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.

Thursday, May 31, 2012

Ups and Downs. Riding the Hormonal Tilt-a-Whirl

I get a lot of phone calls in a day with women who are suspicious of hormonal imbalance.  Interestingly, I have more and more young women seeking help with their PMS woes as well.  Let's remember that aging has it's effects at all stages of life, not just through the menopausal years.  Today I'll give you a brief snippit of what things might point in the direction of hormone problems so I can answer the common questions to a broader audience. And, so I can show you the exit door from this ride.

I'll break this BLOG topic down in a simple to understand list and encourage you to be tested if any of these describe the things you are struggling with.  Could you imagine your face superimposed over this woman's face?  Maybe you're not quite this out of sorts, but I can guarantee that you will find something on this list that correlates with your current status.

Are you a victim of HORMONE HAVOC? Check out this list, but also go to the online womens evaluation and do the assessment.

Abudance of Estrogen (aka Estrogen Dominance):
Water Retention
Breast Swelling
Fibrocystic Breasts
PMS mood swings
Loss of libido
Heavy menses
Uterine fibroids
Craving for sweets
Weight gain

Lack of Estrogen (aka Estrogen Deficiency):
Hot Flashes
Shortness of Breath
Night Sweats
Sleep Disorders
Vaginal Dryness
Dry Skin
Thinning Skin
Mood swings
Memory Loss
Heart Palpitations
Yeast Infections

Abundance of Progesterone (I hardly ever see this unless someone is using too much supplementation)

Lack of Progesterone (many many women)
Food Cravings
Painful Joints
Heavy periods

Testing is SIMPLE, SIMPLE, SIMPLE.  I can provide you a saliva testing kit and a packet of reading materials through the US mail for just $20.  Talk with me or one of our helpful staff members on getting your personal evaluation.  The lab panel that I most often recommend runs only $130.  That's a minimal price to pay to see if you are feeling discombobulated due to hormonal imbalance.

I will touch on some other key topics in the days and weeks to come.  Make sure to check back on topics that might help you feel better and look better the more natural way.

To your good health,
Dr. Sonja

Monday, May 21, 2012

Big Fat Secrets of Skinny People

The majority of thin people whether they have been lean all their life or managed to lose weight and keep it off  share similar strategies to stay thin seemingly with little effort. Thought I would just highlight some of their practices today to help you in your journey to a better you.

How thin people resist the Battle of the Bulge

1) They don't diet.
Or at least not in the deprivation sense of the word.  I know people throw the "lifestyle change" buzz words around a lot, but that's really what it comes down to.  Quick fix crazy diets don't work for the long haul. Thin people tend to eat more fruits and vegetables and more fiber than those who are tipping the scale in the opposite direction.

2) They keep track of their weight
My patients ask me how often I want them to weigh.  EVERYDAY! Yep! It's easier to catch 5 pounds before it turns into 20 pounds. 

3) They Exercise Regularly. 

There's that nasty little E word.  Even a 15 minute walk can help burn 200 calories. If you do it outside you get a dose of Vitamin D too.  Bonus!!

4) They don't solve problems with food.

Many people tend to drown their sorrows in a hefty dose of Apple Pie. Emotional eaters tend to eat purely for emotional reasons and feel tremendous guilt later.  It's better to redirect those emotions into physical fixes rather than food fixes.  Try going for a walk, tackling a messy garage project, or calling a friend who will stop you in your tracks.

5) They stop eating when they are full.

Portion control and not being a part of the clean-plate club are typical attributes of thin people.  Our brain gives us signals to tell us when we are full.  But you have to be paying attention and push off from the table when the "I'm Full" trigger is sent from the body's computer (the brain). 

6) They allow themselves treats.

This seems like too much of an allowance to someone trying to lose weight, but complete deprivation tends to make someone want something even more.  Keep little indulgences in the lifestyle plan from time to time.  I'm not a huge fan of artificial sweetners, but if it means having something with 100 calories instead of with 1000 calories, then I say pick your fix consciously.

7) They move, stand, and fidget more. 

This is my favorite because I'm a fidgeter.   Thin people are rarely sitting.  Researchers at the Mayo Clinic found that on average, a group of lean people sat for two hours a day less than obese subjects, potentially burning up 350 additional calories. 

8) They don't surround themselves with temptation. 

Plain and simple, what's in your pantry is what you will consume.  If you make healthy choices at the grocery store, the accessibility factor will work on your side when it comes to finding something to eat in the cupboard.

9) They don't skip meals.

Going more than six hours will slow your metabolism, plus you'll be out of control trying to find something to eat.  Imagine your stomach as a gas tank.  Keep it between 1/4-3/4 full and you will feel your best.  This can be accomplished by eating small, healthy, mini-meals every 3-4 hours.

10) They eat breakfast.

The National Weight Control Registry tracks the habits and strategies of more than 5,000 people who have maintained weight loss.  Nearly 80% of successful losers eat breakfast every single day. It turns the metabolism switch after a nighttime fast. 

Hope you learned something today!

To your good health,
Dr. Sonja

Wednesday, May 16, 2012

Middle-Age Spread: A Double Whammy

Women have about thirty billion fat cells.  (I thought that would get your attention right off the bat. LOL!) These fat cells perform various functions in the body and one, in particular, is to produce estrogen. Prior to perimenopause, your ovaries provide the estrogen fuel that your body needs. But, the birthdays seem to speed up and the ovaries slow down.  Your fat cells basically increase their production to pick up the slack for the ovaries poor performance.  It's simply your body's way of trying to maintain balance. 

To increase estrogen production, the fat cells multiply and get bigger to be able to store more fat.  (Can I get a witness? I see those hands.)   The fat cells in the belly area are usually the largest and best equipped to produce estrogen than those in the buttocks, hips, and thighs.  Therefore, the fat tends to find it's way right to the mid-section area where we need those pants to button.  (How convenient right? NOT!) This is what we call "The Middle Age Spread".

And as if it couldn't get any worse, its does (Murphys's Law...) There's a Double Whammy problem here!!! Not only are the fat cells working overtime, but the metabolism tends to slow down at midlife.  (Get the kleenex quick)  In her book, Outsmarting the Mid-Life Fat Cell, Debra Waterhouse explains that from age 35 on, the average woman loses about 1.5 pounds of muscle a year while gaining 1.5 pounds of fat. Plain and simple, when you lose a half pound of muscle, you burn less calories in a day.  The more muscle you lose as you age, the less calories that you need and any extra calories are rerouted to, you guessed it, Fat Cells!! (sigh!) 

A weight gain of up to 10 pounds is generally considered OK and somewhat normal through menopause.  Any more than that and your chances become increased for breast cancer and heart
disease.  Boo!!!

Just sharing some little tid-bits of information here.  I hope it helps you to "Battle the Bulge" (so to speak).  I strongly suggest that every woman have their hormones tested if weight gain is a significant problem.  In consultations, weight gain is one of the biggies that come up in the complaint department by women.  With supplementation of estrogen, progesterone, testosterone, and other key hormones, the body won't have to work so hard to keep things in check.  Estrogen Dominance is running rampant these days as I review charts on women having their hormones tested.  And that number is growing by leaps and bounds.  BTW, men are also coming in too.  I can't tell you the number of couples that I've visited with in the last 6 months.  It's great to see.

Get tested!!!!

To your good health,
Dr. Sonja

Tuesday, May 15, 2012

Cholesterol and Hormones, What's the Link?

Today I'm sharing an article that came to my email from a national colleague on the effects of a class of medications called "the Statins".  These agents as many of you may know are prescribed to lower cholesterol.  The other thing that you may not know is that cholesterol is the key substance from which hormones are created.  You don't have to be a scientist, just simply look at the chart above.  See what's at the top of the metabolic pathway?!?! Cholesterol!!! 
So then shouldn't we be asking, "if I lower my cholesterol, won't I also lower my hormone production?" The answer is yes! I've had concern about this class of medications and their effect on hormones for years, but  here's his "take" on the statin drugs. (Lipitor, Crestor, Zocor, etc.)

Passing along his thoughts.....
I get asked the same question quite a bit. "Can you give me some written information that I can pass on to a doctor about cholesterol lowering drugs, the statins?"

I hope my answer helps start the dialog between you and your doctor about alternatives to drugs.

I am going to try something unique in the halls of today's medical practitioners. I will use reason to arrive at a position about the statins.

First, I must be clear that there is absolutely no evidence that elevated cholesterol actually causes any disease. I will acknowledge that cholesterol levels can rise in response to a variety of circumstances. Rising cholesterol might be present when the condition exists, but there isn't evidence that cholesterol causes the condition in the first place.

If someone can demonstrate why rising cholesterol is harmful, I want them to also explain why the levels are rising. What underlying condition is present and how can I address it? Lowering cholesterol levels is akin to holding a wrap over a cut vein. The bleeding stops but the cut remains. Rising cholesterol is nothing more than a symptom. It is not a cause of anything.

Low cholesterol, on the other hand, is exceptionally hazardous to health. Cholesterol is the substance in our body from which all of our hormones are generated. Taking drugs to artificially lower cholesterol is like closing the faucet on our flow of hormones.

In the normal course of things, cholesterol is converted to pregnenolone, which becomes progesterone, which can be converted repeatedly into the hormones we need. Reason dictates that when we lower our cholesterol levels with drugs, we will experience symptoms from low and imbalanced hormones.

Cortisol, for example, is an anti-inflammatory hormone that is generated when needed from other hormones - which themselves start out as cholesterol. A predominant side effect from cholesterol-lowering drugs is muscle and joint pain - pains which are normally controlled by the amounts of naturally occurring cortisol we make in our body. All hormone issues follow the same reasoning. Other hormone levels suffer as well.

Most approaches to lowering cholesterol without drugs fail. Drugs, like statins, work. That means the only way to bring cholesterol levels down is to use a drug.

Again, using reason, is it logical that our bodies were made in such a way as to need a man-made drug to maintain them in a state of health? I say, "no".

To add insult to injury, the regular use of statin drugs does substantial harm by reducing the levels of an important nutrient, Coenzyme Q10, otherwise known as coQ10. This substance is absolutely necessary for good heart health. Fatal disease can follow the loss of CoQ10. People who use statins - not a wise act to begin with - should be serious about taking additional CoQ10.

Cholesterol metabolism is discussed at length in most basic physiology courses. Nothing has happened to alter the mechanisms of action, but our medical system has changed how we view these natural substances and their actions in our bodies. A vital substance, cholesterol, has been demonized. One logical reason for this change is that we now have drugs available that we can use to change cholesterol levels - and they are the only things that will drop cholesterol levels. The existence of the drugs, then, might be the driving force behind the ideas that make cholesterol levels a menace.
I continue to study the cholesterol phenomena with the hope that I will find the cause-effect relationship between cholesterol and disease. To date, it eludes me. Instead of substantiating the connection between rising cholesterol and health, I continue to run into information that takes the exact opposite view.

What Young Women Should Know

Today I want to just simply point out some clinical references that I feel every young woman should read before making decisions about their health, their family planning needs, and their cancer risk.  This is just simply a regurgitation and focus on some articles that I have been made aware of throughout the years and feel compelled to share.  The focus of these references and various clinical studies is on "The Pill" (oral contraceptives containing oestrogens) and the long term effects that have been noted after this class of pharmaceuticals came to market in the 1940's. Please do some literature review for yourself and read further into the noted studies to make a determination if this is the route that you want to take.  I personally am not an advocate of oral contraceptives (or synthetic menopause therapies) because of these types of studies but also because after doing bio-identical hormone therapy for many years, I just don't think there is anything that compares to using a perfect match to the bodies own production when it comes to hormones.  'nuf said. 

Around the time of "the Pills" initial debut (it really became more popular in the 60's) , an American womans lifetime risk of cancer was 1 in 20.  Now it is 1 in 8.  According to a report in the Nov 1995 Natural Fertility Management newsletter, the pill causes 150 chemical changes in a girls body.  Today we are seeing girls as young as 13 on birth control pills to regulate their menstrual cycles, but in some cases simply to control their acne and complexion.

By the mid 1970's a test allowing doctors to identify oestrogen-dependent tumours established that approximately 1/3 of breast cancers contain cell chains that hook up with oestrogen molecules. This is what we call ER+ (Estrogen Receptor positive) tumours.  Very simply, they grow when exposed to oestrogen and shrink when their supply is removed. The Kaiser Permanente tumour registry in the US revealed that from 1974 to 1985, the incidence of ER+ tumours rose 131 percent. Yikes!

Dr. Max Cutler, a highly respected Los Angeles surgeon gave a testimony in the US Senate Hearing which invesigated "the Pill". His testimony, "I have a series of patients who have had two or three breast biopsies.  In some, the biopsies were performed before the patient started to take the contraceptive pill, and a second or third biopsy was performed after the patient had been on the Pill for several years.  Study of surgical specimen under these circumstances presents a unique opportunity to observe the tissue changes." His biopsies showed "increased cellular activity, reflecting the stimulating effects of oestrogen." He testified that "the risk is a potential time bomb with a fuse at least 15 to 20 years in length." Seventeen years later, Dr. Philip Corfman became the director of the endocrine and metabolism division of the FDA and high-dose oral contraceptives were withdrawn from the market.

Dr. Clair Chilvers released a study in Lancet in 1989.  She found that "there was a highly significant trend in risk of breast cancer with the total duration of oral contraceptives.  Women using the Pill between 49-96 months had a 43 percent greater risk of breast cancer and users of more than 97 months had a 74% greater risk. 

This was backed up by the American Journal of Epidemiology in 1989.  This publication reported that women on the Pill for at least 4-10 years beginning early in life have a 40-70 percent greater risk of premenopausal breast cancer than those who never took the Pill.

Harvard School of Public Health in a review paper published in Cancer revealed a statistically significant positive trend in the risk of premenopausal breast cancer for women exposed to oral contraceptives for longer duration.  The risk was predominant in those who used oral contraceptives for at least 4 years prior to their first term pregnancy.

These studies really point out that the dosing, age at therapy start, and length of time on the Pill are the key determinants in increased breast cancer risk and adverse events.  If one has to use birth control pills under the advice of their physician, my advice is to use them for as short a time as possible. 

This is such a sensitive topic, but again one that I think every woman should seek her own answers to based on symptoms, irregularities, and family risk of cancers.  Access to the internet and other forms of educational tools make the path of enlightenment easier these days.  Use these tools wisely.  I encourage every person to "do their homework" when it comes to making a decision such as this. 

To your good health,
Dr. Sonja 

Tuesday, May 1, 2012

Stress 101: Gaining Weight and Getting Wrinkles?

This is the second in a series of posts regarding the impact of stress on our bodies.  Today we will cover the impact of Cortisol.  One of the BIGGIES that I hear in the office from women is the inability to lose weight and the complaint of rapid aging.  No doubt hormones affect skin integrity and give us our "get up and go",   but what if your "get up and go, got up and went?" Cortisol can really help us adapt to the stressors that come up in life as a natural defense mechanism, but also needs to be looked at when the scale just won't budge or if the years are showing too quickly on the body.  If I have just described you, then I would suggest you consider a basic hormone and cortisol test. 

Here's a quick rundown of what Cortisol does under conditions of acute and prolonged stress.

The simple physiology:
Cortisol is released by the hypothalamus and pituitary
Cortisol is a precursor to progesterone
Cortisol is manufactured by the adrenal glands in response to stress.

Prolonged and excessive release of Cortisol results in:
1) Increased gastric acid secretion
2) Infertility
3) Reduction of collagen of the skin (greater than 10x over any other tissues) thus, more wrinkles!!
4) Stimulation of glucose production from the liver. (by as much as 6-10 x) Yikes!!
5) Stealing of protein from muscle tissue
6) Increased blood pressure
7) Insomnia
8) Agitation
9) Hypothyroidism
10) Poor digestion
11) A weakened immune system
12) Hormone Imbalances
13) Anxiety
14) Sudden blood glucose drops and states of hypoglycemia
15) Weight gain.  It's like being on constant steroids.

Cortisol production can fluctuate throughout the day and sometimes work schedules and circadian rhythm patterns can get a person out of sync.  Simply not sleeping at night can also throw Cortisol production off balance.  Interpreting the values according to time of day and symptoms, can be very enlightening to a patient and the way that they have been feeling. That's where I can help if you are concerned that the stress is getting to you.  Often patients come to me for what they think is hormone imbalance, but I always suggest an adrenal panel to determine if Cortisol is one of the contributors to the problems they are having. Is this you?

The testing is simple and affordable and can be done from your own home. Call my office and I'll take a look at your stress management from the inside out. 

To your good health,
Dr. Sonja