friday, March 18, 2011

Playing hookey again-----

I have been suffering from spring fever for a couple weeks now, and although spring does not officially arrive until Sunday evening----it went to 84 degrees here in Charlotte today, close enough. I just had to get to the gardens today and take pictures, so I played hookey from the world and headed off to Belmont, NC (about 40 minutes from my house) to the Daniel Stowe Botanical Gardens. Chatting with and taking pictures of the flowers is so good for the soul (now, it's not quite so good for the back and hip, but that's ok----that's what medicatioin and ice packsk are for!) I got lots of great pictures, here are a few, and you can check them all out on my Facebook Gallery (you don't need to be on Facebook to view the pictures). Have a great weekend, everyone, I have a couple articles to share with you on homones/menopause, and I will try to get them up tomorrow or Sunday.

Wednesday, March 16, 2011

There are advantages to being 50+-------

I had one of those unbelievably cool days today----

WCNC (the NBC television affiliate in Charlotte) has a one hour show daily from 11 am - noon called Charlotte Today, focusing on issues in and around the Charlotte area, particularly those concerning women. Although the show does not usually have a studio audience, today 20 women were chosen to be part of a very special show celebrating the "Fabulous 50's". I was absolutely honoured to be one of the women chosen to be in the audience, and I had an absolute hoot of a time. The cast and crew of the show were absolutely wonderful to us, and it was great to see all the behind the scenes of how the show comes to be. You can click here to see my Facebook album of all the pictures I took (it was a riot to see 20 people running around with cameras taking pictures all over the place---and you do not need to be on Facebook to see the pics), but I wanted to share this special picture with you. Larry Sprinkle (yes, that really is his name!) is the long time meterologist at WCNC, and he does a great deal of charity work in the community. I've wanted to meet him for a long time----today I got my chance, and he was as gracious, kind and personable as I hoped he would be.

At the end of the show, we all got a nice little gift bag of Aveda products, and a book called 50 Things To Do When You Turn 50 ----- I'll put a review of it here on the blog when I read it.

I'll be back tomorrow or Friday with a hormonally related post----until then, have a wonderful week!

Tuesday, March 15, 2011

Give yourself a compassion break

I have been, at times in my life, the absolute champion of beating myself up. I berate myself for putting something unhealthy in my mouth, for not exercising, for not exercising enough, then when I do exercise more I beat myself up for making my back and hip hurt. Even writing this I can see how unproductive it is, but it can be so automatic I don't even think about it. I was in therapy years ago for issues relating to the car accident I was in in 1992, and the therapist really stressed to me that the automatic negative "tape" I was playing in my head was not only a huge drain of my energy (and in those days, my energy was very low so I needed to conserve whenever I could), but was also counterproductive. The more I berated myself, the more junk I ate to prove I was a loser. No wonder my weight shot way over 300 pounds.

I still have to work really hard, and be constantly aware of treating myself well, but I'm getting there. I try to eat carefully at home, not keep junk food in the house. When I am out, however, if I want a few french fries with lunch, I have them, and I don't spend the rest of the day oinking at myself. I exercise pretty much every day, but occasionally I skip a day, and now that's ok too. I used to worry if I missed one day at the gym I would never go back, but now working out is as much a part of my life as breathing I don't worry anymore.

I loved this article in today's Charlotte Observer----it talks about self compassion. It's worth reading (but don't beat yourself up if you don't get to it today!) :)

A New Look at the Older Vagina

Good reading today from the HuffingtonPost.com ---- and for those of you who may be new to the blog, I have stated several times that Dr. Carr has had me on estriol cream for vaginal dryness/atrophy for several years, it works great, and it's inexpensive. I use it at night at bedtime. A healthy vagina is important for not only sexual health, but also for overall health, fragile tissue that tears easily is more prone to infection, and that can lead to urinary tract infections also. If you are afraid to talk to your doctor about this, or your doctor seems to be blowing you off----it might be time for a new doctor. Your sexual health is important, and you need to be able to speak frankly and openly with your health care provider.

Monday, March 14, 2011

60 Minutes Segment last night---everyone needs to watch this!

How do professional women cope with the menopause?

Today's article is from the DailyMail.com (UK). Most of the information on HRT (they're talking about the synthetic HRT---Premarin/Prempro) you've already heard ad nauseum, but do read the second half of the article. If you are a professional woman (working women period are professionals at whatever it is they do)----even though menopause can be an uncomfortable topic----if you are suffering from symptoms at work, you need to be upfront with supervisors/bosses/colleagues about what is going on. Menopause is nothing to be ashamed of, it's a medical issue like anything else. If you need extra ventilation/fan for hot flashes, you have a right to have it. If you are more tired at times, either because of the lethargy that often accompanies hormonal changes, or because you are sleep deprived, a quiet, upfront, no whining chat with your boss about modifying your work day a little is smart. I know in this economy of "you're lucky to have a job" mentality that it's not only possible, but it saddens me to think that still far too many women are ashamed of what transition they are experiencing.

Sunday, March 13, 2011

FDA grants monopoly over preterm labor prevention drug: 15,000 percent price increase then announced

I went to a seminar (put on by one of the local hospitals) Friday night, and the topic was menopause. I love going to that kind of stuff, usually I learn something, and it's a great way to network. The presenter was an OB/GYN.

I knew when he said "we don't know what causes hot flashes" that it was going to be a long hour. Really!?!?!? Are you kidding me!?!?!?! I'm not a doctor and I know what causes hot flashes---HORMONE IMBALANCE. Good grief, it's not that hard. He then started listing all the antidepressants that "studies have shown are helpful with hot flashes". OK, now let me get this straight----symptoms of menopause: hot flashes, weight gain, lethargy (tiredness), insomnia, loss of libido, mental fogginess. Side effects of any antidepressant: weight gain, tiredness, insomnia, lack of sex drive, mental confusion. I think you get the picture----and you just have to imagine me rolling my eyes as I write this.

The doctor then brings up his Powerpoint slides on bioidentical hormones, and it's absolutely right off the FACOG (Fellows of American College of Obstetricians and Gynocologists).....that "there is no scientific evidence to show that bioidentical hormones are safer than synthetic hormones" (yes, there is, but the studies are not done in the US because you can't patent a substance that appears in nature, and therefore the drug companies have no interest in studying it), and the bioidenticals are not "FDA approved". Every time someone says FDA to me I usually just start chanting "Vioxx, Celebrex, Bextra" (the three anti inflamatory drugs that were the focus of a lot of health problems back about 5 years ago ---- all drugs that were FDA approved). Now I have another reason to dislike the FDA, click here to read an article about Makena, a new drug by KV Pharmaceuticals------Makena is progesterone. This makes me so angry I could scream------it's a blatant money issue and part of the reason health care in this country is a joke.

Thursday, March 10, 2011

Tuesday, March 8, 2011

Acupuncture May Ease Hot Flashes

A number of articles came out last year that said studies indicated that acupuncture did not help with hot flashes, but from WebMD.com comes an article that says in a recent (small) study (53 women), acupuncture did help with some menopausal symptoms.

I'm all for acupuncture and other integrative/alternative medicine protocols-----but from personal experience, hormonal balance (bioidentically, of course) is the best way to get relief from hot flashes. Hormones affect every system in the body, so the health benefits are numerous.....great example is right now here in NC, a lot of people are suffering with allergy symptoms (a little earlier than usual because we have had a warm stretch of weather)----I haven't been bothered by allergies at all, and I had severe allergy symptoms before I went on bioidenticals.

Monday, March 7, 2011

Sleepy Adults Feel Effects Every Day

I know I posted an article a week or so ago about combating insomnia, so in that same train of thought......check out this article from MedPageToday.com. It discusses the day to day effect of too little sleep-----and it's important reading. I still struggle a little with getting a good night's sleep, although now that I am hormonally balanced, it's not nearly as bad as it used to be. I take melatonin, and I also take a supplement by Integrative Theraputics called Cortisol Manager. It helps to relax me (and has dropped my cortisol level by 25% in the last year). I also use (although not as regularly as I should) meditation tapes (I love the ones by Andrew Johnson, they are on my IPhone). His voice is very soothing.

It's the big 50!

Just wishing my own hormone physician, Dr. John D. Carr a very, very happy 50th birthday! He is spending the day with his wife and all four of his beautiful childen, so I know he is having a great time at the start of this next decade!

HOUSE CALL: An alternative for hormone replacement therapy

This article from The San Angelo (TX) Times may be repeat information for those of you who have been reading this blog for quite some time, but for those of you who are fairly new to Holy Hormones, this gives a good overview of how bioidentical hormone therapy works. I do want to clarify two points, however:

  • Most doctors who are truly specialists in this field prescribe the hormones individually (usually by creams or some other delivery than by mouth) rather than mixing them together in formulas. Especially when beginning hormone therapy, it's important to be able to pinpoint by trial and error which hormones may be causing unwanted side effects, and that's impossible to do if the hormones are all mixed together. It's impossible to "tweak" dosing if the hormones are mixed together rather than made up individually as creams.
  • Some hormones (estradiol) are available in commercially prepared doses transdermally----by patch. Many of you have heard of the Vivelle Dot or the Climera patch. Each comes in several different dosages. Remember, however, that hormonal balance is not just slapping on a patch of estrogen-----progesterone and testosterone balance is just as important.

Thursday, March 3, 2011

Love this quote:

"The question is not whether we will die, but how we will live."

- Joan Borysenko

Report stresses options for colon cancer screening

(just a minute while I climb on my soapbox-----again)

My father had colon cancer, so I knew I was at higher risk and got a colonoscopy right after I turned 50. I probably should have had it done when I was 45, but ok, at least I got it done. I get SO aggrivated with people my age and older who refuse to have a colonoscopy, citing reasons like their too busy or they have heard horror stories about the bowel prep necessary (I know every doctor uses a slightly different protocol for the prep, but I just didn't think it was that awful). My own mother would never get one, nor did my elderly aunt (why am I surprised, she didn't even get a mammogram until she was 75----and she and my mother were both nurses.) And these people who refuse to get colonoscopies----it's not a financial issue as they all have good insurance or Medicare. Makes. Me. Nuts.

(off the soapbox now)

I found this article on MSNBC.com about how doctors need to give patients options for screening for colon cancer, with the theory being that some screening is better than no screening at all. Colon cancer is one of the cancers that can be cured if you catch it early enough. If you have not gotten a colonoscopy yet----please, please consider it. You are important to a lot of people.