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..


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 14, 2008

Testosterone in Men

Filed under: bioidentical hormones,testosterone — Dr. Bhuiya's Bioidentical Hormone Blog @ 5:48 am
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There has been a lot of buzz about women’s hormones, but you hear very little about men. To make it worse, men do not seek or share this information as women do. How many men do you know who go out for coffee with their buddies and talk about their hormones? Few people appreciate the pervasive effects of testosterone on men’s general health.  


The fact is that as men age, they lose their testosterone. The loss of youthful levels of testosterone with the onset of its associated symptoms is sometimes called andropause. It is the natural diminution (or pause) in production of male hormone (an androgen) as men age.


Testosterone loss in men is a gradual process. Testosterone decline starts around age 30, and may drop 1% to 3 % per year depending on genetics and lifestyle. That means that men can sustain a 20% drop in testosterone by age 50, and a 50% drop by age 80. Each man may experience the symptoms of a decline in testosterone differently depending on what his normal was at his hormonal peak.  Often the symptoms are ignored or rationalized away until the resultant decreased functioning becomes a way of life.


The most obvious and disturbing changes for men are those of sexual function, but equally troubling symptoms of low testosterone may manifest as a decline in mental functions, musculoskeletal conditions, and metabolic or physical diseases.


Changes in mental functioning may manifest as spells of mental fatigue and inability to concentrate, feeling burned out, low energy, tiredness or sleepiness in the afternoon or evening, decrease in mental sharpness, attention, and wit, or a change in creativity like getting spontaneous new ideas. There may be a decrease in desire to start new projects, or a decreased interest in past hobbies or new work-related activities.  Competitiveness may diminish and irritability increase. Memory functions may become impaired with increased forgetfulness. Men can experience a sense of depression with a sense that work, marriage, or recreational activities have lost their significance.


Musculoskeletal symptoms may appear as sore-body syndrome with aches and joint and muscle pains. A decline in flexibility and mobility may be noticed with increased stiffness. Muscle size, tone, and strength may decrease. Physical stamina and athletic performance may decline. Some men experience back pain, neck pain, or a tendency to pull muscles or get leg cramps. Some develop osteoporosis or inflammatory arthritis.


Low testosterone levels correlate with more risk factors of heart disease than any other individual factor in the male body. Cardiovascular risk factors increase in men as testosterone decreases.  Cholesterol and triglyceride levels increase, coronary and major arteries constrict leading to a greater risk of cardiac events, and blood pressure rises. Insulin resistance increases with obesity, adult diabetes, and increased cortisol levels. There is increased central abdominal fat with increased waist to hip ratio. Estrogen levels associated with higher stroke and heart attack rates (and increased fat in the breast and hip area) increase. Another increase associated with decreased testosterone is in lipoprotein A and fibrinogen, which correlate with cardiac events. Also, human growth hormone output decreases leading to a decline in energy, strength, stamina, and heart muscle mass and output. Low testosterone levels are associated with increased incidence of death even after researchers adjust for age, medical problems, and variables.


Although not all signs and symptoms of aging are due to hormonal decline, many correlate well with a decline in hormones and can be alleviated by hormone adjustment.


Treatment of low testosterone should be administered by a doctor trained in hormone therapy after a full history, examination, and laboratory testing. Regular follow-up is important to control symptoms, prevent side effects, and to make sure hormone levels are optimal.




For further informattion contact:

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


July 8, 2008

Testosterone for Women

Filed under: Uncategorized — Dr. Bhuiya's Bioidentical Hormone Blog @ 11:33 pm
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Testosterone is an anabolic steroid produced by both men and women. Anabolic simply means it helps to build you up. Although women have testosterone levels that are only one-tenth to one twelfth the levels of men, it is an important hormone for women.

Testosterone is usually the first hormone to decrease in women and may start to decline in your thirties even before progesterone and estrogen decline.

Testosterone has many beneficial effects in women. Its most well-known effect is restoring libido and improving the ability to orgasm. It increases the size and sensitivity of the clitoris.

Other important benefits are improving mood, reducing depression, and increasing energy. It may help to reduce panic attacks.

Testosterone increases physical strength by building muscle and improving muscle tone. This is an important effect since many women lose upper body strength with age. It also reduces fat and cellulite and increases fat-free mass.

It can reduce aches, pains, and fibromyalgia. It also helps fight fatigue.

Testosterone increases the bone mineral density of the hip and spine preserving bone mass. It improves osteoporosis.

Testosterone is a controlled prescription medication. Testosterone is best administered as a cream or gel through the skin because oral testosterone can be toxic to the liver. Testosterone should not be taken by women in the absence of adequate estrogen levels because it may increase heart disease.

As with all other bio-identical hormone treatments, the effects of testosterone must be monitored by a physician. Signs of too much testosterone are oily skin, acne, over-developed muscles, excess body odor, greasy hair, exaggerated aggression, and disruptive sexual desire.


For further informattion contact:

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




July 6, 2008

Don’t Feel Like Yourself Anymore? It’s Probably Your Hormones!

Filed under: bioidentical hormones — Dr. Bhuiya's Bioidentical Hormone Blog @ 7:01 am
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      Have you had the feeling you’re not quite yourself anymore? Perhaps if you’re a woman it’s hot flashes, night sweats, insomnia, weight gain, loss of sexual interest, irritability or fatigue. It can also be depression, panic attacks, weird dreams, urinary tract infections and urinary leakage, lower back pain, bloating, gas and indigestion.  There may also be memory lapses, aching ankles heels, knees, wrists, shoulders and heels. If you are over 40 years old, you may be experiencing the symptoms of changing hormones and hormone loss.

          As women age, their ovaries are programmed to shut down their function. This occurs over many years called the peri-menopause. First there is a decrease in progesterone and then a decrease in estrogen.  Testosterone, present in small amounts also starts to falter. Thyroid and adrenal function can also decrease.

          Men are not immune to hormone changes, although it happens more gradually. Changes may start to be noticed in the 40’s to 50’s age range. Mental fatigue, inability to concentrate, feeling burned out, depression, loss of initiative, sore joints and muscles, decreased stamina, increasing cholesterol, triglycerides, hypertension, and diabetes may all be associated with decreased testosterone.

          We experience the ravages of aging because we lose our hormones  with age. The goal of anti-aging medicine including hormone, nutrient, and lifestyle therapy is to keep the individual functioning at as close to a middle age level as possible. Men and women are offered little in the way of medical information or preventative treatment for the symptoms of hormonal and nutritional decline. Instead they get a cocktail of sleeping pills, anti-depressants, and pain medication, and  are told to accept that they are “just getting old”.

          Bioidentical hormone therapy, using the same identical molecular structure as the hormones in the human body, can eliminate symptoms and  maintain bone, memory, mobility, and heart health in men and women.

          There is still much confusion in the population concerning  hormone therapy. The “bad press hormone therapy has gotten in past years revolves around a large study called the Women’s Health Initiative which studied women on non-bioidentical  hormones (Premarin made from pregnant horse urine and progestins) which  increase cancer and strokes. Bioidentical hormones  in proper doses are not known to have these effects, alleviate symptoms, and have great benefit.

          Recent studies show that women on bioidentical hormones have a lower incidence of breast cancer than the general population. In addition, they maintain bone density preventing or improving osteoporosis. Women on hormones have a lower incidence of Alzheimer’s disease than those who are not. In addition, the incidence of macular degeneration and cataract formation is lower. Estrogen is the important hormone in women for maintaining heart health. In men, the most important hormone is testosterone, accounting for heart health, bone health, and brain health.

          Twenty-five percent of our population, the Baby Boomers,  are passing into older age. The goal is to keep functioning at a high physiologic level and continuing to make contributions while avoiding the decline of health that  burdens family and society.  What a benefit!

For further informattion contact:

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

Hello world!

Filed under: bioidentical hormones — Dr. Bhuiya's Bioidentical Hormone Blog @ 5:27 am
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Welcome to my blog. It’s about informing men and women about bioidentical hormone replacement therapy that can provide optimal health and vitality for your whole lifespan. Currently, the average lifespan of a man is 78 years and 83 years for a woman. You could easily live into your 90’s with a prudent lifestyle. But who wants to live to be 90 if we can’t sleep, have no energy, lose our memory, lose our minds (Alzheimer’s), lose our eyesight, lose our muscles, break weak bones, are depressed, have no sex drive, develop multiple diseases of aging, and wind up in a nursing home?

We now have the means now to change all that. We age because we lose our hormones. By replacing our hormones and nutrients we can avoid the symptoms of hormone loss like hot flashes, night sweats, insomnia, and low libido, and stay healthy for the rest of our lives. Estrogen in women and testosterone in men are reponsible for heart health, bone health, brain health, and eye health.

When you feel good, you want to look good. I’ll talk about the latest in non-surgical aesthetic procedures for improving appearance including Botox, fillers, laser skin rejuvenation, photofacial, and skin care. Feel better, look better!

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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