Many women have come to our clinic on estrogen pills and are dismayed when we switch them to creams. “I like the convenience of a pill” and “Pills travel better” are common complaints we hear. What’s wrong with oral estrogen anyway?

A study published in the journal of the American Heart Association found that women taking oral estrogen had four times the risk of developing a serious blood clots than those using patches, gels, or creams. Women using transdermal (through the skin) estrogen, on the other hand, were at no higher risk of developing clots than those who weren’t even using estrogen. When using transdermal estrogen, the hormone bypasses the liver and enters the bloodstream directly, as your natural hormones do. This cuts down on side affects and is a more effective treatment.

Patches travel well and there are many different bases for cremes and gels. Ask your provider about your options. Safety and convenience…you can have it all!

Men’s testosterone levels start to drop by 1% to 3% each year starting around age 30. That averages out to a 20% drop by age 50 and a 50% drop by age 80.

What does that mean to you? Low testosterone levels can lead to a whole host of problems, such as: lowered libido, reduced muscle mass, decreased bone density, higher fat mass, obesity, low energy, irritability, and insulin resistance. Low testosterone levels(along with decreased DHEA and IGF-1 levels) are also associated with increased mortality. Your body does not “snap back” from illness or injury like it used to.

Is testosterone replacement the answer? Not necessarily. Your provider needs to consider the reason you have a deficiency. In younger men (those under 50 years old) the problem isn’t usually the lack of testosterone. The pituitary gland may slow down or stop producing luteinizing hormone (LH) . LH stimulates the testes to produce testosterone. Giving a patient that has low LH production testosterone will only compound the problem. With the extra testosterone circulating, the body thinks it’s got enough testosterone and will not even try to produce LH. This patient needs the pituitary gland stimulated to produce his own LH.

On the other hand, the over-50 patient may need supplementation because his testes aren’t producing as much testosterone as they used to.

Some men need a combination of the two approaches. Your provider will look at lab results, history and current symptoms to create the best plan of action for you.

Many different hormones affect your sleep. Deficiencies or imbalance can lead to exhaustion, weight gain, and faster aging. Sleep-deprived people have higher levels of the stress hormone cortisol and lower levels of thyroid stimulating hormone (TSH). They commonly have reduced cognitive function and alertness during the day. Some conditions linked to sleep deprivation include: hypertension, heart disease, type-2 diabetes, depression and obesity.

How do hormones influence the body to  encourage sleep? Let’s take a closer look:

• Melatonin-produced nightly by the pineal gland. Lowers body temperature and promotes good sleep. Commonly decreases with PMS, which can lead to sleep problems.
• Growth Hormone-secreted by the pituitary gland. Necessary throughout life for growth, development and repair of body tissues. It is secreted as you fall asleep, relaxes you and helps maintain sleep.
• Cortisol-secreted by the adrenal glands. Stimulates slow-wave, restorative sleep and production of growth hormone. Deficiency can cause you to feel exhausted after a full nights’ sleep.
• Thyroid hormones-Triiodothyroinine (T3) and Thyroxine (T4) secreted by the thyroid gland have been shown to improve sleep quality. Deficiency may cause you to wake with a swollen face and puffy eyelids.
• Estrogens-produced mainly by the ovaries. Estrogens regulate the production of many of the hormones important to sleep, such as: melatonin, growth hormone and cortisol. Estrogens are believed to enhance REM sleep, the stage where we process information from the day.
• Progesterone-produced in the corpus luteum. Has a calming, sedative affect. Reduces the amount of time it takes to fall asleep and helps you stay asleep.
• Testosterone-produced in the ovaries and adrenal glands in women, and in the testes in men. Not much is known about testosterone’s role in sleep, but deficiency has been linked to fatigue-even after a full night’s sleep. Women are twice as likely as men to have sleep problems, leading researchers to take another look at testosterone’s role in sleep.

There are ways of soothing hormone-related symptoms that can interfere with sleep. Cut down on caffeine, salt and alcohol to reduce bloating, exercise regularly and eat right. Sometimes, however, the best solution may involve balancing your hormones, rather than just treating the symptoms. Talk to your provider today about getting a good night’s sleep.

Do you know the most effective way and time to take your thyroid medication? Here are some helpful hints:

• Take first thing in the morning, on an empty stomach. Thyroid is very delicate-if it has to compete with any other medications or food, the thyroid will lose! You will suffer poor absorption and not get the full effect from your medication.
• Don’t eat or drink anything (except water) for 1/2 hour after taking your thyroid. Give it time to break down and be absorbed into your system.
• Cut back on soy products. Soy contains isoflavones, which are classified as “endocrine disruptors”-plants which act as hormones in the body. They can suppress thyroid function, worsening hypothyroidism.
• Be careful when and how you are taking calcium. Calcium interferes with thyroid absorption. Take your calcium supplements 12 hours after your thyroid to prevent problems. Don’t take thyroid with calcium fortified juices or milk.
• Don’t take your thyroid in the evening. For most people, thyroid is a stimulant. You probably won’t sleep much if you take your thyroid late in the day.

An estimated 27 million Americans have thyroid disease-either hypothyroidism (underactivity of the thyroid gland) or hyperthyroidism (overactivity of the thyroid gland). An estimated 26 million Americans have osteoporosis-a disease that causes bones to become spongy and brittle. The relationship between the two diseases is a controversial one.

Having long periods of hyperthyroidism has been shown to increase the risk of osteoporosis. The controversy stems from providers suppressing thyroid function to the lower normal levels in treating hypothyroidism. Several studies have shown that there is no additional risk of osteoporosis when patients thyroid function is suppressed, and that many patients feel best in the low end of the TSH range. Other studies have found that long-term treatment with thyroid supplementation was associated with a slight risk of osteoporotic fracture. As you look at the study subjects, however…an interesting pattern presents itself. The studies that reported bone loss were associated with “estrogen deprived, postmenopausal” women. Further research has shown that most bone loss comes from a combination of sources: low estrogen levels (as in menopause); poor lifestyle choices-smoking, alcohol use, poor diet; and disease/medication use. It’s important for you to discuss treatment options with your doctor to come up with a plan to keep you feeling great AND protect your bones.

Breast cancer is the most common life threatening cancer among women. However, it is no longer looked upon as a fatal disease, but is seen as a chronic illness. Breast cancer is being diagnosed earlier and has higher cure rates due to early detection by mammograms and self breast exams.

One out of eight women will get breast cancer, 77% of those are diagnosed in women over the age of 50. The chance of dying from breast cancer is 1 in 33.

Only 5-10% of cancers are hereditary, this means 90-95% of breast cancers occur on their own.

Breast cancer is the number one cause of cancer death among females aged 15-54 years old. It is the second leading cause of cancer death among females 55-74 years old, behind lung cancer.

85% of breast cancers occur in the duct tissue (which carry milk to the nipple) and 15% occur in the lobules (glands that produce milk).

Women are more likely than men to get breast cancer, but nearly 1700 men are diagnosed each year with breast cancer.

Risk factors for breast cancer include:

• having your first child after the age of 30
• first menstrual period before the age of 12
• going through menopause after the age of 55
• having no children
• having radiation therapy on the chest or breast-the younger the person is when she received radiation, the higher her risk for getting breast cancer
• DES exposure
• an older woman with dense breast tissue
• overweight or obesity after menopause
• limited physical activity
• more than one alcoholic drink per day
• being Caucasion
• gene mutations in BRCA1 and BRCA2
• personal history of breast cancer
• family history of breast cancer
• older age

February 7, 2007

The International Academy of Compounding Pharmacists issued a press release challenging the North American Menopause Society to disclose the fact that it receives funding from the drug manufacturer Wyeth.

What does that mean to me??

A lot of the negative press lately about the dangers of compounded medications has come directly from NAMS and Wyeth-makers of Premarin and Prempro. These medications are in direct competition with compounded medications.

Senators Ted Kennedy (D-Mass), Richard Burr (R-N.C.), and Pat Roberts (R-KS) have proposed legislation that would take regulation of compounding pharmacies away from the State Boards of Pharmacy and bring it under the FDA. In spite of the fact that compounding medications is heavily regulated, it is being painted as a dangerous, unnecessary practice.

Did you know hormones are not the only compounded medications that would be affected? Topical pain medications, cancer medications, inhalation products, sustained release capsules, some injections, and possibly even veterinary medications could be made unavailable to patients.

If the proposed legislation should pass, your cost as a consumer could rise dramatically. Often compounded medications are less expensive than their commercially available counterparts. Compounded medications can be put in different bases and into creams, capsules, drops etc. to get around allergies as well.

You can keep informed about this issue at www. savemymedicine.org.

You’ll hear a lot of terms bandied about in regards to hormone therapy. What does it all mean? Here’s a quick primer to get you started:

• Bioidentical-means that the hormone is chemically identical to human hormones. Examples are estradiol, progesterone, testosterone, etc. Many are compounded, but not all. Some commercially available bioidentical hormones are: Estrace, Estraderm, Prometrium, and Testim. The hormones may be identical to human, but are not collected from humans. They are made synthetically.
• Natural-often used to describe hormones that come from plants and animals. They are not necessarily the same as human hormones, and therefore are not necessarily safe.
• Phytoestrogens-estrogen from plants. Many are taken to alleviate menopausal symptoms, such as: soy, red clover, wild yam, etc. In most cases, they aren’t strong enough to provide relief.