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, April 24, 2014

7 Million Women: Are You One? Is Your Daughter At Risk?

I just did a consultation with a 53 year old woman who is certain that she had PCOS (poly-cystic-ovarian-syndrome) with a long history of female issues and eventually a hysterectomy, but "back then" she stated, they just didn't know it. (It always makes me sad to hear this because she struggled with infertility and never had children along with all of the other painful details of her medical history.)

Last week I consulted with a 18 year old and her mother who had checked out a book at the library on PCOS and became suspicious that this was the problem for her daughter. She was experiencing horrible menstrual cramps and pain with the few menstrual cycles that she did have each year. I had her test her hormone levels through saliva collection and she did have lab result indicators that pointed to this disease. The next step was a visit to her doctor for an ultrasound and other tests. I also designed a custom regimen to combat high testosterone levels, erratic blood sugars, and missed menstrual cycles.   Thankfully she is young and if PCOS is the problem, then interventional and functional medicine can help her. Yay!!

We do know about the implications of PCOS "these days". Read on mothers, daughters, granddaughters, sisters, grandmothers..... you might just help someone you care about.

This is a SHOUT out to girls and young women who may be dealing with hidden practices and secrets related to polycystic ovaries. What do you mean(?), you might be asking. Did you know that it is not uncommon for a woman with this disease to have to shave various areas of their body (lip line/chin/etc)? Did you know that these women often struggle with depression? Did you know that it is common for them to  skip menstrual cycles of just not have them at all? Did you know that infertility is a huge problem for these women? Did you know that these women can be more prone to developing diabetes?

Did you know that PCOS is becoming more prevalent?
An estimated 7 million women and adolescent girls are affected by PCOS, with less than 50% diagnosed.  PCOS is responsible for 70% of infertility issues in women who have difficulty ovulating.  Studies have shown that approximately 40% of patients with diabetes between the ages of 20-50 may have PCOS.  In addition, studies have found that if a mother has PCOS, there is a 50% chance that her daughter will also have PCOS. (pcosfoundation)

Let me just give you a running list of some of the symptoms of PCOS (Polycystic Ovary Syndrome).

Infrequent menstrual periods, no menstrual periods, irregular bleeding, infertility because of no ovulation, increased hair growth on the face, chest, stomach, back, thumbs, or toes-a condition called hirsutism. Here's some more: ovarian cysts, acne, oily skin, dandruff, weight gain or obesity (around the waist), insulin resistance or type 2 diabetes, high cholesterol, high blood pressure, male-pattern baldness or thinning hair, patches of thickened or dark brown skin on the neck, arms, breasts, or thighs, skin tags in the armpits or neck area, anxiety or depression due to appearance or infertility, sleep apnea and excessive snoring. Hidden struggles as you see.... Who wants anyone to notice these things? It makes me sad to see young women dealing with this syndrome.

There is no single test to determine if a woman has PCOS. A comprehensive medical history will usually be taken along with a physical exam by the doctor. I totally recommend that a person have a hormone panel done because there are some key identifiers and values that are helpful in determining if this is the problem. I remember a 23 year old female that came my way about 3 years ago. She was referred by a friend who suggested she come in and get tested for many of the signs you. Thankfully she did. After evaluating the lab results, I was able to refer her on to a physician who did more testing and started her on a prescription regimen that gave her quality of life again. Her depression improved, she lost weight, the hair growth lessened on her face, she just looked brighter overall. Yeah!!

There are effective treatments for PCOS. (some prescription, some herbal, some lifestyle modification) If you know of a woman who may be dealing with these troublesome symptoms, please have her give my office a call. I would love to talk with them. I can walk them through the testing process, work with their personal physician, and get them on the road to better health. Time is critical in treating this syndrome. Call right away!

Thursday, April 17, 2014

Do Men Have a Man-o-pause?

Do men have a menopause?

(A blog for men. ZRT Laboratory)
Declining levels of testosterone and DHEA are commonly seen in men beginning in the fourth decade of life. These anabolic hormones are particularly important in men, as they are the major players in maintaining both physical and mental health. For example, they increase energy and decrease fatigue; they help in maintaining erectile function and normal sex drive; and they increase the strength of all structural tissues in the skin, bones, and muscles, including the heart. Proper levels of androgens also help to prevent depression and mental fatigue.
Yes, men do experience age-related changes in their hormone levels.
This hormonal decline, referred to as andropause, often coincides with symptoms of aging in males. The term andropause, named after the male hormones known as androgens, is the counterpart to menopause in women when production of estrogens and progesterone by the ovaries begins to decline. But, the drop is more gradual in men than the hormonal “roller coaster” so often experienced by women during menopause.
Stress management, exercise, proper nutrition, dietary supplements (particularly zinc and selenium), and androgen replacement therapy with physician guidance have all been shown to raise androgen levels in men and help to counter andropause symptoms.

Do you test for hormonal imbalances in men?

Yes. Undiagnosed hormonal imbalances are often linked to increased risks for prostate disease, low sex drive, rapid aging, and poor quality of life in general.

Man up guys and get your hormones tested!  It's easy and something that you can do from the convenience of your own home.

Call us today. 

~Dr Sonja

Wednesday, April 16, 2014

Hormones, Adrenals, Thyroid, Insulin, and More Get Tested!

Where do I begin to determine whether my hormones are balanced?
To get a general idea of whether or not your hormones are balanced, record the symptoms you are currently experiencing. Your symptoms may point to a deficiency or excess of certain hormones.

My symptoms suggest that I have a hormone imbalance, but how do I find out for sure?

To confirm your symptoms of hormonal imbalance, we recommend measuring those hormones. You might consider ordering our Female/Male Saliva Profile I that tests estradiol, progesterone, testosterone, DHEA-S and AM cortisol. This panel, along with the more comprehensive Female/Male Saliva Profile II and Female/Male Saliva Profile III, provide you with a broader picture of your present hormone levels and identify specific imbalances. For the most comprehensive assessment of hormonal imbalance, including tests for reproductive, adrenal, and thyroid hormone testing, consider ordering one of our Comprehensive Profiles.

What is the link between polycystic ovaries and hormonal imbalance?

Polycystic ovaries occur when numerous growths/cysts develop on the ovaries. This is commonly associated with a hormonal imbalance such as estrogen dominance and/or an excess of male hormones. In many cases, these cysts are benign and can shrink or even disappear when the hormone imbalance is corrected. The ovaries should be removed if the cysts are cancerous or causing pain and do not respond to treatment.

What is the link between uterine fibroids and hormonal imbalance?

Estrogen dominance, an imbalance caused by excess estrogen in the relative absence of progesterone, can cause the uterine lining to grow undetected. This can lead to the growth of tough, fibrous, non-cancerous lumps called fibroids. While the average fibroid is an undetectable lump in the wall of the uterus, about the size of a hen’s egg, larger fibroids often cause irregular bleeding and heavy or painful periods. Fibroids are the most common physical reason for excessive bleeding during menstruation.
Fibroids can grow dramatically during perimenopause when they are stimulated by hormonal imbalances and fluctuations in the body. Large fibroids secrete estradiol, the most potent form of estrogen, leading to estrogen dominance. Monitoring your estrogen levels through routine hormone testing and taking appropriate steps to maintain a proper balance of estrogen to progesterone is especially important. Please note: recent information cautions against the use of progesterone for the treatment of larger fibroids. With all fibroids, hormone supplementation should be kept as low as possible.

What is the link between hormonal imbalance and breast cancer?

There are many factors associated with hormonal imbalance and increased risk of breast cancer including:
  • Declining levels of progesterone with age and/or with removal of the ovaries in hysterectomy
  • Environmental, “xeno”-hormones in the form of pollutants and pesticides
  • Oral contraceptives
  • Synthetic hormone replacement therapy
These factors can contribute to an excess of estrogen in the body known as “estrogen dominance.” Since estrogen stimulates cell growth, a predominance of it, especially in the absence of adequate levels of progesterone (common in the menopausal years with the waning of ovulation), presents an increased risk of cancer, particularly in the breast.

What can hormone testing tell me if I have breast cancer?

Saliva testing in women with breast cancer often reveals a unique hormone profile. If you are interested in understanding your hormone status in regard to breast cancer, we recommend our Female/Male Saliva Profile II. This profile includes estradiol, progesterone, testosterone, DHEA-S, AM (morning) and PM (night) cortisols. For the most comprehensive assessment of hormonal imbalance, including tests for reproductive, adrenal, and thyroid hormone testing, consider ordering one of our Comprehensive Profiles.

What is the link between thyroid function and hormonal imbalance?

Hypothyroidism or low thyroid is more common in women than men and often occurs during the perimenopausal and postmenopausal years. Approximately 26% of women in or near menopause are diagnosed with hypothyroidism. When estrogen is not counterbalanced with progesterone, a predominance of estrogen can inhibit the action of thyroid hormone at the cell level. Saliva hormone testing often reveals that women who are estrogen dominant tend to have menopausal symptoms associated with symptoms typically associated with low thyroid such as: feeling cold all the time, weight gain or inability to lose weight, thinning hair, sleep disturbances and fatigue, mood swings, depression, mental confusion, hair loss and low libido. Levels of the primary thyroid hormones can be tested as part of ZRT’s blood spot Thyroid Panel.

What can I do to prevent estrogen dominance?

First, we recommend testing your hormones using Female/Male Saliva Profile I to determine the extent of estrogen dominance. If your progesterone/estradiol (Pg/E2) ratio is low, this indicates that progesterone levels are inadequate in relation to estrogen levels. This is a clear indication of estrogen dominance. If this is the case, it would be a good idea to talk to your health care provider about supplementing with bioidentical progesterone to balance estrogen levels. It is also helpful to monitor your symptoms and your hormone levels regularly while following a program of hormone balance. Other important steps to take include: reducing the use of pesticides, pollutants, and chemicals in your home; eating organic foods that are free of hormones and PCB sprays; maintaining an ideal weight (excess fat increases estrogen production); exercising regularly; and avoiding unnecessary stress whenever possible.

What is insulin resistance and how do you test for it?

Insulin resistance occurs when cells “resist” the action of insulin to transport glucose into the cells of the body for energy production. Excess stress and lack of exercise in combination with simple sugars and carbohydrates cause the body to produce extra insulin in an attempt to normalize blood sugar levels. This results in overly high levels of insulin in the blood. Insulin resistance is associated with obesity, increased risk for Type 2 diabetes, and cardiovascular disease.

Blood spot testing provides a simple way to measure fasting insulin levels, particularly in people at risk for the condition. The test offers insight into imbalances in individuals who have symptoms despite a normal blood glucose test.

Am I a candidate for the fasting insulin test?

The following people are all strong candidates for testing:
  • Individuals with known or suspected hypoglycemia, insulin resistance, diabetes, pre-diabetes, family history of diabetes, being overweight or obese.
  • Women with irregular periods, scalp hair loss, increased facial or body hair, or polycystic ovarian syndrome.
  • Individuals with symptoms of anxiety, palpitations, profuse sweating, fatigue, irritability, weakness, shakiness, dizziness, food or sugar cravings, excess weight around the waist, or high blood sugar levels.

What is adrenal fatigue and how is it tested?

Many people today suffer from the adrenal glands' inability to respond to stress. This condition stems from various factors including chronic stress, sleep deprivation, excess caffeine and carbohydrates, chronic pain, extreme exercise, and a generally unbalanced lifestyle. Also known as adrenal insufficiency, the problem shows up with a set of symptoms ranging from chronic fatigue to infertility. Those with a hectic lifestyle are potentially at risk, but the problem is more prevalent among medical professionals, police officers, executives, teachers, single working parents, or anyone who has a very stressful lifestyle.
Adrenal fatigue is tested by measuring cortisol, a key stress response hormone. Cortisol is produced by the adrenal glands 24 hours a day, although output varies at different times throughout the day. Cortisol output is highest upon waking to energize us for the day ahead and declines steadily throughout the day, reaching its lowest point at night in preparation for sleep. Individuals with adrenal fatigue have a flattened cortisol profile. This means that there is no morning surge of the hormone. Cortisol can be collected once in the morning or twice a day (morning and bedtime). It may be necessary to measure cortisol four times a day if levels are out of range and symptoms indicate the need to test adrenal function throughout the day.

A great reference from my preferred hormone testing lab, ZRT. Now call me and let's get YOU tested!


Thursday, April 3, 2014

Hormone Therapy for a Common Female Problem

I couldn't help but revisit an informational folder I have been collecting over the years of doing customized medicine on the topic of vaginal pain syndromes. This  "common" alphabet soup of symptoms is "uncommonly" talked about in the outside world. I don't mind talking about it at all because I actually make a living on helping find answers for troublesome symptoms such as this through creative medicines. Let me give you a little insight into what happens in the urogenital zone as women age.

During the reproductive years, three estrogens of importance are Estradiol, Estrone, and Estriol. About five years before actual menopause, the production of Estradiol begins to decline, and after menopause the production ceases almost completely. Consequently, estrone and estriol become the main circulating estrogens. This decrease and shift of estrogens commonly brings noticeable changes such as hot flashes, atrophy (thinning and inflammation of the vaginal walls due to a decline in estrogen), and an increased risk of osteoporosis and cardiovascular disease.

Studies have indicated that 50% of otherwise healthy women over 60 years have symptoms of urogenital atrophy. That's 1 in 2 and thus why I call it common. The symptoms are vaginal dryness, pain, itching, urination complaints, recurrent vaginal infections and urinary tract infections. The answer is often estrogen replacement therapy and we have hundreds of patients that get a common formulation to help with these problems. In fact, the OB/GYN's that we collaborate with will order a customized formulation for their patients needing some help in this area.

Lichen Sclerosis (LS) is another Uro-zone problem that can be associated with hormone deficiency. LS is a benign and progressive skin disease that creates patchy, white skin usually around the genital area. It can affect both men and women at any age, but usually is found in menopause aged females. Some medical articles suggest that androgen deficiency (testosterone) is a culprit and that testoserone replacement therapies applied to the affected area can help promote healthy skin and healing of the wounds associated with this condition. A soothing base can be used to promote good saturation of the therapy into the diseased tissue which gives great relief to those who suffer from this.

Sometimes with vaginal area pain there can be a neuropathic process causing pain sensitivity affecting activities of daily living. Working with a physician to determine if the issue is related to muscle constriction of the pelvic floor, involvement of the hormonal system, genetic and disease factors, or sexually transmitted diseases is important in determining a plan of action for creative medicine interventions. Very effective creams, suppositories, and sprays can be customized and formulated to control multiple issues contributing to the pain and on a per individual basis.  Painful intercourse is a concern for these patients as it tends to bring about a breakdown in sexual relationships for those experiencing this problem. But, the good news is that it's very treatable.

I think it's so important for women and men to know that there are options in treating these conditions. And believe me, throughout the years, I have responded to these needs many, many times. We can cover a lot of territory (literally) in the creative medicines that we provide for these and other things. I have a go-to formulation that works like magic for those with vaginal atrophy, dryness, and painful intercourse.  Don't let this be a problem in your life.

To your good health,
Dr. Sonja

Tuesday, April 1, 2014

Can You Afford Anti-Aging Therapies?

I'm going to get to a point here, so stick with me bloggers.

The cost of coffee: According to Accounting Principals’ latest Workonomix survey, the average American worker is shelling out more than $20 a week on coffee, for a yearly average of $1,092

The cost of eating out: Another huge expense for the American worker is lunch, with 66% of the workforce opting to buy their midday meal rather than pack one. This comes at an average cost of around $37/week, making it significantly more expensive than commuting or coffee.  **That's $148/month which doesn't include weekends and nights out.  Whoa!!

Now for comparison, what are you spending on your health?

Are you feeling the effects of aging?  Are you noticing changes with your skin, hair, and nails?  Are your "healthy" friends making you feel left behind? Is your day interrupted by feeling hot inside and breaking out into sweats?  Are you ready to blow your fuse with your spouse and co-workers? Are you having trouble remembering when you last slept and woke up relaxed and ready? Are you just having trouble remembering in general?  Are you on the verge of crying one minute and lashing out in anger the next? Are you feeling old and uninterested?

*****What would you do if I told you that $130 could change your life?*****

Seriously!  People spend more money eating out in a month than they do on their health.  Here's a Hormones 101 lesson that can change everything about the way you look, feel, and live each day. Ready?  Let's talk about just a couple of hormones that affect more than you can imagine. 

Estrogen has about 400 crucial functions in the body. Of course it would be difficult to list them all on this blog, but here's a few of the major benefits.

Increases metabolic rate
Helps you sleep more deeply
Dilates your arteries reducing blood pressure
Maintains the amount of collagen in the skin
Helps with memory
Helps with fine motor skills
Increases energy
Decreases wrinkles
Protects your eyes
Reduces irritability, anxiety, and depression levels

Symptoms of decreased estrogen
The BIGGIES and the reason that most women seek help.
Hot Flashes
Night sweats
Rapidly aging/thinning skin
Vaginal dryness
Foggy Thinking
Mood Swings

Progesterone has many roles:
Precursor to other sex hormones (estrogen and testosterone) and cortisol

Maintains the lining of the uterus
It's a natural diuretic.
Promotes thermogenesis. Fat burning for energy
Acts as a natural antidepressant and calming hormone
Aids the thyroid
Normalizes blood clotting
Helps maintain sex drive
Helps maintain normal blood sugar levels
Helps keep estrogen in check.
Promotes bone building and protects against osteoporosis

Common symptoms of progesterone deficiency:
Low sex drive
Anxiety (how many patients start anti-anxiety meds as they age??? You don't want to know
Food cravings
Trouble going to sleep
Painful breasts
Weight gain
Water retention
Painful joints
Decreased urine flow

Progesterone tends to decline in women at about age 35-40 years old (just as a general aging guide).  For those who have gone through a hysterectomy, hormonal changes often follow soon after the surgery.  I suggest getting a hormone evalution 4-6 weeks post-surgery.

Now, after reading this and having any correlations to your own personal status, why would you put off spending just $130 to have your hormones checked?  This profile I mention is more than just a couple of hormones.  It's all of the sex hormones (Estrogen/Progesterone/Testosterone) along with the status of your Adrenal Glands.  And, BONUS, you can do this from the convenience of our own home.  Why wait any longer?  Get this on your health calendar, ASAP!

Now you might be asking, "Can't a simple herbal remedy work for me?" 

CAUTION!!! There are many over-the-counter formulations and versions of hormones available through the internet and other avenues. Talk with a licensed healthcare provider who has special knowledge of hormonal imbalance before you take that route.  I suggest every woman have either a blood draw or saliva test to find out their hormone levels.  Why? Because otherwise, it's a guess as to what the true problem is and risks can be associated with using the wrong product, in the wrong person, at the wrong dose.  Bio-identical hormone replacement therapy is the best choice for those wanting a treatment designed specific to their hormone levels, medical history, and desired outcomes.  I personally wouldn't do it any other way. 

I do hope you evaluate the cost of your good health.  It's worth a great amount to how you live, look, and feel.  I should mention that customized therapy is VERY affordable if you do not have insurance. For those that do, we can bill your prescription insurance provider for the treatments approved by your personal physician or practitioner.  That's a win-win no matter what your coverage status! 

You Can't Afford Not To!! 

To your good health,
Dr. Sonja