Hormone Health MD Bioidentical Blog

July 26, 2008

Hormones, Osteoporosis, and Hip Fractures

Elderly women are at greater risk of death after a hip fracture than after breast cancer, according to a recent article in Medscape Medical News citing a study by Jane A.Cauley, DrPH,  at the University of Pittsburgh. The death rate was 48.1% after a hip fracture versus 25.1% after a breast cancer diagnosis.

What causes hip fractures?  Osteoporosis! Women with osteoporosis are the most likely to sustain a hip fracture. Osteoporosis advances rapidly after menopause due to the dramatic drop in hormones.

According to the National Osteoporosis Foundation, half of the women over 50 will have an osteoporotic fracture before they die. Half of the women surviving a hip fracture will not be able to walk and a quarter will need long term nursing care. A woman’s risk of hip fracture is equal to her combined risk of developing breast, uterine, and ovarian cancer.

Women are not the only ones who suffer from this problem. Men also get osteoporosis, although it is poorly recognized by the medical community.  Men typically develop osteoporosis slower and it appears later than in women.  Testosterone begins to diminish in the early 30’s and decreases 1-3%  per year, increasing the risk for bone loss. Men over 65 have a hip fracture rate of 5 in 1,000. Men over 65 are at risk and should have a bone density test done, as well as calcium, magnesium, thyroid, Vitamin D, and hormone levels.

            By 2010, over 52 million men and women age 50 years and older will either have osteoporosis or be at increased risk because of low bone mass per the National Osteoprosis Foundation. Approximately 20% of those that develop hip fractures will die the year after the fracture from surgery complications such a pneumonia or blood clots in the lung according to the CDC.

            The best therapy for osteoporosis is replacing lost hormones. In women, estrogen saves more bone tissue than very large doses of calcium according to the National Institute on Aging. In the May 2004 Journal of the American Medical Association, British researchers described a link between hormone replacement therapy and a reduced risk of bone fracture in post-menopausal women.

            Poor nutrition and inadequate intake of nutrients, lack of adequate exercise, unhealthy lifestyle including cigarettes and alcohol, and race also contribute to osteoporosis. Hormone replacement in men and women is of key importance for bone health.

            Replacemen with biodentical hormones is key. All three hormones are necessary in order to build and maintain bone: estrogen, progesterone, and testosterone. If you are taking Premarin, you are only getting an estrogen effect, and a dangerous one.You don’t want to trade one problem for another by taking alien synthetic molecules orally, like Premarin and Provera,  that can increase heart disease, stroke, and breast cancer. Remember all estrogen, even bioidentical, should be taken transdermally. Any oral estrogen can increase C-reactive protein which correlates with a higher incidence of heart disease. Provera or medrxyprogesterone has no benefit for bone, and in fact inhibits beneficial progesterone production and effects by binding to progesterone receptor sites.

            The synthetic pharmaceutical medications for osteoporosis, like Fosamax, are problematic. They do not allow for the natural turn-over and remodeling of bone and what you essentially wind up with is a lot of old brittle bone. In addition, one study showed that combining estrogen with Fosamax may increase fractures. In addition, Fosamax is correlated with bone problems in the jaw.

           Vitamin D is very important to build bone and prevent osteoporosis. Even in the sun belts, Vitamin D levels are low among men and women due to interior jobs, sun-screen over-use, and lack of ability of aging skin to convert sunlight to Vitamin D. Get your 25 hydroxy Vitamin D levels checked with a blood test, and if they are low step up your supplementation until they come up.

             Nutrient supplementation needs to be more than just calcium to build bone. Calcium citrate is OK, but calcium hydroxyapetite is best. Don’t exceed 1600 mg total of calcium per day unless you want calcium in your arteries and kidneys too. Other important nutrients for bone building are Vitamin K, magnesium, manganese, boron, and strontium. Othomolecular makes a great supplement that has all you need for bone maintenance or improvement of osteoporosis called ProBono. Patient report joints feeling better on it as well.

            Make sure you get a baseline bone density scan when you are in the perimenopausal years so you know where you are starting out. If you have osteopenia, take action. You can prevent osteoporosis!

For further information contact:

Aref Bhuiya, M.D., 5655 Lindero Canyon Rd., Ste. 202, Westlake Village, CA 91362, 818-597-3223..

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July 20, 2008

Making Sense of Hormones

 

As we age we lose our hormones. All of our good building up hormones start declining after age 30.   Cortisol and insulin tend to increase, which can harm our health. These changes are detrimental to our vitality and our health.

 

These hormone changes are part of the cycle of life, a building up and then shutting down. Hormones are the highest in our most vital and healthy time of our life, our teens and twenties when we have our highest energy and best health, our “child-bearing years”. After this time, about age 30, our genetics dictate that our good hormones decline: testosterone, estrogen, progesterone, thyroid hormone, and growth hormone.  Hormones that can harm us, cortisol and insulin, start to rise.  At about age 40, hormone decline accelerates in women as the ovaries begin shutting down hormone production in the peri-menopause. Men’s hormones continue to decline. This is nature’s way of shutting us down and eliminating us. It is not a coincidence that the healthiest time of our lives is when we have our full complement of hormones, nor that we begin developing the diseases of aging, heart, bone, brain, and eye problem, as our hormones decline. We age because we lose our hormones!

 

This was not as issue prior to 1900, when the average age of death was 50. Most men and women did not experience the full force of hormone loss. Now with the average age of death at 80, we can live 30 years or more without our hormones and the consequences.

 

Certainly, lifestyle, exercise, body weight and exercise, nutrient supplements all contribute to being healthy and may help make the process of hormone loss easier or make certain hormone loss slower. But none of these things will put your hormones back. Acupuncture, chiropractic, yoga, and Aruvedic medicine may also help alleviate hormone symptoms, but none will not put your hormones back. The only way to keep your youthful compliment of hormones is by replacing them, and only with hormones that have the same exact molecular structure that is native to the human body.

 

When we enter our 40’s women start feeling these changes as ovaries start to shut down production of sex hormones in peri-menopause and menopause. Nature is most cruel to women because symptoms of perimenopause can be swift and profound. Menopause has been often likened to falling off a cliff where men’s andropause is likened to rolling down a hill. Men begin noticing the more gradual decline in testosterone called andropause. Meanwhile thyroid hormone and growth hormone also declines.

 

In women testosterone is the first to start declining, then progesterone. In their 40’s, women start noticing insomnia, irritability, mood swings, depression, low libido, hair loss, and migraines directly associated with low progesterone. Estrogen also starts declining, but is the last to go with hot flashes, weepiness, night sweats, and lack of energy. The symptoms of hormone change can continue for 15-20 prior to loss of menstruation.

 

With loss of testosterone, men experience fatigue, memory loss, loss of libido, loss of muscle mass, weight gain, decreased athletic ability, muscle aches, and decreased interest in activities.

 

Thyroid hormone and growth hormone play vital roles in hour health and energy as well, and need to be replaced and even optimized (but not abused) when deficient with bioidentical equivalents.

 

Bioidentical hormone replacement will alleviate the symptoms of menopause and andropause.   I am often asked, “Do I have to take them forever?”.  The answer is yes. If you stop taking hormones all your symptoms will come back. Once you stop making your hormones, they are gone. They do not come back unless you put them back with bioidentical hormone replacement.

 

The long term consequences of lack of hormones are weight gain, loss of muscle mass, heart disease, high cholesterol, diabetes, colon cancer, macular degeneration, cataract formation, high blood pressure, and osteoporosis. A lower chance of having these problems keeps me happily taking my hormones and vitamins each day.  I also feel the same way I did in my 30’s!

 

We all will die some day. The fact is that our cells can only divide so many times. Each time they divide they lose some DNA, and when a critical limit is met, they die. Current maximum age is believed to be 120 years due to this effect.

 

Of course we have to fuel our cells with nutrients and vitamins, limit our exposure to toxins and chemicals, and detoxify. 

 

We are living longer because we have great living conditions and can prevent mortality from many diseases and accidents. But most of us will feel lousy for the last 30 years struggling with symptoms and disease until we come to accept our age and poor state of wellness. 50% of those who live to be 85 will have Alzheimer’s (estrogen can prevent Alzheimer’s disease).

 

It doesn’t have to be that way. With bioidentical hormone and nutrient replacement you can enjoy feeling good for the rest of your life. The means is available. The choice is yours.

For further informattion contact:

Aref Bhuiya M.D., 5655 Lindero Canyon Rd., Ste. 202, Westlake Village, CA 91362, 818-597-3223.

 

July 15, 2008

Emotional and Hormonal Health

We often think of emotional health in terms of what’s going on in our lives, but more often it is tied to what’s going on in our bodies.

 

Emotional health is very much tied to our hormones. Depression in particular can be governed by deficiencies and imbalances in our hormones.

 

In men, testosterone deficiency is linked with depression, irritability, and lack of motivation. The term “grumpy old men” is often used to describe the emotional changes that occur in men with testosterone deficiency. In women, lack of testosterone can be associated with lack of emotional shield and panic attacks.

 

In women, estrogen enhances formation of serotonin and estrogen deficiency can cause depression, but lack of progesterone is also tied to depression, irritability, and mood swings. With decreasing estrogen and progesterone in the pre- and peri-menopause it makes sense why women experience more depression in mid-life. Lack of estrogen can also effect concentration and memory.

 

 Post- partum depression is really a disorder of a precipitous drop in progesterone after childbirth and inability to rebound from this drop. Some informed obstetricians treat this change in mood not with anti-depressants but with bioidentical progesterone with great success.

 

 Many young women on the birth control pill or other forms of hormonal birth control experience increased depression, irritability, and mood swings. This is because the synthetic hormones in these drugs interfere with normal hormone balance, occupying normal progesterone receptors in addition to decreasing the production in progesterone eliminating the natural calming effect of this hormone.

 

Another hormone that can affect emotional health is cortisol (the stress hormone) excess or deficiency. These conditions can cause irritability, confusion, sleep disturbances, mood disturbances, depression, emotional imbalances, foggy thinking, and panic disorders.

 

Thyroid hormone deficiency can also cause depression, anxiety or panic attacks, decreased memory, inability to concentrate, slow speech, insomnia, and agitation.

 

Growth Hormone deficiency can also manifest not only as a lack of motivation but also as a lack of sociability.   In addition, a prominent characteristic of low growth hormone is an inability to concentrate and a failing memory.

 

A deficiency in any of our major hormones can have mental and emotional effects. The best way to determine if hormone loss is a factor in your mental health is to see a doctor familiar with the emotional effects of hormone loss, discuss your symptoms, and have hormone testing. If deficiencies are detected, replace lost hormones only with bioidentical hormones. It could make all the difference!

For further informattion contact:

Aref Bhuiya M.D., 5655 Lindero Canyon Rd., Ste. 202, Westlake Village, CA 91362, 818-597-3223.

July 10, 2008

Menopause and the Women’s Health Initiative Study

Filed under: bioidentical hormones,Menopause,Safety of Hormones — Dr. Bhuiya's Bioidentical Hormone Blog @ 6:43 am
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Every day in the United States 3,500 women enter menopause.  Symptoms, however, can begin as long as fifteen years prior.  

         

          The normal age to go through menopause ranges from 35 to 55. Therefore, you may easily live one half of your life missing your hormones, and we age because we lose our hormones.

 

Until recently, the only hormonal therapy available in this country has been synthetic hormone replacement, that is, Premarin and Provera or Prempro.

 

          The government sponsored Women’s Health Initiative Program halted its study on Prempro, containing Premarin (horse urine estrogen) plus Provera, a progestin (synthetic progesterone, also called hydroxy-progesterone), on July 9, 2002.  This was three years early because of an increased risk of breast cancer in women taking this drug.

         

          The study revealed the following results:

· The stroke rate was 41 % higher in women taking Prempro 

· Women on Prempro had double the rate of blood clots.    

· Women on Prempro had an increase in breast cancer of 26%.

· Women on Prempro had a 22% increase in heart disease.

 

The results of the Women’s Health Initiative Study brought to the forefront why synthetic hormonal therapy will become a treatment of the past.

 

It is clear that Prempro increases the risk for disease and prompted the call for women to get off these synthetic hormones. Due to the above study Wyeth, the drug company that makes Prempro, has lost tremendous sales. Women and doctors have turned to a safe alternative which is bio-identical hormones. Wyeth’s loss of revenue has prompted the company to lobby for restrictions on compounding pharmacies to turn people back to using Prempro.

 

The safe alternative, bioidentical hormones: estradiol, progesterone, and testosterone, are all approved by the FDA in other medications at a set dose. The difference in compounding is that the dose is tailored to the patient’s needs through laboratory testing so they are not overdosed or under-dosed.

 

The recent Wyeth-provoked onslaught by the FDA on compounding pharmacies is the loophole that estriol, a weak estrogen present in the human body and often added to bio-identical estrogen compounds for breast cancer protection, is not in any FDA approved medications, but it is not necessary for treatment. Note that estriol is a part of the U.S. Pharmacopeia (USP).

 

The Wyeth-driven FDA also objected to compounding pharmacies using the term “bio-identical”.  What better term to describe substances that have the same exact molecular structures as those found in the human body (perhaps human-identical)?

 

The answer for hormone replacement is customized, safe, compounded, bio-identical hormone replacement that is a prescription issued in response to individual symptoms and laboratory analysis and tailored to the individual’s needs.

 

For further informattion contact

Aref Bhuiya M.D., 5655 Lindero Canyon Rd., Ste. 202, Westlake Village, CA 91362,

818-597-3223.

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