The Link: Testosterone and Diabetes

Do you have Diabetes?  Does diabetes run in your family?  Is your testosterone level low?  Is there a link between the two?

Studies are showing a direct link between low testosterone in men and diabetes.  For those that do not (yet) have diabetes, you should strongly consider keeping your testosterone levels up to par.  For those that have already been diagnosed with diabetes, please consider having your testosterone level evaluated.  Why? Testosterone helps the body's tissues to absorb more blood sugar in response to insulin.  Men with low T are more resistant to insulin and need to produce more in order to maintain normal blood sugar levels.  Here's the results of just one study that I captured on the National Institutes of Health website. 

CONTEXT: Low testosterone levels are common in men with type 2 diabetes and may be associated with insulin resistance.

OBJECTIVE: We investigated prevalence of testosterone deficiency and the relationship between testosterone and insulin resistance in a large cohort of men with type 2 and type 1 diabetes.

DESIGN: The study was a cross-sectional survey of 580 men with type 2 diabetes and 69 men with type 1 diabetes. A subgroup of 262 men with type 2 diabetes was then reassessed after a median of 6 months.

RESULTS: Forty-three percent of men with type 2 diabetes had a reduced total testosterone, and 57% had a reduced calculated free testosterone. Low testosterone levels were independently associated with insulin resistance in men with type 1 diabetes as well as type 2 diabetes. Serial measurements also revealed an inverse relationship between changes in testosterone levels and insulin resistance.

CONCLUSIONS: Testosterone deficiency is common in men with diabetes, regardless of the type. Testosterone levels are partly influenced by insulin resistance, which may represent an important avenue for intervention, whereas the utility of testosterone replacement remains to be established in prospective trials.

I'm suggesting that men at ~age 45 have their testosterone levels checked.  Men go through a natural aging process resulting in Andropause.  The symptoms for men tend to look something like these listed below.   Testing is easy and I can provide an at-home kit to help you determine where you measure up on the T scale.  It's simple and affordable and important in health, wellness, and longevity. What are you waiting for?

BONE LOSS, BACK PAIN  DECREASED MUSCLE STRENGTH  DECREASE ENDURANCE      DECREASE URINE FLOW  DEPRESSION, IRRITABILITY, MOODINESS  DIFFICULTY CONCENTRATING       INSOMNIA  WEIGHT GAIN AROUND THE WAIST  ERECTILE DYSFUNCTION  HIGH CHOLESTEROL  HOT FLASHES  LOW LIBIDO  INCREASED RISK FOR Heart Events  INCREASED RISK FOR BREAST CANCER

Hormone Testing: Saliva Collection

A provider with ZRT for greater than a decade.  WOW!!  Things are really changing for the better in addressing hormonal imbalances.  "Assess and Address" your concerns through this at-home testing option.  I can provide the kit, walk you through the process, and explain your personal results.   Ask a friend if they've done it, and I bet you'll be surprised at who's taking charge of their health in this way.

I highly recommend you test your hormones! The sooner the better in your quest for better health and wellness.

Dr. Sonja O'Bryan

The Real Reason People Go to the Doctor

STRESS!!!!!

It's one thing to look at sex hormones (and often there are deficiencies), but it's another to look at stress hormones. I had two patients just last week who had very high Cortisol levels. A high Cortisol level is not a good thing and if left untreated, can put a person on the road to chronic diseases. Here are a few things that should get a Stressaholics attention.   How well are you doing with your Stress Management?  If you're not quite sure, I can help you determine the answer to that question.


Metabolic Effects of High Cortisol

Increased appetite, accelerated muscle breakdown, and enhanced fat storage---------> obesity

Elevated cholesterol and triglyceride levels----------------> heart disease

Elevated blood pressure----------------->heart disease

Alterations in brain neurochemistry -------------------->depression/anxiety

Physical atrophy of brain cells-------------------->Alzheimers disease

Insulin resistance and elevated blood sugars----------->diabetes

Accelerated bone breakdown-------------->osteoporosis

Reduced levels of testosterone and estrogen----------------->suppressed libido

Suppression of immune activity--------------->Frequent colds/flu/infection

Reduced synthesis of brain neurotransmitters---------------->memory and concentration problems.

Insomnia------> fatigue, poor immune function, weight gain.

If you think you might be suffering from conditions related to stress, call me!! And remember, stress comes in many forms.

And just so you know . . . often I can recommend integrative treatments, natural supplements, and some simple lifestyle changes that will help you sleep better and manage stress better to help for the long haul. Stress is inevitable in our fast paced society. That's a given. But continued and unresolved stress can really take a toll on the body. Stress is really the #1 reason for doctors visits when you begin to assess things fully. High blood pressure, anxiety, depression, insomnia, and persistent respiratory illnesses could very possibly be connected to your stress. 

The testing is simple and affordable. Give me a call if I can help.
To your good health,

Dr. Sonja

Ladies Only

Vaginal burning, itching, dryness, and discomfort are usually the ways that women describe the pain they feel with menopause.  Hot flashes are the most talked about menopause symptom, but almost 50% of menopausal women experience atrophic vaginitis.    Remember when I say menopause, I'm talking BOTH surgically induced (hysterectomy) and natural (normal aging). The decline in estrogen basically causes thinning and inflammation of the vaginal walls. Over time and left untreated, this nuisance can lead to other things like discomfort during intercourse, recurrent urinary tract infections, and incontinence. So how do you treat it? Often, Estrogen therapy applied vaginally 2-3 times weekly can give resolution.  We have a 'go-to' formulation that seems to do the trick for this need really, really well.  Soothing cream base, moisturing ingredients, and very affordable. In fact, our local OB/Gyn's prescribe it for their patients all-the-time. 

Today I consulted with a patient who has a condition called vulvar lichen planus. This goes even further beyond the vaginitis and REALLY affects skin integrity. These women deal with cracking skin, itchy patches, sores, and other painful matters. For them, the treatment plan often includes a multi-ingredient customized medicine to treat multiple aspects of the pain.

Not long after, I got an email from a prescriber asking for help with a young patient who recently had a baby. The young mom complained of stabbing pains and constant hurting in the vagina since having the baby. The approach was much the same with her. I interviewed her and got a better understanding of what the pain intensity was, when it happened the most, etc. etc. We were able to go to the lab and make a customized pain formula for her. Hoorah!!

Very real stuff. Very treatable. When I visit with patients one on one, it's amazing to hear the 'hidden' problems they experience. It doesn't have to be hidden. Seek help. Now that's good advice.


~DrSonja

Should I Take Hormones? Heart Disease, Breast Cancer, Osteoporosis, Symptom Relief

Hopefully this BLOG will help to answer the #1 question so many women have when it comes to using hormones.

 This is an article that came out on FOX News showing that all hormones are NOT created equal, but that using the right kind of hormones, can be beneficial in many different ways to a persons health.  I think it's a great article, understandable, and very informative in answering the big question about their use.

**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.


From FOX NEWS:
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, AND 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
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.

Testosterone
Believe it or not, women need testosterone too – in much lower amounts than men, but it is a necessary female hormone. 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.

Osteoporosis
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.

I didn't stop providing Bio-identicals to patients even when the WHI study "experts" were crossing their arms and rolling their eyes about using this more natural approach to hormone balance.  Thankfully during that time our patients continued to use the therapies that are now known to bring health, disease reduction, youthfulness, longevity, and symptom control.  Today, our patient pool is growing like crazy, which is exciting and keeps us very busy.

Something to think about: What's really sad and disturbing to me is that for over 10 years, women were told that hormones were not "good" for them.   Will we see increased heart disease, cancer, and osteoporosis in these same women that could have prevented some of these risks by at least taking bio-identicals instead?  I'm afraid the answer will be yes! Others serving in this field of medicine agree.  And what about all of those years they suffered through the symptoms of hot flashes, sweating, irritability, nervousness, and the rest of the implications that menopause can bring about.  Doesn't that count for anything? 

If you have any of these disease risks in your family, find yourself struggling with symptoms, or just want some general questions answered, please give us a call.   We are happy to provide you with resources and information to help you make a well-informed decision about your hormone "health"care. 

To your good health,
Dr. Sonja


Read more: http://www.foxnews.com/health/2012/06/06/using-bioidentical-hormone-therapy-to-find-relief-from-menopause/#ixzz24Nr4hTzR

A Treatment Worth Mentioning for Autism. We've Got It Covered

First things first:
The diagnosis of Autism is best managed by a team of professionals often including psychologists, neurologists, speech therapists, primary care physicians, and other professionals with a knowledge of it's effects. Autism is a complex disorder that affects children, and the prevalence seems to be steadily increasing. 

There are many theories as to why this is happening in our pediatric population, but one such theory and an area of long-term research indicates a link to opioid-excess (beta-endorphins).  This can often be realized in young patients that seem to have a high tolerance to pain, less interaction socially, repetitive behaviors, and even some unusual behaviors such as walking regularly on the toes.  These children also may demonstrate poking of body parts, skin picking, self-biting, punching and slapping the head, lip chewing, removal of hair, along with other things.  Many of these behaviors are repetitive and the child is not aware that they are even doing so.   Opioid excess is an interesting connection because researchers have gone so far as to treat young animals with pain pills (containing opioids) and they exhibit similar behaviors as autistic children.  Interesting huh?  

Today's blog is to present an awareness about this opioid-excess connection in Autism, and also to introduce a treatment that is making a significant impact in the lives of those with Autism.  As I did my research and reading, I couldn't help but think of all of the parents that simply don't know about this therapy option.  And by the way, it's very affordable whether covered by insurance or not and we provide it to many patients in our care.

Naltrexone is a medication that is used to halt the effects of opioids and has been used for many years (since the 70's actually) in the treatment of drug and alcohol addiction.  The typical dosing usually requires 50mg-150mg per day to block the drug response of heroin or morphine and even alcohol.  For young patients with Autism however,  a LOW dose naltrexone is used and must be formulated in a custom lab in very small dosages.  Remember, the same principle and mechanism of action is desired in patients with Autism because they tend to have opioid-excess.  In other words, the medication halts the effects of the high endorphins.  The dose needed, however, is much, much lower than in the case of opioid addictions.  In fact, a fraction of what the prescription strength naltrexone provides. 

Various case studies exist for this treatment in patients with Autism and many include an introduction of the therapy, withdrawal, and re-introduction.  Many parents realized that while on the low dose naltrexone, their children exhibited fewer of these behaviors, engaged more socially, and didn't inflict self-harm as much as when not on the medication.  The low dose naltrexone had a positive impact on behavioral problems, seizures, impulsivity, and hyperactivity which are some of the main symptoms of Autism. A help to the child and a help to the parent, right?  Now that's a win-win!

Many children with Autism are treated with the classic regimen of mood altering/stabilizing agents with no knowledge that this low-dose naltrexone (LDN) treatment even exists.   If Autism affects your life in some way whether through a direct family member, a friend, or perhaps an acquaintance, please feel free to pass this information along.  And even more importantly, please take some time, personally, to read about low dose naltrexone and it's place in the treatment of Autism. I think Low Dose Naltrexone is a treatment that we are going to see more of in the future for this and other diseases such as Cancer, Crohn's, Multiple Sclerosis, and more. 

As always, please call us if we can help you in navigating treatment options for your concerns and conditions.  The Custom Compounding Center has been creating unique and effective therapies for almost 15 years now.  Wow, time flys!  Our professional staff is dedicated to working with you on whatever ails you.  I feel confident that we can help you in some way.  Give us a call

Anti-Aging Medicine: Often Means Getting You Back to "Your OLD Self"

Fatigue is one of the most common complaints of those living in today's high paced, fast food, deadline driven world and interruptions in a persons schedule can make seizing the day near impossible.  I'm not sure what the statistic would be of those coming to me for help, but I'm guessing that >90% of those that I interview will express fatigue as a noticeable concern.  What about you?  How are you feeling in the area of stress and fatigue?  Not sure?  In this blog,  and because it seems to be so prevalent, I want to simply cover a little background to help you determine if something can be done to help you get "back on your game".

If you have symptoms such as tiredness, difficulty concentrating, inability to lose weight, anxiety, or depression, then you may be suffering from adrenal fatigue.  This clinical condition dates back as far as the medical texts of the 1800's, and the prescription for treatment then was simply to "relax".  That's about as helpful as telling someone who is depressed to "cheer up" while you softly pat them on the shoulder.  It just doesn't quite work like that.  Despite effective diagnostic tools and treatment regimens, most clinicians are not informed or prepared to treat adrenal fatigue as a threat to health.  I say threat to health, because I personally wonder how often there are car accidents, falls, illnesses, and diseases that can be connected to long term fatigue, insomnia, weight gain, anxiety, etc.

How extreme is the fatigue?  That's a reasonable and necessary question because there is another condition called Addison's disease where the adrenal glands are not functioning.  While Addison's disease is often caused by autoimmune problems, adrenal fatigue is most commonly caused by stress.  Conventional medicine recognizes Addison's disease, but not necessarily the hypoadrenia state of adrenal fatigue.   I've never really understood that, and don't have the same clinical perspective about it.  The person experiencing either will have similar symptoms, and both, in my opinion, should be treated.

Does this list describe you?

Symptoms of Adrenal Fatigue:
Tendency to gain weight and inability to lose it
High frequency of illness and difficulty getting well
Tendency to tremble under pressure
Reduced sex drive
Lightheaded upon rising
Lack of concentration
Need for coffee or stimulants
Depression
Dry and thin skin
Low body temperature
Nervousness
Unexplained hair loss
Alternating constipation and diarrhea
Upset stomach
Emotional behaviors and expressions
Rapid Aging

The reality is that stress is no longer a mystery to treat and our body has a built is mechanism to give clinicians diagnostic identifiers.  The mission control center of our body are the adrenal glands and when they get short circuited due to stress, the whole body can go haywire and physical manifestations can present (like those above).  The good news is that hormones produced by the adrenals can easily be tested, and if out of range, can be treated through natural and restorative therapies.   It's rare that I recommend only an adrenal hormone panel because the sex hormones are also intricately connected to everything in the endocrine system as well.  Estrogen, Progesterone, and Testosterone can have a significant impact on well being, energy, weight, emotions, mood, etc.  While testing one aspect of adrenal fatigue, it's important to test others.  And it's very affordable to do so as you see below.

So what do you do with this information?
If this describes you, or is a concern to you, then call our office for an at-home saliva testing kit.  417-231-4544. We only charge $10 for the packet of information and the testing kit.  Mention this blog for that deal!!  From there, you will simply need to follow the instructions within the kit for testing, or call us to help guide you through the process before shipping off your sample to the lab. A good panel to evaluate sex hormones and adrenals hormones is typically $130.  That's a small price to pay to identify what the source of your concerns might be.  Then, once your results post to me, I will call you and design a treatment plan for you.  Remember, I'm ALL about natural when possible, but sometimes the intervention and expertise of your personal medical doctor will be necessary to get you back to your "old" self.  It's rare that practitioners in Anti-Aging Medicine focus on getting you back to your old self, but in this case, that's a good thing.

Give us a call today!



Dr. Sonja O'Bryan, Pharm. D. ABAAHP
Board Certified Health Practitioner Diplomate
American Academy of Anti-Aging Medicine