Customized Medicines

Customized Medicines
Dr. Sonja O'Bryan, Pharm.D., ABAAHP Board Certified Health Practitioner Diplomate-American Academy of Anti-Aging Medicine: "Creative Medicines" for Hormones-Weight-Pain-Fatigue-Skin Diseases-Pediatrics-Autoimmune Disorders-Veterinary Needs. Using Complimentary, Integrative, Regenerative, Bio-Identical, and Lifestyle Medicine For Health and Healing.

Tuesday, January 17, 2012

Are you feeling HOT, HOT, HOT?

The number one symptom menopausal women complain of is HOT FLASHES.  I doubt that's a big shocker to anyone reading this article.  And just so you know, I've heard just about every statement imagineable from women who try to describe their FLARE-UPs to me in the office.  I love hearing them and have collected some favorites throughout the years which I now look back on and smile about.

Flinging the covers off at night, fanning like a crazy person, running the A/C in 50 degree weather are all explanations talked about day-in and day-out around here.  It's fun in the way that they describe the problem of hot flashes, but I promise you there is a sincere cry for help when they get to the point of seeing me to help uncover the problem.  I remember a patient a few years ago that sat in the chair and dripped with sweat as I tried to interview her.  It was sad to have to watch her suffer in that way but there was an even greater problem that the hot flashes had brought about.  The affection of her spouse had dimished because of her constant and profuse sweating.  She felt half-human at that point and really needed some answers.

So what happens when a "Hot Flash" strikes? (no pun intended.....I told you I've heard them all)
 Vasomotor flushing is the technical term and happens when blood vessels in the skin of the head and neck open more widely than usual, allowing more blood to shift into that area.  This creates the heat and redness that a woman feels during a "Hot Flash".  The reasons for the onset of the hot flash can be many, but usually are the result of declining estrogens and rising levels of follicle stimulating hormone (FSH).  The real problem is that one never knows when they are going to happen.  NEWS BULLETIN!!!..... Usually 'hot flashes' will occur right during something very important or when you are in front of A LOT of people. (Murphys Law right?)

What should you do if you are feeling Hot, Hot, Hot?

Hormone testing (saliva is my preference) helps to identify the degree to which things are out-of-whack and should always be used as a guide for care and treatment.  Everyday, I work with M.D.'s, Nurse Practitioners, and PA's from all over the area and in other states who are more than welcome to call and discuss your care plan with me.  Why?  Because a patient should use only the hormones that are identified as deficient and not something that is convenient and packed with unnecessary components for their body.  I suggest a full hormone panel before doing ANYthing in the world of hormones.  In my patients, I require Estrogen, Progesterone, Testosterone, and sometimes DHEA, and Cortisol levels to be tested. Hormone testing just gives a good picture of what's going on inside.  The other important part of the process is a patient interview.  This helps me to consider other health concerns and family history information. 

Throughout the years I have been surprised a few times to see that the problem was not estrogen, but one of the other hormones (that I mentioned above) being out of balance.  There have also been a few times that the problem was not hormonal, but a stress related condition for which I recommended herbal remedies and lifestyle changes.  Honestly, it would have been terrible to put estrogen therapy on board with these patients when estrogen wasn't the problem at all.  That's why I enjoy serving in the field of customized medicine.  It's about each person and each need and it's why this field of medicine is growing almost exponentially throughout the country.  "Cookie cutter" medicine is simply not the best approach to hormone problems anymore.

So if you're "all fired up" and feeling Hot Hot Hot, please don't hesitate to give me a call.
Maybe I can help cool things down a bit for you.

To your good health,
Dr Sonja

Monday, January 9, 2012


If I were to name a customized medicine after 25 years of being in this profession, I would probably call it this.  Why the long word? Because that's just how they do the nomenclature in this business, but also, it reflects the lists of medications that usually appear in my office as I talk with patients.

This fancy name is what I refer to as the Cocktail of Aging. Many women and men that come to my office for a consultation on aging, reproductive issues, menopausal symptoms, and the like, will often share their medical history of insomnia, depression, anxiety, weight gain, irritability, anxiety, and so on.  But they will also share a medication list for a pill to treat each and every symptom that they struggle with.  I take the information, close their chart, and begin to simply describe the process of aging and the things that can occur as a result of improper hormone balance.  Polypharmacy is not the answer but getting to the real cause of the problem is a much better way to approach things.

Here's what I simply share with my patients. 

Take a quick look at these symptoms of Estrogen Deficiency:

shortness of breath, insomnia, vaginal dryness, anxiety, headache, heart palpitations, incontinence (to name a few)....  Now a Menopause Cocktail list for this patient might include: Proventil Inhaler, Lunesta, Vagifem, Xanax, Hydrocodone, Propranolol, and Detrol.  (in order of symptom need). 

And then I share, here's some of the symptoms of Progesterone Deficiency:

Headache, Anxiety, Moodiness and Irritability, Depression, Cravings, Trouble going to sleep, Weight gain, Water Retention.    The Menopause Cocktail for this might include:  Imitrex, Ativan, Prozac, Ambien, Phentermine, and Lasix.

Moving right along to Testosterone Deficiency:

Low libido, Fatigue, Aches and Pains, Incontinence, Depression, Bone Loss, Decreased Muscle Mass, Fibromyalgia, Thinning Skin, and Decreased Stamina.   So the Cocktail for this patient might include EstraTest, Gabapentin, Ibuprofen, Detrol, Celexa, Fosamax, and Lidoderm patches. 

This is not just about the women either.  WHAT ABOUT MEN?  (I'm glad you asked)

Here's a quick review of the symptoms men deal with as they go through Andropause: Bone loss, Back pain, Decreased Muscle Strength, Decreased Urine Flow, Depression, E.D., High cholesterol, Hot flashes, Low Libido, Irritability, Moodiness, Insomnia, and weight gain especially in the abdominal area.  So 'his' cocktail might include: Calcium +D, Hydrocodone, Flomax, Paxil, Viagra, Lipitor, ....etc....   Maybe for the men I would call the medicine ZyTestraPrexaPaxil just to have a fun name for the guys.

Really it's not fun at all to sit down with a patient who has been existing in the world of polypharmacy.  Often they find their way to me after years and years of taking multiple medicines just to exist in the real world.   I am thankful that providers are really listening to the opinions of their patients these days as they come to a formalized answer as to the source of the problem.  I tell patients that they are their best healthcare provider.  They know how they feel.  They know what works and what doesn't.  And in this age, it's common for patients to come to my office having done their own research beforehand.  I love that and encourage it. 

Are you on a COCKTAIL of band-aid pharmaceuticals?  Have you ever once considered that hormones are to blame? 

My goal in this blog is to point your attention in a different direction as to some of the reasons why you might be feeling worn out, burnt out, crabby, sad, anxious, tired, and so on.  I have tested hundreds of patients throughout the years and now work with patients and providers all over Missouri and in other states who want to assess these other reasons.  Give me a call and I will be happy to share more information with you.

To your good health,
Dr. Sonja

Wednesday, January 4, 2012

Tea Time

I have never been much of a tea drinker,  but after doing some research on this topic, I feel confident that my multivitamin regimen will always include various forms of tea.  Mine personally includes green tea, black tea, and oolong tea to be very specific.  I feel the tea gives me energy, helps maintain my weight, and gives me focus as I go about my day.  If you are not using tea (either drinking or in capsule form), then please pay attention to the facts in this blog.

Tracing back to 700 A.D., tea houses became popular social centers amongs poets, royalty, educators, and physicians. And tea is still a staple in Chinese households today.  I did not realize this, but the US is now China's seconds largest importer of tea. WOW!  Americans like their tea.  All teas come from an evergreen plant 'Camellia sinensis' which produces many types of teas (~300).  The plants can grow crazy high (50 feet), but most are kept at about 5 feet tall.  Of the 300 varieties of tea, there are really 5 types that are of importance to health and longevity.  I want to keep the blog short so I feel doing just a simple breakdown list is probably the best approach. 
So here goes....lets talk teas.

Types of Teas
1. Black Tea-(fully fermented) has a smoky flavor. has warming properties so it's best in colder months. is good for people with pain in the extremities due to cold weather.  is good for poor circulation, arthritis, and coughs caused by a cold.  Pu-er black tea is the most effective for weight, triglycerides, and cholesterol.  It is used in Chinese medicinals to decrease risk of stroke, atherosclerosis, and obesity.

2.  Oolong Tea- (half fermented) can aid in digestion. can decrease absorption of fats from big meals. is beneficial for patients who have skin problems such as acne.

3.  Green Tea- (not fermented) has a weaker ability to boost metabolism as compared to the other teas.  popular during summers because of their cooling properties. has a high antioxidant content.  Gunpowder tea is the green tea with the highest antioxidant content.

4.  Flower, Fruit, and Scented Teas: (black, green, and oolong) a popular tea during summer because of it's cooling properties, decreased effect on  sweating, dehydration, headaches, irritability, allergies, and eye problems.  Fruit teas are great for those with intestinal and stomach problems such as bloating, gas, indigestion, and heartburn.

5. White tea is not readily available unfortunately because of its seasonal extraction process.

Research proves that tea has antibacterial, antiviral, and antifungal properties.  It lowers blood glucose, prevents tooth decay, boosts the immune system, and increases blood flow and energy.  Tea can also decrease plaque in blood vessels.  There's more. The polyphenols in tea contain powerful antioxidants that aid in cancer prevention.  And, both black and green tea inhibit the activity of enzymes linked to Alzheimers disease.  WOW! Pour me a cup.

Cancer: heavy smokers who drank at least 4 cups of tea each day had a 31% reduction in a chemical that is released causing DNA damage. (American Assoc. for Cancer Research)

Blood Pressure: Habitual tea drinkers showed a decrease in both systolic and diastolic blood pressure over the course of a year.

Other Uses: Washing a cut to prevent infection. Treating athletes foot. Placing tea leaves in a pillow case to serve as an air freshener. Mouthwash for bad breath.  Who knew???

What about the caffeine? a common misconception is that caffeine is bad.  (I'm actually quite fond of it myself. LOL!) Teas are caffeinated but release differently than coffee products which give a quick jolt.  Teas boost energy and focus by giving a slow steady release throughout the day.  Caffeine in tea is significantly lower than that found in coffee.  Patients sensitive to coffee can usually handle tea just fine. 

So there you have it.  Tea Time is good for you.   Invite me over, we'll sip some tea. :)

To your good health,
Dr. Sonja