I'm guessing that a lot of my readers can relate to the problem of recurrent urinary tract infections, particularly in the peri/postmenopausal stages of life. The infections usually cause frequent and/or painful urination, and can cause significant pelvic discomfort. The usual treatment is antibiotics, and from many women I have talked to, they end up on antibiotics several times a year, if not more often. The antibiotics can have a whole range of side effects, and it's important to note that after a number of courses of treatment, the body can build a resistance to the antibiotics, and stronger antibiotics have to be used.
I think a better approach is to address the issues surrounding why so many peri/post menopausal women get frequent urinary tract infections in the first place, and one of those reasons is the genital and urethral tissue becoming thinner and more fragile with the loss of estrogen. Most peri/post menopausal women notice vaginal dryness and/or atrophy as they age, but are often too embarrassed to talk to their doctor's about it (and we will address that in a separate post!) This is not just a matter of sexual health (although that is very important) but about urological health.
A study detailed on WebMd.com discusses using vaginal estrogen in post menopausal women to alleviate the deterioration of the genital tissue. The article is not specific as to whether bioidentical estrogen was used, and if so, if the estrogen used was estradiol, or the weaker form of estrogen, estriol. I have taken estriol cream vaginally for about 5 years (and writing this post reminded me that I need to call the pharmacy to order more!) I have not had a urinary tract infection in years, and I attribute that post menopausally to the estriol cream. I have it compounded, and it's about $100 for a three month supply. Not having to be on antibiotics (I haven't been on an antibiotic since 2007, and that was for a bug bite I scratched too hard in my sleep!) is wonderful. Ironically, when I was younger, I was one of those women who used to get a vaginal infection every time I was on an antibiotic (which was frequently, I taught high school and spent much of every winter battling upper respiratory infections and strep throat).
Talk to your doctor about using bioidentical estrogen for vaginal dryness/atrophy. I have a couple good articles to share with you, so hopefully I will be able to post several times this week. Happy first full week of summer!
Sunday, June 23, 2013
Tuesday, June 18, 2013
54 years ago today------
Sunday, June 9, 2013
Progesterone and Brain Health.......
For the past several years, studies have been conducted to gauge the effect of using bioidentical progesterone on patients who have suffered a traumatic brain injury (fall, car accident, other causes.) Naturally, as someone who takes bioidentical progesterone herself and has seen a significant increase in my cognitive function, I have taken interest in these studies. It is my hope that someday progesterone therapy will be a mainstream medicine standard for treating traumatic brain injuries.
One of the important facets of this treatment protocol is using the progesterone as soon as possible after the brain injury to minimize the damage. This, of course, presents a challenge to healthcare practitioners, because consent for treatment, particularly in clinical trials, is vital. I was in an experimental medical protocol trial once, many years ago, and it was related to a medication that may or may not (never knew if I received the medication being studied or a placebo) have been administered during a reconstructive knee surgery. I remember that the medication being studied was supposed to help relieve nausea post surgery, and that pre-operatively I had to sign a boatload of consent forms. For the record, I was wildly sick to my stomach for 24 hours after the surgery.
Because patients with TBI are often unable to consent to participating in a clinical trial because they are incapacitated or unconscious, obtaining consent is often difficult to impossible. The Boston Globe has an article on their website detailing the dilemma of getting consent for the progesterone and TBI study being conducted at Boston Medical Center and Massachusetts General Hospital. I hope the researchers are successful in finding a way to navigate the laws in place, because this is an important study that could affect patients of all ages.
If you would like to learn a little more about how progesterone affects brain health, be sure to read this article from Virginia Hopkin's website, she is a terrific resource for information about bioidentical hormones. Be sure to sign up for her newsletter!
One of the important facets of this treatment protocol is using the progesterone as soon as possible after the brain injury to minimize the damage. This, of course, presents a challenge to healthcare practitioners, because consent for treatment, particularly in clinical trials, is vital. I was in an experimental medical protocol trial once, many years ago, and it was related to a medication that may or may not (never knew if I received the medication being studied or a placebo) have been administered during a reconstructive knee surgery. I remember that the medication being studied was supposed to help relieve nausea post surgery, and that pre-operatively I had to sign a boatload of consent forms. For the record, I was wildly sick to my stomach for 24 hours after the surgery.
Because patients with TBI are often unable to consent to participating in a clinical trial because they are incapacitated or unconscious, obtaining consent is often difficult to impossible. The Boston Globe has an article on their website detailing the dilemma of getting consent for the progesterone and TBI study being conducted at Boston Medical Center and Massachusetts General Hospital. I hope the researchers are successful in finding a way to navigate the laws in place, because this is an important study that could affect patients of all ages.
If you would like to learn a little more about how progesterone affects brain health, be sure to read this article from Virginia Hopkin's website, she is a terrific resource for information about bioidentical hormones. Be sure to sign up for her newsletter!
Sunday, June 2, 2013
Levoxyl recalled, may be unavailable until 2014
Damn. I was sure I had posted about this back in April, but if I did the post disappeared because I do not see it on my newsfeed.
I take Levoxyl (brand name) for T4 hypothyroidism. Dr. Carr always orders brand name Levoxyl instead of generic because of its efficacy and consistency of dosage. I went to refill my prescription today and found that because of a drug recall by Pfizer (article link is to Endocrine Today), Levoxyl in any dosage is not available at this time, and the drug may not be available again until 2014. I am NOT a happy camper.
I know many of my readers also take Levoxyl, so it affects a lot of us. If you are taking brand name, you need to speak with your doctor's office to find out about alternatives until this gets straightened out. The generics work for some people, others have had heart palpitations (usually brief). I'll keep you updated on how I will be dealing with this medication issue, but as I always remind readers, check with your doctor before making any changes in your medication or supplement regimen.
I take Levoxyl (brand name) for T4 hypothyroidism. Dr. Carr always orders brand name Levoxyl instead of generic because of its efficacy and consistency of dosage. I went to refill my prescription today and found that because of a drug recall by Pfizer (article link is to Endocrine Today), Levoxyl in any dosage is not available at this time, and the drug may not be available again until 2014. I am NOT a happy camper.
I know many of my readers also take Levoxyl, so it affects a lot of us. If you are taking brand name, you need to speak with your doctor's office to find out about alternatives until this gets straightened out. The generics work for some people, others have had heart palpitations (usually brief). I'll keep you updated on how I will be dealing with this medication issue, but as I always remind readers, check with your doctor before making any changes in your medication or supplement regimen.
Depomed Fails to Win U.S. Approval for Menopause Drug
Good morning, everyone, and thank you for your patience! I got away from posting for a few weeks for a couple reasons.
1. Life. I am making some big changes in my life, and while they are positive changes, the steps involved have pretty much consumed me for the last 6-7 weeks. I'm still transitioning, but making progress. Details to come!
2. A lack of any newsworthy items on menopause/hormones lately. Sometimes the news is filled with information about health studies, new ideas, and sometimes it's not.
I was not at all surprised to see this article Friday in Bloomberg News. I wrote about this drug (Sefelsa) back a few months ago, it is a form of Gabapentin, which some of you may be familiar with as Neurontin. I actually took Neurontin for about 4 months a number of years ago (pre-bioidentical hormone balance) for chronic pain issues, but it didn't help me with pain management. I was perimenopausal at the time, and I know it did not help me with hot flashes (believe me, I would have remembered if it did!)
Hot flashes are caused by a hormonal deficiency, NOT a Neurontin deficiency, and not an anti-depressant deficiency. I know my regular readers have heard me say this a number of times, but three days after I started bioidentical progesterone cream, I had no more hot flashes. None. When articles like this use phrases like a "non hormonal alternative", I read that to say "instead of just replacing in your body the hormones that you had as a younger woman (or man) but lose as you age, we would rather fill you up with expensive, possibly toxic medications-----let's not bother treating the underlying cause of your medical problem, let's just give you drugs to mask the symptoms." It makes me (and many other patients and their physicians) just crazy.
1. Life. I am making some big changes in my life, and while they are positive changes, the steps involved have pretty much consumed me for the last 6-7 weeks. I'm still transitioning, but making progress. Details to come!
2. A lack of any newsworthy items on menopause/hormones lately. Sometimes the news is filled with information about health studies, new ideas, and sometimes it's not.
I was not at all surprised to see this article Friday in Bloomberg News. I wrote about this drug (Sefelsa) back a few months ago, it is a form of Gabapentin, which some of you may be familiar with as Neurontin. I actually took Neurontin for about 4 months a number of years ago (pre-bioidentical hormone balance) for chronic pain issues, but it didn't help me with pain management. I was perimenopausal at the time, and I know it did not help me with hot flashes (believe me, I would have remembered if it did!)
Hot flashes are caused by a hormonal deficiency, NOT a Neurontin deficiency, and not an anti-depressant deficiency. I know my regular readers have heard me say this a number of times, but three days after I started bioidentical progesterone cream, I had no more hot flashes. None. When articles like this use phrases like a "non hormonal alternative", I read that to say "instead of just replacing in your body the hormones that you had as a younger woman (or man) but lose as you age, we would rather fill you up with expensive, possibly toxic medications-----let's not bother treating the underlying cause of your medical problem, let's just give you drugs to mask the symptoms." It makes me (and many other patients and their physicians) just crazy.
Monday, May 6, 2013
Stress study offers clues for new antidepressant drugs
Until I became a patient in Dr. Carr's practice in NC (before he moved to CA), I had a number of doctors, including a boatload of assorted specialists relating to the injuries from my long ago car accident, and not one of them ever spent more than about 60 seconds talking to me about stress. I didn't even know what cortisol (the stress hormone) was until I started seeing Dr. Carr, and I sure didn't know what an important role it plays in our overall health.
My cortisol levels are now checked on a regular basis. My levels are likely always to be somewhat elevated because: a) I deal with chronic pain, which stresses the body, and b) I have dealt with lifelong anxiety and depression issues, which also put a strain on both body and mind. My depression and anxiety are far better now that I am hormonally optimized, but it is and likely always will be a work in progress.
Dr. Carr has told me more than once that optimally, the cortisol level should be about 10 or under. Mine at last check was 10.9, which I consider to be a major accomplishment! Two years ago, my cortisol level was 19.7, and in the time since, I have made major, deliberate changes in effort to get the levels down.
I detailed a serious bullying issue (yeah, that actually happens to women our age) in a previous blog post. At the time that all of that occurred, my cortisol level was hugely elevated, and since getting those awful women out of my life, my cortisiol level has dropped nearly in half. Those women really were making me sick! An interesting footnote to the story......since that blog post was written, one of the women involved in the bullying tried to reconnect with me though a mutual friend. I emailed the woman directly and told her in no uncertain terms that my life was richer and more meaningful than a year and a half ago, and that my self respect left no room in my life for people who went out of their way to hurt, humiliate and ostracize me the way she and her friends did. It's a closed chapter in my life and I am very much at peace with the way I handled it.
I've taken steps to step out of the routine once in a while and really "play". I budget to do it so it doesn't cause financial stress, but I consider it an important part of my overall health. My last "mini-vacation" was doubly the fun because it came up unexpectedly. I got a last minute ticket to see Barry Manilow (go ahead and laugh, he was hot when I was a teenager!) in Raleigh, and I spent the night at a hotel right across the street from the concert venue. I drove up early in the day so I could rest my back in the afternoon, and being so close to the venue I didn't have to leave to go over to the concert until close to curtain time. The show as WONDERFUL!!!! Barry's still got it :), and I had a blast. The next morning, I happened upon a really great arts and crafts festival in a beautiful park on a beautiful day. I had to use my cane to get around because my back was pretty painful, but it was more than worth it. Two of the best days I've had in a long time, and a great way to celebrate spring. I make a concerted effort to get together with friends that I am comfortable with, people I can laugh and be silly with. I also make time to pursue my hobbies of knitting (it's really a great stress reliever, and I have used it for years to manage pain levels), reading (and you can immensely cut down on the cost of that hobby by availing yourself of library resources), and I have recently become interested in Zentangle. I can't overemphasize the importance of having a passion. I also work out regularly, cardio, interval training, light weights. It's good for the mind and body.
I also take supplements to manage my cortisol levels. In the morning, I take Adrenevive and at night I take Cortisol Manager, both have played a crucial role in managing my stress. I also meditate, although I must admit I am not as consistent with it as I would like to be (but trying not to stress over that!)
I ran across this article in Reuter's this morning, that a study has been done on the effect of cortisol level on brain cells. The article talks about how the information learned in the study can help develop new drugs, specifically antidepressants, in the future. Wouldn't it make more sense to spend some of those resources on bioidentical hormone optimization, educating patients on ways to reduce stress, and studying the importance of supplements in managing cortisiol levels?
Take some time to really think through ways to manage the stress in your life. If you have a chronic pain issue in your life that is not being addressed, see your doctor about it. I am blessed to have a pain management physician who understands the mind/body connection and is my biggest cheerleader in my efforts to manage my cortisol levels. If there are people in your life who are making you crazy, get rid of them or find ways to minimize your contact with them. If you are over scheduled, prioritize and delegate. I learned a long time ago to stop being general manager of the universe. Be a supportive friend and cultivate healthy relationships. Don't take on and try to solve all your friend's problems, I've already tried that and it doesn't work. Most importantly, be your own best friend. Stop beating yourself up (and you know you are doing it !). Work on being at peace.
My cortisol levels are now checked on a regular basis. My levels are likely always to be somewhat elevated because: a) I deal with chronic pain, which stresses the body, and b) I have dealt with lifelong anxiety and depression issues, which also put a strain on both body and mind. My depression and anxiety are far better now that I am hormonally optimized, but it is and likely always will be a work in progress.
Dr. Carr has told me more than once that optimally, the cortisol level should be about 10 or under. Mine at last check was 10.9, which I consider to be a major accomplishment! Two years ago, my cortisol level was 19.7, and in the time since, I have made major, deliberate changes in effort to get the levels down.
I detailed a serious bullying issue (yeah, that actually happens to women our age) in a previous blog post. At the time that all of that occurred, my cortisol level was hugely elevated, and since getting those awful women out of my life, my cortisiol level has dropped nearly in half. Those women really were making me sick! An interesting footnote to the story......since that blog post was written, one of the women involved in the bullying tried to reconnect with me though a mutual friend. I emailed the woman directly and told her in no uncertain terms that my life was richer and more meaningful than a year and a half ago, and that my self respect left no room in my life for people who went out of their way to hurt, humiliate and ostracize me the way she and her friends did. It's a closed chapter in my life and I am very much at peace with the way I handled it.
I've taken steps to step out of the routine once in a while and really "play". I budget to do it so it doesn't cause financial stress, but I consider it an important part of my overall health. My last "mini-vacation" was doubly the fun because it came up unexpectedly. I got a last minute ticket to see Barry Manilow (go ahead and laugh, he was hot when I was a teenager!) in Raleigh, and I spent the night at a hotel right across the street from the concert venue. I drove up early in the day so I could rest my back in the afternoon, and being so close to the venue I didn't have to leave to go over to the concert until close to curtain time. The show as WONDERFUL!!!! Barry's still got it :), and I had a blast. The next morning, I happened upon a really great arts and crafts festival in a beautiful park on a beautiful day. I had to use my cane to get around because my back was pretty painful, but it was more than worth it. Two of the best days I've had in a long time, and a great way to celebrate spring. I make a concerted effort to get together with friends that I am comfortable with, people I can laugh and be silly with. I also make time to pursue my hobbies of knitting (it's really a great stress reliever, and I have used it for years to manage pain levels), reading (and you can immensely cut down on the cost of that hobby by availing yourself of library resources), and I have recently become interested in Zentangle. I can't overemphasize the importance of having a passion. I also work out regularly, cardio, interval training, light weights. It's good for the mind and body.
I also take supplements to manage my cortisol levels. In the morning, I take Adrenevive and at night I take Cortisol Manager, both have played a crucial role in managing my stress. I also meditate, although I must admit I am not as consistent with it as I would like to be (but trying not to stress over that!)
I ran across this article in Reuter's this morning, that a study has been done on the effect of cortisol level on brain cells. The article talks about how the information learned in the study can help develop new drugs, specifically antidepressants, in the future. Wouldn't it make more sense to spend some of those resources on bioidentical hormone optimization, educating patients on ways to reduce stress, and studying the importance of supplements in managing cortisiol levels?
Take some time to really think through ways to manage the stress in your life. If you have a chronic pain issue in your life that is not being addressed, see your doctor about it. I am blessed to have a pain management physician who understands the mind/body connection and is my biggest cheerleader in my efforts to manage my cortisol levels. If there are people in your life who are making you crazy, get rid of them or find ways to minimize your contact with them. If you are over scheduled, prioritize and delegate. I learned a long time ago to stop being general manager of the universe. Be a supportive friend and cultivate healthy relationships. Don't take on and try to solve all your friend's problems, I've already tried that and it doesn't work. Most importantly, be your own best friend. Stop beating yourself up (and you know you are doing it !). Work on being at peace.
Tuesday, April 30, 2013
The Compounding Pharmacy Debate..................
Many patients, me included, get at least some of their bioidentical hormones from compounding pharmacies. I get my progesterone cream, my estriol cream (for vaginal atrophy) and my T3 capsules compounded. My estradiol and testosterone are purchased at my local big box store pharmacy. I inject both of those medications once weekly (for me, Sundays), and I have found that it is easier to keep my hormone levels optimal with the protocol I am on.
I know most of you are aware of the fiasco and many deaths from tainted injections made by the New England Compounding Center last fall. Clearly the ball was dropped in regard to oversight over this pharmacy, which was not acting as a compounding pharmacy, but as a manufacturer, thus stepping way over the lines of what they were supposed to be doing. It frightened (justifiably) many people, and I spent a couple months reassuring patients from a patient's point of view that this was an aberration, that this is NOT the way most compounding pharmacies do business. I have NEVER had a problem with any of the hormone creams I have taken, and I have used at least five different pharmacies over the course of the last 6 1/2 years.
There is much discussion in Congress right now about whether or not the FDA (Food and Drug Administration) should be given broader access to regulate compounding pharmacies, which now are under the control of state pharmaceutical boards. I will be the first to tell you I am not a fan of the FDA, I think they are in bed with Big Pharma and have done a great deal to harm our health care system. A couple of years ago, I read something in an article that really struck home "Remember that every drug recalled by the FDA has first been declared safe and effective by the FDA". That's important.
Do we need to make sure that another rogue "compounding pharmacy" doesn't get greedy and decide to make oodles of money by stepping over the line to become a drug manufacturer instead of a compounding pharmacy? Sure do. Does giving the FDA broad but ill defined power the answer? Read this article and an opposing opinion from USA Today to help you decide.
I know most of you are aware of the fiasco and many deaths from tainted injections made by the New England Compounding Center last fall. Clearly the ball was dropped in regard to oversight over this pharmacy, which was not acting as a compounding pharmacy, but as a manufacturer, thus stepping way over the lines of what they were supposed to be doing. It frightened (justifiably) many people, and I spent a couple months reassuring patients from a patient's point of view that this was an aberration, that this is NOT the way most compounding pharmacies do business. I have NEVER had a problem with any of the hormone creams I have taken, and I have used at least five different pharmacies over the course of the last 6 1/2 years.
There is much discussion in Congress right now about whether or not the FDA (Food and Drug Administration) should be given broader access to regulate compounding pharmacies, which now are under the control of state pharmaceutical boards. I will be the first to tell you I am not a fan of the FDA, I think they are in bed with Big Pharma and have done a great deal to harm our health care system. A couple of years ago, I read something in an article that really struck home "Remember that every drug recalled by the FDA has first been declared safe and effective by the FDA". That's important.
Do we need to make sure that another rogue "compounding pharmacy" doesn't get greedy and decide to make oodles of money by stepping over the line to become a drug manufacturer instead of a compounding pharmacy? Sure do. Does giving the FDA broad but ill defined power the answer? Read this article and an opposing opinion from USA Today to help you decide.
Saturday, April 20, 2013
Uterine Fibroids and Vitamin D
I've been doing this blog for about four years now, and the more women I talk to, the more I convinced that there are less than two dozen women over the age of 50 who still have their uterus. I'm kidding. Sort of. The number one cause of hysterectomy in women is uterine fibroids. I had a hysterectomy in 2002 for fibroids; they weren't huge but caused a lot of pain, and the bleeding was so heavy (and erratic) that I became severely anemic. I had to have 8 weeks of iron infusions by IV (3 hour sessions---ugh) for 8 weeks preoperatively just to get my blood levels high enough to be cleared for the surgery. What was supposed to be a 24 hour hospital stay post operatively ended being 8 days----I bled post operatively necessitating a second surgery, and then developed a urinary tract infection from the catheter. Not my idea of a great time.
In the NY Times, I read about a new study out that suggests that a low level of Vitamin D increases the risk of uterine fibroids in women. I was interested to see that the risk of fibroids was reduced even when a woman's Vitamin D level was as low as 20------even by the ridiculously low standards of mainstream medicine, a level of 20 ng/ml is considered insufficient. Some mainstream (read that to mean old school) physicians consider 30 ng/ml to be "adequate:", but more and more doctors are striving to get their patients up to at least 50 ng/ml. Dr. Carr (my physician) likes his patients in the optimal range of 70-100 ng/ml, and my last reading in February came in at 78. I often get asked how much Vitamin D I take. Right now I am taking 15000 IUs daily, 2 - 5000 IU capsules, and then I get another 5000 IUs in the L-Arginine powder I take daily (it's a supplement, has a lot of benefits including heart health, but also contains Vitamin D). The brand of capsules I take is Ortho Molecular, I cannot stress enough the importance of taking a good quality supplement. I ran out one time, and being lazy (and distracted, I forgot to add it to my supplement order) I picked up some at a big box store and took it for about 3 months. When I had my blood work done, my Vitamin D level had dropped by about 10 point. Vitamin D is not an expensive supplement, and the Ortho Molecular brand (I have also used Integrative Theraputics) is just about the same price as the drug store brands. Now that we are (finally) getting into warm weather, I will be out in the sunshine more, and at the end of this month I will drop back to taking one 5000 IU capsule and my L-Arginine. I swim outside about 5-6 days a week in the summer without sunscreen, so I get a good dose of Vitamin D courtesy of the NC sunshine!
If any of my readers are from the Boston area, my thoughts have been with you this week, and I am very glad they caught that second terrorist suspect alive. I watched some of the coverage yesterday, but in my concerted effort to reduce my stress level, I didn't focus on it and went about my day and stayed as busy as I could. Yesterday my back was really painful, so I had an in the house day (I refer to it as a play quietly day), I read, listened to music, did a little Zentangle artwork (I'm finding this a great way to meditate!), knit for a while, and did some gentle stretching every time I got up to move around. My back is definitely better today, I am being careful not to sit for very long at a time, and thank goodness for my iPad to browse online when I am laying down resting.
Hope wherever you are and whatever you are doing, you are having a great weekend!
In the NY Times, I read about a new study out that suggests that a low level of Vitamin D increases the risk of uterine fibroids in women. I was interested to see that the risk of fibroids was reduced even when a woman's Vitamin D level was as low as 20------even by the ridiculously low standards of mainstream medicine, a level of 20 ng/ml is considered insufficient. Some mainstream (read that to mean old school) physicians consider 30 ng/ml to be "adequate:", but more and more doctors are striving to get their patients up to at least 50 ng/ml. Dr. Carr (my physician) likes his patients in the optimal range of 70-100 ng/ml, and my last reading in February came in at 78. I often get asked how much Vitamin D I take. Right now I am taking 15000 IUs daily, 2 - 5000 IU capsules, and then I get another 5000 IUs in the L-Arginine powder I take daily (it's a supplement, has a lot of benefits including heart health, but also contains Vitamin D). The brand of capsules I take is Ortho Molecular, I cannot stress enough the importance of taking a good quality supplement. I ran out one time, and being lazy (and distracted, I forgot to add it to my supplement order) I picked up some at a big box store and took it for about 3 months. When I had my blood work done, my Vitamin D level had dropped by about 10 point. Vitamin D is not an expensive supplement, and the Ortho Molecular brand (I have also used Integrative Theraputics) is just about the same price as the drug store brands. Now that we are (finally) getting into warm weather, I will be out in the sunshine more, and at the end of this month I will drop back to taking one 5000 IU capsule and my L-Arginine. I swim outside about 5-6 days a week in the summer without sunscreen, so I get a good dose of Vitamin D courtesy of the NC sunshine!
If any of my readers are from the Boston area, my thoughts have been with you this week, and I am very glad they caught that second terrorist suspect alive. I watched some of the coverage yesterday, but in my concerted effort to reduce my stress level, I didn't focus on it and went about my day and stayed as busy as I could. Yesterday my back was really painful, so I had an in the house day (I refer to it as a play quietly day), I read, listened to music, did a little Zentangle artwork (I'm finding this a great way to meditate!), knit for a while, and did some gentle stretching every time I got up to move around. My back is definitely better today, I am being careful not to sit for very long at a time, and thank goodness for my iPad to browse online when I am laying down resting.
Hope wherever you are and whatever you are doing, you are having a great weekend!
Sunday, April 14, 2013
I haven't forgotten you------
But lately, there has been little news to share in the world of bioidentical hormones and related menopause issues. I hope everyone is enjoying these first weeks of spring, which have been very slow to come to the Southeast. It's finally here, however, and I have been enjoying some beautiful, sunny, mild days, perfect for capri pants and sandals! Luckily, the progesterone cream keeps me allergy free, but lots of folks around here are sneezing and have very itchy eyes.
Hard to believe tomorrow is tax day..........the month of April is half gone! I'll be back soon as soon as I have any good articles to share with you, in the meantime, enjoy the rest of your weekend!
Hard to believe tomorrow is tax day..........the month of April is half gone! I'll be back soon as soon as I have any good articles to share with you, in the meantime, enjoy the rest of your weekend!
Monday, March 25, 2013
Osphena
The FDA has recently approved a new drug for peri/menopausal women called Osphena. It's an oral drug that acts like estrogen on vaginal tissue, easing symptoms of thinning of the vaginal tissue, and the dryness that often causes sex to be painful or impossible. Here is the FDA's press release about the approval of Osphena.
This drug is a perfect example of women getting screwed over by the pharmaceutical companies. Bioidentical estriol cream has been used for many, many years to treat vaginal atrophy. Estriol is the weakest of the three estrogens, and in a vaginal cream (compounded) is even used in women who have been treated for breast cancer. But because estriol cannot be patented, the drug manufacturers don't want to hear about it (or have women hear about it). Doesn't it make more sense that if a woman is having a problem with vaginal dryness, that you give her something to put in her vagina rather than in her mouth? I didn't even go to medical school and it's clear to me that topical treatment, replacing what the body has lost with age, makes more sense than giving an oral medication that has unwanted side effects. I almost choked when I read that some of the side effects of Osphena are thickening of the uterine lining (that's because mainstream medicine hasn't figured out yet that women need progesterone too!), and hot flashes/excessive sweating. Really? Are you kidding me?
I've taken bioidentical estriol cream vaginally (at night just before bed) for more than five years, and it works fine. It's relatively inexpensive (I think about $60 for a two month supply), and has no side effects. If you are having an issue with dryness and/or painful sex, talk to your doctor.
Still very few signs of spring here in NC, as in much of the country. Usually by now I am full time into capri pants and sandals, not this year! I had a wonderful girl's day out with a friend on Saturday, lunch and theater (we went to see the national touring company of Wicked----it was amazing!) and I wore a sweater and a shawl. I'll be glad to see April arrive. Have a great week!
This drug is a perfect example of women getting screwed over by the pharmaceutical companies. Bioidentical estriol cream has been used for many, many years to treat vaginal atrophy. Estriol is the weakest of the three estrogens, and in a vaginal cream (compounded) is even used in women who have been treated for breast cancer. But because estriol cannot be patented, the drug manufacturers don't want to hear about it (or have women hear about it). Doesn't it make more sense that if a woman is having a problem with vaginal dryness, that you give her something to put in her vagina rather than in her mouth? I didn't even go to medical school and it's clear to me that topical treatment, replacing what the body has lost with age, makes more sense than giving an oral medication that has unwanted side effects. I almost choked when I read that some of the side effects of Osphena are thickening of the uterine lining (that's because mainstream medicine hasn't figured out yet that women need progesterone too!), and hot flashes/excessive sweating. Really? Are you kidding me?
I've taken bioidentical estriol cream vaginally (at night just before bed) for more than five years, and it works fine. It's relatively inexpensive (I think about $60 for a two month supply), and has no side effects. If you are having an issue with dryness and/or painful sex, talk to your doctor.
Still very few signs of spring here in NC, as in much of the country. Usually by now I am full time into capri pants and sandals, not this year! I had a wonderful girl's day out with a friend on Saturday, lunch and theater (we went to see the national touring company of Wicked----it was amazing!) and I wore a sweater and a shawl. I'll be glad to see April arrive. Have a great week!
Tuesday, March 19, 2013
One in three elderly have dementia when they die
I think many if not nearly all of my readers are affected by this report in today's USA Today. Many of us are now or have had to care for elderly parents or grandparents, and far too many of our elderly loved ones have suffered from some form of dementia or Alzheimer's disease. I have a friend who lost her husband just about a year ago from frontal temporal dementia (at the age of 63, he developed the disease in his late 50's), and it was utterly painful to watch the progression of the disease and how it affected the entire family. I feel truly blessed that although my mother was an invalid the last few years of her life, her mind was (very) sharp until the morning she died. I'm not sure I could have kept her at home if dementia or other cognitive impairments were an issue along with her physical frailties.
I can't say that I know that bioidentical hormone optimization is cutting my risk for developing dementia in my later years, but I feel like better health at the cellular level, as well as keeping my hormone levels optimized, exercise, and keeping my mind busy and engaged are all helping in the fight. For those of you who are currently taking care of loved ones with dementia and cognitive issues, my thoughts are with you. It's a very difficult thing to endure, but please try to remember to take care of yourself too. As my doctor told me when I was taking care of my mother "you can't pour from an empty pitcher."
Happy Spring starting tomorrow! It sure won't feel like it here in NC, we have had a cold, cloudy, miserable winter. Today is the lone seasonal day of the week, tomorrow the high here will barely reach 50 degrees, and that is nearly 12-15 degrees below average. Boo, hiss. Make it a great week!
I can't say that I know that bioidentical hormone optimization is cutting my risk for developing dementia in my later years, but I feel like better health at the cellular level, as well as keeping my hormone levels optimized, exercise, and keeping my mind busy and engaged are all helping in the fight. For those of you who are currently taking care of loved ones with dementia and cognitive issues, my thoughts are with you. It's a very difficult thing to endure, but please try to remember to take care of yourself too. As my doctor told me when I was taking care of my mother "you can't pour from an empty pitcher."
Happy Spring starting tomorrow! It sure won't feel like it here in NC, we have had a cold, cloudy, miserable winter. Today is the lone seasonal day of the week, tomorrow the high here will barely reach 50 degrees, and that is nearly 12-15 degrees below average. Boo, hiss. Make it a great week!
Friday, March 8, 2013
F.D.A. Panel Advises Against Two Medicines to Treat Hot Flashes
There have been a number of articles all over the media this week about the FDA's decision to advise against two drugs that have recently been developed for hot flashes-----one is a form of Neurontin (originally used for epilepsy) and another called Sefelsa. Check out this story from the New York Times.
Several interesting points in the story:
Several interesting points in the story:
- Hot flashes are caused by a hormone deficiency. Suffering from hot flashes is not indicative of a Neurontin or a Sefelsa deficiency.
- In paragraph seven, the article discusses the 2002 Women's Health Initiative Study. As I have detailed in other posts, that study (which has now been largely debunked for a variety of reasons) used SYNTHETIC hormones (Premarin and Prempro) which are not hormones at all, they are drugs-----made from horse urine. The bioidentical hormones used in bioidentical hormone replacement therapy are synthesized in a lab, but are made from plant sources and have the IDENTICAL molecular structure of the hormones that we have in our bodies that we lose when we age.
- Paragraph nine sums it up nicely----a doctor is quoted as saying that women are "begging for alternatives" and if there are no effective drugs available "they will get help on their own without us". I have news for that doctor, a lot of women, me included, are already getting help without relying on mainstream/conventional medicine. We seek out doctors who are experts in bioidentical hormones, who know that balancing our hormones is a far healthier, safer option than filling us with daily handfuls of toxic, expensive medications.
- Both of the drugs not approved had only "marginal effectiveness". I was having 10-20 moderate to severe hot flashes daily before I started on the bioidentical hormones (progesterone specifically). Three days after I started the progesterone cream, I no longer had ANY hot flashes, and that was 6 1/2 years ago. From 20 hot flashes a day to 0 in 6 1/2 years to me indicates far more than the marginal effectiveness the drugs provide. Oh, and check out the side effects of Neurontin, they are frightening.
At the end of the article, there is a mention about a drug for vaginal dryness called Osphena, and that will be the subject of a separate post.
Have a great weekend, everyone, I am off to the gym, and then heading down to the quilt show today!
Sunday, March 3, 2013
Calcium and VItamin D
If you have looked at any news this week (paper, Internet, TV) I'm sure you have heard that the US Preventative Task Force has come out saying that calcium and Vitamin D, taken at levels of 1000 mg of calcium daily and 400 IUs Vitamin D daily do not strengthen bones. This article from USAToday is one of many covering the subject.
I have NEVER taken calcium for bone health, even after I was diagnosed with osteopenia in 2004. Dr. Carr (who was my physician at that time too, he was still living in NC) told me that calcium was not what strengthened bones, and in fact, could cause kidney problems (kidney stones) and cardiac problems. He put me on Vitamin D3, along with Vitamin K (helps with absorption), and he encouraged me to start weight training (resistance exercise). Working out in the pool is good cardio but does not stress the bones enough. Ditto for fitness walking.
The study in the media this week is, in my opinion, a joke. Calcium does not build bone. Testosterone does. 400 IUs of Vitamin D is nowhere near enough for most (if not all) people, right now I am taking 15,000 IUs of Vitamin D, and once spring really gets here and I am outdoors more, I will probably back down to 10,000 IUs of Vitamin D. Dr. Carr likes his patients to be at levels somewhere between 70-100 ng/ml (I believe the preventative task force considers 30 ng/ml to be "adequate"), and my blood work two weeks ago showed my Vitamin D to be at 78! I've detailed in other posts on this blog that my last DEXA scan in 2009 showed a total reversal of my osteopenia, which of course thrilled me and my doctors. I asked Dr. Carr and Dr. Hines (my pain management doctor) about repeating the DEXA (bone density) scan, and both said that given how many radiologic studies I have had after the accident, that it's not worth subjecting me to any more radiation unnecessarily. Even if the DEXA showed some backsliding in my bone density, they wouldn't change the treatment (resistance training, testosterone and Vitamin D). I will never, ever take the osteoporosis drugs, and I know Dr. Carr will never prescribe them for me. Or for anyone.
My back and hip, as I have detailed before, are still quite problematic from a long ago car accident. I fall every couple of months, sometimes my hip just doesn't hold me up when I put weight down on it. If I am in the middle of a stride, I go down hard on all fours. I haven't broken anything in all those falls, usually all I have is skinned knees and/or hands, and I'm usually pretty sore for a couple days afterward.
Please check with your practitioner before making any changes to your medications/hormones/supplements, and if you have not had a Vitamin D level checked lately, insist on it at your next visit.
Cold here in NC, I'm ready for spring! Enjoy the rest of your weekend.
I have NEVER taken calcium for bone health, even after I was diagnosed with osteopenia in 2004. Dr. Carr (who was my physician at that time too, he was still living in NC) told me that calcium was not what strengthened bones, and in fact, could cause kidney problems (kidney stones) and cardiac problems. He put me on Vitamin D3, along with Vitamin K (helps with absorption), and he encouraged me to start weight training (resistance exercise). Working out in the pool is good cardio but does not stress the bones enough. Ditto for fitness walking.
The study in the media this week is, in my opinion, a joke. Calcium does not build bone. Testosterone does. 400 IUs of Vitamin D is nowhere near enough for most (if not all) people, right now I am taking 15,000 IUs of Vitamin D, and once spring really gets here and I am outdoors more, I will probably back down to 10,000 IUs of Vitamin D. Dr. Carr likes his patients to be at levels somewhere between 70-100 ng/ml (I believe the preventative task force considers 30 ng/ml to be "adequate"), and my blood work two weeks ago showed my Vitamin D to be at 78! I've detailed in other posts on this blog that my last DEXA scan in 2009 showed a total reversal of my osteopenia, which of course thrilled me and my doctors. I asked Dr. Carr and Dr. Hines (my pain management doctor) about repeating the DEXA (bone density) scan, and both said that given how many radiologic studies I have had after the accident, that it's not worth subjecting me to any more radiation unnecessarily. Even if the DEXA showed some backsliding in my bone density, they wouldn't change the treatment (resistance training, testosterone and Vitamin D). I will never, ever take the osteoporosis drugs, and I know Dr. Carr will never prescribe them for me. Or for anyone.
My back and hip, as I have detailed before, are still quite problematic from a long ago car accident. I fall every couple of months, sometimes my hip just doesn't hold me up when I put weight down on it. If I am in the middle of a stride, I go down hard on all fours. I haven't broken anything in all those falls, usually all I have is skinned knees and/or hands, and I'm usually pretty sore for a couple days afterward.
Please check with your practitioner before making any changes to your medications/hormones/supplements, and if you have not had a Vitamin D level checked lately, insist on it at your next visit.
Cold here in NC, I'm ready for spring! Enjoy the rest of your weekend.
Sunday, February 24, 2013
Lab Tests
Good morning, everyone! I had a bunch of blood work done about a week and a half ago, and thought I would update you on my "hormone progress" (I realize that makes me sound very self centered, but actually it's for educational purposes!)
My progesterone is still on the very low side of optimal, but for me that's not unusual. I take my progesterone cream (and it's a higher concentration than many people take) 4 times daily, but I burn through it pretty quickly because of a chronic pain issue, so keeping the levels up is always a struggle.
Thyroid: my TSH is up slightly (still well below 1.0), and my T3 and T4 are slightly down from my last labs in August 2012. Since Dr. Carr is all about proceeding cautiously and only changing on thing at a time (which is a good thing-----sometimes doctors will make wholesale changes in a patient's medications/hormones and then you have no idea what is or isn't helping!) we have upped my T3 medication slightly. I suspected my thyroid was faintly off, for a couple months I have had less energy than usual, and my focus/concentration have been somewhat off. I noticed I wasn't reading as much as I usually do (lack of concentration makes it less fun!), and since the first of the year I have messed up on several knitting patterns, mistakes that normally I wouldn't make.
The great news-----my Vitamin D level is 78! That's the highest it has EVER been......a couple of summers ago it got to 70, but that was from my being out in an outdoor pool 5-6 days a week doing water exercise. I'm thrilled! I'm taking 10,000 IUs a day of Ortho Molecular Vitamin D:
My progesterone is still on the very low side of optimal, but for me that's not unusual. I take my progesterone cream (and it's a higher concentration than many people take) 4 times daily, but I burn through it pretty quickly because of a chronic pain issue, so keeping the levels up is always a struggle.
Thyroid: my TSH is up slightly (still well below 1.0), and my T3 and T4 are slightly down from my last labs in August 2012. Since Dr. Carr is all about proceeding cautiously and only changing on thing at a time (which is a good thing-----sometimes doctors will make wholesale changes in a patient's medications/hormones and then you have no idea what is or isn't helping!) we have upped my T3 medication slightly. I suspected my thyroid was faintly off, for a couple months I have had less energy than usual, and my focus/concentration have been somewhat off. I noticed I wasn't reading as much as I usually do (lack of concentration makes it less fun!), and since the first of the year I have messed up on several knitting patterns, mistakes that normally I wouldn't make.
The great news-----my Vitamin D level is 78! That's the highest it has EVER been......a couple of summers ago it got to 70, but that was from my being out in an outdoor pool 5-6 days a week doing water exercise. I'm thrilled! I'm taking 10,000 IUs a day of Ortho Molecular Vitamin D:
And another 5000 IUs (for a total of 15,000 IUs daily) of L-Arginine:
Both of these supplements can be obtained through Dr. Carr's office (you do not need to be a patient of Dr. Carr to purchase supplements from his office).
Even better news---my cortisol level has dropped again to 10.9! It was as high as 19.7, so I guess the concerted effort I have made to reduce the stress in my life is making a difference. Of course, I do take two different supplements to help----in the morning, I take 2 Adrene-Vive:
and at night I take two Cortisol Manager:
I was really skeptical about these supplements when I started taking them, but the lab work clearly shows the benefit. Again, available through Dr. Carr's office.
I detailed in an earlier post that I am now taking my testosterone and estradiol by weekly injection. I am happy to say my testosterone level is FINALLY in the optimal range (yay, me!) and so is my estradiol. Taking these two hormones by injection is the only way I have been able to get my levels up, and something you may want to discuss with your doctor (provided you aren't afraid to inject yourself once a week---honestly, the needle is so small you barely feel it!) It's far more cost effective, too. As an example, my testosterone cream was about $90 (and may be more) for a 60 day supply. My bottle of testosterone cost $99, but will last me well over a year!!!!! My bottle of estradiol is about $40, and lasts about 2 months. Additionally, I pay about $15 for 30 syringes and the accompanying BD needles (a thicker needle used to draw up the hormone into the syringe---the solutions are thick). 30 syringes lasts me nearly 4 months, do the math and you will see how more cost effective injections are, and with the added benefit of two less creams to deal with. Talk to your health care practitioner to see if this is an available option for you.
My hormonal balance has unquestionably made me healthier, and therefore, less of a burden to society and my health insurance carrier. I urge you to read this (lengthy) article from Time Magazine, it's an eye opener.
Have a great Sunday, everyone! Finally the sun is back out (for one day) here in NC. I'm going to head out to straighten up my car, take it to get it vacuumed, and go for a walk. Then this afternoon I am going to settle in and knit. Whatever you do, make it a great day!
Tuesday, February 19, 2013
HRC Medical Centers
Hi everyone, apparently this one slipped right by me. All HRC Medical Centers are now closed. They were a chain of bioidentical hormone replacement clinics located mostly in Southeast states (they heavily advertised their center in Charlotte on radio, TV and print media), and got into a lot of trouble with the TN State Attorney General. Their "retired" medical director, Dan Hale, did jail time for Medicare fraud, lost his medical license, and went on to open this chain of clinics. I have gotten numerous complaints about the centers here in NC, and Mr./Dr. Hale is not real popular with the State of NC (read letter for fuller explanation).
I hate this not because I was ever a fan of HRC Medical (believe me, I wasn't) but because incidents like this give a bad name to the practitioners who are truly experts in bioidentical hormones and are in it to help patients. It was clear from the outset that HRC Medical had a lot of problems with their clinics, and I am glad that no other patients will be subjected to their "brand" of medical care.
I hate this not because I was ever a fan of HRC Medical (believe me, I wasn't) but because incidents like this give a bad name to the practitioners who are truly experts in bioidentical hormones and are in it to help patients. It was clear from the outset that HRC Medical had a lot of problems with their clinics, and I am glad that no other patients will be subjected to their "brand" of medical care.
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