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

Sunday, November 17, 2013

Some weekend "reading"...

A few quick reads for you from my news feed this week:

Suzy Cohen is a pharmacist who writes a syndicated column.  Last week, a reader asked about erectile dysfunction, and I thought her answer was worth sharing with you.  I particularly like the first line of the second paragraph of the answer, comparing giving a man Cialis/Viagra for erectile dysfunction instead of finding out if he is hormonally deficient to jump starting a battery every time a car won't start to replacing the battery outright.  Brilliant, and the analogy can be applied to so many other health problems.  As I wrote in an earlier post, Brisdelle, which is a reformulation of the antidepressant Paxil, is being marketed to women for hot flashes.  Ladies, we have hormonal deficiencies that need to be addressed, not Paxil deficiencies!

On nearly the same topic (giving drugs when hormonal balance is more likely the answer)---I'm sure most of you have seen the news reports about new guidelines for giving statins (cholesterol lowering) drugs to more patients.  Often, high cholesterol levels are due to thyroid imbalance, and yet I am constantly astonished at the number of patients who tell me they have NEVER had their thyroid levels checked, or who only have ever had a TSH (thyroid stimulating hormone) blood test.  A normal TSH is not necessarily indicative of normal thyroid, a complete panel of blood work should always include T4 and T3 levels.  Even among the women that I know who are taking thyroid medication, they are only taking medication for the T4 thyroid.  Very few doctors (unless they are hormone specialists and/or practicing age management medicine) even check the T3 levels.  Dr. Carr does a thyroid panel on me several times a year to make sure I am taking the right dose of my T4 med (I was using Levoxyl until it was no longer available, I then swiched to Synthroid and had to up the dose as it is not as effective for me) and T3 (I have that compounded, and I take it twice a day......will be taking second dose as soon as I finish this post!)

I had a wonderful day yesterday going to my first college basketball game! So much fun, I understand enough about the game to follow it, and it was simply a wonderful day with a great friend and a new experience for me.  I was driving home from Charlotte about 5 pm when I realized how early it gets dark.  No matter what, we are not getting enough sunlight exposure this time of year (even on the days when the sun is fully out!) and so getting adequate Vitamin D is vital.  From early October to at least mid March, I increase my dose of Vitamin D from 5000 IUs daily to 10,000 IUs daily, and it generally keeps me in the optimal range of 70-100 ng/ml (blood work test).  Are you taking enough Vitamin D?  The paltry amount in a multi-vitamin won't cut it (usually less than 400 IUs), and it is nearly impossible to get it from food.  As always, check with your doctor, and if you haven't had your level tested, insist on it at your next visit.

Hope everyone is having a good weekend......today is kind of an "in" day for me (although I ran to the grocery store earlier this morning).  I'm catching up on laundry, resting my back, and this afternoon I am going to either dig into a new book or pick up my knitting for a while.  Breathe deep, enjoy your day and have a good week!

PCCA Awards Peter Koshland, PharmD, With George Roentsch Scholarship

I want to add my congratulations to Peter Koshland of Koshland Pharmacy on his receiving the The George Roentsch Scholarship from the Professional Compounding Centers of America.  I am a regular reader of Peter's blog, (and I have referred a number of people who tell me that their doctor wants them to go on Paxil for hot flashes to Peter's recent blog post on the subject---it is important reading), and if you live in the San Francisco Bay area, I highly recommend his pharmacy (click here for website.)  We need more pharmacists like Peter to advocate for bioidentical hormone health!

Sunday, November 10, 2013

This and That.......

Good afternoon from sunny and relatively warm NC!  A gorgeous fall weekend out there, but we are likely to get nailed with a cold front by mid week. Ah, such is the season here in the Southeast.

Today I am going to address a few "hormonal issues":

  • I'm sure nearly all of you have either heard or read about the study done by the Veteran's Administration regarding testosterone and men over 60.  I understand the study was featured in a segment of Good Morning America, and USA Today and a number of other newspapers did articles about the study findings.  First of all, all of the men in this study were at the VA for cardiac catheterizations, which means most of them already had confirmed heart disease.  This is not 8,700 healthy men we are talking about.  Many had other risk factors for heart attacks, including diabetes, high blood pressure and obesity.  Also, although not discussed in the USA Today article, another article I read said the men who were given testosterone were using the gel form of administration, which is known to have widely varying effects on raising men's testosterone levels. Nowhere have I seen any discussion of the levels of testosterone in the men who were taking testosterone, either before or after they were given testosterone. The study is absurd and I am sad that it has gotten as much press coverage as it has....it drives me nuts when so little real, valid information is shared about these studies. Dr. Carr has taught me so much about reading past the headlines, and even reading past the contents of the article to ask questions about risk factors, methodology of studies, and even who might be sponsoring the study (if it's a drug company, be very skeptical.)

  • Not hormone related, but since a significant number of middle aged women and men have knee problems (me included!) I thought you might find this interesting.  According to NBC News, doctors have discovered a new ligament in the human knee called anterolateral ligament (ALL). My first thought was "great, one more ligament for me to worry about popping!" 
  • Yes, it's time for me to go off on another rant about Vitamin D levels.  The days are getting shorter, the sun isn't as strong as it is during the spring and summer, and almost all age management/bioidentical hormone specialists will tell you that anyone over 40 needs to be supplementing their Vitamin D3, that you cannot keep your levels in the optimal range with food and sunshine alone.  Dr. Carr likes his patients to be between 70-100 ng/ml (blood test), and the last time mine was checked in late September it was a nice, healthy 78.  I am often asked how much Vitamin D I take.  From April to about early October, I take 5000 IU's daily, and the rest of the year I take 10,000 IUs daily.  I take it with Vitamin K for better absorption.  I do not use drugstore brands of Vitamin D, right now I am taking Life Extension brand, but have used OrthoMolecular with good results.  The only reason I don't use Ortho right now is because it looks EXACTLY like my DHEA capsule, if I drop one on the floor (a common occurrence since I fractured my arm in August), I have no idea which one it was to replace it.  My jaw dropped when I read this article from NBC News Health about an uptick in rickets in the UK, which is caused by Vitamin D deficiency.  In this day and age, in an industrialized country like the UK (with health care for all), this is an entirely preventable problem!  I know my bones are stronger because of my Vitamin D optimization, and there is considerable evidence that Vitamin D helps with seasonal affective disorder (SAD).  I also believe it has helped boost my immunity, as I am very rarely sick, I have had maybe two very light colds in the last 7 years, have not been on an antibiotic in at least 8 years.   As always, check with your doctor, but if he/she blows you off about getting a Vitamin D blood test, stand your ground and insist on getting one!  I've had a number of people tell me their doctor says they don't need a Vitamin D test because they (the doctor) are sure it's normal.  Number one, normal and optimal are two different things, and secondly, if your doctor can tell by looking at you that your Vitamin D level is normal than he must have some sort of superpower. 

  • There's a "new" drug out for hot flashes called Brisdelle.  It is not a new drug, it's simply Paxil (an antidepressant, and an old one at that) that has now been FDA approved for hot flashes. Check out the list from Web MD of side effects for Paxil, you will note it includes sweating, which is kind of ironic since the drug is being given for hot flashes.   We have a hormone deficiency, ladies, we do not have an antidpressant deficiency.  I am continually astonished (and appalled) at how many women are taking antidpressants, have been for 10 years or more, and don't think it's a big deal.  I took them for years before I got my hormones balanced, and am happy beyond belief that I do not take them anymore.  As always, do not, and I mean NEVER, go off an antidepressant cold turkey......weaning off an antidpressant should always be done under the supervision of a doctor.  
I think that's about it for today.  Happy Veteran's Day to all of you who have served our country.  My mother, as well as her sister and brother, were all in World War II at the same time.....I cannot imagine what my Grandma went through.  

My mom, circa 1942

Mom's sister, my Aunt Rocky (Betty), not sure of the date but about 1942 also.

Mom's brother, my Uncle Jack.  Again, circa 1942-1943.  I never met Uncle Jack, he died of a lung ailment when I was two years old. I am told I have his (and Aunt Rocky's) sharp, wicked sense of humour, and for that I am grateful!

Saturday, November 2, 2013

Good for the soul-------------

I've been away for a few days-----my first trip to Myrtle Beach! My friend Karen had an oceanfront condo for a week, and she graciously invited me to come stay with her for as long as I wanted.  I drove down Wednesday afternoon, and we all left about mid-morning on Saturday.  We mostly relaxed, at unhealthy food (hey, I get points for being honest), swam in the hotel pool (heated, and it was above average temperatures while I was there), and I spent part of Friday meeting the parents of a friend for lunch.

I took a couple slow but powerful walks on the beach------helped me to clear my head, reset my priorities, and I think now I am ready to put the effort into really, really getting back on track.  The weeks following my arm fracture have been very stressful---pain, physical therapy, anxiety about falling again, life stuff and so on.  Although I have been exercising, I haven't felt like I've been able to get back to maximizing my potential consistently, and the walks on the beach gave me time to talk to myself gently (I'm working on not beating myself up) about taking better care of myself.  I'm ready.

I wanted to share a few of the sunrise pictures I took (I'm still in awe that I had that kind of view each morning while sitting in my jammies!)......click here to see the entire album of pictures on Facebook (you do not need to be on FB to see the album).   Enjoy......I'm going to download these into my iPad and use as a slideshow with an "ocean wave" sound...........it will help me focus on my meditation.