10 dumb things you do at the doc's office

Good morning and Happy Memorial Day!

Check out this article from CNN.com. Medical care is expensive, whether it's out of pocket or covered by insurance, so it's important to make the most of your office visit. I think my friends get tired of hearing me say that they need to be upfront with every doctor/healthcare practitioner who treats them about what medicines they are taking----including bioidentical hormones, supplements and over the counter medications. I get emails from ladies all the time who tell me they have not told their primary care doctor they are taking bioidenticals because they fear the primary care doctor will laugh at or scold them. It drives me nuts ---- both that the patient isn't being upfront, and that the doctor would ridicule a patient. I also encourage everyone to make a list of your medications, hormones, supplements, surgeries, and emergency contacts and keep a copy with you at all times.

Have a great holiday, remember why we observe Memorial Day and stay safe!

30 Worst Cities in the US For Ragweed Allergies

People are surprised (and often skeptical) that bioidentical hormone balance cured my seasonal allergies (don't forget, hormones affect every system in the body). I have said it before, here in NC allergy season is long and difficult, both in the spring and the fall. I would take the hormones for no other reason then the relief from allergies (overall, Charlotte is in the top 5 of worst allergy cities in the US), never mind all the other health benefits!

USAToday.com posted a list of the 30 worst cities in the US for ragweed allergies, according to data from Quest Diagnostics. Click here to check and see if your city is listed!

Sharing a great quote with you!

"Joyfulness keeps the heart and face young. A good laugh makes us better friends with ourselves and everybody around us."

- Orison Swett Marden

What Not to Say to Thyroid Patients

If you don't already subscribe to Mary Shomon's weekly newsletter on what's up in the world of thyroid imbalance, you are missing some valuable information. I really like the article she featured this week-----I am willing to bet many of you have heard one or more of these comments from friends, family, and sadly, yes, health care providers.

I like this quote!

"We must look for ways to be an active force in our own lives. We must take charge of our own destinies, design a life of substance and truly begin to live our dreams."
- Les Brown

Please watch this video!

Morbid obesity reduces the effectiveness of levothyroxine for patients with hypothyroidism

This article from EndocrineWeb.com popped up on the newsfeed this morning, and I thought it was a good one to share with you all (or for those in the South, including me, y'all!). Levothyroxine is the generic term for Levoxyl, and it's given for hypothyroidism (thyroid is a hormone)----specifically for the T4 (storage part of the thyroid hormones). Too often only the TSH (thyroid stimulating hormone) is addressed, when actually the T4 and T3 measurements are more indicitive of what is really going on with the thyroid.

Today may be our first 90 degree day here in NC for the summer---and I know much of the country is experiencing the first real hot spell of the year. Don't forget to hydrate---hydrate---hydrate! Drink before you feel thirsty, and don't leave the house with out a bottle of water. Hydrate before and after exercising. Make it a habit----and plain old water is the best hydration!

Life After 50: Women's Worst Fear After 50? It's Not What You Think

I'm sharing this article from The HuffingtonPost.com with my blog readers because I think the topic is something we all think about, either occasionally or obsessively :) I've never been married (just never found the right guy), so I try to take the steps necessary to take care of my self so that I CAN take care of myself in the long run. I think realizing it's all on me, that there isn't a family to take care of me is what finally pushed me to start taking better care of myself. I have a ways to go, but I am much healthier and at peace than I was five years ago. Enjoy!

I'm likely going to take the weekend off (taking a little mini vacation tomorrow), so let me be the first to wish you a good weekend. I'll be back on Monday!

Man-O-Pause? Men Too Experience Hormonal Decline

Good article to share with you today from MedicalNewsToday.com. Yes, men also experience hormonal decline---it's called andropause. It is finally gaining wider recognition as a legitimate medical problem. Share this article with the guy in your life!

Osteoporosis Awareness Month

May is Osteoporosis Awareness Month-----I'm not exactly sure how you should celebrate it, perhaps take your bones out to lunch, maybe treat them to some ice cream (yeah, I vote for that one!!!!). You can learn more about the National Osteoporosis Foundation by clicking here, and check out this article from Sign On San Diego---outlines some of the risk factors for the disease. If you have any of the risk factors, or you are over 50, be sure to get with your health care practitioner to discuss a bone density scan. It's easy, and it's painless.

Printable Exercise Guides from Women's Health Magazine

Oh, stop whining and rolling your eyes at me----you know that exercise is good for the mind, body and spirit (yeah, yeah, blah, blah.) I will be honest, I am not one of those people who hops out of bed in the morning yelling "I can't wait to get to the gym" ---- truth be known, I am not one to hop out of bed period. However, once I finally got my head out of my butt five years ago and started taking care of myself, I knew that like it or not, exercise had to be one of the components of a healthier lifestyle. Once I am at the gym or out taking a fitness walk, I'm fine, it's just getting there that's sometimes hard.

Some of my regular blog readers know that I was in a horrific car crash in 1992, I broke both legs, my right arm, crushed my pelvis, internal injuries. It was a mess, I had 15 surgeries to get put back together, the last three at the Mayo Clinic. My back and hip are still very messed up, staying in any one position for me is tremendously difficult. When I am blogging, I am up every 10-15 minutes to walk around, and my "movie group" friends will attest to the fact that when we go to the movies, I get the aisle seat so I can get up and move at least twice during the movie. When I exercise, I lay down afterward with an ice pack to try and settle the pain down, and I largely schedule my day around my workouts. Some days I can do more than others, and occasionally, if my back is having a good day---I blow off my exercises and go do something fun. I'm not whining (well, maybe a little)----I know what could have happened in the accident and didn't, and I've made at least a degree of peace that normal for me is a little different than it was before I got hurt.

Exercising increases my pain level. Simple fact. I am under the regular care of a pain management doctor who is, in my opinion as good as anyone I have seen at Mayo's Pain Managment Center or the Cleveland Clinic's. Dr. Hines has been my physician since before I started taking care of myself, and he has supported me through every phase of my life changes---he fully supports my bioidentical hormone balance (in fact, he and Dr. Carr know each other). The testosterone I take daily has allowed me to build some muscle tissue in my back, which increases the stability. Dr. Hines is my biggest cheerleader in my exercise efforts. We talk about it all the time, and we understand that there is a difference between injuring my back and my back hurting. Bottom line, my exercise program enhances the quality of my life---if I don't work out, I won't be strong enough to do anything else.

I am adamant to people that they need to check with their doctors before starting an exercise program---most of us by the time we hit the peri/menopausal period of our lives have at least one medical issue that necessitates us getting checked out and discussing an exercise program with a practitioner. Not everyone needs/can do the same exercise---I can't do anything that involved jumping or pounding on my hips, and I have found that using an eliptical machine sets off intense neuropathic, burning pain in my upper legs after less than 2 minutes of use (I don't use the eliptical machine at all now). Water aerobics was a great exercise when I first started working out, and it's great for anyone with joint issues. I still do it occasionally, but it doesn't really challenge me enough anymore. I love the water, and this summer I will get in a few gentle workouts a week in the condo pool. It's important to vary the workouts so you are getting both cardio and resistance/weight workouts ---- the resistance workouts are crucial to bone health.

OK, I'll get down off my soapbox now. I found this site on Women's Health Magazine----there are a lot of downloadable/printable workouts. I've printed off several, none of them I can quite do completely (balancing for me is also a big issue as my right side is much weaker than my left), but I can mix, match and modify for an at home workout (I belong to a gym, but occasionally like to do a workout at home). Browse through it, pick a few exercises you might like to do, and get out there and exercise!

I couldn't resist sharing this quote with you!

"One of the first duties of the physician is to educate the masses not to take medicine."

- William Osler

(shaking my head)

Why Premarin and Prempro are still being made and prescribed is a mystery to me. We have much better alternatives (bioidentical hormone therapy), and the dangers of these drugs is well known. Nonetheless, they're still out there, and Pfizer is now setting aside "beaucoup bucks" to settle the lawsuits these drugs have generated. Check out today's article from BloombergNews.com.

Hot flashes may last a decade or more: study

Nothing like a little good news to brighten up Monday morning (I'm being sarcastic!) Reuters.com is reporting that a study being reported in this month's Obstetrics and Gynocology indicates that hot flashes in women may last 10 or more years. This is different from the mainstream medicine accepted guideline of hot flashes lasting about 5 years.

From talking to a lot of women who are older than me, most have told me their hot flashes last at least 10 years, sometimes much longer. Women in their 70's routinely tell me they are still having them. Those of us who are (bioidentically) hormonally balanced are lucky that we don't have to deal with all that. When I started the progesterone cream in September 2006, my hot flashes were so severe I was soaking 2-3 outfits per day---and that's not an exageration. Three days after starting the progesterone, I had my last hot flash, and it was mild. Never mind all the other health benefits bioidentical hormone balance provides-----I'd take it just to not burst into flames multiple times each day!

Happy Mother's Day to all!

This is a picture of my mother in June 1958 with her favourite daughter (did I mention I am an only child?) Whatever you do, however you celebrate, make it a great day!

Smart Living: Adrenal fatigue syndrome--Real or fake?

There is a lot of controversy over whether adrenal fatigue even exists, but I am in the camp that it does, and it affects a significant number of people, especially around the peri/menopausal and post menopause age group. I suffer from it myself---my cortisol level had hovered around 19.8 for quite a while, but with stress reduction practices and supplements, I have been able to reduce it to about 15. I have chronic back and hip pain, which stresses the body and contributes I just had blood work done and don't have the results back yet, so I don't know what it is right now.

This piece from AustinYNN.com came up this morning, a short article and video about the symptoms and treatments for adrenal fatigue. I am sure you will see yourself in some of the symptoms. I have not yet read the book mentioned in the piece, but I have it on my Amazon.com list for when I next place an order!

Have a great weekend, everyone, and for all the moms out there, Happy Mother's Day!

Expert talks about the very real option of hormone replacement therapy

If you hear a grinding noise, it's my teeth----I just posted a response to this article on the LA Times website. The "expert" says the "scientific community" feels bioidentical hormones are "balderdash". Yep, that's me commenting at the end of the article-------------grrrrrr.

Watch Out! Medications That Interfere with Certain Birth Control

I've posted articles like this before on the blog----but not in quite a while. For those of you who are still taking birth control pills of any type, it's extra important that you talk to your healthcare practitioner about any new medications you are taking. As this article from Empowher.com points out, certain medications can affect the efficacy of birth control pills (and at the peri/menopausal stage of life, I am guessing an unexpected pregnancy would not be welcome news).

Another related reminder, be absolutely sure that when you go to see a new health care practitoner, for hormonal balance or anything else, that you take with you a list of ALL prescription medications, hormones and supplements that you are taking. Do not rely on your memomy to just tell the doctor what you are taking, write it down and take it with you. I am amazed at the number of people who don't tell their doctor all of what they are taking, or stop taking medications and don't tell their doctors! Don't be one of them------to expect the best in medical care, you too need to give your best effort, and that includes sharing with your doctor everything that you are taking as medications/supplements.

Breast Cancer Linked to Vitamin D Deficiency

Usually the minute I post an article like this one from ThirdAge.com another study is released that contradicts the study I am posting about----that's just the way life goes. This article talks about a possible link between low levels of Vitamin D and increased risk of breast cancer. I've said it before----this is something you need to talk to your doctor about, and if you have not had a Vitamin D level blood test, push to get one! The amount of Vitamin D necessary for you is as individual as it is for every patient, I take 5000 IUs of Vitamin D year round, and bump it up to 10,000 IUs in the months of November-February.

What may be best for controlling diabetics' blood sugar? Sustained, structured exercise

Here's one more reason to engage in regular, sustained exercise......check out this article from the LA Times. Share this article with the diabetic in your life.

Make A Muscle: Weight a minute.

Good article debunking myths about weight training vs. cardio and women training vs. men. Check out this piece from the WickedLocalDedham.com

Hormones play a role in all health problems

Let me be clear, I am not promoting the practice of the doctor who wrote this article----I have no idea who he is, how he practices or if his patients are satisfied. I was struck by the title of the article "Hormones Play A Role in All Health Problems" because you so rarely here that from a health care practitioner. I have been telling patients that for years, and I am a great example, both my bone density problems and my seasonal allergies were alleviated by hormonal balance. To read more, click here for the article from the Times&Transcript.com.

Replacing hormones: Pellet implantation

I know a lot of you have questions about pellet therapy for bioidentical hormones. It's only available for estrogen and testosterone, I am pretty sure it will never be available for progesterone because of the molecular structure of that hormone. My own physician, Dr. Carr, has done pellet therapy successfully with a lot of patients, the only reason I have not done it is because of the distance involved (I live in NC, he is in Southern CA).

This piece from a Colorado Fox News affiliate includes a video that gives a pretty good overview of the pellet insertion process. Thought you might enjoy seeing it, especially if you are considering pellet therapy.

Calcium Intake - Err on the Side of Too Much

In a word - NO! This article on the Empowher.com website is scaring me. Women who are at risk for cardiac problems especially should talk to their doctors about taking calcium!!!! New readers to this blog may not have seen Dr. Carr's comments on the subject a couple months back, so I am (with his permission) reposting his thoughts about post menopausal women and calcium as it relates to bone and cardiac health:

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 does 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.
(http://www.foxnews.com/health/2010/07/30/calcium-supplements)
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.

Stressing it out

Adrenal fatigue is somewhat controversial in the medical community (ok, it's actually quite controversial). Some doctors swear on a stack it doesn't even exist, but more and more doctors are taking it seriously. I have it myself, my cortisol level had risen to nearly 20 (my doctor likes it around 10). Much of my "stress" is from chronic back and hip pain from a car accident many years ago----I take medication for the pain, as well as do gentle exercises and meditate, but pain is a tremendous stressor on the body. Even bioidentically hormonally balanced, I am still somewhat of a type "A" personality, a little high strung and anxious. Dr. Carr, my own physician in CA, takes adrenal fatigue very seriously---he knows about my efforts to reduce my stress levels, and about 18-20 months ago he started me on a nighttime supplement called Cortisol Manager (it's available from his office). I started out taking 2 at night, and then was able to cut to one a night. It helps with sleep, and although I was a skeptic, it has reduced my cortisol level by 25%.

I came across this article today in the StarOnline.com, it's' by a doctor in Britain. It gives a very good overview of what adrenal fatigue is, what contributes to it, how to reduce your risk, etc. I want to point out a very important line in the article, the one about only taking DHEA under a doctor's supervision, and only after you have been tested to see if there is an insufficiency. DHEA is a supplement sold over the counter, but it is a powerful substance and should never be taken unless it's needed.

My favourite book on Adrenal Fatigue is Adrenal Fatigue, The 21st Century Syndrome by Dr. James Wilson. Best price is at Amazon.com.