Healthy eating begins with learning how to “eat smart”-it’s not just what you eat, but how you eat. Your food choices can reduce your risk of illnesses such as heart disease, cancer, and diabetes, as well as defend against depression. Additionally, learning the habits of healthy eating can boost your energy, sharpen your memory and stabilize your mood. You can expand your range of healthy food choices and learn how to plan ahead to create and maintain a satisfying, healthy diet year round.

Say yes to good fats. Unsaturated fats can not only help you lose weight, but can improve levels of cholesterol and other fat particles in the blood, strengthen the heart against dangerous erratic heartbeats, and fight the gradual clogging of the arteries. Fish oil, walnuts, almonds, wild salmon, tuna, are all examples of healthy fats.  Upgrade your carbohydrates. Instead of simply cutting carbs (which are essential to energy), shift from the refined, processed carbohydrates (such as white bread) and quickly digested starches (such as potatoes and white rice) to whole-grain, high-fiber foods (e.g., sprouted or whole-grain bread and grains such as wild brown rice, beans and other legumes). They’ll give you longer-lasting energy and lower your risk of heart disease and diabetes. 

Choose healthy proteins.  Eat more protein from vegetable sources such as beans and nuts – supplemented by fish and fowl – and less red meat and dairy products.  

Sodas and Sugared Drinks – “Wasted” Calories. The “drink industry” makes a fortune selling consumers carbohydrates in the form of sodas, fruit drinks, fruit punch, “energy drinks,” and other liquid drinks. These are all mainly sugar solutions. Many contain large quantities of caffeine. Read labels.  Lifetime Health offers healthy protein bars and drinks if needed.

Stay hydrated. Drink plenty of water, and avoid drinking empty calories, especially from sugared beverages.

Take a “quality’ multivitamin every day. These will not replace healthy eating, but can help provide some “nutrition insurance.”

Do not skip breakfast. It’s called “breakfast” for a reason. When you wake up, your blood sugar is at a “fasting level.” Breaking that fast gives you energy for the day ahead. Breakfast SHOULD NOT INCLUDE highly refined carbohydrates (including most fast foods, breakfast cereals, bagels, tacos, and breads) and foods with a lot of sugar (such as muffins, doughnuts, and pastries). Replace these foods with good fat (eggs, some cheese, nuts), some kind of fiber (a whole-grain food or slow cooked oatmeal), and/or a good dose of other protein. These foods release sugar into your bloodstream and will help sustain your energy level and concentration throughout the day. 

Unless you are on the hCG Diet, eat only 3 meals per day and DO NOT SNACK during the day. This way of eating maximizes your fat burning time and minimizes your fat storage time.

(Note that grains turn into sugar quickly so eliminate refined grains and preferably all non-sprouted grains.) 

If not complete elimination, then limit to a maximum of 25 grams a day as long as you’re healthy. If you have diabetes, heart disease, high cholesterol or are overweight, you’d be wise to keep your fructose consumption below 15 grams a day, including that from whole fruits.

Why is Sugar Bad? Sugar feeds cancer, feeds bad bacteria, increases fat, increases triglycerides, increases blood pressure and causes Insulin Resistance, Pre-Diabetes and Diabetes. 

The bad bacteria in our gut, which supports 80% of our immune system, LOVES sugar. Bad bacteria is very efficient at taking sugar from our food and storing it as fat in our fat cells. The more sugar you eat, the more you feed your  gut’s bad bacteria and the fatter your fat cells (and the larger your waist size).

Consuming sugars and grains (except sprouted grains) raises your blood sugar. The higher your blood sugar, the more damage done to your body and the faster you age. Synthetic sugars are as bad or  often worse than real sugar. Typical signs of aging include elevated levels of glucose, insulin and triglycerides.

Lab Tests: Each of us should know three numbers that are critical to obtaining optimal health and optimal weight.  Fasting Glucose, Fasting Insulin and HA1C (pre-diabetes and diabetes test). These numbers will identify if you have a Sugar Problem which also identifies Insulin Resistance.   

The higher the blood sugar rise, the more damage is done to your body.

The higher your insulin level, the faster you age AND increase your risk of developing chronic degenerative illnesses.

Typical signs of aging include elevated levels of glucose, insulin and triglycerides.

So what should you do if you want to slow aging, reduce body fat, prevent chronic disease and avoid diabetes?  

1.   TEST YOUR BLOOD (Fasting Glucose, Fasting Insulin and HA1C) 

2.    ELIMINATE SUGAR AND NON-SPROUTED GRAINS (or no more than 15 to 25 grams per day).

3.    TAKE A QUALITY PROBIOTIC (50 billion or 30 billion).

How? Our 15 Day, 225 Billion Probiotic Program. Easy, Simple

Why: Eighty percent (80%) of your immune system is located in your gut. The bad bacteria in your gut loves sugar and refined carbohydrates. Bad bacteria is also very efficient at removing sugar from the foods we eat and storing it in fat cells.

Ensuring that you’re getting a regular supply of good bacteria in your digestive system is essential to supporting your immune system, which is your number one defense system against ALL disease. It is also essential to effectively reducing body fat and eliminating sugar and refined carb cravings.

Symptoms of an Unhealthy Gut: Most people do not have the optimal balance of good and bad bacteria in their intestines. This imbalance creates havoc on our health in many ways including: heart burn, acid reflux, gas and bloating, irritable bowel syndrome, upset stomach, GERD, diverticulitus, constipation or diarrhea, fatigue, headaches, and obesity or other weight struggles.

Fat Storage: When the balance between good bacteria and bad bacteria favors the bad bacteria, our body stores fat. Our digestive system works poorly. Our metabolism is slowed. This makes it difficult to reduce body fat and makes it easy to store body fat.

Metabolic Syndrome and Lean Body Mass. Several studies have now found that lean people tend to have higher amounts of various healthy bacteria compared to obese people, and researchers suggest that certain bacteria may cause low-grade inflammation in your body, contributing to obesity and difficulty to lose weight.

What is the solution offered by pharmaceutical medicine? Prilosec, Nexium. Tums. All of these have significant side effects and are supposed to be used for short term relief. In fact, drugs such as Nexium, Prilosec, Prevacid and Protonix are not supposed to be used continuously for more than eight weeks. YET, this restriction is commonly ignored by patients and physicians.

The Health Benefits of Maintaining a Healthy Balance of Bacteria. Your body contains about 100 trillion bacteria — more than 10 TIMES the number of cells you have in your whole body. The ideal ratio between the bacteria in your body is 85 percent “good” and 15 percent “bad.”

This ratio is essential for:

The proper development and function of your immune system
Protection against over-growth of other microorganisms that could cause disease

Digestion of food and absorption of nutrients

The probiotics in your gut also play a role in helping numerous bodily functions, such as:

Digesting and absorbing certain carbohydrates

Producing vitamins, absorbing minerals and eliminating toxins

Keeping bad bacteria under control

Preventing allergies. Friendly bacteria train your immune system to distinguish between pathogens and non-harmful antigens, and to respond appropriately

How to Optimize the Bacteria in Your Gut

Eliminate (or reduce to less than 15 grams to 25 grams per day) sugary and processed foods (including un-sprouted grains).
When you eat a healthy diet that is low in sugars and low in processed foods, the good bacteria in your gut flourishes and builds up a major defense against the bad bacteria.

Be aware of the following items that influence your gut bacteria; another reason to have a daily regimen of a quality Probiotic:

     Antibiotics
     Chlorinated water
     Antibacterial soap
     Agricultural chemicals
     Pollution

Due to the thousands of toxins that surround most of us on a daily basis, good “Gut Health” requires a healthy diet, a high-quality probiotic supplement and eating fermented foods. Note that sugary yoghurt does NOT help with Gut Health. They are also pasteurized and pasteurization kills the naturally occurring probiotics. Unsweetened, unpasteurized Kefir is healthy. Add blueberries or raspberries for flavor.

Recommendation: 15 days of PRObiotic 225, followed by 30 days of 50 Billion Probiotic followed by maintenance of 30 billion Probiotic.

Start the New Year with a Healthy Gut. Lay the foundation for a Lean Body.

PRObiotic 225 Program Special: $99.00
Includes 15 day supply of Probiotic 225, Eating Guide, Cardio Support, Chromemate

Add the all of the following labs for $49.00:
Cholesterol Panel, Complete Blood Count, Comprehensive Metabolic Panel, Thyroid Panel, Ferritin (iron) Test, Ha1c (pre-diabetes and diabetes)

**Prices and products subject to change without notice.

We also decrease the risk by ensuring that estradiol is  going down the 2-hydroxy estradiol pathway. Indole-3-Carbinol, DIM 9di-indolmethane and various other compounds found in cruceriferous vegetables will favor the 2-hydroxyestrone pathway so ensure your estradiol is going down the correct and safe pathway.

Joseph R. Feste, MD, FACOG, AACS, AACG

If you are experiencing any of the below symptoms, you may want to have your thyroid tested as well as your iodine levels and then, after speaking with your doctor, consider whether adding extra iodine to your diet would be beneficial.

Hypothyroidism
Low iodine levels can lead to hypothyroidism. This is because iodine regulates thyroid hormones in the body.

Fatigue
Fatigue is a common symptom of iodine deficiency and hypothyroidism.

Weight Gain
Low iodine levels can cause weight gain. Weight gain may be one of the early warning signs of hypothyroidism.

Depression
Like fatigue and weight gain, depression is a common symptom of hypothyroidism caused by iodine deficiency.

Goiter
When iodine levels in the body are too low, the thyroid can enlarge. An enlarged thyroid is referred to as a goiter.

Fibrocystic Breast Disease
Research indicates that iodine deficiency may be responsible for fibrocystic breast disease, a condition in which painful but benign lumps develop in the breasts that can worsen with hormonal fluctuations.

Pregnancy Complications
Iodine deficiency in pregnant women can lead to complications including miscarriage, stillbirth, premature delivery and birth defects.

Symptoms of iodine deficiency include high blood pressure and those associated with decreased thyroid functioning, such as weight gain, fatigue, weakness, goiter and depression. 

We recommend all patients take one of our Natural Iodine Complex each day to receive the benefits of Iodine. The important difference is that the Natural Iodine Complex contains the correct therapeutic amounts of 12.5 mg and include molecular idodine, sodium iodide and potassium iodide. You typically will not find these therapeutic amounts in over the counter or health food Iodine.

Joseph R. Feste, MD, FACOG, AACS, AACG

Estrone (E1), estradiol (E2) and estriol (E3) are the three estrogens. Synthetic estrogen (premarin) is made up of E1 and E2 estrogen. E1 is the main estrogen that the body makes post menopausally, and most researchers believe that high E1 levels increase the risk of breast cancer. Therefore, we no longer prescribe Tri-Est, we use Bi-Est instead. E2 or estradiol is the estrogen that plays a role in the 400 functions mentioned previously. E3 is the estrogen that helps to prevent breast cancer, so much so that it is now being used experimentally instead of Tamoxifen to treat breast cancer. Research suggests that E3 may also hold promise as a treatment for multiple sclerosis. However, E3 does not offer the bone, heart and memory protection that E2 does. E3 estrogen is 80 times weaker than E2.

Estrogen Metabolism

The metabolism of estrogen in women changes after menopause. The body metabolizes estrogen into two major pathways and one minor. The two major are 2 and 16-hydroxyeone (2-OH and 16 OH, respectively). The minor pathway is 4-hydroxyestrone (4-OH). 2-OH is the good metabolite. 2-OH does not stimulate cell growth and it blocks the action of stronger estrogens that may be carcinogenic. 16-OH has a significantly stronger estrogenic activity, and studies that it may increase the risk of breast cancer. 4-OH is also not desirable as it may directly damage DNA and cause mutations, thus it is thought to promote cancer development. Premarin breaks down exclusively into 4-hydroxyestrogen. Therefore it is not big surprise that Premarin was a problem.

In our practice, we check women’s estrogen metabolism. It only makes sense to see if they are making too much E1. It makes sense to look to see if they are making the wrong kinds of estrogen. In the United States 2 and 16-hydroxyestrogen testing is readily available, and in some countries it is also possible to measure a woman’s 4-hydroxyestrogen levels as well. We are not measuring 4-hydroxyestrogen in the United States yet, but it is a minor pathway and it is more important to be aware of a woman’s 2-hroxyestrogen and 16-hydroxyestrogen levels.

How can you encourage the body to metabolize estrogen into 2-OH? The first thing to do is measure the patients estrogen levels. Moderate exercise raises 2-OH levels, so the second thing to do is get your patient to exercise regularly. Cauliflower, kale, Brussels sprouts, and cabbage, all push estrogen metabolism down the 2-OH pathway. As does flax and soy. Soy presents a confusing picture though because the literature is split. One half of people believe that soy decreases breast cancer, while the other half believes it increases breast cancer. Kudzu helps, and supplementary indole-3-carbinol for women who already have breast cancer is 500 mg a day. A high-protein diet, or in other words, not eating too many carbohydrates will push metabolism down the 2-OH pathway. The Omega-3 fatty acids EPA and DHA, vitamin B6, vitamin B12, and folate all help to raise 2-OH levels. If a patient is obese, then they do tend to make more 16-OH. Therefore women who are overweight have an increased risk of breast cancer. See our Natural Estrogen Protection product and cardio support.

In 2004, Dr. Miia Kivipelto of the Karolinska Institute in Sweden to told an international conference n Alzheimer’s disease in Philadelphia of his 21- year study.  The study found that people who were obese in middle age were twice as likely to develop dementia when they got old as those who were of normal weight.  For those who also had high cholesterol and high blood pressure in middle age, the risk of dementia was six times higher.   Many other studies also speak about the relationship between diet and the most serious forms of dementia, such as Alzheimer’s.  They are saying that if you want to get Alzheimer’s disease, eat a diet high in meat, fat, saturated fat, cholesterol, sugar, and white flour.  If you don’t, avoid such foods, and instead eat a diet high in fresh vegetables, whole grains, fresh fruit, and legumes, and be sure to get enough DHA and other omega-3 fats. 

Scientific studies continue to show positive links between eating a Mediterranean diet and reduced risk of dementia, including Alzheimer’s disease. This is due to the Mediterranean diet’s proven positive effects on improving cholesterol, blood sugar levels, and blood vessel health, as well as reducing inflammation, all of which have been associated with mild cognitive impairment and Alzheimer’s disease. One comprehensive study published in the Journal of the American Medical Association found that individuals who follow a Mediterranean-type diet had a 32-40% decreased risk for developing Alzheimer’s disease.  This is especially significant as Baby Boomers — a huge portion of the population – are moving into their golden years when cognitive decline is common. 

The following foods have been proven to be brain-healthy.   Fresh fruits, especially brightly colored fruits, such as blueberries and raspberries. Berry compounds counteract inflammation in the body, which has been associated with Alzheimer’s disease. Vegetables, especially leafy green vegetables, for their high levels of vitamins E and D, and dietary fiber.   Eaten on a regular basis, vegetables have a positive effect on brain health and help prevent age-related illnesses.   Specific spices that have amazing protective properties – cinnamon, rosemary, oregano, and turmeric reduce inflammation and increase blood flow. Cinnamon is also known to regulate blood sugar and reduce cholesterol, important to brain health.   Whole grains. Substituting whole wheat products for white flour, bread, rice and pasta helps to maintain weight and improve cardiovascular health which directly contributes to brain health.   Foods containing omega-three fatty acids. Omega-3s are naturally found in your brain and as you age levels of these fats in your body drop. Food sources of omega-3s such as fish, green vegetables, walnuts and flax seed replace the losses and improve transmission of nerve impulses.

Studies have also shown that high intake of saturated fat and cholesterol clogs the arteries and is associated with higher risk for Alzheimer’s disease. However, HDL (or “good”) cholesterol may help protect brain cells. Use mono- and polyunsaturated fats, such as olive oil, for example. Try baking or grilling food instead of frying.

Another great way to reduce your risk of Alzheimer’s disease is through physical exercise.   Exercise strengthens the pumping force of your heart, increases blood flow to your brain, increases exercise tolerance, reduces body weight, lowers blood pressure, reduces bad cholesterol (both LDL and total), increases good cholesterol (HDL), and increases insulin sensitivity, all of which enhance health and reduce the risk for diseases that can affect brain functioning, such as cardiovascular conditions.

Physical exercise is essential for maintaining good blood flow to the brain as well as to encourage new brain cells. It also can significantly reduce the risk of heart attack, stroke and diabetes, and thereby protect against those risk factors for Alzheimer’s and other dementias.   Studies continue to point to physical exercise as the most effective therapy today to prevent Alzheimer’s.

Dr. Ronald Petersen, director of the Alzheimer’s Research Center at the Mayo Clinic  has stated, “Regular physical exercise is probably the best means we have of preventing Alzheimer’s disease today, better than medications, better than intellectual activity, better than supplements and diet.”

Alzheimer’s Disease is not an evitable part of aging.  It is a disease and as such we can protect ourselves from it by choosing what we eat more carefully and making sure that we keep our bodies active through regular exercise. 

References

Barberger-Gateau P. Raffaitin C. Letenneur L, et al. Dietary patterns and risk of dementia: the three-city cohort study. Neurology. 2007 Nov 13;69(20):1921-30

Bourre JM, The role of nutritional factors on the structure and function of the brain: an update on dietary requirements, 2004 Sep;160(8-9):767-92

Bourre JM. Effects of nutrients (in food) on structure and function of the nervous system: update on dietary requirements for brain. Part 2: macronutrients. J Nutr Health Aging, 2006 Sep-Oct;10(5): 386-99

Brain Health, Alzheimer’s Association,  October 18, 2007. http://www.alz.org/we_can_help_brain_health_maintain_your_brain.asp

Shankle.W.R., & Amen, D. G., 2004 Preventing Alzheimer’s Ways to help, prevent, delay, detect, and even half Alzheimer’s disease and other forms of memory loss.  New York. G.P. Putnam’s Sons.

There are three main types of diabetes. Type 1 diabetes (previously known as insulin-dependent or childhood-onset diabetes) is characterized by a lack of insulin production. Type 1 diabetes is an autoimmune disease. An autoimmune disease results when the body’s system for fighting infection—the immune system—turns against a part of the body. In diabetes, the immune system attacks and destroys the insulin-producing beta cells in the pancreas. The pancreas then produces little or no insulin. A person who has type 1 diabetes must take insulin daily to live.

Type 2 diabetes is the most common form of diabetes. About 90 to 95 percent of people with diabetes have type 2. This form of diabetes is most often associated with older age, obesity, family history of diabetes, previous history of gestational diabetes, physical inactivity, and certain ethnicities. About 80 percent of people with type 2 diabetes are overweight. Type 2 diabetes is increasingly being diagnosed in children and adolescents. The symptoms of type 2 diabetes develop gradually. Their onset is not as sudden as in type 1 diabetes. Symptoms may include fatigue, frequent urination, increased thirst and hunger, weight loss, blurred vision, and slow healing of wounds or sores. Some people have no symptoms.

And the third type of diabetes is gestational diabetes, which is hyperglycemia that is first recognized during pregnancy. Some women develop gestational diabetes late in pregnancy. Although this form of diabetes usually disappears after the birth of the baby, women who have had gestational diabetes have a 40 to 60 percent chance of developing type 2 diabetes within 5 to 10 years. Maintaining a reasonable body weight and being physically active may help prevent development of type 2 diabetes. About 3 to 8 percent of pregnant women in the United States develop gestational diabetes. As with type 2 diabetes, gestational diabetes occurs more often in some ethnic groups and among women with a family history of diabetes. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin. Women with gestational diabetes may not experience any symptoms.

What is Prediabetes? People with pre-diabetes have blood glucose levels that are higher than normal but not high enough for a diagnosis of diabetes. This condition raises the risk of developing type 2 diabetes, heart disease, and stroke.

Pre-diabetes is becoming more common in the United States. The U.S. Department of Health and Human Services estimates that at least 57 million U.S. adults ages 20 or older had pre-diabetes in 2007. Those with pre-diabetes are likely to develop type 2 diabetes within 10 years, unless they take steps to prevent or delay diabetes.

The good news is that people with pre-diabetes can do a lot to prevent or delay diabetes. Studies have clearly shown that people can lower their risk of developing diabetes by losing 5 to 7 percent of their body weight through diet and increased physical activity. A major study of more than 3,000 people with IGT found that diet and exercise resulting in a 5 to 7 percent weight loss—about 10 to 14 pounds in a person who weighs 200 pounds— lowered the incidence of type 2 diabetes by nearly 60 percent. Study participants lost weight by cutting fat and calories in their diet and by exercising—most chose walking—at least 30 minutes a day, 5 days a week.

Recent data from the Centers for Disease Control and Prevention (CDC) paint an urgent picture of the state of diabetes, estimating that nearly 26 million children and adults in the United States are now living with diabetes. With one out of every three Americans at high risk for type 2 diabetes, emphasis must be placed on prevention and lifestyle modifications that can delay or prevent type 2 diabetes, a debilitating disease that can lead to blindness, kidney failure, heart disease and death.

“We’ve seen that diabetes has been on the rise for quite a while, but the new data from the CDC is a real wake-up call. One in four Americans living with diabetes is still undiagnosed, highlighting how essential it is for Americans to know if they are at risk and take action, if needed,” said Robert R. Henry, MD, President, Medicine & Science, American Diabetes Association. “Let’s use these devastating new numbers as inspiration to work harder and stop diabetes in its tracks.”

Early diagnosis of type 2 diabetes is critical to successful treatment and delaying and preventing some of its complications. For many, diagnosis may come seven to ten years after the actual onset of diabetes, often only after patients have already started to show signs of one or more of its complications. Studies have shown that exercising 150 minutes a week and losing 7% of your body weight (about 15 pounds if you weigh 200 pounds), can prevent or delay type 2 diabetes by 57%.

References:
2004-2006 National Health Interview Survey (NHIS), National Center for Health Statistics, Centers for Disease Control and Prevention. Available at: www.cdc.gov/nchs/nhis.htm.

Cowie CC, Rust KF, Byrd-Holt DD, Eberhardt MS, Flegal KM, Engelgau MM, Saydah SH, Williams DE, Geiss LS, Gregg EW. Prevalence of diabetes and impaired fasting glucose in adults in the U.S. population: NHANES 1999-2002. Diabetes Care. 2006;29(6):1263-1268.

Harris MI, Flegal KM, Cowie CC, Eberhardt MS, Goldstein DE, Little RR, Wiedmeyer HM, Byrd-Holt DD. Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U.S. adults. The Third National Health and Nutrition Examination Survey (NHANES III) 1988-1994. Diabetes Care. 1998;21(4):518-524.

Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine. 2002;346(6):393-403.

National Diabetes Fact Sheet of the National Center for Chronic Disease Prevention and Heath Promotion; NCHS; CDC; ADA; AACE

Williams DE, Cadwell BL, Cheng YJ, Cowie CC, Gregg EW, Geiss LS, Engelgau MM, Venkat Narayan KM, Imperatore G. Prevalence of impaired fasting glucose and its relationship with cardiovascular disease risk factors in US adolescents, 1999-2000. Pediatrics. 2005;116;1122-1126.

MYTH #1: THYROID IS DANGEROUS FOR THE HEART

Is thyroid hormone bad for the heart? No. Yes, it is true that hyperthyroidism is associated with atrial fibrillation; however optimizing thyroid hormone is associated with numerous benefits.

Improves lipids

Improves CHF

Has a positive inotropic effect upon the heart

Is vasodilatory

Prevents maladaptive cardiac remodeling after acute MI

Normalizes the QT interval, thus reducing the odds of lethal arrhythmias

Improves C-reactive protein (CRP_ and homocysteine levels

Improves arterial stiffness and endothelial dysfunction

It is important to remember that T3 is the active hormone and T4 is the prohormone. The heart needs T3 as it is unable to convert T4 into T3. Signs of low T3 in cardiovascular disease include:

Bradycardia, narrowed pulse pressure, and diastolic hypertension

Dyslipidemia

Endothelial dysfunction

Elevated CRP and homocysteine

Iervasi et al found that low T3 is a strong predictor of death in cardiovascular patients. In this study, low T3 was defined as <3.1 pg/mL free T3, which is interesting because it is within the confines of the reference range (2.3 to 4.2 pg/mL), albeit in the bad half of the reference range – remember, as anti-aging physicians we want optimal levels, not reference range levels. Results showed that low T3 was the strongest independent predictor of death – more than dyslipidemia and more than a poor ejection fraction. Furthermore, the authors concluded that low T3 might be directly implicated in the poor prognosis of cardiac patients.

So, we can see that thyroid hormone is clearly not dangerous for the heart. It is very important to measure free T3 and reverse T3 in cardiac patients, and it is equally important not to be afraid of optimizing T3 – it should be in the upper third of the reference range (3.5-4.2 pg/mL). A patient’s life may well depend on it. Treat mild hypothyroidism by optimizing free T3 to reduce all components of metabolic syndrome. DO not rely on the TSH. Look at the patient’s clinical picture and look at free T3, and remember that it is important to consider symptoms, not just numbers.

MYTH #2: TESTOSTERONE CAUSE PROSTATE CANCER TO GROW

The bottom line is that testosterone does not cause prostate cancer to grow. The notion that testosterone causes prostate cancer to grow was based on one case report from 1941 – one patient. There is no relationship between testosterone, dihydrotestesterone, estradiol, and prostate cancer, and there are no reports of prostate cancer in men treated with testosterone after radical prostatectomy.

Results of a perspective study of 11,606 men by Khaw et al led the authors to conclude. “In men, endogenous testosterone concentrations are inversely related to mortality due to cardiovascular disease and all causes.” The authors also write: “Prospective studies or supplementation studies, reviewed elsewhere, have not reported significant relationships of endogenous testosterone concentrations or of testosterone supplementation with prostate cancer. Although in the present analysis, there are insufficient power to examine the relationships with prostate or other specific cancers, we observed an inverse relationship of endogenous testosterone concentrations with cancer mortality.”

Another study, this time a review of 18 prospective studies that included 3886 men with incident prostate cancer and 6438 control subjects, examined the association between endogenous sex hormone sand prostate cancer risk. NO associations were found between the risk of prostate cancer and serum concentrations of testosterone, calculated free testosterone, dihydrotestosterone, dehydroepiandrosterone sulfate, adnrosternedione, androstanediol glucuronide, estradiol, or calculated free estradiol.

So, there is plenty of evidence to show that testosterone does not increase the risk of prostate cancer. There is also evidence showing that endogenous testosterone concentrations are inversely related to mortality due to cardiovascular disease and all causes, but is there any evidence to show treating men with testosterone after radical prostatectomy is safe? Yes, there is. Agarwal and Oefelein studies 10 hypogonadal patients treated with radical prostatectomy for organ-confined prostate cancer to determine if TRT could be administered safely without causing recurrent prostate tumor. Results showed that after receiving TRT for approximately 19 months total testosterone levels and hypogonadal symptoms had improved significantly, and there were no prostate cancer recurrences or increases in PSA. These results led the authors to conclude: “In highly select patients after radical prostatectomy TRT can be administered carefully and with benefit to hypogonadal patients with prostate cancer.”

MYTH #3: TESTOSTERONE CAUSES ANGRY AND AGGRESSIVE BEHAVIOR

This is just another hormone replacement myth. In fact, TRT has quite the opposite effect on behavior. Much of the bad press about TRT stems from media stories about anabolic steroid abuse – we are not concerned with abusing anabolic steroids, we are concerned with abusing anabolic steroids, we are concerned with restoring testosterone to physiologic levels. Studies have shown that men who have their testosterone levels restored with TRT are less likely to suffer from depression, are less moody, more sociable and gregarious, and have more energy. O’Connor et al investigated the effects of TRT on self- and partner-reported aggression and mood. Eight hypogonadal men received 200 mg intramuscular testosterone biweekly for 8 weeks. Results showed that TRT led to significant reductions in negative mood (tension, anger, and fatigue). Furthermore, there was no increase in self- and partner-reported aggression or mood disturbances. Thus, we can conclude that TRT does not cause or worsen angry or aggressive behavior.

MYTH #4: GROWTH HORMONE CAUSES CANCER

A paper by Jenkins et al entitled “Does growth hormone cause cancer?” concluded: “Extensive studies of the outcome of GH replacement in childhood cancer survivors show no evidence of an excess of d novo cancers, and more recent surveillance of children and adults treated with GH has revealed no increase in observed cancer risk.

If you look at the package insert for GH it says that it should not be used in patients with an active malignancy. However, the Growth Hormone Research Society published a paper in the Journal of Clinical Endocrinology and Metabolism, saying that their is no data to support this labeling, and that current knowledge does not warrant additional warning about cancer risk. The authors of this paper say that this line should be removed from the package insert because there is no evidence to show that GH increases cancer recurrence or de novo cancer or leukemia. In conclusion, the notion that GH causes cancer is another myth.

MYTH #5: ADULT GROWTH HORMONE DEFICIENCY IS ONLY SEEN IN PATIENTS WITH SEVERE MULTIPLE PITUITARY DEFICIENCIES SINCE CHILDHOOD

A review by Popovic et al showed that some degree of hypopituitarism is found in 35-40% of TBI patients, and suggested that untreated TBI-induced hypopituitiarism contributes to the chronic neurobehavioral problems seen in many head-injured patients. Preliminary data suggests that people suffering from TBI-induced hypopituitarism experience significant improvements in concentration, memory, depression, anxiety, and fatigue when treated with GH. The authors of this review concluded that pituitary failure is poorly recognized and can occur even with minor head injuries.

Thus, all TBI, cerebrovascular accident, and subarachnoid hemorrhage patients should be evaluated for AGHD within a year of the event, and they should be treated if a deficiency exists. In the future, it may be possible to treat all TBI patients with GH if they have symptoms of GH deficiency however at present patients need to have been given a diagnosis of AGHD before they can be treated.

MYTH #6: PROGESTERONE TREATMENT IS ONLY FOR MENOPAUSAL WOMEN WHO HAVE A UTERUS

Progesterone is neuroprotective. There is a basic science to support this and now there are human trials. Pettus et al found that when progesterone is given after TBI it reduces the initial cytotoxic surge of inflammatory factors, decreases levels of nuclear factor kappa beta (NFKB), and decreases levels of inflammatory eicosanoids. So, how does progesterone exert this neuroprotective effect? The neuroprotective properties of progesterone are probably derived from the action of allopregnanoline (APa), a neuroactive roperties of progesterone are probably derived from the action of alloprenganolone (APa), a neuroactive metabolite of progesterone, which turns on neuronal stem cells. Wang et al found that APa promotes the proliferation of roden neuroprogenitor cells (NPCs) derived from the hippocampus, and increases human neural stem cells (hNSCs) derived from the cerebral cortex. Results also showed that APa regulates cell-cycle gene and protein expression.

MYTH #7: PROGESTERONE EQUALS PROGESTIN

Fournier et al compared the association between different forms of hormone replacement therapy more than 8,000 women. Results showed that women treated with bioidentical estradiol and progesterone were no more likely to develop breast cancer rates than women who had never used any form of HRT. However, women treated with estradiol and progestin (Provera) had a 69% increased risk of developing breast cancer.

Other research has shown that more progesterone a woman is exposed to over the course of her life, the lower her risk of breast cancer. So, let’s make it clear once and for all – progesterone and progestin are not the same.

CONCLUDING REMARKS

There are many myths surrounding hormone replacement therapies, however form the evidence presented above, we can see that not one of them is true. Hormone optimization provides us with an extremely powerful anti-aging tool to maximize quality of life.