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.

Wednesday, August 29, 2012

Go on an EDIT, not a DIET

Losing weight is a perpetual cycle in the lives of people.  I have responded to countless questions throughout the years and often say that a person needs to go on an EDIT instead of that bad little word "diet".  Simply editing the foods we eat, and the amount of exercise we get, and the social influences that we fall prey to, can have a lasting impact on weight for the long haul. So many fail because they go about it all wrong and then they get frustrated at the thought of even trying again.  I hope to share some tips in the coming weeks on ways to edit your life for weight loss without giving up everything that you love. 

Here's a document I had in my archives that I wanted to share about weight loss and the concept of slow and steady wins the race.  I have known several people throughout the years who have had gallstones develop as a result of weight loss happening too quickly.  That little tidbit of information is pointed out in this article as well as some other things you should know before starting for what I hope to be your last and successful time.  Remember EDIT, not diet.


There isn't a magic pill for quick weight loss, so to lose weight, you must exercise and watch what your eat. Many turn to fad diets, but the results are often fleeting. The best type of weight loss plan is one that it teaches you to make lifestyle changes towards healthful eating and an active lifestyle, and not to attempt to shed pounds overnight. Quick weight loss can have a number of effects on the body.

Weight Gain

Weight gain is an unfortunate effect of quick weight loss. It might sound odd, but after the "miracle diet" is over and you resume regular eating and exercise patterns, the weight will come back on faster than it came off. Yo-yo dieting is a cycle when dieters end up heavier than they were before they started one or more quick weight loss diets. It is a wiser choice to eat healthfully, count calories, exercise regularly and responsibly, and to lose no more than 1 pound per week.  *****(I think that 2 pounds is okay too especially in someone with more to lose)~DrS

Sagging Skin and Stretch Marks

The skin only has so much elasticity (and this decreases with age) so weight gain and weight loss usually result in both sagging skin and stretch marks. The quicker the gain or loss, the greater the effect on the skin.


Fatigue of the muscles and overall mental and physical exhaustion are side effects from quick weight loss diets that restrict calories and don't encourage a balanced diet. Many diets focus on what you eat but not what you do. Nutritionist Kimberly Snyder does not suggest skipping meals, but encourages dieters to have a "green smoothie" as a meal replacement. The smoothie will provide valuable nutrients for dieters in addition to cleansing and detoxifying the body. A regular exercise program not only burns calories but also increases resting metabolism and boosts energy.

Reduction in Metabolic Rate

The body has amazing ways of protecting itself. If you suddenly reduce your caloric intake, your metabolic rate will also slow itself down as your body slips into conservation mode. This is why some people lose a lot of weight quickly, but then, even though they are still eating the same greatly reduced amount of calories, their weight loss stalls and they are unable to lose another pound unless they drop their caloric intake again or amp up their exercise program.


Quick weight loss can add stress to organs such as the heart, liver and stomach, but gallstones have been specifically linked to both obesity and rapid weight loss. According to the National Institutes of Health (NIH) as many as 20 million Americans have gallstones. Gallstones can be painful (symptomatic gallstones) or they may cause no pain at all (silent gallstones). Silent gallstones are often the result of a very low-calorie diet (VLCD) or from recurrent weigh loss of gain of more than 10 lbs. Silent gallstones are most likely the result of the constant change in the balance of bile salts and cholesterol. Bile salts are responsible for breaking down fat, and bile breaks down cholesterol. Gallstones form out of excess fats and cholesterol when bile and bile salt production is hindered.

Positive Effects
There are other positive effects, in addition to boosting self-image with a slimmer physique, but these are usually attributed to responsible weight loss and not to quick weight loss. When your body is at a healthy weight for your height and frame, there is less stress on the heart, lungs and joints and you are less at risk for many disorders and diseases that result from being overweight and inactive

Monday, August 27, 2012

Take Them or Leave Them? The Ovaries

Women faced with a hysterectomy (aka surgical menopause) often have concern and should discuss the issue of taking or leaving the ovaries with this life changing surgery.  I do understand that sometimes there is just simply no choice in having a hysterectomy with prolonged issues of bleeding, pain, and cancer risk, but I also think women need to be aware of this information before going in for the surgery in situations where there might be an option to retain the ovaries.

William Parker MD and Cathleen Rivera MD reported that removing the ovaries is detrimental to overall health and results in increased mortality.  Now this is a big study and it's why I like to share it for purposes of this blog.  Here are the facts of the study found in the National Institutes of Health library:

Dr. Parker followed 30,000 women for 24 years after their hysterectomy.  Half had the ovaries removed and half did not. The group with the ovaries removed DID have lower rates of ovarian and breast cancer.  BUT, they also had a MARKED increase in death from heart disease and other cancers. :(  The group with the ovaries removed had a HIGHER ALL-cause morality rate.  

And another study:
Dr Rivera followed 1,000 premenopausal women (under 45 yo) after hysterectomy and found that the removal of the ovaries resulted in a disturbing 84% INCREASE IN DEATH from heart disease.  That word death should get somebody's attention.

I haven't even traveled down the trail of osteoporosis, thyroid disease, and Alzheimers Disease in this blog all which now show a strong association to hormone imbalance. 

Now sometimes there's not a choice to have the ovaries removed.  It is necessary in some cases. The experts would agree that if a woman has a high risk of ovarian or family breast cancer, and positive genetic markers, then it would make sense to remove the ovaries. 

"Real world" scenario here:
So, here's how the conversation might go in a physician/surgeons office (just using myself as mock patient here). 
"Sonja, you need to have a hysterectomy to remove these fibroids." Dr. X. 

"Will you need to remove my ovaries as well?" I reply. 

"If I take the ovaries it eliminates the chance of ovarian cancers, and you don't need them anyway." Dr. X  responds.

"Say what?" (yes that's exactly what I would say. smile)

Why would I respond that way? Because, I just shared the evidence of 30,000 women in a 24 year study.   What about my risk for other diseases (strong family history of heart disease), and what about the risk for other cancers?  It simply doesn't add up in my case.  Sorry Dr. X, I'm keeping my ovaries.   (BTW, I'm not facing a surgery and in the best of health.  This is strictly for example!) 

Now, what about those who HAVE to have the ovaries removed?  Well, there is a good ending to this post for those facing this surgery and if you've already had a hysterectomy with your ovaries removed, there is also hope for you.  Modern science and studies do prove that hormone replacement therapy can reduce the increased risks or heart disease associated with ovary removal with hysterectomy.  The bio-identical hormones are the best plan for patients (over synthetics) and can be customized to an individuals needs and hormone levels.  The testing is simple and I can work with your personal physician to provide the necessary hormones that you have lost due to a hysterectomy.  I just finished up two hysterectomy patient charts this morning with each showing varied hormone levels, varied family histories, varied physical attributes, varied concerns, etc. etc.  Each will receive a unique formulation to match their imbalance and symptoms.  It's great to be able to provide this option for women.  I also provide testing and individualized treatment for men.

Get tested and get treated! 

To your good health,
Dr. Sonja

Thursday, August 23, 2012

Hooey on Hormones? Not so!!

Good Morning Blog Family!

I just wanted to take a moment to show you what's going on in the "hormone world". (I live there you know. smile) This is an article that came out on FOX News recently.  I simply picked theirs for today, but there's a surge of media attention coming to this issue on womens health.  Pay attention to key words in this article: "Bioidentical",  "Progestins (bad)", " Progesterone" (bioidentical and good).  Also pay attention to the statistics and evidence that we have showing us that womens health is more at risk by not using hormones than in using them. 

I put my progesterone on this morning before coming to work.  That's the truth with my hand up!!!!  I never stopped believing in hormone therapy, for myself or for my patients, even despite some bad interpretation of results 10 years ago when women had their hormones yanked because of a poor study.  Finally, this year 2012, someone was smart enough to go back and really look at the data of the WHI study, and the experts now say, "oops we were wrong", hormones are actually good for women.  To my patients who continued to believe that this treatment was the right thing to do....GOOD FOR YOU!!   I knew it was a bunch of HOOEY because I (and other medical colleagues) interpreted the study the way that I was trained to.   It's been a pleasure to take care of you all of these years and there are women coming in by the droves to take care of their health in this way.  I love it!  Bring it on!!

One thing you must remember before reading this is that testing is critical.  What you might think is an "Estrogen Issue", most often is a "Progesterone Issue" and vice versa.  There are a lot of companies "popping up" trying to provide hormones in unusual settings.  That happened with HCG for weight loss and there was a lot of patient damage done.  Now HCG is back in the hands of physicians again and not the local grocery store.  (sorry a little rant I guess)  So, a word of caution is to BE CAREFUL!!  I work as a part of a medical team and I have an excellent reputation with physicians and nurse practitioners across the US.  Why?  Because your care does matter and all things have to be considered in your medical history when considering hormone replacement therapy.  These are hormones which need to be monitored just like you would do if you were on blood pressure meds, seizure meds, or anything else. 

Menopause is a natural condition that all women will experience in their lifetime. The term menopause describes a constellation of changes that generally occur in a woman’s fifties or sixties, with the symptoms of change often becoming noticeable in her forties. During this time, the ovaries stop producing eggs, menstrual cycles become less frequent and eventually stop, and estrogen and progesterone decline.

The hormonal decline that occurs with menopause causes uncomfortable symptoms that lead many women to seek relief. Relief is rumored to exist with a steady soy diet or acupuncture, but hormone replacement therapy (HRT) is known as the most effective. Many women, however, live in fear of hormone therapy, questioning its safety and the impact it will have on their long term health.

Traditional/Non-bioidentical vs. Bioidentical Hormones
This fear stems from the results of the 1991 long-term study on the safety and efficacy of hormone therapy, known as the Women’s Health Initiative (WHI). The study tested synthetic, or traditional, hormone therapy on postmenopausal women. One branch of the study, which compared the effects of estrogen-only therapy with estrogen-progestin therapy, had to be halted early in 2002 due to adverse health conditions that developed among many of the subjects.
The subjects of the study were limited to postmenopausal women, with a combined average age of 68 years old. These two factors are significant - most of the women studied had been in a state of hormonal decline or complete loss of hormones for fifteen years or more, putting them at-risk for the development of diseases that estrogen, progesterone and testosterone might have prevented if administered earlier in their lifespan.
The WHI study used traditional/non-bioidentical hormones, not bioidentical hormones for therapies administered to these subjects. Unlike bioidentical hormones, non-bioidentical hormones are not designed to mimic the natural structure of human endogenous hormones. Instead, non-bioidentical hormones bind tightly to the specified cell receptors and initiate prolonged stimulation. This action inhibits the natural metabolic process designed for hormones metabolism and contributes to the body’s inability to wean the traditional hormones from your system.
The difference between bioidentical hormones and traditional hormones is deeply layered. Unlike bioidentical hormones, traditional hormones may be patented by pharmaceutical companies, therefore dosages vary from person to person by mere milligrams dictated by your doctor, while bioidentical hormones are prescribed precisely to meet your individual needs. Although traditional hormones can mimic the effects of hormones on certain biological pathways, they rarely offer the same effectiveness at a deeper, molecular level as your natural hormones. Bioidentical hormones, however, mimic the affinity human endogenous hormones have – performing effectively within each biological, at all levels.

Relief from Symptoms of Menopause through BHRT
Bioidentical hormone replacement therapy (BHRT) is a safe and effective means for women to find relief from symptoms of menopause. There are individual and combination therapies available, along with a variety of delivery methods. Physicians specializing in BHRT will assess your needs through detailed lab testing to determine which hormones and delivery methods are right for you.

Estrogen Estrogen is notoriously the female hormone. For women, it is linked to many, functions that impact beauty and function. Low estrogen often causes diminished sex drive because the vaginal walls become thinner and drier when this hormone is lacking - making intercourse painful. Orgasms may also become more difficult to achieve and less intense. Reduced estrogen causes a reduction in collagen - which is responsible for building skin and connective tissue - leading to thinner, drier and wrinkled skin

Progesterone has a host of functions inside the female body, regulating a symphony of other hormones: estrogen, testosterone, cortisol – without it or with low levels, wellness is undoubtedly threatened. Progesterone serves a function in the central nervous system, producing calming effects and impacting memory and cognitive ability. Progesterone also works in conjunction with estrogen to help regulate the action of the cells that form new bone and downplays the effects of mineral corticosteroids, such as cortisol. This effect makes it pivotal in reducing water-retention and bloating. Bioidentical progesterone performs these same functions, while progestin (the traditional form) exclusively regulates the menstrual cycle and exacerbates side effects of having an imbalance of progesterone.

TestosteroneBelieve it or not, women need testosterone too – generally in lower quantities than men, but it is necessary. In women, testosterone plays a role in sex drive, building and sustaining lean muscle mass and managing mood swings. There are many options for testosterone replacement therapy including oral capsules, injections, creams, gels and pellets. Some women experience greater declines in this hormone than others

BHRT & Disease Prevention
Many women toil over whether or not to pursue hormone therapy as their bodies approach menopause. It can be a difficult decision, especially with all the media headlines and fears instilled from previous studies, like the WHI. Fortunately, experts and researchers have continued to pursue in-depth studies and analysis on hormone therapy and the results yield good news for women.

Heart Disease
In March 2011, the medical journal, Menopause, published the findings of The California Teachers’ Study (CTS), a long-term analysis surveying, measuring and observing the effects of hormone therapy – traditional or bioidentical. The subjects, 71,000 retired female teachers between the ages of 30 and 90, were followed for nine years. The CTS study revealed that women aged 34 to 59 experienced a decreased risk of heart disease with the use of hormone therapy, while women aged 70 to 84 saw no increase in heart disease risk. In comparison to the WHI, the results were consistent - women of the WHI study, aged 50 to 59, also experienced a decreased risk of heart disease, while those not receiving hormone therapy experienced an increased risk.

Breast Cancer
Breast cancer is among the biggest concerns of women when considering whether or not to pursue hormone therapy. The WHI study observed an increase in breast cancer in women who were on non-bioidentical estrogen combined with progestin (non-bioidentical progesterone.) It matters what kind you use ladies!!!  (my two cents added)

In 2005, the International Journal of Cancer published the results of a study out of France that tested the risk of breast cancer using various types of hormone therapy. The study concluded that women experienced a decreased risk of breast cancer when using estrogen-only hormone replacement therapy, regardless of type – traditional or bioidentical. Researchers observed significant increases in breast cancer incidence among women who used estrogen hormone therapy combined with NON-bioidentical progesterone versus little to no incidence of the disease among women who used estrogen therapy combined with natural (bioidentical) progesterone. 

A November 2011 study, also published in the journal, Menopause, took a closer look at the effects of discontinuation of HRT at varying points in the lifespan. This study analyzed the bone density of 50,000 women who were either on HRT or had discontinued use. These women were followed for more than six years, during which time researchers observed a 55 percent increase in hip fractures among women who had discontinued HRT. (That statement makes me cringe.  Sad sad sad that these women were misinformed.) Even more alarming was the steady decline of bone density observed each year for women who did not return to HRT. The WHI also showed that women taking non-bioidentical estrogens had a decreased risk of hip fractures.

To your good health,
Dr. Sonja

Read more:

Monday, August 20, 2012

Go Figure.....How Overweight Are You?

One can easily understand that they are overweight by looking in the mirror or stepping on the scale, but just how far away from "normal" are you.  Today I just simply wanted to give you a "Go Figure" on your own method to determine where your numbers lie.  The number on the scale is important, but it becomes even more important when you determine it's value against the height of an individual.  So, get your calculator out and crunch your numbers.  I hope after that, you will begin to "crunch" the numbers by making some lifestyle changes. 

To calculate your BMI (Body Mass Index) use this equation:

1.  Find your weight in pounds and multiply by 705

2. Now find your height in inches, and multiply that number by itself. (height squared)

3.  Now divide the height number by your weight.  That number is your BMI

Say you're a 130 pound woman who stands 5 ft 7 inches tall (or 67 inches tall)

130 pounds x 705=91,650

67 inches x 67 inches=4,489

Now divide 91,650 by 4,489 to get 20.4

20.4 is the BMI

Now here's the guide for your BMI value:




>30 =Obese

Remember that obesity is linked to these and other health consequences:

High blood pressure
High blood cholesterol
Heart disease, stroke, and chest pain
Congestive Heart Failure
Gallbladder disease and gallstones
Sleep Apnea
Pregnancy complications
Menstrual and Hormone irregularities
Bladder Control Problems
Kidney Disease

Call me if I can help you get your BMI back in check.
I've coached many people to their weight loss goals throughout the years.

Give the gift of health to yourself. Victory is possible!!

To your good health,
Dr. Sonja

Tuesday, August 14, 2012

BPA Free! What's the big deal?

I've had this thought looming in my mind for some time and as I went school shopping with my 3 children, I couldn't help once again seeing the words BPA FREE stamped on various products throughout the stores.  Many consumers may not pay attention to these little details, but when you specialize in hormone replacement therapy and see the impact of our environment on patients, it means a great deal more.  Today I wanted to cover that little tidbit of information that you see on various plastics in our stores these days, BPA FREE. 

What's the big deal?  Well, it actually is a big deal and I hope you learn something today. 

BPA.  What is it? 
BPA is an acronym for Bisphenol A.  It's essentially a synthetic hormone (estrogen) structurally and functionally related to Diethylstilbesterol (DES).  Now I probably should back up and explain that chemical a little too.  DES was banned in 1971 for use in pregnant women using it (3 decades of use. gasp!!) to prevent miscarriage because it was found to increase cancer risk at least 40x more than the general population. Sadly, it was striking young women and they were termed "DES daughters". At birth, DES daughters commonly had defective reproductive organs.  As women, these "daughters" faced a 2 in 3 chance of failing to produce a live baby with each pregnancy. 
DES was also added to animal feed to promote growth in chickens, sheep, and beef cattle.  DES use in meat production continued until 1979.  Today, sadly, they just use different hormones in production. (I'll save that for another blog)  There are many farmers who are producing hormone free products and their businesses are booming. 

Now back to BPA. 
BPA was first considered for use as an estrogenic human drug, but DES took the forefront instead.  However, in the 1950's it was found that BPA could be used to create epoxy and plastic resins.  In the U.S., BPA use amounts to 2 billion pounds per year, much of it in clear plastic bottles, food containers, BABY BOTTLES (gasp again!!), and metal and INFANT FORMULA cans (bad bad bad). Today nearly 93 percent of Americans carry detectable amounts of BPA in their urine (Centers for Disease Control).  Why might that be?  Over 6 billion pounds of BPA is produced and over 100 tons released into the atmosphere worldwide annually.  (yes, that's every year)  Does that make you want to hold your breath or what?!?!

Canada has banned the use of BPA in baby bottles.  Minnesota and Connecticut have also joined Canda in banning BPA from some baby products. 

What about problems with general health and hormones?  (I'm glad you asked)

BPA binds to Thyroid and Estrogen receptors and inhibits their normal effect causing thyroid and hormone disruptions. Xenoestrogens are tricky to the endocrine system, and cause the body's normal production to be out of whack with the external influence of these chemicals.  It's a medical fact and cited in numerous books and articles from experts throughout the U.S.

Just for fun, walk through your house and look at all the plastics.  Structurally similar molecules to BPA are found in many things: toothpaste, mouthwash, soaps, deodorants, shaving creams, cleaning supplies, kitchen utensils, trash bags, clothing, bedding, and childrens toys. 

What can you do to help yourself and your family?  Well, here's a few little things to get you going.
Minimize plastic exposure by using glass, ceramic, and stainless steel containers.  Avoid microwaving in plastic containers.  Read labels and look for potentially harmful chemicals.  Buy "certified organic" or "hormone free" as much as possible.  Its' very sad to me that you have to pay so much more for these safer alternatives.  I think the government should invest in those farmers who are producing truly "organic" products. (my two cents)

I would love to hear your comments or personal insight on this topic.  It's a very broad subject, to say the least, and I'm always in tune to the term "environmentally friendly" these days .  That term is "all fine and good", but what about the impact on patients health, disease risk, and hormone imblance to produce mass quanities of something that is supposed to be considered safe.....and convenient.  Some things we just cannot afford to wait 30 years to find out that it's wrong.  And especially when it affects the health of people.

To your good health,
Dr. Sonja