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, September 17, 2014

A Common Hormone Link: Infertility, Osteoporosis, and Cancer

Infertility, Osteoporosis, Cancer, and Natural Progesterone

Natural PROGESTERONE, which has many beneficial functions that are described in a new book* by John R. Lee, MD,
  • is a precursor of other sex hormones, i.e., estrogen and testosterone
  • maintains secretory endometrium (the inner secretory lining of the uterus)
  • protects against breast fibrocysts
  • is a natural diuretic
  • helps use fat for energy
  • is a natural antidepressant
  • helps thyroid hormone action
  • normalizes blood clotting
  • restores libido
  • helps normalize blood sugar levels
  • normalizes zinc and copper levels
  • restores proper cell oxygen levels
  • protects against endometrial cancer
  • helps protect against breast cancer
  • stimulates osteoblast-mediated bone building
  • is necessary for survival of embryo and fetus throughout gestation
  • is a precursor of cortisone synthesis by the adrenal cortex.
On the other hand the various synthetic progestins are not precursors of the adrenal hormones or the sex hormones and cannot be easily broken down by the liver. Dr. Lee mentions many side effects from synthetic progestins, including that they may
  • increase the risk of birth defects such as heart and limb defects if taken during the first four months of pregnancy . . .
  • cause fluid retention, epilepsy, migraine, asthma, cardiac or renal dysfunction . . .
  • cause or contribute to depression . . .
  • decrease glucose tolerance; diabetic patients must be carefully monitored.
In this review of Dr. Lee's book the effects of natural progesterone in combating female infertility, osteoporosis, and cancer will be outlined. .
In the menstrual cycle at the crucial time—right after ovulation— low levels of progesterone in relation to estrogen can result in female infertility. Progesterone is the natural hormone that makes possible the survival of the fertilized egg; It is produced by a special tissue (corpus luteum) formed by the follicle from which the matured ovum emerges. Progesterone is essential for the proper development of the uterine lining so that it can receive and nourish a fertilized ovum. As the placenta develops, it assumes and progressively increases the production of progesterone for the duration of the gestation period, i.e., until birth of the baby. During the third trimester, progesterone is produced at the rate of more than 300 milligrams per day, an astounding level of hormone production which, for other hormones, is usually measured in micrograms per day. . . . Progesterone (unlike estrogen and testosterone) is devoid of secondary sex characteristics. Thus, its effects in promoting the development of the fetus are independent of the baby's gender. The fetus is allowed to develop according to its own DNA code and not be affected by the hormones of the mother.
Bones are living tissue and, unlike teeth, they can grow as the body grows, mend when broken, and continually renew themselves throughout life. Bone can be thought of as mineralized cartilage. . . . Bone forming cells (osteocytes) differentiate into osteoclast and osteoblast varieties. Osteoclast cells continually travel through bone tissue looking for older bone previously mineralized and in need of renewal. Osteoclasts resorb (dissolve away) such bone leaving tiny unfilled spaced (lacunae) behind. Osteoblasts then move into these spaces and produce new bone. This astounding process of continual resorption (by osteoclasts) and new bone formation (by osteoblasts), called remodeling, is the mechanism for the remarkable repair abilities and the continuing strength of our bones.
At any stage in life, one's bone status is a product of the balance between these two functions of bone resorption and new bone formation. . . .
  • Estrogen retards osteoclast-mediated bone resorption
  • Natural progesterone stimulates osteoblast-mediated new bone formation
  • Some progestins [synthetic forms of progesterone, which can be patented, used profitably in birth control pills, and which have many deleterious side effects] may also stimulate new bone formation to a lessor degree.
Many factors are involved in osteoporosis. Exercises, particularly weight-bearing ones, and appropriate nutrition are absolutely essential for avoiding osteoporosis.
Mineralized bone (hydroxyapatite) is a crystalline structure and, as such, will respond to physical stress just as other crystalline structures do. In particular, any force tending to distort the crystalline arrangement generates an electric voltage, called the piezoelectric effect, producing a small electric current (discovered by Pierre Curie in 1883). This also happens in mineralized bone and may explain the wondrous ability of osteoclast and osteoblast action in constructing and reinforcing bone trabeculae along lines best suited for maximum strength and physical efficiency. When viewed microscopically, trabeculae remind one of the vaulted chambers and flying buttresses of the best Gothic churches.
Dr. Lee deals with many factors in the treatment of postmenopausal osteoporosis and summarizes as follows:
Since calcium is the predominant mineral in bone building, it is helpful to follow the chain of events that facilitate its bone use from ingestion to incorporation into bone.
facilitating factors
Ingested calcium
gastric hydrochloric acid (HCl) and vitamin D
Absorbed calcium
exercise, progesterone (stimulates osteoblasts), estrogen (restrains osteoclasts), magnesium, micronutrients. Avoid excess protein, diuretics, antibiotics, fluoride, and metabolic acidosis.
Bone incorporation
Natural progesterone is effectively absorbed through the skin. Dr. Lee. has had excellent success increasing the bone density of osteoporotic patients who used progesterone cream, not constantly but as prescribed, along with a diet emphasizing leafy green and other vegetables (Over 5000 plants contain progesterone-like supplements, and appropriate exercise.
Interestingly, a comparison of patients younger than 70 years of age with those over 70 showed no difference in the bone response to progesterone. Further, patients who are now well up in their 80's continue to enjoy strong bones without evident bone loss while continuing their use of natural progesterone. Age is not the cause of osteoporosis; poor nutrition, lack of exercise, and progesterone deficiency are the major factors.
Breast cancer and uterine cancer are promoted by some and controlled by other gonadal hormones, namely, the estrogens and progesterone. The three principal estrogens produced by our bodies are estradiol, estrone, and estriol. The latter is particularly high during pregnancy. In the Journal of the American Medical Association; in 1966;it was reported that women with breast cancer excreted 30 to 60 per cent less estriol than non-cancer controls; and that remission of cancer in patients receiving endocrine therapy occurred only in those whose estriol quotient rose. On the other hand, estradiol and estrone are known promoters of uterine cancer. Specifically, among the three major natural estrogens, estradiol is the most stimulating to breast tissue, estrone is second, and estriol by far the least.
What about progesterone? Breast cancer and uterine cancer tend to occur when estrogen levels are high relative to progesterone. Dr. Lee calls this &estrogen dominance.
In the case of breast cancer, consider the following observations:
  • Breast cancer is more likely to occur in premenopausal women with normal or high estrogen levels and low progesterone levels. . . . it also occurs after menopause when women are given estrogen supplements without progesterone.
  • Among premenopausal women, breast cancer recurrence or late metastases after mastectomy for breast cancer is more common when surgery had been performed during the first half of the menstrual cycle (when estrogen is the dominant hormone) than when surgery had been performed during the latter half of the menstrual cycle (when progesterone is dominant). . . .
  • Treatment of males with estrogen (for prostatic cancer or after trans-sexual surgery) is associated with an increased risk of breast cancer
  • Recently, industrial pollutants having potent estrogenic effects, called xenoestrogens, are being recognized as a pervasive environmental threat, likely to be a contributing factor in the incidence of breast cancer. . . .
The cancer protective benefit of progesterone is clearly indicated by the prospective study in which premenopausal women with low progesterone levels were found to have 5.4 times the risk of developing premenopausal breast cancer and a 10-fold increase in deaths from all malignant neoplasms compared to those with normal progesterone levels. . . .
Thus, the evidence is strong that unopposed estradiol and estrone are carcinogenic for breasts, and both progesterone and estriol, the two major hormones throughout pregnancy, are protective against breast cancer.
Dr. Lee asks why the natural and beneficial hormones progesterone and estriol are not prescribed for women rather than the deleterious synthetic estrogens and progestins. He answers by pointing out that the synthetic forms, which are never found in any living creature, can be patented and sold profitably and that many doctors, who get advertisements for the synthetic products from the pharmaceutical companies, are not aware that the natural hormones, progesterone and estriol are also available.
[Editor's note: I thoroughly enjoyed reading Dr. Lee's book. It is delightfully written and most informative.]

Natural Progesterone: The Multiple Roles of a Remarkable Hormone , BLL Publishing, P.O. Box 2068, Sebastopol, CA 95473; 99 pages, paperback.
Article from NOHA* NEWS, Fall 1994
*The American Nutrition Association was formerly known as the Nutrition for Optimal Health Association [NOHA].

Tuesday, September 9, 2014

Special Products for Special Concerns of Special People

Often people don't completely understand what to take or where to turn for their anti-aging and wellness recommendations.    A little of this, and a little of that, can add up to a lot of unnecessary $pending on regimens that a person might not actually need.  Can you relate?  This is where our team fits best.  Not only do we design custom regimens for hormonal imbalance and pain, but we also design custom and over-the-counter integrative and functional regimens as well .  I refer to it as prescribed supplements.  In fact, if I'm working with a physician or practitioner on a patients profile, I also include specific recommendations for nutraceuticals in addition to hormone therapy customs.  Why?  Key nutrients are essential in how hormones metabolize in the body.  If a person is relying on diet alone to make that happen, I can almost guarantee it's not enough.  With our clinical databases, clinical support team, and networking providers coast-to-coast, we can find answers for YOU and get you on a regimen to address your unfortunate family medical history, your current diagnosis, or simply your attempt to just be healthier overall.  You are the most important person in our world and it's why we are seeing such tremendous success in Branson MO. 

  I work primarily with pharmaceutical grade and high quality products for which you must be a healthcare practitioner to purchase and use in patient care.  When selecting products, I also try to keep cost and effectiveness at the forefront of what I stock and offer to clients.  And remember, we have access to the top anti-aging/wellness/functional/regenenerative/integrative product lines out there.  We provide a great resource to patients.  I'm proud of that and have seen a tremendous shift over the last 10 years in how people are trying to stay ahead of the disease curve. 

To give you and idea, here's a few of the special orders that I have placed for patients and practitioners over the last few weeks.  Some of these have been so popular and effective with patients that I keep them in stock.

~Weight loss product clinically proven to have effect in 2 weeks with no stimulant effects.  I actually did a trial of this one to make sure it didn't cause the jitters.  It doesn't.  All good!!  

~Stress and Adrenal Fatigue Restoration Protocols.  Again, I've personally tried many of the products that I recommend and continue to take many of the supplements in this regimen myself.

~Products for reduction of high Homocysteine levels

~Ovulation regulation for fertility

~Testosterone support formula for Men

~End Fatigue Sleep Revitalization Formulas

~Anxiety Balance formulations

~Healthy Hormone Metabolizers

~Glucose Support Formulas

~Alzheimer's/Dementia Brain Support Formulas

~Polycystic Ovary Syndrome support

~Womens GI Formulation

~Anti-inflammatory Nutraceuticals

~Joint and Muscle Restoration Products

~Skin Care Agents

~Blood Pressure Support Formula

~Meal Replacement Shakes

~Collagen Support Formulations

~Skin care/ Fine lines and wrinkles remedies

And remember that we also offer testing kits:
Hormone Testing
Adrenal Testing
Thyroid Testing
Weight Management Testing
Iodine Testing
Fertility Testing
Sleep Profile Testing .....

Standard Tests
Saliva, blood spot and dried urine are used for the minimally-invasive hormone testing.  The simplicity of sample collection and stability of samples in storage and transport have made these ideal for clinical use as well as research.  See the table below for a full list of our current test offerings.
TestBlood SpotSalivaDried Urine
Estradiol (E2) 
Progesterone (Pg) 
Testosterone (T), free  
Testosterone (T), total  
Estriol (E3)  
Estrone (E1)  
Cortisol (C), free  
Cortisol (C), total  
Prostate Specific Antigen (PSA)  
Free Thyroxine (fT4)  
Free Triiodothyronine (fT3)  
Thyroid Stimulating Hormone (TSH)  
Thyroid Peroxidase Hormone (TPO)  
Thyroxine (T4), total  
IGF-1 (Somatomedin C)  
Luteinizing Hormone (LH)  
Follicle-Stimulating Hormone (FSH)  
Insulin (Ins), fasting  
Cholesterol (CH), total  
HDL Cholesterol (HDL)  
High-Sensitivity C-Reactive Protein (hsCRP)  
Hemoglobin A1c (HbA1c)  
Triglycerides (TG)  
Vitamin D, Total  
25-OH Vitamin D2  
25-OH Vitamin D3  
Iodine (I)  
Bromine (Br)  
Arsenic (Ar)  
Selenium (Se)  
Mercury (Hg)  
Creatinine (Cr)  

.......and the list goes on and on in all that we are providing.    It truly is the FUTURE of medicine NOW!!!  If you would like a personal evaluation and a custom designed regimen, please don't hesitate to call our team.  We're happy to answer your questions, make recommendations, work with your doctor, or whatever you need.  We can also ship the products straight to your home.  Or, if you're in the area, stop by and see us personally.  It's a great city to catch a LIVE Family Friendly show while you're visiting. 

To your good health,
Dr. Sonja

Monday, September 8, 2014

Part 2: Metabolic Changes with Aging

Thanks for staying tuned in to the blog.  All 90,000 of you.  :)  WOW!

As promised I wanted to follow up with part 2 (of 2) discussing the metabolic changes that can come about with the aging process.  Could obesity, diabetes, and poor metabolism be connected to menopause and hormonal imbalance?  Science is showing that the answer is YES!  Are cholesterol, depression, and heart disease connected?  Again, science is proving YES!

Here's some key evidence and interest of where hormone balance is headed.  I've served in this realm for many, many years and I can tell you that the trend in medical care to pay attention to hormonal imbalance and it's connection to disease is moving up, up, up.  Remember to check back to Part 1 for more information about hormones and aging as well.

Insulin Resistance and Diabetes:
The HERS study and the WHI study, suggest that estrogen alone, or when estrogen is combined with progestogen, actually can reduce the instance of new-onset diabetes.  (Remember that medroxyprogesterone (synthetic), is not the same as progesterone.  You want to do the bio-identical version to get the best health benefits.)  Furthermore, integrating hormone replacement therapy into the care of those with impaired glucose tolerance, metabolic syndrome, and diabetes has been shown to improve glucose.   Not only that, but the evidence is showing strongly that insulin resistance is improved, lipid/cholesterol profiles are improved, blood pressure is improved, and abdominal obesity is improved when hormones are appropriately restore and balanced.  With estrogen loss it appears that a woman faces increased central body fat, increased low-density lipoproteins, increased triglycerides, decreased HDL's, increased glucose and increased insulin resistance which can all lead to other diseases.  Instead of putting a Band-Aid on these other problems, it might be a good idea to look into hormone deficiency as an underlying contributor.  Will we one day see hormone therapy included in regimens for diabetes and cardiovascular disease?  It's not out of line if you ask me and other professionals serving in this unique area of medical care.

Blood Pressure/Cholesterol/Depression/Anxiety 

Here's some real data shared from a physician serving in the realm of bio-identical hormone replacement therapy.  Her information was cited in OBGYN news magazine Jan 15, 2009 after she tracked 150 women on transdermal (cream or topical) hormone replacement therapy at baseline and then 1 yr later.   Look at how the numbers moved.  In a positive direction.  Yay!

Blood Pressure 133/80 -------->121/76 @ 1yr on therapy
Triglycerides 175--------------->120 @ 1yr on therapy
Fasting glucose 110------------->92 @ 1 yr on therapy
Hamilton Depression Score 6.6--------->5.0 @ 1 yr on therapy
Hamilton Anxiety Score 9.6 ------------>6.5 @ 1yr on therapy

WOW right?  Pretty compelling evidence.....

Body Fat Redistribution "The Spare Tire Syndrome"

The explanation for this peri- & post- menopausal nuisance can go in a lot of directions, but I'll try to zone in on a few reasons for this common complaint.  Often women don't feel good due to poor sleep (progesterone deficiency), hot flashes (estrogen deficiency), body aches, and adrenal fatigue.  The body tries to compensate for the loss of energy and low level adrenal hormones by triggering cravings for sugar, salt, and caffeine.  Guess where those things hang out after consumed?  Right where they are not wanted.   A diet will be a great struggle for a person until these weight contributing factors are dealt with appropriately.  Hormones should be tested and that's why the lab that I have used for over a decade has now come out with a Weight Management Testing Kit. Remember also that lifestyle modification to address sleep and stress is a crucial piece in 'figuring' things out too.  That's where it's important to work with a practitioner looking at all aspects.

Also worth mentioning, is that between the ages of 20-40, women also experience approximately a 50% drop in DHEA levels.  Gasp!  That can have a major impact especially for women complaining of fatigue, weight gain, poor concentration, and so on.  Low DHEA can also have a significant impact on metabolism.  Many prescribed supplements for weight loss will include DHEA as an agent to help move the numbers on the bathroom scale down.  I would not suggest that you take DHEA without doing a hormone panel because of it's capability to metabolize into other hormones that you may not need.   Again, work with someone well educated in the area of hormonal imbalance.

Low Testosterone
If you don't have enough, you're going to notice.

 Declining testosterone production is another offending culprit in the weight/metabolism world.  Addressing "Low T" can help with lean muscle mass, vitality, stamina, and weight control.  Get this! I just reviewed a patients profile today and at 50 years old the normal range is 16-55 (saliva) for Testosterone.  She came in at a 10.  No wonder she's drained, gaining weight, and having other associated symptoms.  No wonder!!  She's feeling the impact of low T.  It's not just a man thing.

Please do yourself a health favor and get your hormones tested.  Talk with your doctor about your symptoms and assess and address your personal imbalances.

To your good hormone health,
Dr. Sonja

Wednesday, September 3, 2014

Part 1: Metabolic Changes With Aging

Today's blog is to mention just a few of the metabolic changes that can occur in the process of aging.  Although many things can be expected, it does not mean that they cannot be prevented, treated, or simply pushed back a few years from what's typically normal.  Women especially tend to gain and struggle with their weight more than ever before after going through menopause or experiencing a hysterectomy.  They also complain of dry, brittle hair, aging skin, poor concentration, fatigue, insomnia, etc.   To give you some of the reasons for this, it's probably easiest to break things down into some categories to help you better understand.   So, here goes...

Thyroid: By the age of 60, about 17% of women and about 9% of men have been diagnosed with hypothyroidism.  That's just those we know about.  Thyroid disease is one of those conditions that seems to go undiagnosed because values look "normal".   My position statement is that normal is not necessarily optimal.  Plenty of patients that I have come into contact over the years struggled for a long time until they finally found a practitioner that was willing to treat their symptoms outside of the numbers appearing normal.  My experience has been that after a hysterectomy, most women should stay on top of thyroid health like never before. Many women will tell you that they had a hysterectomy and then a few years later received the diagnosis of hypothyroidism.  Why?  The endocrine system is intricately designed with hormone and feedback loops.  Upset one thing and something else is going to be affected.  Experience has taught me a great deal simply by listening and putting two and two together.

Perimenopause: This period of time for women usually begins in the 40's with about 95% of women seeing this transitional onset into menopause at the ages of 39-51.  The average time this stage lasts is about 2-8 years and with it comes a lot of biological changes.  Ovarian function changes, menstrual cycles begin to vary, there's less frequent ovulation thereby resulting in lower progesterone production, and the hormones estrogen, progesterone, and testosterone all begin to decline.  Estrogen production can go low enough that menstrual cycles will cease to exist and after missing 12 periods, a woman is deemed to be in menopause.  Just think about a time period of YEARS when describing the changes that take place.  This is why I encourage women to test at least in their early 40's so that a benchmark can be established.  I personally tested at 37 years old and found some hormonal imbalances that I have addressed ever since.  Hormone restoration to youthful years is possible with custom/compounded bio-identical hormone replacement therapy.  Yay!

Menopause: Once menopause strikes, the adrenal glands try to pick up the pace to help what's been lost in the function of the ovaries.  Androstenedione, DHEA, and DHEA Sulfate, hormones produced by the adrenal glands, also take a dive resulting in about 70% less production than what the body was used to operating in younger ages.  Testosterone production decreases by 25% after menopause.  This can bring on loss of vitality, poor stamina, bone loss, loss of lean muscle mass, incontinence and many other things.  Even though things decline, the problem really comes into play because of the shift of hormones.  The androgen to estrogen ratio becomes significantly more out of balance because of estrogens plummet and there's less conversion of`androstenedione to testosterone.  This results in hair thinning and the pesky facial hair and acne that older women complain of.  Even with testosterones decline, there's still not enough estrogen to oppose it. 

Okay, so that's part 1.  I know there's a lot to process when talking about hormonal imbalance, but the BIG message in all of this, especially if you can relate to the content of this blog, is to assess and address the imbalances.  Better sooner, than later. 

In Part 2 we will cover insulin resistance, diabetes, obesity, and metabolism.  Stay tuned!

To your good hormone health,
Dr. Sonja