Archive for the ‘Hormone Physician’ Category

Texas resident Hunter Howard shares journey ater testing positive for coronavirus.

Texas resident Hunter Howard shares journey ater testing positive for coronavirus.

Texas resident Hunter Howard shares journey ater testing positive for coronavirus.

Texas resident Hunter Howard shares journey ater testing positive for coronavirus.

Texas resident shares personal journey of testing positive for coronavirus

It has been 14 days since Hunter Howard first suspected he had contracted COVID-19.

Ten days since it was confirmed.

Now Howard, a 50-year-old Dallas resident, is recovering and out of quarantine. Yet his breathing is labored at times, his sense of taste is altered and intestinal problems ensue.

Coronavirus: How Harris County's stay-at-home order compares to other counties, states

I went for a walk yesterday and after about five blocks, I had to sit down. I couldnt breathe, Howard said Wednesday.

Howard, who has no underlying health conditions, believes he caught the virus via an infected passenger seated behind him on a flight home from Aspen, Colo.,on March 9. Upon his return to Dallas, it was life as normal.

Until March 12.

I had a slight fever and a dry cough. It is a light tickle in the back of your throat. There was no phlegm or mucus, said Howard, who is the president of Dallas-based Hormone Therapeutics.

By the next day, he began experiencing head and body aches, fatigue and night sweats. His fever was also rising, but he had no way to measure his temperature due to a shortage of thermometersamid the coronavirus pandemic.

Houston: Rapper Scarface says he tested positive for coronavirus

He relied on Gatorade to help replenish his electrolytes. I was incredibly thirsty. I was surprised by how much Gatorade I needed, Howard said.

After calling his doctor, Howard decided not to seek additional medical attention.

My physician told me there were only 42 testing units allocated to Dallas at that time and unless I needed a ventilator, I should stay home and rest, said Howard. He also said if I felt like I needed help to come in.

Two days later, his symptoms worsened considerably.

My fever was much higher and my breathing was really labored. I felt like my lungs were two paper bags. I could hear them crackling every time I would take a breath, said Howard.

He also experienced intense body pains, including discomfort in his back and chest.

I felt like I had a strap around my chest. The pain felt like it was coming out of the bottom lobes of my lungs and rib cage. It was uncomfortable to lie down, he said.

But the most alarming thing was the fear of the unknown.

The symptoms were worsening and I did not know how much worse it might get. I was being told to self-quarantine unless I needed ICU breathing support, he said. When do you make a decision to go in? At what point do you need to take better care of yourself?

After taking physician-advised doses of 1600mg of Tylenol, his situation improved. My fever broke and I have been feeling better ever since, said Howard.

On March 16, four days after he originally suspected he may be afflicted, Howard received a physician referral to get tested for COVID-19 at Baylor Scott & White Medical Center in Greenville.

The test requires a swab from a hard-to-reach area of the throat. To get there, technicians insert a nasopharyngeal swab essentially a giant Q-tip deep into the patients nose.

It stings the nostrils but only takes around 10 seconds, Howard said. A day later, it was confirmed that Howard had the coronavirus.

Howard was released from quarantine this week, but complications from the virus remain. His sense of smell and taste buds are still slightly off, and he has ongoing nausea and intestinal problems.

Still, he believes the worst is behind him. Now, hes dishing out advice to others.

Most of us will get the coronavirus. Safeguard your immune system, eat well and rest, Howard said.

We need to all protect the elderly and those with immunosuppression or lung and breathing issues by following social guidelines, and with the lack of beds and ventilators and medication, I believe we need shelter-in-place to slow down the transmission of this virus.

@marcydeluna

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Texas resident shares personal journey of testing positive for coronavirus - Laredo Morning Times

Global Humanitarian Leader Offers Evidence-based Breathing Techniques to Help Healthcare Workers Stay Resilient and Strong on the Frontlines.; Launches New Online Happiness Program to Help the General Public Manage Stress and Anxiety

WASHINGTON, March 30, 2020 /PRNewswire/ --Today, on the occasion of National Doctors' Day, the Art of Living, a global educational and humanitarian non-profit, has launched a first-ever opportunity for healthcare workers across the US to learn its powerful breathing meditation - at no cost - to help sustain them during the COVID-19 pandemic. The Art of Living is also providing free content to the general public, as well as a new online Happiness Program, to help all manage stress and anxiety during these turbulent times.

"To all the doctors, the paramedics, frontline workers and all other healthcare professionals, for your services, your dedication, we cannot express our gratitude enough," said global humanitarian, spiritual leader, and founder of the Art of Living, Sri Sri Ravi Shankar. "Please don't ignore yourself. Your good rest is absolutely essential and it's necessary to keep you charged and keep you healthy. Art of Living Foundation and its counselors are ready for you, anytime to help you. This meditation will be tremendously beneficial to you. You'll feel the energy and enthusiasm renewed in you to carry your noble mission forward."

Beginning today, any US healthcare worker can access the online course by visiting http://www.aolf.me/covid19 and register using their professional license number. The Happiness Program, which has been taught in person to millions across the world, has been adapted to a new online platform, and tailored specifically to busy healthcare providers. The self-paced format can be accessed from anywhere, and in just a few minutes, will equip health care workers with powerful, evidence-based breathing and meditation techniques.

The program was developed in collaboration with leaders of the Provider Well-being Program at Children's National Hospital in Washington, DC and other healthcare experts from around the country. Children's National implemented the in-person course for some of their healthcare providers last year. "We found this course significantly reduced burnout and anxiety among our providers, some of whom said the daily practices have transformed their entire lives," said Dr. Hemant Sharma, Chief of Allergy and Immunology at Children's National and co-lead of Well-being. "At this time of immense strain on healthcare systems world-wide, we are so grateful to the Art of Living for offering these evidence-based practices to bolster the physical and mental well-being of those caring for the sick."

"Healthcare workers, including doctors, nurses, and the entire team, are giving their all on the front lines of this pandemic," said Dr. Christiane Corriveau, a critical care physician and co-lead of Well-being at Children's National. "This takes a great personal toll on them and we want to do whatever we can to sustain and support healthcare workers in these challenging times."

Over 70 independent studies have demonstrated a range of scientific benefits from practicing the breathing exercises taught on the Art of Living Happiness Program. Research has shown the practices decrease anxiety, reduce the stress hormone cortisol by over 50%, improve immune cell counts within as little as three weeks, and improve time spent in deep sleep three-fold.

In addition to its commitment to support healthcare workers, the Art of Living is also offering following to the community at large:

A Moment of Peace in Troubled Times: Two live guided meditations daily led by our meditation experts. These sessions are Suitable for beginners as well as advanced meditators. In addition, we also offer on-demand meditations guided by Sri Sri Ravi Shankar. (Access Here)

Online Happiness Program: Offered at a reduced cost to all members of the general public to help them manage the stress and anxiety provoked by these uncertain times. (Access Here)

Art of Living Journey App: All the premium meditation content on the app is made free for a limited time. Download Android version here. Download iOS version here.

About Art of Living

Operating in 156 countries, The Art of Living Foundation (AOLF) is a non-profit, educational and humanitarian organization founded in 1981 by the humanitarian and spiritual leader Sri Sri Ravi Shankar. All of AOLF's programs are inspired by Sri Sri's philosophy of creating world peace through a stress-free and violence-free society. AOLF has touched over 400 million lives through numerous educational and self-development programs and tools that facilitate the elimination of stress and foster deep and profound inner peace, happiness and well-being for individuals.

About Children's National Hospital

Children's National Hospital, based in Washington, D.C., celebrates150yearsof pediatric care, research and commitment to community. Volunteers opened the hospital in 1870 with 12 beds to care for Civil War orphans. Today, 150 years stronger, it is the nation's No. 6 children's hospital. It is ranked No. 1 fornewborn carefor the third straight year and ranked in all specialties evaluated by "U.S. News & World Report." Children's National is transforming pediatric medicine for all children. In 2020, it will open the Children's National Research and Innovation Campus, the first in the nation dedicated to pediatric research. It has been designated twice as a Magnethospital, demonstrating the highest standards of nursing and patient care delivery. This pediatric academic health system offers expert care through a convenient, community-based primary care network and specialty outpatient centers in the D.C., metropolitan area, including the Maryland and Northern Virginia suburbs. Children's National is home to theChildren's National Research InstituteandSheikh Zayed Institute for Pediatric Surgical Innovationand is the nation's seventh-highest NIH-funded children's hospital. It is recognized for its expertise and innovation in pediatric care and as a strong voice for children through advocacy at the local, regional and national levels.

For more information, follow us onFacebook,InstagramandTwitter.

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Art of Living Partners with Children's National Hospital to Provide Free Access to its One-of-a-kind Breathing Meditation for US Healthcare Workers...

Henry J. "Trip" Goolsby, III, MD

NEW ORLEANS (PRWEB) March 27, 2020

It occurred to me, as I was listening to a number of complaints, worries, and debates related to the recent pandemic crisis, that a few simple measures taken by everyone will assure their immune system is optimized for the challenge of a viral incursion.

Granted, avoidance and the current imposition of social distancing are the best means by which not to acquire the new plague, but what are some additional simple actions that will assist you in empowering your immune system, in the event it is challenged by any viral threat?

The following tools, while not exhaustive nor all-inclusive, will, at the very least, prevent you from undermining the very system that will be called upon to defend and heal you; these tools are based on my career-long exposure as a Medical Oncologist and Hematologist, to the inherited and acquired immune-compromise.

#1 Creation of - and Gratitude for- A Personal Image of an immune system gifted with an extraordinary ability to recognize and destroy any viral threat. Understanding that the Adaptive Immune Response is the main immunologic response system that will respond to and provide protection from future insults from viruses, it is important to create an image of a super response from this system when thinking about it.

Your personal image of your optimized immune system should include any combination of these cells destroying and eliminating your favorite viral culprit at the moment.

A component of your imaging process should also include meditation (5-10 minutes twice daily) focusing on the dynamic ability of your immune system protecting and eliminating viral challenges. This same exercise should be implemented with feelings of gratitude.

#2 Nutrition: Quality nutrition is essential for the optimum function of all of the systems of your body.

What may not be so common to the knowledge base is the nefarious effect of the different macronutrients that constitute our foods. I am most concerned about the impact of carbohydrates when it comes to the optimum function of the immune systems. An excess of carbohydrates (more than 30 gm of net carbs per day) creates what is termed Advanced Glycation End Products (AGEPs).

The progressive toxicity and ultimately destructive inflammatory response produced by these substances severely compromise the ability of the immune system to respond to threats in real time. The inflammation generated by AGEPs detracts and deviates the resources of the immune system making necessary resources unavailable.

How to address this challenge? Institute minimization of carbohydrate nutrients from your daily intake, particularly if you are diabetic or borderline diabetic. In the latter instances, it may be necessary to decrease the amount of diabetic medicine you are taking and require guidance from your family physician.

#3 Exercise: Even though many fitness centers/gyms are closed, in the interest of social distancing, continued focus on some type of daily routine, and in particular, a high-intensity interval training (HIIT) program, should be maintained, or initiated.

For example, if you have a favorite Marvel or DC superhero, chances are high there is a HIIT workout for that superhero. Check out https://darebee.com for great free workouts you can do from home.

The benefits of exercise on the immune system is well documented. Exercise also improves many other aspects of your life that secondarily impact your ability to respond to the challenges of any disease.

#4 Optimized Hormone and Metabolic Balancing: The impact of various hormone deficiencies and suboptimal hormone balance (menopause, Low-T, suboptimal thyroid balance, adrenal insufficiency....) on the immune system can be dramatic. Many other medical conditions, autoimmune disease, and chronic metabolic diseases result from the suboptimal balance of this complex system. Any efforts to achieve a youthful optimum balance will ensure an optimally functioning immune response.

#5 Stay Calm and Dont Buy The Hype - Medias job is to dramatize and amplify the facts to capitalize and draw attention to current events announced by their organizations.

In the medias efforts to get the news out in this fashion, many people are prone to getting caught up in over-dramatization.

What does this do?

The emotional repercussions can range anywhere from guilt and anger to shame, anxiety, and fear.

What do these emotions cause and what do they do to the immune system?

They promote, to varying degrees, the stress responses that serve to stimulate the secretion of a multitude of hormones and molecular messengers that serve to compromise the ability to respond to infectious challenges.

Deliberately choosing to focus on your optimum health outcome, despite what is being broadcast (e.g., news of trauma, devastation, and adverse emotions which attempt to invade your calm) serves you in avoiding the suppression of your immune response biologically.

Your focus on the health outcome you desire has a quantum ability to attach you to your entangled multiple worlds outcome of the affirmed image of extraordinarily awesome health and immune response.

#6 Thymosin Peptide Optimization (This is a prophylactic and therapeutic intervention for the appropriate risk groups).

For those over forty years of age, deterioration in the immune response and immune surveillance system is well documented and studied.

The correlated increase in chronic disease morbidity is associated with the decline of the immune organizing peptide, Thymosin Alpha One (TA1).

Pending the development of a useful therapeutic intervention, or the availability of an effective vaccine, subsidizing TA1 for individuals in the high-risk age groups, which at this juncture seem to be in large part those over 40 years of age, may provide a protective benefit and enhance their immune response effectiveness. Seeking out a physician experienced in its usage may be of significant benefit.

###

Trip Goolsby, MD is a bestselling author, new thought leader in integrative medicine and the Cofounder of Infinite Health Integrative Medicine Center, which provides elite precision-medicine health optimization, longevity, and regenerative medicine services. For more information about how you can boost your immune system visit http://www.YourInfiniteHealth.com and/or reserve your initial consultation this week by calling 504-323-0025 or 337-312-8234 - Tele-appointments are now also available.

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6 Keys to Boosting Your Immune System During COVID-19 March 27, 2020Health optimization and - PR Web

It acts as a true miracle pill! One speaks of fasting with Dr. Petra Bracht over the Interval, then it comes very quickly to these superlative.

The a physician Nutrition specialist and author from Bad Homburg in Germany is certainly one of the pioneers of the diet method eating Pause, and she practiced the method since the end of the 1980s, out of Conviction.

fasting is the Trend, according to a Forsa-survey on behalf of the DAK 63 percent of Germans are in favour of for themselves to reduce, at least temporarily, the diet, or change, or by 20 percent more than almost ten years ago.

Particular interval of fasting, even intermittent fasting is becoming more and more popular. Because in addition to the weight loss of this method can be attributed to many health effects.

However, Only little of it is scientifically proven as yet, clearly. Although there are a number of animal experiments in rats and monkeys, the fasting, an effect of Interval around the cells health and life expectancy show yet so simple to humans, such results can not be transferred.

As healthy interval fasting

A study from Graz, with 100 participants may bring with it the discussion now, because it shows that, Already after four weeks of positive effects in humans on the health evidence.

And even after six months were no negative (side) effects detected. The researchers from the Institute for Molecular Biosciences to a rather rare variant of the interval fasting: 36:12. This is about the perfect fast formula?

a Brief explanation: When intermittent fasting, you eat during a fixed period of time, as usual, ends, without changing the amount and type of food followed by a Phase in which no or only very reduced calories, are allowed in the amounts as follows.

The best known is the Schema 16:8 is: Of the 24 hours of each day is an eight hour period for eating is reserved, followed by 16 hours in which the body gets no food.

Who eats Breakfast so, for example, 9 oclock, may eat as usual for lunch and must have finished his evening meal till 17 oclock then just calories, are allowed free drinks, more water, tea, coffee in moderation is said necessarily recommended.

The 5:2 principle, the Plan runs not hours, but days of operation: five days you can eat as usual, two days are almost time.

At this, the calorie intake is limited to around 500 calories for women and 700 for men. This is no more than a small meal. The Graz researchers chose for their study a middle ground, the Alternate Day Fasting or 36:12.

Visible results after four weeks of

Of the 100 subjects, half was allowed to eat for six months, so only every second day. Together with the night before and after the day of fasting that results in a rhythm of 12 to 36 hours.

The other 50 participants ate, as always, however, the researchers selected the biochemist Frank Madeo after some time, 25 from this group at random, the four weeks to the 36:12-almost rhythm changed. So they wanted to explore the short-term effects.

Countless data from body fat to blood pressure, bone density to the insulin value, the Grazer documented. And were amazed: after only four weeks of fasting, the participants had reduced their weight by 4.5 percent, and effective belly fat lost.

This visceral fat around the internal organs is considered to be particularly harmful. The cholesterol level decreased, also the amount of proteins in the body that make the researchers of ageing processes responsible.

More muscles despite the absence of

And thats just a few of the results of the investigation. You confirm what has been observed by Dr. Petra Bracht also in their work with patients virtually: I have been practicing interval fasting for more than 30 years. I havent started, there was the concept yet.

From the American natural healing scene is the Knowledge that it is much better not to eat so often came, and to process, especially that it gives the body time for the food alone. This seemed to me to be very logical, and I have tried it myself to a time when there were six to eight small meals are recommended the day.

One of the most exciting effects that you get when you fast found and also the Graz study confirmed the Autophagy: in the past, it was thought that fasting would consume proteins and thus the breakdown of muscle to carry. But that is not true.

In the Autophagy-mode, the body is already consumed proteins, splits it into individual amino acids and gives the body back. Therefore, we observe that people who are fasting, and this move can build muscle mass. Our body uses old protein, new muscles and also to make antibodies, explains the expert.

feelings of happiness during the interval fasting

In women, the time of the Autophagy begins after 13 to 14 hours of fasting, men and a good hour later, adds Dr. Bracht.

thats Why men in particular of a longer fast would benefit interval. I recommend to men to be fasting, therefore, more like 18 hours, the Doctor says, the eating itself usually only in a time window of two to four hours of the day.

Still another effect is seen in practice as well as in the experiment: During the interval fasting of the body between the carbohydrate processing in the food phases and fat burning, known as ketosis goes, in the fast breaks.

Both alternates, what the cells need. Anything else would be harmful, says Dr. Bracht.

The ketone bodies in the fasting phase by means of an increase the production of the appropriate hormones for the mood of the people is stimulated. And this feeling makes us the hunger the hours easier to bear.

the Graz study showed this mood. Also, the hormone boost also acts as an anti-inflammatory with a variety of positive effects on health.

Even small steps will help

the question of the ideal almost Remains the interval. Im a Fan of 16:8. All other methods do not have this waiver in-character, which is why many people keep on that, says Dr done.

And warns of excessive goals: Its not about all or nothing. Basically, every day I intervallfaste is a Plus for the health.

sources

Peter Schmidt-Feneberg

*The post Healthy and effective: weight loss with intermittent fasting: All is a question of timing, published by FitForFun. Contact with the executives here.

FitForFun

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Healthy and effective: weight loss with intermittent fasting: a question of timing - The KXAN 36 News

Scientists around the globe are testing existing drugs to treat Covid-19 patients. Some of these drugs are already approved for treating other diseases, such as Malaria, HIV and arthritis.

Novel Coronavirus (SARS-Cov-2) has disrupted the entire globe, every country is being affected with this coronavirus disease (Covid-19). Since there is no confirmed treatment, scientists are testing existing drugs to treat this disease. Following are brief about some drugs which are shortlisted to treat Covid-19 patients.

Chloroquine has been used to treat patients with malaria for nearly a century. It was discovered in 1934 by an Italian scientist. The active ingredient in the malaria drug Resochin. It is on the World Health Organizations List of Essential Medicines, the safest and most effective medicines needed in a health system.

Chloroquine is a synthetic version of quinine. Quinine is a natural compound found in the bark of cinchona trees. Chloroquine works by essentially slowing down virus entry to cells, which can slow replication rate. It is already known to be safe for humans, as well as cost effective.

Hydroxychloroquine is closely related to chloroquine. It is regarded as less toxic metabolite of the malaria drug.

Hydroxychloroquine is used to treat certain autoimmune diseases, like lupus and rheumatoid arthritis. It has been on the market since the 1950s. It works by disrupting communications between cells in the immune system. Scientists hope it might help mitigate cytokine storms.

Kaletra is a combination of two antiviral drugs, lopinavir and ritonavir, which are used to combat HIV. It is widely available and clinical trials are underway.

These two drugs complement each other. Lopinavir prevents viral enzymes from cutting up important proteins, that are key to HIVs reproduction. Whereas, Ritonavir helps boost lopinavirs concentrations in cells. But a recent study suggested it has no benefits for Covid-19 severe cases.

Remdesivir was developed to fight Ebola virus but failed to prove effective. In case of SARS and MERS, Remdesivir showed some positive results. Both of these diseases are caused by coronaviruses. So that, it is considered to be effective against this novel coronavirus (SARS-Cov-2).

It is unclear yet that how Remdesivir works, but a new study shows that it appears to block RNA replication during the reproductive cycle of a coronavirus.

Losartan is a hypertension drug that reduces blood pressure by preventing a hormone called angiotensin from binding to receptors on blood vessels.

Losartan works by blocking a receptor, or doorway into cells that the chemical called angiotensin II uses to enter the cells and raise blood pressure. SARS-CoV-2 binds to the angiotensin-converting enzyme 2 (ACE2) receptor.

Favipiravir or Avigan is a flu drug developed in Japan. It has shown promising results in treating mild to moderate cases of Covid-19. This antiviral drug has been used in Japan to treat influenza. It was approved last month as an experimental to treat Covid-19 infections.

Actemra is an immunosuppressant that is used to quiet Cytokine storms. Actemra or Tocilizumab is approved to treat rheumatoid arthritis and juvenile rheumatoid arthritis. It blocks a cell receptor that binds interleukin 6 (IL-6). Interlukin 6 is a cytokine or a type of protein released by the immune system, that can trigger dangerous inflammatory cascades.

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7 powerful drugs being explored to treat Covid-19 patients - - Technology Times Pakistan

Texas resident Hunter Howard shares journey ater testing positive for coronavirus.

Texas resident Hunter Howard shares journey ater testing positive for coronavirus.

Texas resident Hunter Howard shares journey ater testing positive for coronavirus.

Texas resident Hunter Howard shares journey ater testing positive for coronavirus.

Texas resident shares personal journey of testing positive for coronavirus

It has been 14 days since Hunter Howard first suspected he had contracted COVID-19.

Ten days since it was confirmed.

Now Howard, a 50-year-old Dallas resident, is recovering and out of quarantine. Yet his breathing is labored at times, his sense of taste is altered and intestinal problems ensue.

Coronavirus: How Harris County's stay-at-home order compares to other counties, states

I went for a walk yesterday and after about five blocks, I had to sit down. I couldnt breathe, Howard said Wednesday.

Howard, who has no underlying health conditions, believes he caught the virus via an infected passenger seated behind him on a flight home from Aspen, Colo.,on March 9. Upon his return to Dallas, it was life as normal.

Until March 12.

I had a slight fever and a dry cough. It is a light tickle in the back of your throat. There was no phlegm or mucus, said Howard, who is the president of Dallas-based Hormone Therapeutics.

By the next day, he began experiencing head and body aches, fatigue and night sweats. His fever was also rising, but he had no way to measure his temperature due to a shortage of thermometersamid the coronavirus pandemic.

Houston: Rapper Scarface says he tested positive for coronavirus

He relied on Gatorade to help replenish his electrolytes. I was incredibly thirsty. I was surprised by how much Gatorade I needed, Howard said.

After calling his doctor, Howard decided not to seek additional medical attention.

My physician told me there were only 42 testing units allocated to Dallas at that time and unless I needed a ventilator, I should stay home and rest, said Howard. He also said if I felt like I needed help to come in.

Two days later, his symptoms worsened considerably.

My fever was much higher and my breathing was really labored. I felt like my lungs were two paper bags. I could hear them crackling every time I would take a breath, said Howard.

He also experienced intense body pains, including discomfort in his back and chest.

I felt like I had a strap around my chest. The pain felt like it was coming out of the bottom lobes of my lungs and rib cage. It was uncomfortable to lie down, he said.

But the most alarming thing was the fear of the unknown.

The symptoms were worsening and I did not know how much worse it might get. I was being told to self-quarantine unless I needed ICU breathing support, he said. When do you make a decision to go in? At what point do you need to take better care of yourself?

After taking physician-advised doses of 1600mg of Tylenol, his situation improved. My fever broke and I have been feeling better ever since, said Howard.

On March 16, four days after he originally suspected he may be afflicted, Howard received a physician referral to get tested for COVID-19 at Baylor Scott & White Medical Center in Greenville.

The test requires a swab from a hard-to-reach area of the throat. To get there, technicians insert a nasopharyngeal swab essentially a giant Q-tip deep into the patients nose.

It stings the nostrils but only takes around 10 seconds, Howard said. A day later, it was confirmed that Howard had the coronavirus.

Howard was released from quarantine this week, but complications from the virus remain. His sense of smell and taste buds are still slightly off, and he has ongoing nausea and intestinal problems.

Still, he believes the worst is behind him. Now, hes dishing out advice to others.

Most of us will get the coronavirus. Safeguard your immune system, eat well and rest, Howard said.

We need to all protect the elderly and those with immunosuppression or lung and breathing issues by following social guidelines, and with the lack of beds and ventilators and medication, I believe we need shelter-in-place to slow down the transmission of this virus.

@marcydeluna

Read the original here:
Texas resident shares personal journey of testing positive for coronavirus - Chron

After teasing positive top-line results last November, a deeper dive into Merck & Co. and Bayers heart failure drug vericiguat helped kick off this years scientific meeting of the American College of Cardiology, presented virtually as a late-breaking trial.

The data was highly anticipated, especially since the two Big Pharma partners decided to continue with clinical testingand enroll over 5,000 high-risk participants worldwideafter the novel compound missed its primary endpoints in two previous phase 2 studies.

The phase 3 VICTORIA trial saw a 10% drop in a composite rate of cardiovascular deaths and related hospitalizations, among patients with recently worsening heart failure and reduced ejection fraction. Compared to placebo, the treatment difference with vericiguat started to become apparent after three months.

With a median follow-up period of 10.8 months, patients showed significant reductions in hospitalizations when looked at specifically, however the reduction in cardiovascular-related deaths alone was not statistically significant.

The study, simultaneously published in the New England Journal of Medicine, said the overall difference between the drug and placebo translated to an absolute risk reduction of 4.2 events per 100 patient-yearsor, that it would take about 24 to 28 people treated with vericiguat for one year to prevent one cardiovascular-related death or hospitalization.

For a group of patients with this form of high-risk heart failure, where other heart failure drugs have rarely been studied, vericiguat provides a significant novel addition to usual treatment, said the studys lead author and presenter, Paul Armstrong, a distinguished university professor of medicine at the University of Albertas Canadian VIGOUR Centre.

This is a sick population that has a significant unmet need, Armstrong added. Of the 6.5 million adults in the U.S. suffering from heart failure, many have decompensating conditions leading to repeat hospital visits, and few options for slowing the progression of the disease.

RELATED:Bayer, Merck's vericiguat hits endpoint in heart failure phase 3

Vericiguat is a novel guanylate cyclase stimulator, designed to boost a cell signaling pathway that helps relax blood vessels and increase blood flow, as well as improve heart muscle function.

Its two phase 2 studies enrolled chronic heart failure patients with reduced ejection fraction and preserved ejection fraction, respectively. Vericiguat didnt meet eithers primary endpoints measuring the hormone biomarker N-terminal pro B-type natriuretic peptide, or NT-proBNP, which is released by the heart in response to pressure changes and associated with worsening heart failure.

Still, Bayer and Merck felt there were clear dose responses when looking at the studies subgroups individually, with vericiguats effect sizes on par with clinical trials of other heart failure drugs, according to Mercks vice president and head of global clinical cardiovascular development, Joerg Koglin. This, as well as the drugs safety data, pushed the two companies to forge ahead with the larger trial.

Of course now, seeing the phase 3 results, we felt that it was the right decision, Koglin said in an interview with FierceBiotech. But Bayer and Merck were very closely aligned on this...I wouldnt put it into big gamble category.

This is not just another chronic heart failure study, he said. It is differentiated because it really studied a clinical problem that has not been studied before in other big heart failure trials. It didnt look at broad chronic heart failureit specifically focused on what we believed was a huge unmet clinical need.

Vericiguats safety profile included similar rates of serious adverse events compared to placebo, as well as no adverse effects related to electrolytes or kidney function. That gave the study the unique chance to enroll decompensating patients with higher levels of renal impairment at baseline compared to other drugs, Koglin said.

Now the companies are currently discussing the VICTORIA data with regulators, and expect to finalize plans for follow-up studies over the next six months.

This study is not only answering questionsdoes it work, is it safe, and were we able to enroll a unique patient populationbut the study also generates a number of additional hypotheses, he said, which includes vericiguats relationship with NT-proBNP.

Patients with lower levels had shown greater treatment effect sizes, but those in the highest quartile at the start of the study trended more toward placebo. That will be interesting for us to study, to figure out what it means and why, and how it should or should not inform the use of the drug.

Meanwhile, the ACCs flagship meeting, presented together with the World Congress of Cardiology, will continue virtually this year after being forced to cancel its in-person plans at Chicagos McCormick Place due to the spreading coronavirus pandemic. The large annual confabs of the American Association for Cancer Research and the American Society for Clinical Oncology, among several other medical meetings, have also postponed or gone online.

As a physician-scientist, if you work for three-and-a-half to four years on a program like this, its a little bit of a bummer that youre not able to present the results face-to-face in front of 15,000 cardiologists, Koglin said. But it is what it isand Im glad that we can still get the data out. And being able to do so with a simultaneous publication in the New England Journal I think will do the trick.

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ACC: Bayer and Merck's vericiguat leads off virtual meeting with positive phase 3 heart failure data - FierceBiotech

Say youre feeling depressed, distressed, helpless or anxious. Whom should you turn to for professional help? A cognitive behavioral therapist, whod challenge your dysfunctional thoughts? An old-fashioned Freudian analyst, who might have you lie on a couch, spending months, maybe years, and thousands of dollars delving into your unconscious responses to the ways your parents raised you? But what if all you need is a much less expensive social worker or even a life coach?

These questions have fueled a fierce debate among researchers and clinical practitioners. The argument isnt whether talk therapy is helpful. Hundreds of clinical trials have shown that various mainstream forms of psychotherapy can help treat many mental afflictions, including depression, anxiety, post-traumatic stress, obsessive-compulsive disorder and eating disorders. Indeed, most Americans prefer talk therapy to medication, and talk therapy alone may work just as well and in some cases last longer than medication for some mental health problems. The argument is more about how and why these treatments work, and, accordingly, which therapeutic approaches are most likely to achieve the best results at the lowest cost.

On one side are those who say choosing the right approach is essential, implying that some strategies are clearly better than others. The other side argues that any good therapist will do, because factors common to most psychotherapies especially a strong bond between patient and therapist are whats most important. In between these two camps, but just as involved in the debate, are agnostics who argue that its too soon to choose sides we still just dont know enough about how therapy works.

There are high stakes in this dispute. This isnt just about a bunch of academics fighting each other, says Bruce Wampold, a psychologist now retired from the University of WisconsinMadison. There are tremendous implications for how mental health care is delivered and managed. More and more mental health patients are being treated solely with medication prescribed by general practitioners, with many talk therapists voicing concern that insurance firms and health plans are threatening their profession in their efforts to cut costs. And even when patients are given access to talk therapy, insurers tend to push for the cheapest, most time-limited strategies, which are often not in the interest of patients, Wampold says.

Antidepressants have replaced psychotherapy as the main treatment for depression in the United States. Use of psychotherapy continues to decline.

People have been trying to talk other people into feeling better for more than 3,000 years. Ancient Greeks counseled patients suffering from addictions and psychoses. For nearly 2,500 years, Buddhists have handed down a canon of advice to people struggling with day-to-day emotional suffering. But it was only at the end of the nineteenth century that the Austrian neurologist Sigmund Freud popularized the talking cure.

These days, more than 130,000 licensed US psychiatrists and psychologists provide what is often a blend of Freudian-ish psychodynamic therapy (focused on childhood experiences) and cognitive behavioral therapy (focused on challenging negative thought patterns). But you can also receive some version of talk therapy from a social worker, counselor or marriage and family therapist or conceivably even from a life coach, mentor, hypnotist, neurofeedback practitioner or shaman (see sidebar below).

In 1936, the eminent US psychologist Saul Rosenzweig proposed that a therapists preferred method was all but irrelevant. Instead, he wrote, factors common to most therapies will determine the outcome more strongly than any of the therapys specific features.

Given a therapist who has an effective personality and who consistently adheres in his treatment to a system of concepts which he has mastered and which is in one significant way or another adapted to the problems of the sick personality, then it is of comparatively little consequence what particular method that therapist uses, he wrote.

Rosenzweig began his iconic paper with a passage from Lewis Carrolls Alices Adventures in Wonderland in which a dodo bird, judging contestants in a race, declares that all have won and all must have prizes. He thus set the stage for the long-running debate over what has since been known as the dodo bird verdict.

All must have prizes, the dodo told Alice after a race in Wonderland. Are all psychotherapy methods also winners? An influential twentieth century scholar proposed the idea.

CREDIT: BRYAN SATALINO

In subsequent years, researchers identified several potential common factors, ranging from the therapists office environment to the placebo effect, which has a strong role in both talk therapy and medication. Yet at the top of the list of factors is the relationship, whats called the therapeutic alliance, between patient and therapist.

The reasoning is that this positive emotional bond, made up of trust, respect, affection and high expectations for improvement, inspires each member of the pair to keep showing up and doing the hard work that therapy demands. Specifically, researchers have found, a strong alliance will help the therapist and patient reach consensus on their goals, as well as on what sort of tasks such as free association, Socratic questioning, or homework will help achieve them.

Sixty years after Rosenzweig put his stake in the ground, Wampold and colleagues reviewed more than 200 scientific studies comparing the effectiveness of mainstream therapies, mostly variants of psychodynamic and cognitive-therapy tactics used by well-trained practitioners. They found only minimal differences between outcomes, concluding that bona fide treatments are roughly equivalent. (That conclusion may not extend to outlier therapies such as shamanism, Wampold and other researchers warn, which havent been sufficiently evaluated.)

The bottom line, according to Wampold, is: You cant have psychotherapy without a relationship. Every patient knows that. And every psychotherapist knows it.

The bond between therapist and patient has a bigger impact on the success of psychotherapy than the type of therapy, studies find. Other factors include everything that happens outside the therapists office, including other events in the patients life and society as a whole.

In recent decades, researchers have published scores of papers emphasizing the importance of the bond between patient and therapist. In 2018, a task force for the American Psychological Association concluded: The psychotherapy relationship makes substantial and consistent contributions to outcome independent of the type of treatment.

In 2019, however, psychologist Pim Cuijpers, a leading agnostic, weighed in with a paper in the Annual Review of Clinical Psychology arguing that were still far from knowing how talk therapy works.

CREDIT: RODHO / SHUTTERSTOCK

Forty-five million Americans more than 18 percent of the nations adult population are currently dealing with a mental illness, according to the nonprofit Mental Health America. Perhaps never before have they had so many options for treatment. Psychologist John Norcross at the University of Scranton in Pennsylvania has counted more than 500 different types of psychotherapies. The diversity is also impressive. Websites advertise such arcanely titled brands as Multi-Faceted Intuitive Wellness, Vedic Astrology and Transpersonal Counseling and Personal Totem Pole Process.

In 2018, a pair of worried researchers published a list of therapies practiced by social workers billing themselves as specialists in such alleged treatments as angel card readings, cuddle party facilitations, ancestral healing and bilateral stimulation. In Amsterdam, research psychologist Pim Cuijpers is keeping his own list of offbeat treatments for anxiety and depression, both individualized and therapist-led, including studies on the impact of Chinese calligraphy practice, ingesting saffron, chewing gum and participating in karaoke. Theres even an entire book on the psychotherapeutic value of constricting ones anus 100 times a day.

Few of the outlier treatments have been studied in depth, so while theres little evidence that any of them work, theres also no clear proof that they dont. Still, for years, mainstream psychotherapists and researchers have warned that theyre part of a dangerous trend.

Of course, some critics have just as vehemently attacked Freudian psychoanalysis, which only a few decades ago was considered the gold standard. In 1975, Nobel Prizewinning biologist Peter Medawar famously dismissed psychoanalytic theory as the most stupendous intellectual confidence trick of the twentieth century.

As the debate rages on as to how psychotherapy works, new therapies are sure to keep emerging. Buyers beware.

Katherine Ellison

Earlier studies have been inconclusive, wrote Cuijpers and two colleagues at Vrije University Amsterdam. They cited flaws including researcher bias in favor of particular therapies and an excess of papers that show an association between a treatment and an outcome without proving which facet of the treatment caused the outcome. Whats more, they suggested, some studies purporting to compare different therapy types tip the scales by comparing the researchers favorite with another form of therapy designed to fail in other words not a tested, bona fide strategy.

Solving the mystery once and for all will require much more work, they wrote, adding: It is as if we have been in a pilot phase of research for five decades.

In a 2007 review, Yale psychologist and child psychiatry researcher Alan Kazdin voiced a similar complaint, urging researchers to focus their studies on the ways that the patient-therapist relationship may be helpful rather than simply determining that it helps. How does one get from my therapist and I are bonding to my marriage, anxiety, and tics are better? Kazdin asked in his paper. This is a leap with the intervening steps unspecified or untested, at least to my knowledge. Reached by Knowable, Kazdin said that after 13 years, he still sees this gap in the research.

In recent years, some professional organizations have vouched for some psychotherapies over others, based on a preponderance of evidence that certain methods lead to good outcomes for specific diagnoses. The treatments most often touted as having strong research support have been versions of cognitive behavioral therapy (CBT), which one organization, the Society of Clinical Psychology, recommends for everything from adult attention-deficit hyperactivity disorder to obsessive-compulsive disorder to irritable bowel syndrome.

Critics note, however, that CBTs clear rules and comparatively brief time frames have made it easier to study experimentally than more complex, open-ended therapies, thus yielding more net evidence that it gets results without proving that it is better or worse than any other therapy. Indeed, in recent years, some experts have challenged CBTs reputation as the gold standard, with research suggesting that longer-term, psychoanalytic therapy can be more effective in some cases.

Wampold argues that a greater diversity of options will allow therapists and patients to find the approach that works best for them. Unless theres convincing evidence that one treatment is superior, he says, you should allow therapists to give the treatment they can deliver most effectively and patients should have the right to choose the treatments they prefer.

Patient preferences do make a difference. In a 2018 meta-analysis of 53 studies involving more than 16,000 patients, researchers called such preferences crucial to outcomes. The authors advised that psychotherapists should educate patients about different types of talk therapy and elicit their preferences as to the therapists strategies.

Any resolution to this long-running conflict may ultimately come from the lab, and its so-far elusive promise of delivering indisputable biological evidence of the most effective treatments.

Some researchers are now using functional magnetic resonance imaging scans to track subtle changes in certain brain regions during and after psychotherapy. One day, perhaps, therapists will be able to post before-and-after scans of patients brains, highlighting the improvements, much as plastic surgeons do today. But not yet. The studies so far have mainly focused on laying the groundwork by determining which areas of the brain are affected by therapy, says University of Pittsburgh psychiatrist Jay Fournier. Researchers want to pinpoint how the brain changes in each patient as a result of different treatments and what sorts of changes best predict long-term recovery. They also hope to gain a more nuanced understanding of which characteristics in a patient might predict response to different sorts of treatments.

Analyzing results of 22 studies that scanned patients brains before and after undergoing therapy, researchers found some consistent changes in brain activity. Blue highlights indicate brain regions where activity decreased after therapy, including the cingulate cortex (rostral ACC) and insula, which are involved in emotional processing and anxiety. IFG refers to the inferior frontal gyrus, which is involved in language processing.

CREDIT: L. MARWOOD ET AL / NEUROSCIENCE & BIOBEHAVIORAL REVIEWS 2018

Others searching for concrete markers of a patients progress have been measuring neurochemical changes during therapy. We dont just ask the depressed patient if hes feeling better, says Sigal Zilcha-Mano, a clinical psychologist and expert on the patient-therapist bond at the University of Haifa in Israel. She and her team also measure levels of the stress hormone cortisol, the bonding hormone oxytocin, body temperatures, and the synchrony of speech and movement between patient and therapist.

These measurements, which capture changes many patients and therapists arent aware of in the moment, may eventually present a detailed portrait of what can be among the most intense of human relationships. One day, Zilcha-Mano says, they may also enable more precise, individualized, tailored treatments for each patient. Its a matter of traits and states, she explains. Patients may come to therapy with the trait of being more or less able to trust and form relationships. But depending on the skill of the therapist, they may enter a state of being more open to such a bond. The real-time portrait of chemical changes and movements could someday illuminate this process, particularly in the case of oxytocin, considered to be an important biological marker of trust.

In whatever way it might happen, breaking through the current impasse over what makes psychotherapy effective could help practitioners do a better job, Cuijpers and his colleagues argue. Psychotherapeutic treatments for depression havent improved in decades, they note.

They also hope that more cogent explanations for how talk therapy works could help revive the approach, which other critics say has long suffered from a reputation of lacking scientific credibility.

Understanding how therapies work, write Cuijpers and his colleagues, may make it possible to develop treatments that focus on the core processes and are, therefore, more effective and efficient, and more acceptable to patients.

Skepticism about how psychotherapy works was a problem long before Freud came on the scene. Its at least as old as the charismatic German physician Franz Anton Mesmer, born in 1734. His practice of mesmerism relied on claims that he could manipulate an invisible bodily fluid through animal magnetism. Mesmer established a strong rapport with his patients with nervous disorders, many of whom ended up feeling they had been cured.

But he alienated other doctors, and in 1784, while Mesmer was practicing in Paris, King Louis XVI appointed an international commission of scientists and physicians, including Benjamin Franklin, to investigate his methods. They concluded that he couldnt support his claims of invisible fluids or animal magnetism, ruining his reputation.

Mesmers treatment worked at least for some but not his explanation of how it did so. Psychotherapys quest for legitimacy continues.

Excerpt from:
Psychotherapy on the couch - Knowable Magazine

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Theres a stranger at the door.

At every home around the world from Milan to Modestoas well as from Santa Cruz to Watsonville. It is a cousin to a more familiar presence in our lives, the persistent low-grade angst endemic to contemporary life. But this stranger is exponentially more unsettling and ominous. No one knows the toll it will demand.

That stranger is not so much the COVID-19 virus now threatening the worlds health and economy as it is the dread and anxiety that attends it. Fear of the virus has reached every neighborhood, if not every household, in the world.

How do we take the measure of this frightening new mutation of social anxiety? Most people are already negotiating with the stranger. Denying it, like a Florida spring breaker, is not the responsible option. Facing it, adapting to it, even listening to it is likely to lead to a better outcome for health and peace of mind.

Still, there is an emerging consensus on how to deal with pandemic anxiety that reflects a ritual familiar to anyone who has traveled on a commercial flight. In case of turbulence, when the oxygen masks drop, weve been told hundreds of times, secure your mask first. Then help others with theirs.

To survive the crisis will likely require a renewed sense of community and helping others. But it makes sense that to be an effective helper, everyone will need to come to some kind of self-assessment on their mental and emotional health. Spreading panic or denial will help no one and will probably lead to more suffering. Before engaging with the world, at least in an effective and helpful manner, all of us will have to come to an understanding with the stranger at the door.

First off, advises Santa Cruz physician Dawn Motyka, its crucial to understand the distinction between the viral infection itself and the anxiety of avoiding it. Motyka says she has seen patients who are convinced that they have contracted the illnessand that they may be developing pneumoniabecause they are experiencing the inability to draw a deep breath.

This I feel like I cant get a full breath of air thing is a very common symptom of anxiety, Motyka says. I tell people to walk up and down the stairs a couple of times. If you can manage it, you dont have pneumonia. If you have some kind of pulmonary thing, any amount of exertion will just wipe you out.

Motyka defines anxiety as a state of persistent heightened physiological arousal. Anxiety releases adrenaline, the bodys go-to hormone in fight-or-flight situations of immediate threat. The human psyche is equipped to deal with environmental threats, but not so much a constant state of uncertainty and dread. The metaphor Motyka likes is that of a car revving its engine but not necessarily going anywhere.

Our society is so overstimulating that so many people get trapped with the accelerator slightly pressed at all times, she says.

Anxiety, she insists, is not solely a psychological stateit has physiological dimensions in the body. Its a physiological state that can be generated by a thought, and often is, she says. But it can also be generated by a pattern of physical stimulation in the environment, like a cellphone alert going off all the time.

Especially in an environment where shelter in place and social distancing have become the new normal, managing anxiety is always a question of balance. Your body, as well as your mind, needs down timediversions such as reading, listening to music, or gardening.

I always think of Gone With the Wind, Motyka says. Scarlett OHara says, I just cant think about this right now. Ill think about it tomorrow. Thats good advice sometimes. Budget the amount of time you spend catastrophizing.

Leigh Anne Jasheway is a wellness and stress-management expert, and a stand-up comedian. Jasheway has published more than two dozen books, and has keynoted events across the country with the message that a healthy sense of humor is one of the keys to a sane and balanced life. While emphasizing that there is nothing inherently funny about COVID-19, Jasheway says cultivating humor is a valuable coping mechanism.

The reason we have a sense of humor is for arousal relief, she says, which is the release of negative emotional states, as well as for social bonding. Rather than saying just change your attitudetheres a little bit of privilege in that kind of languageits more like changing the prism through which you look at things.

Spirituality is another realm that has lessons of facing dread and intense fears and their effects on mental health. Much of what Buddhist meditation has taught, for example, has now been embraced in the medical world, most prominently, the benefits of focusing on breathing as a means of managing stress and anxiety.

Catherine Toldi is a Zen priest and teacher at the Santa Cruz Zen Center. One of her studentsa single parent working multiple jobs and living with stress pre-pandemictold her recently about the meditation practice shes been teaching, This is exactly what weve been practicing for all these years. Here it is, the ultimate practice conversation. In a way, its almost a relief to face a real fear instead of the fears that I make up in my head.

Zen practice, Toldi says, is a way to take a step to the side to watch how the brain works. If youre a person who, over the years, has painstakingly been looking at your mind, you can take that step back and say, Hmm, how do I want to think about this right now? Rather than just being like a fish on a hook that immediately goes wherever your mind is telling you to go. Were not under the illusion that were in control of this thing going on. But ultimately, we are the ones who choose what radio station were going to listen to in our brain.

Toldi also points to the Zen paradox that working on ones self is the same as loving others. Meditation, she says, is not about my awakeningthis is not about me going off on some mountaintop somewhere. Its about you. What do you need?

The evolution of the pandemic might mean that once people are more secure or certain in their own situation, then they might focus on another impulse: to care for the community.

In Santa Cruz County, there are enormous and immediate needs in the nonprofit sector. Many nonprofits, whether they are arts-oriented or health and human services, typically hold their annual fundraisers in the spring. This year, those events have uniformly been cancelled, abruptly cutting off lifeblood financing.

You really have this triple whammy, says Karen Delaney, the executive director of the Santa Cruz Volunteer Center. Everybody has had to cancel their fundraisers while trying to cope with both elevated risk and elevated need.

Suzanne Willis of Second Harvest Food Bank says her organization is receiving about 10 times the call volume for their services from a year ago, at the same time that many of their volunteers are retirees and in the demographic most vulnerable to the virus.

Second Harvest is converting many of their farmers-market distribution points to a more grab-and-go style, which means an even greater demand for volunteers to bag food for pickup.

The most important thing to hear in Santa Cruz County, says Willis, is that the food bank is here, and we have food. We have a pipeline coming in and were not going to run out.

But Second Harvest needs volunteers to work in either of two shifts daily, working mild physical labor in a warehouse with safety protocols in place.

The situation is similar at Grey Bears, which delivers food to seniors and other clients at 150 sites around the county. Gov. Gavin Newsoms stay-at-home orders last week reduced the number of 65-and-over volunteers able to work at Grey Bears.

Were all kind of moving through this blindfolded, says Tim Brattan of Grey Bears, who calculates that theyve lost about half of their volunteer force. (Those who) are receiving our services, I would urge them to stick with us. Were committed to this. Were going to keep providing this essential service.

Most nonprofits are in critical need of both volunteer energy and financial donations. Susan True, the CEO of the Community Foundation Santa Cruz County, says donors are beginning to step up.

Were seeing an incredible desire to act, says True, who has established a quick response fund at the foundation. Donors to the fund include many of the dependable names the foundation has depended on in the past, as well as many new people looking to give. The nature of the philanthropy suggests that people are only beginning to focus on the community.

When you think about the [2019] wildfires in Sonoma County, most of the donations in that situation came within the first week, says True. But this is a really different situation where the effects are multiplying so quickly that we anticipate people understanding the depth of crisis much later, when they actually see it. We dont have that visibility yet.

The Volunteer Center is gearing up for a bigger push for raising funds for local nonprofits by re-imagining their annual Human Race fundraiser. The race, now in its 40th year, has historically brought together the countys nonprofits for a May walkathon. This years event has been converted to an online fundraising effort.

Theres probably not going to be an actual walkathon on May 9, says Delaney, though we hope there will be some sort of celebration, depending on what happens.

Instead, the Human Race is now a six-week GoFundMe-style fund-raising campaign, which kicks off this week, to fill the hole created by the cancellation of the various spring fundraisers around the county.

Not every nonprofit knows how to do online fundraising, Delaney says. But the way the web-based Human Race (humanracesc.org) will go is that any person can pick their favorite charity, create their own fundraising page and raise money for the causes they care about.

Charitable donation is often a function of habit. But this year, Delaney says, a new kind of thinking and new kind of action is required.

Its not an event, she says. Its a campaign. In the past, weve asked people to gather some money from friends, show up at the race, and walk. Now were asking people, as youre sheltering in place, to connect the way youre connecting otherwise, online or over the phone, and spend a little time stepping up for the community.

Still, she says the Human Race will commit to one sign of normal times: There will still be T-shirts.

The Volunteer Center of Santa Cruz Countys Human Race will be fundraising online March 25-May 9. Go to humanracesc.org to donate or begin fundraising for your favorite cause.

For continuing in-depth coverage of the new coronavirus and its effects locally, visit goodtimes.sc/category/santa-cruz-news/coronavirus.

To learn about action you can take now, whether youre seeking assistance or want to find ways of supporting the community, visit goodtimes.sc/santa-cruz-coronavirus-resources.

Wallace Baine has been an arts writer, film critic, columnist and editor in Santa Cruz for more than 25 years. He is the author of A Light in the Midst of Darkness, a cultural history of the independent bookseller Bookshop Santa Cruz, as well as the book Rhymes with Vain: Belabored Humor and Attempted Profundity, and the story collection The Last Temptation of Lincoln. He is a staff writer for Good Times, Metro Silicon Valley and San Benito/South Valley magazine.

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Giving Back to the Santa Cruz Community Amid Coronavirus - Good Times Weekly

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Alicia Morgans: Hi, I am so excited to have here with me today, Dr. Declan Murphy and Dr. Michael Hofman, two professors from the Peter MacCallum Cancer Center in Melbourne, Australia, also with the University of Melbourne there in Australia. I am so excited to have you here to talk with me today about the ProPSMA trial and the results that are being presented at EAU 2020 as well as being published in the Lancet this year.

So Michael and Declan, can you tell me a little bit about why this trial, why now, what are the issues that we have as clinicians trying to understand and stage patients with high risk localized disease and why was this work so important?

Declan Murphy: Well, thank you Alicia and I'm good day from Melbourne. It's very nice to be connecting with you all today. The reason we did this study was, first of all, we know that patients with high-risk localized prostate cancer are at higher risk of biochemical occurrence or biochemical persistence following treatment of the primary, whether that's surgery or radiotherapy. And we all know that one of the reasons why patients have a higher rate of biochemical recurrence is that standard conventional imaging fails to identify the true state of disease in these patients.

We know that many of these patients will have lymph node disease or even distant disease that's not apparent on conventional imaging using CT bone scan and even MRI scan. So that's the background to the patient population that we studied in this study. And here in Australia and in a number of other countries around the world, we have had really quite a lot of encouraging experience using novel imaging, PSMA PET/CT to be precise over the past five or six years.

And we already know from retrospective or community experience actually in Australia that PSMA PET/CT appears to have better performance characteristics in staging these higher-risk patients. So with that in mind, we designed this study and before we go into the detail of that, I'll hand over to Michael who leads our PSMA PET/CT program here at Peter MacCallum Cancer Center to just explain a little about PSMA PET/CT.

Michael Hofman: Thank you. So PSMA is prostate-specific membrane antigen. This is a cell surface glycoprotein overexpressed in prostate cancer. And to do the scan, we injected intravenously a small radiolabeled peptide that binds to this receptor. It's then taken up into the prostate cancer cells and we put the patient on the PET scanner, a positron emission tomography scanner. And this enables us to image the whole body and see where that radiation has gone to.

And it's combined at the same time with a CT on the PET/CT scanner so that we can see the anatomic background. And this allows us to localize both the primary prostate cancer and any distant metastatic disease in a way that bone scan and CT have never really been able to do before. It's a very sensitive test. We can detect deposits down to around three millimeters in size. And with the CT we can localize very precisely where that abnormality is.

Alicia Morgans: Wonderful. So as we think about this, particularly from the United States where we don't have routine availability of things like PSMA PET/CTs. I always think about how hard it might be to replace our conventional imaging strategy. So our CTs and our bone scans with something new. There's going to have to be a bar that we meet that shows that a new imaging strategy is at least as good, if not better, than the strategy that we already have.

And it seems that this study was ... really one of its goals, was really to help to define that or to meet that bar, at least to help us understand if it could meet that bar. But I'd love to hear about the study and how did you design it? What were its goals and objectives and what were the arms in the trial?

Michael Hofman: Yeah so this is a multicenter, randomized study conducted at 10 large centers around Australia. These were centers that had nuclear medicine facilities that could do the gallium PSMA PET scans, but also multidisciplinary uro-oncology teams with both urologic surgeons and radiation oncologists treating these patients. And what we did is the primary aim was to see whether the PSMA PET/CT was more accurate than the combined findings of conventional staging. That being bone scan and CT and we randomized patients to receive either the PSMA PET or the current standard of care imaging, bone scan or CT.

Then there was a selective crossover because we did not want to deny patients with a normal CT and bone scan access to this new technology. So patients with fewer than three unequivocal distant metastases crossed over and had the other imaging arm. And then importantly, we followed patients up carefully for six months and at six months patients selectively had repeat imaging and then the principal investigators at each site used all the information up until that six-month time point, including the repeat imaging to define the ground truth.

That may have been histopathologic evaluation through a biopsy of bone metastasis or it might've been the fact that a bone metastasis went from being absent on CT to a sclerotic lesion at six months combined with appropriate changes in PSA. So we had a predefined criteria system that enabled us to define the ground truth and this enabled us to very cleanly define the accuracy of the staging investigations and accurately compare at bone scan to CT.

We also had a number of key secondary outcome measures, the main one being management impact. The referring physicians were asked to record their management intent prior to randomization, then after first-line imaging, after second-line imaging so we could see whether these results resulted in a change in patient management. We also looked at the difference in equivocal results between the two arms. These are the number of uncertain findings as the result of a scan report.

We looked at the radiation dose of the two imaging and modalities between the two arms. And we also looked at findings in the patients that crossed over to second-line and that gave us an assessment of the incremental accuracy of both conventional imaging or PSMA PET after first-line imaging.

Alicia Morgans: Wonderful. So can you tell me and just remind us specifically who were these patients? We talked about high-risk patients at the start, but I think this was high-risk patients. And how many did you end up enrolling in each of your arms?

Declan Murphy: So the patients we selected for this study were newly diagnosed patients with high-risk features. So predominantly, this is around what we consider to be traditional high-risk features by D'Amico or NCCN or EAU criteria. So PSA greater than 20 or clinically T3 cancer or ISUP grade group, four or five, which are the classic high risks. But we also chose to include ISUP group three so that's old fashioned Gleason 4+3=7. Because we're aware within that higher intermediate risk category, these men have a higher chance of biochemical recurrence. So we thought it would be of value to include these higher intermediate risks as well as the classic high risks.

So these were newly diagnosed patients. They were allowed to have PSA levels and up to 100 and in other words, they were being considered for curative-intent treatment either with surgery or radiotherapy. And as Michael pointed out, management intent was a key secondary endpoint of the study. So once we diagnosed these patients that had their biopsy, we hadn't done any staging, we then recorded the management intent, whether that may be surgery or radiotherapy or so on. And then we submit them to the study and I'll hand over to Michael and he'll describe at the study schema, which we can show to you as well on the screens.

Michael Hofman: Yeah, so this was a 300 patient study. We randomized 302 patients, 152 in the conventional arm and the 150 in the PSMA PET/CT arm. They were followed up at six months. We had very few drop-offs. We had two patients in the conventional arm and three patients in the PSMA arm. And that means we were able to analyze the primary endpoint in 150 patients in the conventional arm and 145 patients in the PSMA PET arm and the results, in summary, the reference standard showed that 30% of these men had nodal or distant metastatic disease. And what we showed is that PSMA PET/CT had a 27% greater accuracy than conventional imaging. So that's an accuracy of 92% for PSMA PET compared to 65 for bone scan CT. And this is one scan, the PSMA PET compared to two scans or two visits, the CT and the bone scan.So we must remember that the advantage of a PSMA PET is that it's a one-stop-shop.

And we also broke that down into nodal or distant metastatic subgroups. So end-stage or end-stage and PSMA PET was as similarly superior. And we also performed a sensitivity analysis where equivocal lesions were considered positive for metastatic disease rather than at negative. And the superiority of PSMA PET persisted in that sensitivity analysis as well. So I think the take-home message here is that the primary endpoint of accuracy showed a large difference in favor of PSMA PET/CT.

Alicia Morgans: So really interesting. And Declan, as an urologic oncologist, I'd love to hear your thoughts on those patients who ended up going forward with surgery. Because presumably some of them would have. Were there patients who had nodal positivity, for example, at the time of surgery that were missed by the PSMA or what was the false positive and false negative rate at the time of surgery?Because I think that this is something that people talk about, "Oh, PSMA could have a lot of false positives or certainly miss things if they're too small." So what was your experience?

Declan Murphy: Yeah, so yes, a significant proportion of these patients did go on and have surgery. So, therefore, the radical prostatectomy and lymph nodes become the ground truth, if you like, for those patients. But let me tell you, as we've seen in other retrospective series and in big systematic reviews that we've done on experience of PSMA PET/CT. We see first of all that the specificity is extremely high, well over 90% in other words, if you see high avidity in a lesion, a lymph node for example, on PSMA PET/CT, it's almost always right.

And that's a really important point. I think that ProPSMA will help emphasize previous data predominantly retrospective open to selection bias, but in this prospective study, we show with very tight control of multicenter on the PET imaging, we show very high specificity. If these things light up, it's almost always right.

On the other hand, on the sensitivity side, we always know that every imaging modality, even advanced molecular imaging like PSMA PET/CT will always be incapable of detecting tiny lesions below a certain threshold. But as Michael mentioned at the start, we do see extraordinary sensitivity once lesions get to about three millimeters in size or thereabouts compared to, for example, as we know with conventional imaging with CT and we cannot define a node as being positive until it gets to 10 millimeters in size.

You know that is the threshold because of the lack of specificity in conventional imaging. But what we see is once you're down to, once you're at about three millimeters or above, you will see avidity in many lesions, below that you will not. So a PSMA PET/CT from a surgeon's perspective will never replace a lymph node dissection if you really value seeing whether these nodes are positive or not.

But as we will see in the management impact from this study, this imaging has moved the conversation forward for a lot of clinicians managing these patients. So what do you do in your high-risk patient who has a negative PSMA PET/CT for nodes, do we still need to go and do a node dissection? Well, if you really value the staging, many will still do a node dissection, but we also know that lymph node dissection does not improve survival in high-risk prostate cancer and those lead to complications in a proportion of patients, again by current EAU guidelines.

And I think what we see in Australia and other countries where there's a lot of PSMA PET/CT is people will counsel their patients and say, "Well, look your PET/CT is negative for the nodes." If we did a node dissection, a proportion of patients will still have microscopic disease, but it's not going to improve your survival and it does lead to an increase in complications. And I believe that we will see less lymph node dissection in patients who have negative PET scans and whether that's right or wrong.

And one of the other aspects about novel imaging for staging these patients, Alicia, is that you do see lymph nodes in places that are outside the standard template for an extended pelvic lymph node dissection. And this explains to me why these patients do not have a survival benefit. It's because we are seeing lymph nodes in the presacral spaces, the mesorectal spaces, left supraclavicular lymph nodes and so on without necessarily having nodes in the classic internal-external iliac regions there for example.

So I think the management impact is very significant as Michael will come to in a second when we speak about this, but an obvious flow on from that, which I'm sure we'll discuss is does this improve outcomes for our patients? It certainly has higher accuracy as we've just demonstrated. It has a high management impact. But this study is not designed to show whether that will improve longer-term outcomes for our patients.

Alicia Morgans: And maybe the next study will be an adaptive surgical approach around the PSMA findings. And you can see if you do a dissection in the mesorectal area or if you address more distant disease either by not operating on them or by using SBRT for something that perhaps you can change outcomes. But the first step may be in identifying the extent of disease and its location. So certainly this seems to be a step in the right direction.

And I'd love to hear from Michael, from a nuclear medicine perspective. This was a group of patients who all had a PSA that was greater than or equal to 20 nanograms per milliliter or as I understand, although that, please correct me if I'm wrong. If patients have high-risk features by other criteria, perhaps they didn't need to have a PSA that high. But if you're trying to apply this data in a clinical space, you may have a PSA that's lower. What is your PSA threshold for thinking about using PSMA PET in this setting?

Michael Hofman: Yeah, so in this study, you did not have to have a PSA greater than 20 which was one of the measures of high-risk disease. But you might just have had Gleason grade group three, four or five or clinical T stage three or greater.

Alicia Morgans: Very good. But if you were applying this data, I usually think about this cutoff of around two or sometimes people say down to one or 1.5. Where is your cutoff when you're thinking about a PSMA PET? For those of us who don't have access to these scanners at this point, where do you see the highest accuracy? And I think we all recognize and you should tell us that this is a curve, right? So there's no absolute value of PSA that's going to be the cutoff above which or below which will have an accurate scan. But where do you think about things being generally more accurate versus less?

Michael Hofman: Yeah, look, it's a great question. In this study, most of the patients are actually selected on the basis of histopathology, so the Gleason grade group and PSA, therefore, did not play a part. So we have not actually teased out some of these subgroup analyses, but I think your PSA question is a very interesting one to go back and look at the data and see if there's a threshold below, which even despite having a Gleason grade group three perhaps if your PSA is 1.5, do you need a PSMA PET? These are some further analyses that we can look at.

Declan Murphy: But I think we could say to clinicians out there, Alicia, that if you're looking at this data and trying to think how does it apply to my practice or how might it apply if I have access to PSMA PET/CT? I would make two points.

First of all, they had these inclusion criteria. That's what we use in practice nowadays. So if you have these high-risk or higher intermediate-risk, in other words, that grade group three at least in 4+3 at diagnosis, then what this trial shows is first of all, and the accuracy is much higher and if you have a PSMA PET/CT, so that's our routine staging, we might as well get that accurate information.

And the second point, which will I hope have global implications is that we see this trial as being a vehicle to help get PSMA PET/CT standardized around the world and reimbursed around the world. Unlike a lot of the oncology trials that readout as positive endpoints, the survival benefit, et cetera. But sometimes the drug is so expensive in countries it's really not going to be impactful.

PSMA PET/CT, at least in our experience is not an expensive imaging tool. And we see this as a platform for people all around the world to work with their local nuclear medicine people with their regulators, with their funding bodies to say, "Hey, come on, the cost, we'll show this in this study of doing a PSMA PET/CT" for us is about equivalent to doing a CT and a bone scan in our environment.

So why would we do that when we have higher accuracy and, and perhaps Michael, we'll talk about the equivocal studies and the radiation dose, which were important secondary endpoints, which I think feed into an argument that we would like to see carried on around the world about making this scan available on a widespread basis?

Michael Hofman: Yeah, and I think it's worth adding that a key feature of this study is that we assist PSMA PET as a replacement for CT and bone scan. So many imaging studies for new tests look at the additional value of adding a new test. This study was saying, "Well, if you were scheduled for a CT and bone scan" and not everyone needs imaging. If you're low risk, you don't need imaging. But if you are a patient that needs a CT and bone scan by current guidelines, then you are better off having a PSMA PET as singles test rather than two tests." Instead, you no longer need the CT and the bone scan.

And just want to go back and focus on some of the secondary objectives of the study. So the primary objective being accuracy, but then management impact. We looked at management impact and we defined a medium or high impact as a change in therapeutic modality. So let's say surgery to hormone therapy or a change within the therapy. So for example, Declan's looked at the scan and is now going to extend his pelvic nodal dissection a little bit or the radiation oncologist is going to change his radiation field. And that's encompassed a significant management change. And that occurred in 15% of patients who underwent a CT in bone scan and 27% in patients with a PSMA PET/CT. So that's almost like doubling of the high to medium management impact of the study.

Another key secondary objective was looking at equivocal or uncertain findings between the imaging arms because no one likes to get a bone scan or CT scan back saying that there is an equivocal abnormality, it could be a metastasis, but we really don't know. And the conventional arm had equivocal findings in 23% so almost a quarter of scans versus PSMA PET that had equivocal findings in 7%, so that's a significant reduction and that's attributed to the high tumor contrast.

These tumors light up very brightly on a PSMA PET scan. It's easy for the readers to look at these scans. We also looked at reporter agreement, so all the PSMA PET scans were read a second time by a core imaging laboratory of experts and we compared it to the local review at the 10 sites around Australia. And it's important that PSMA PET was found to have a very high reporter agreement, a Kappa score of .88 so experts were agreeing amongst each other. This is really important because it's very hard to have an accurate test if five people look at the scan and come up with different conclusions.

And the last key secondary endpoint that I'd like to mention was radiation dose. Now because these are often well men that are going to be cured and we don't want to expose them to large amounts of radiation from diagnostic imaging and PET scanning might sound a little bit scary to people out there who aren't familiar with the technology, but in fact, the PSMA PET scan approach exposed men to half the radiation of a CT and bone scan. So that was eight millisieverts that's for a PSMA PET/CT compared to 19 millisieverts with a combination of a CT and bone scan.

Alicia Morgans: So when we think about it from a nuclear medicine perspective in terms of rolling out technology, there's high agreement between the local readers and these experts suggesting that with some training this is something that can be disseminated or implemented at sites around the world with really good accuracy. And for the patients to understand the importance of radiation. They all know it anyway, but they would actually receive half of the dose of radiation with this assessment as compared to the combination of bone scans and CTs that we actually re routinely use.

That's very, very critically important information. So as we wrap this up, and this is again, phenomenal work, gentlemen and to your entire teams. Because this has been something that I think the world has been waiting for, to think about trying to broaden the spectrum of applicability of PSMA PET. What would your take-home message be to audiences around the world as they're trying to think about how do we get this technology? How do we use your data in our day to day practices?

Declan Murphy: Well, thank you. Alicia. I'll give you my perspective on it as someone who's worked closely with Michael and Rod Hicks and his other colleagues in here and at other centers is I think there's a great opportunity space for clinicians like me and you working in prostate cancer to buddy up with talented nuclear medicine physicians all around the world. And often there's a bit of a disconnect there. Before all this came along, nuc med didn't come into our tumor board into our multidisciplinary team meetings.

But when all the PSMA PET started arriving, we started saying, "Hey folks, come and sit in our meeting. We'd all learn from each other." And now we have this really productive environment that's leading to lots of trials and also trials in therapies like lutetium PSMA. So I say to people out there, if you don't have a close working relationship with the nuc meds in your hospital, you should go down and find where they live. A knock on their door and say, "Hello, I'm a prostate cancer clinician, are you interested in PSMA PET?" And they're going to go, "Oh yes, I've just been to a conference and everyone's talking about PSMA PET" or "Do you have any prostate cancer patients?".

Because that community is very interested just as we are as prostate cancer clinicians and my messages to encourage people to go and work with each other. Encourage yourselves to share the tumor boards together or have virtual meetings together because I think there's a great opportunity space as this trial shows that for us to hopefully make a difference for our patients by collaborating more with our nuc med physicians.

Michael Hofman: Yeah. I share that key message as part of this study we set up a Tencent network around Australia with really multidisciplinary expertise. That network's now being used for several further studies both in the PSMA PET imaging space, but also in lutetium PSMA therapy space. And maybe I'll leave you with the key message of the trial, which is really that the data that we've produced here as support PSMA PET/CT as a replacement to the current standard of CT and bone scan, and we think this is beneficial for patients as a one-stop-shop investigation and also improving that patient navigation through the imaging pathway with fewer hospital visits and less radiation dose, more accurate imaging.

Alicia Morgans: Wonderful. Well, I sincerely appreciate your time. I know that everyone viewing and listening will be on the lookout for that Lancet paper, which is coming out in March, which is really going to detail the findings from this ProPSMA Phase III trial that looked at PSMA PET/CT as a replacement for CT and bone scan in the high-risk localized prostate cancer population. And certainly, I'm sure that they will be on the lookout for your presentation at EAU.

Thank you both so much for your time and again, congratulations on this excellent work.

Declan Murphy: Thank you.

Michael Hofman: Thank you so much.

Originally posted here:
PSMA PET/CT Imaging for Staging High-risk Prostate Cancer Prior to Curative-intent Surgery or Radiotherapy (proPSMA) - Michael Hofman and Declan...

On a Friday evening last month, Fernando Tatis Jr. sauntered toward an area beside the home dugout at Peoria Stadium. A spring training game against the Chicago Cubs was nearing its start. Tatis, the Padres magnetic young shortstop, had finished warming up on the field. With time to spare, he approached the barrier between players and fans.

Baseballs, pens and various other items were thrust in his direction. Hopeful pleas filled the air. The assembled throng appeared to be a typical collection of autograph-seekers, with one exception: A woman with a shaved head stood in the front row. In one hand, Gina Grosso held a baseball. In the other, she clutched a poster board advertising an unusual request.

All I want for CHEMO is for TATIS to sign my BALD HEAD!

Within seconds, the message had been spotted by its intended recipient. Tatis briefly stopped to sign for a couple of young children.

And then, Tatis recalled, I went straight to...

Visit link:
Fernando Tatis Jr., a signature and the moment a fan hopes will help save lives - The Athletic

Dr. Gaines of Life Gaines Medical & Aesthetics Center sends out info about the COVID-19 virus for concerned patients and the general public in South Florida

Boca Raton, Florida--(Newsfile Corp. - March 20, 2020) - LifeGaines reaches out to its patients and community who are concerned about COVID-19, the novel coronavirus.

"Dear LifeGaines Medical & Aesthetics Family,

"The staff at LifeGaines takes your health and safety seriously and we won't compromise when it comes to protecting our patients. We are closely monitoring the World Health Organization and CDC with regard to ongoing developments of the coronavirus (COVID-19) and we are committed to providing you a safe and clean environment.

"In an effort to reassure our patients, we want to inform you that we are continuing our rigorous routines to keep our practice sanitized and clean and will continue to take every precaution to keep you safe. Our daily safety standards include disinfecting our treatment rooms and equipment after each treatment and thoroughly washing our hands. We also wear new, clean gloves when applying products to our patients' skin and discard after each use. Also, our office is cleaned daily including wiping down tabletops, doorknobs, and equipment using medical-grade disinfectants."

Dr. LifeGaines reaches out to patients and community in light of COVID-19

To view an enhanced version of this graphic, please visit:https://media.zenfs.com/en-us/newsfile_64/2f7e8700c7c06672c2bf9192647742d9

Please don't hesitate to contact us with any questions or concerns at (561) 931-2430. We look forward to seeing you soon.

https://www.facebook.com/LifeGaines/posts/1067452740282001 - Dr. Gaines gives a message on Facebook about how he is boosting his immune system as the COVID-19 virus spreads across the U.S.

Dr. Gaines talks about the benefits of IV ozone therapy. In addition to immunotherapy which helps boost someone's immune system, one should also drink plenty of water and get enough rest.

Story continues

LifeGaines is mobile and visiting patients at their homes with the IV ozone therapy treatment. Inquire about this by calling LifeGaines.Learn about IV Vitamin Therapy here: https://lifegaines.com/wellness-therapies/iv-vitamin-therapy/

Don't hesitate to contact LifeGaines with any questions or concerns at (561) 931-2430.

About Dr. Gaines' LifeGaines team:

LifeGaines is one of the most highly respected age management medical teams anywhere. Age management medicine pioneer Dr. Richard Gaines has years of experience specializing in hormone replacement therapy, sexual wellness, platelet-rich plasma, stem cells, aesthetics, and advanced age management protocols.

About Dr. Gaines:

Dr. Richard Gaines graduated from Boston University School of Medicine in 1981. He completed his internship at Tufts University School of Medicine in 1981 and his residency at Harvard Medical School in 1985, where he was an anesthesiology fellow at Brigham and Women's Hospital. He served as a physician at Huntington General Hospital, as an anesthesiologist at Harvard Community Health Plan and at Sheridan Healthcorp. Dr. Gaines opened an age management and wellness practice after a 40-year career as a physician and health care executive. He has a Fellowship in Anti-Aging and Regenerative Medicine (FAARM) from the American Academy of Anti-Aging Medicine, he's board-certified from the American Board of Anti-Aging & Regenerative Medicine (ABAARM) and he's certified as a Functional Medicine Practitioner with advanced training at The Institute for Functional Medicine.

LifeGaines is responsible for this press release.

To view the source version of this press release, please visit https://www.newsfilecorp.com/release/53638

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Dr. Gaines Provides Insight Into How People Can Best Protect Themselves and Their Families From the COVID-19 Virus - Yahoo Finance

Stock image, St. George News

CONTRIBUTED CONTENT Have you seen your doctor because you suffer from fatigue, brain fog, hair loss, digestive issues, joint pain, or other symptoms, and you were told your blood test is normal? You may have even been given a prescription for antidepressants, because your tests dont seem to indicate you have a physical health problem.

You know something is wrong and that youre not supposed to feel this way, but what is the cause? At RedRiver Health and Wellness Center, we believe the reason your blood test didnt show anything wrong with you is because most doctors use lab ranges instead of functional ranges when evaluating the results.

A lab range identifies acute disorders and diseases, while a functional range uses parameters of optimal health and identifies problems that often can still be reversed. This allows you to do something about the problem before its too late.

For instance, using a functional range, you can identify hypothyroidism even though your primary thyroid marker is normal according to a lab range.

Address your health problem before its too late

In functional medicine, we identify and manage the root cause of symptoms instead of using drugs or surgery to stamp them out although medications or surgery may still be necessary in some cases. The most common analogy we use in functional medicine is that when the check engine light comes on, we look under the hood to diagnose the problem instead of turning off the engine light.

Functional blood test ranges, which outline the parameters of good health, are an important tool to help us with this.

What is the difference between functional ranges and lab ranges on a blood test?

For the most part, lab ranges are based on a bell-curve analysis of the people who had blood drawn at that lab over a certain period of time. Naturally, many of these people are getting their blood drawn because they have a health problem.As a result, lab ranges have broadened over the last 20-30 years as the health of the United States population has declined.

This means many people with health issues may be told nothing is wrong because their labs fit in with most people at that lab. If you want to evaluate your health in terms of what is optimal, then functional ranges are the way to go.

Looking for patterns on a functional blood test

With a functional blood test, we also look at patterns of markers instead of looking at each marker in isolation. This is based on understanding that various aspects of human physiology are interrelated and affect one another. Doing this allows us to see how different systems influence one another to cause a pattern of symptoms.

For instance, evaluating immune cells more broadly can give us clues as to whether inflammation is chronic or acute and whether it is caused by a virus, bacteria, allergies or parasites. Other patterns can help us spot fatty liver, leaky gut, different types of anemia or autoimmune disorders. This then helps us determine what types of testing are further needed.

Functional blood tests are more thorough

Functional medicine blood tests are also more comprehensive than a standard blood test.For example, a basic thyroid test from your doctor probably only looks at TSH, or thyroidstimulating hormone. However, because autoimmune Hashimotos, which attacks and destroys the thyroid gland, causes 90% of hypothyroid cases in the United States, we run autoimmunemarkers to screen for Hashimotos. We also look at other markers to see whether additional factors are contributing to your low thyroid symptoms.

Ask my office for more information regarding a functional blood test if you are struggling withchronic health symptoms that are sabotaging your quality of life.

Written by JOSH REDD, chiropractic physician atRedRiver Health and Wellness Center.

S P O N S O R E D C O N T E N T

About Dr. Josh Redd

Josh Redd, MS, DABFM, DAAIM, is a chiropractic physician and author of the Amazon bestselling book The Truth About Low Thyroid. Redd owns seven functional medicine clinics in the western United States and sees patients from across the country and around the world who are suffering from challenging autoimmune, endocrine and neurological disorders. He also teaches thousands of health care practitioners about functional medicine and immunology, thyroid health, neurology, lab testing and more.

Resources

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Sponsored content may be submitted to or developed by St. George News for publication on behalf of the sponsor and in the sponsor's interest. It may include promotional pieces, features, announcements, news releases and advertisements. Opinions expressed in sponsored content are those of the sponsor and not representative of St. George News. Sponsors have no influence over St. George News reporting and product apart from their own sponsored content.

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Identify the root of your symptoms using functional blood tests at RedRiver Health and Wellness - St George News

Imbalance of hormones causes many issues. When any hormone current within the physique turns into kind of than the prescribed restrict, then illnesses begin to happen. It is essential for ladies and men to stay wholesome that the steadiness of hormones within the physique is maintained. Hormones have an effect on not solely the physique but additionally the mind and feelings.

AIIMS physician Anurag Shahi, related to http://www.myupchar.com, says that hormones are the chemical parts of the physique, which make many glands within the physique. These highly effective chemical compounds are unfold all through the physique together with blood and helps the tissues and inside organs of their work. When the steadiness of hormones turns into ineffective, a selected hormone both decreases or turns into an excessive amount of.

->This situation is named hormone imbalance or hormone imbalance.

Specific meals may help steadiness hormones. There is a risk of enchancment in total well being with out taking any drugs. Although everybody's physique reacts otherwise, these wholesome meals are possible to make sure a nutritious diet that helps the physique operate higher.

Flaxseed seedsLinseed seeds can have all types of advantages for hormones. Linseed seed is a superb supply of 'phytoestrogens' and it particularly incorporates a sort of phytoestrogen, which is named lignan. Lignans have each estrogenic and antiestrogenic results, and are identified to have protecting advantages towards particular kinds of most cancers. Linseed seeds are additionally a very good supply of omega-Three fatty acids, fiber and antioxidants.

The nutsNuts like almonds have an effect on the endocrine system, which can assist cut back levels of cholesterol. They may assist decrease insulin and steadiness blood sugar ranges.

Walnuts specifically include polyphenols, which might defend the guts by combating free radicals within the physique. This ingredient may include anti-inflammatory brokers and is wealthy in omega-3s, that are wonderful for mind well being.

PomegranateThis antioxidant-rich fruit could assist in blocking estrogen manufacturing within the physique. Pomegranate has the power to stop the kinds of breast most cancers that react to estrogen. Pomegranate incorporates a pure agent that may inhibit an enzyme within the physique of girls that converts estrone into estradiol. It is a robust estrogen that may play a task within the origin of hormonal most cancers.

turmericTurmeric is at all times often known as a very good methodology for the remedy of irritation, as its made from curcumin. Many therapeutic properties are present in turmeric. This conventional Indian spice has the power to scale back ache throughout arthritis. Curcumin, the lively ingredient of turmeric, can simulate estrogen exercise. This herb may help cut back the ache of durations.

Read more:
Use these items to appropriate hormone imbalance - Sahiwal Tv

The Utah State Legislature passed 510 bills over this years 45-day general session, ranging from a bill to fund affordable housing projects to a law regulating the disposal of fetal remains.

While this is lower than the number of bills passed during last years session, 574, or the 2018 session, 533, Utahs lawmakers still considered hundreds of bills that will impact the lives of residents.

Here is a look at some of the bills that did, and didnt, make it through the 2020 legislative session:

Bills that passed

Polygamy decriminalization: Sen. Deidre Henderson, R-Spanish Fork, sponsored a bill this session to reclassify bigamy as an infraction instead of a third-degree felony. Henderson said polygamists in Utah are tired of being treated like second-class citizens and feel like Utah has legalized prejudice against them. S.B. 102 received overwhelming support from lawmakers, 19 of whom signed on as co-sponsors. Prosecutors and polygamists testified in legislative committees that decriminalizing bigamy would prevent abuse in polygamist communities and lead to social integration.

Affordable housing: A bill sponsored by Lehi Republican Sen. Jacob Anderegg asked the legislature for $35 million to fund the development of affordable housing and provide rental assistance to families who are at risk of becoming homeless. While S.B. 39s funding was cut to $10 million, it successfully made it through the House and Senate. Anderegg said the bill is the result of work by the states Commission on Housing Affordability and believes it will help low-income Utahns who are legitimately one life event away from being homeless. The $10 million will go into the states Olene Walker Housing Loan Fund and be used to fund housing for low and moderate-income residents.

Violence against Indigenous women task force: Rep. Angela Romero, D-Salt Lake City, introduced a bill to create a Murdered and Missing Indigenous Women and Girls Task Force to study violence experienced by Native American women. The task force would consist of members of the House and Senate, a representative of a Native American victim advocate organization, and the director of the Utah Division of Indian Affairs. Native American women experience domestic abuse, sexual assault and other forms of violence at rates higher than nearly any other group. The House and Senate both passed H.B. 116 unanimously.

Fetal remains disposal: Sen. Curt Bramble, R-Provo, sponsored a bill to require medical facilities to either cremate or bury the fetal remains of abortions or miscarriages, leaving the decision between the two forms of disposition up to the mother. Bramble said the bill gives women more choices and ensures that fetal remains are disposed of in a dignified way. Critics of the bill say women already have a choice over disposition options and that it unnecessarily interferes with the doctor-patient relationship. Lawmakers amended the bill to only focus on abortion, but that amendment was later abandoned.

Abortion prohibition: A bill sponsored by Sen. Dan McCay, R-Riverton, would ban abortions in Utah at any stage of gestation, although it wouldnt go into effect unless the United States Supreme Court overturned its 1973 Roe v. Wade ruling. S.B. 174 passed through both chambers and, if Roe v. Wade were overturned, would make it a second degree felony for a physician to perform an abortion in Utah, with exceptions made for cases of rape, incest, or if the life of the mother were in danger.

Mental health services: A bill sponsored by Rep. Steve Eliason, R-Sandy, will expand Utahs mobile crisis outreach teams and fund the development of a behavior health receiving center. The bill asks for $5.9 million in one-time funds and an additional $10.8 million in ongoing money. H.B. 32 passed through both chambers unanimously. Another bill of Eliasons, H.B. 35, would study the need for adult beds at the Utah State Hospital.

Prosecutor and jail data collection requirements: Provo Republican Rep. Marsha Judkins sponsored a bill that would up the reporting requirements for attorneys offices and county jails throughout the state. Specifically, H.B. 22 would require county jails to compile information on inmate gender, race and ethnicity and require prosecutors to report whether charges were brought or if a plea bargain was reached, among other data points. Judkins said the bill will help increase transparency in Utahs criminal justice system and give lawmakers a better understanding of how to address concerns.

Public education funding: Lawmakers passed a proposal to amend the Utah Constitution to expand how income tax dollars can be spent to allow spending on children and individuals with a disability. Additionally, they passed a bill sponsored by Rep. Robert Spendlove, R-Sandy, to provide growth and stabilization in public education funding.

Pornography labeling: A bill introduced by Rep. Brady Brammer, R-Highland, would require all pornography in state to include a label warning about the harms porn can cause minors. The attorney general or any member of the public would be able to bring action against pornography manufacturers who failed to do so.

Bills that didnt pass

County government changes: Brammer also sponsored a bill this session that would require counties with populations greater than 500,000 to switch to either an executive-council form of government or council-manager form. The bill targeted Utah County, which will ask voters in November whether the county should switch from a three-member commission to a full-time mayor and part-time five-member council. H.B. 257 stalled in the House Political Subdivisions Committee on Feb. 12.

Clergy abuse reporting requirements: Rep. Romero also sponsored a bill this session that would remove child abuse reporting exemptions for clergy members and religious leaders. The bill received pushback from the Catholic League for Religious and Civil Rights, who argued that it would require priests to break the Seal of Confession. The bill was numbered but never made it to a House committee.

Hormone therapy for transgender minors: After abandoning legislation that would ban gender reassignment surgery and hormone therapy for transgender Utahns under the age of 18, Rep. Brad Daw, R-Orem, proposed a bill to study existing research on the health impacts of such practices. Daw said research that puberty blockers like Lupron have been shown to have negative side effects while LGBTQ+ activists said the bill targeted transgender youth. H.B. 449 failed in the House on a 17-55 vote.

Mandatory ultrasounds: West Jordan Republican Rep. Steve Christiansen sponsored a bill that would mandate that physicians performing abortions display fetal images of each unborn child to the mother and make each unborn childs heartbeat audible. All six of Utahs women senators, both Democrats and Republicans, walked off the Senate floor in protest of H.B. 364. While the bill originally passed both chambers, it was held in the House on the last day of the session.

Rent control: Rep. Jennifer Dailey-Provost, D-Salt Lake City, introduced a bill that would give cities and counties the authority to impose rent control measures within their jurisdiction. Currently, there is a state provision prohibiting municipalities from doing so. H.B. 131 was never heard in committee.

Read more:
Polygamy, abortion, affordable housing: What passed during Utah's legislative session - Daily Herald

Results of the National Resident Matching Program will be released on March 20. As Match Day drew near, Margaret Miller, student member of the AAFP Board of Directors and a fourth-year medical student at East Tennessee State University's Quillen College of Medicine, met with Kelly Thibert, D.O., M.P.H., resident member of the Board and a third-year resident at the Grant Family Medicine Residency at the OhioHealth Grant Medical Center, to discuss their respective Match experiences.

We're sharing their conversation below for the benefit of others awaiting Match results this week, as well as medical students who will participate in the process in the future. We also have been sharing other fourth-year students' answers to some of these same questions recently on Instagram.(www.instagram.com)

Kelly: Matching is a long process, and you're finally almost at the end. What has it been like for you?

Margaret: My experience is a little unique in that I am "couples matching." My husband is matching into internal medicine, so my experience is probably different than most applicants'. I did a few more interviews than a single applicant might, so that made my interview season longer.

I really didn't anticipate how exhausting the process would be! I like to think of myself as an outgoing person, but you meet a lot of new people and get fed a lot of information at each interview. It can be quite overwhelming sometimes to be traveling, to be away from your partner and trying to imagine yourself as a doctor in a new place you're not familiar with. I'm glad that's behind me. I'm anxious to find out where I'll be going.

What's the Match experience like from the other side, as a resident meeting candidates?

Kelly: The Match process from the resident side is actually really exciting and fun, which is a great change from going through the Match as a student. We get to participate in recruitment season, interview season and, of course, Match Day. Throughout the entire yearlong process of getting to know so many people -- who are potentially going to be part of your program -- you get inspired by all the passion they have and their excitement about becoming family doctors.

One of my favorite things about being a resident on Match Day is that we get to celebrate and welcome new people to our family. As residents, we spend many hours away from our families with this other family. These are people you want to know and love and like. It's exciting to see who is going to be part of your residency family. In my program, we have a Match Day celebration where we close the office during the second half of the day in anticipation of the release of names. This year, the celebration will look a bit different; more technology will be used than we typically would have, and we will not gather together in person to celebrate (social distancing), but we will unveil our newest 10 family members electronically and with no less excitement than any other year. We will then reach out to shower the newest residents with the "Grant Love" that our program is known for. It's really exciting from our end, which is a very different experience from the student perspective.

Margaret: My favorite interviews were definitely the ones where I had great conversations with faculty and residents who inspired me, and I was really excited by the opportunity that I might get to work with them as mentor or role model if I was a resident there. I would agree there are moments that can be really inspiring and invigorating for students as well, but it's still a lot!

What would you tell your pre-Match self if you could go back in time?

Kelly: Probably the biggest thing I would tell myself is just to chill out. I would say, "You have worked so hard to get where you are, from studying all the time to taking board exams and passing board exams. You've gotten to the point where you're about to become a physician. I know the Match is a huge thing and a huge step and it feels like you have no control over it. You have done marvelous things, and great things are coming your way. Things will work out as they will, and now it's out of your hands, so just chill out."

Margaret: I think that's the most difficult thing at this point. Things really are out of my hands. I don't have any control over the process from here on out. I've already sent my rank list and we're just in a waiting period, so good distractions are always welcome.

Kelly: What were you looking for in programs, and do you think you found it?

Margaret: I hope I found it. I definitely think I did at a handful of places.

There are a lot of things across the board that are pretty similar between programs because of certain core requirements that every program has to meet. For me, there were a few things that stood out to make a program different. One would be access to education and training opportunities in particular medical areas that I'm interested in, including hormone replacement therapy and caring for LGBTQ populations, and also a program that incorporated getting certification to do medication-assisted therapy. Other things I am interested in are advocacy and finding a place willing to let me continue working with the AAFP and other organizations.

Having a diverse group of residents was important to me -- people from different backgrounds from different parts of the country, people who look different from me and have different perspectives on medicine.

Lastly, the biggest thing that differentiates a program is the people you meet. I felt like I met more faculty than residents, so for me finding faculty I felt I could be close to, train under and learn a lot from was what I was looking for. I definitely think I found that. I hope I end up at one of those places where I felt like I found it.

Kelly: What are you excited or nervous about, knowing you're soon going to be a family physician?

Margaret: There are a lot of things I'm nervous about, but I'm actually more excited. I feel so ready to move on to the next part of my training.

I'm excited to have my own patients. As a student, you work so much as part of a team and introduce yourself as part of the team. It will be nice to see people over the course of my residency and help them deal with issues over time.

There are parts of medicine I'm nervous about, but the thing I really am hopeful about is that places I interviewed at -- and I would say this about almost all of them -- is that the support systems and faculty at each one really felt passionate about teaching, and that's why they were there. Maybe their particular emphasis of what they were interested in teaching wasn't what I was looking for, but they were still really supportive, kind people who were looking to train great residents, so I feel less nervous than I do excited. I'm more nervous about the Match than I am residency itself.

What have been the most meaningful moments of being a family physician for you?

Kelly: Being able to have my own patients and care for the whole family while practicing full-spectrum family medicine. People often say we are the cradle-to-grave specialty, and it's so true. We care for prenatal patients, deliver their babies and see them in the office with their families. They might bring Grandma in, too, because they liked the way you cared for them. Then you get to care for the whole family, even up through hospice and palliative care, which is a really important part of medicine.

We're so fortunate to be part of patients' lives. They allow us to be part of very intimate moments -- whether good or bad -- sometimes things they don't allow family members to be part of. These have been the most memorable things for me.

But also getting to know more about family medicine. You think you know about the specialty you are matching into, but you don't know the breadth and how incredible the specialty is until you're in it. You get to participate in things like the AAFP and get to know so many more people and the things they are doing in family medicine. I'm inspired daily by the family physicians I meet. I'm really happy I chose this profession and specialty.

Margaret: What's your advice for students transitioning to residency?

Kelly: Don't study. Take a break.

I had a different path to residency. I spent a year doing health policy between medical school and residency, so I felt like I had to study, and I did review some clinical stuff. Looking back, I don't know how much that helped me compared to the things I actually learned firsthand in the hospital. All the things you learned in medical school will help you, but nothing will give you what you need more than just being there and doing it as a resident.

You have worked so hard to get to this point. Take a break and celebrate the fact that you are about to become a family doctor.

So, what would you tell a first-year student already nervous about matching?

Margaret: The Match is definitely not something I worried about as a first-year, and I would not recommend worrying about it as first-year. Focus on the day-to-day of what you are doing. Nothing will prepare you more for your fourth year than first year, second year and third year, each in their time. You have enough on your plate to worry about first year!

As far as tips for nerves in general, try to balance your life the best you can. I think that's different for everyone in medical school. For me it was sometimes yoga or traveling, but it also was vegging out on the couch and watching Netflix after a big test. Getting involved in things that reminded me why I wanted to be a doctor in the first place was my saving grace.

What about your Match experience? When you were going through it, what affected where you applied and what were you looking for?

Kelly: I was all over the place because I was looking specifically for training. Location didn't matter so much because I thought whether I trained in a rural or suburban area, as long as I had the acuity and patient load, I would learn what I needed to learn and could go wherever I wanted, whether that be a rural or suburban setting.

Margaret: Family medicine is so different for different people. What kind of questions were you asking on the interview trail?

Kelly: It's funny because I was asking a lot of same questions you asked. I was looking for MAT training, gender-affirming care experiences, comprehensive reproductive health care, opportunities to participate in advocacy and social justice, and the ability to remain involved in the Academy. I think all those things are important.

Patients are so often marginalized and people might not have the bandwidth or knowledge set to provide these aspects of care. It's such a passion of mine. I wanted to be able to provide these things for patients no matter where I ended up.

I also was looking for places where I would be heavily trained in inpatient care and obstetrics. I feel wholeheartedly that it's important to be trained in inpatient and obstetric medicine as a family medicine doctor. We need to understand what has medically happened during a patient's admission because we then continue to manage the outcomes once they are discharged -- some of us even continue to care for patients in those inpatient and obstetric settings as family medicine doctors.

That's what's great about family medicine: We have such a breadth of practice that one can always find what they're looking for.

Margaret: Did you find all the things you were looking for?

Kelly: I 100% did, which is really incredible.

The rest is here:
Match Q&A: Will You Find What You're Looking For? - AAFP News

Theres quite a bit of confusion around the ACE proteins and coronavirus infection, and I can see why. The names in this area are pretty confusing, for one thing, and if youre not familiar with the tangled feedback loops that you get in human biology, it all starts to look like a tangle of wires pretty quickly. So lets have a look at the outlines of the system.

At right is a (pretty darn simplified) scheme. Angiotensinogen is a 452-amino-acid protein thats secreted by the liver (and has several functions all by itself). Its first ten amino acids are cleaved off by the enzyme renin to give you Angiotensin-I (also known as proangiotensin). That small peptide is then made even smaller by angiotensin-converting enzyme 1 (ACE-1), and interestingly, no ones ever found a function for angiotensin-1 other than to sit around and get cleaved in this way. This extra regulatory step has presumably come in handy over the eons.

ACE-1 takes off two more amino acids to give you the octapeptide known as angiotensin-II, and that one has profound effects on raising blood pressure (it has many other functions as well). It does this by binding to cell-surface proteins called angiotensin receptors (theres more than one type of these and they have a whole list of other downstream functions, but that takes us further afield). So you can see how an ACE-1 inhibitor could be good for high blood pressure, by blocking any formation of angiotensin II, and a renin inhibitor would be as well, by blocking the whole process a bit further upstream, and something that blocked that last binding step (an antagonist of the angiotensin receptor) would also probably work. All three of those are in fact classes of hypertension drugs the ACE-1 inhibitors came first (captopril in 1980, a famous triumph of 1970s med-chem and led to a whole slew of improved -opril drugs). The angiotensin receptor blockers came next (drugs with the -sartan suffix), and there are several of them. Renin inhibitors were far more painful to discover and develop, for a lot of reasons, and theres still only one on the market (from 2007).

Now to the coronavirus connection. Youll note that ACE-2 enzyme in the chart, and that one (formerly rather obscure) is having its moment in the the spotlight. Its expressed near the surface of various epithelial cells blood vessels, for sure, but also lung, intestine, and others. As shown, it is capable of clipping both angiotensin-I and angiotensin-II down further, to even small peptides (angiotensin 1-9 and 1-7) that have activities of their own. So it has its cardiovascular roles to play, but its become known for being a protein recognized by various coronaviruses to gain cell entry. There are others, naturally, and their relative importance can differ from virus to virus, but ACE-2 was shown to be important for the earlier SARS virus, and this current SARS-CoV-2 is quite similar. A cryo-EM structure of full-length ACE-2 with a coronovirus spike protein has recently appeared.

So something that binds to ACE2 and interferes with that viral hijacking would probably be quite interesting. Problem is, we dont have much of anything like that. ACE-1 inhibitors, as fate would have it, are not inhibitors of ACE-2 the enzymes are cousins, but not similar enough for the activity to cross over. Its not completely clear to me if a small molecule inhibitor in the active site would interfere with the viral interaction anyway, and it would be nice to have a few to see, but Im not aware of any such compounds. The confusion around the phrase angiotensin receptors has led to some people outside of the medical field wondering if the antagonist drugs (the sartans) would interfere with ACE-2, but that doesnt happen, either (theres another story with those, though see below).

A recent letter to The Lancet has noted that comorbidities reported so far for severe coronavirus patients include hypertension and either type I or type II diabetes. These patients are often being treated with ACE-1 inhibitors or angiotensin-receptor antagonists. The tricky part is that both diabetes itself and treatment with either of those drug classes increases the expression of ACE-2 protein. At first thought, that would probably not be a good thing, loading up the cells with more viral target proteins. But wait: theres another effect, as noted in this new paper. It builds on reports from China to suggest that a mechanism of lung injury during the viral infection may be through inappropriate effects of excess free angiotensin-II protein, which is floating around out there because the ACE-2 that would normally be soaking it up is occupied by coronavirus particles. If thats the problem, then increasing the amount of ACE-2 protein might paradoxically be just what you want to do to restore some balance to the angiotensin system. In that case administering more angiotensin receptor antagonists would be an effective way to upregulate the production of ACE-2.

There are a lot of such bounce-shot three-cushion mechanisms out there, so its not a crazy suggestion. That second paper proposes sorting through the existing patient data to see if there are correlations between severity of infection and angiotensin receptor antagonist therapy in particular, and I believe that this is ongoing. Epithelial cells are going to have ACE-2 protein on their surfaces no matter what, so the virus is going to be attacking those as a route of entry. If that second paper is right, then it could be that throwing more ACE-2 onto those membrane doesnt make the viral infection much worse, but does lessen the associated lung injury. If were going to have a lot more coronavirus patients, this would be a very good thing to know.

View post:
Angiotensin and the Coronavirus - Science Magazine

Find out how to optimize your circadian rhythm so you can sleep better.

What do blue-light blocking glasses, sleep trackers, tech fasts and sleep supplements all have in common? Besides the fact that they are meant to help you sleep better, they all, in some way, attempt to help you regulate or optimize your circadian rhythm.

Read more:8 products to help you stop snoring

Your circadian rhythm is the internal "clock" that helps your body function, adapt and yes -- sleep. The two things that affect your circadian rhythm the most are environment and light, according to Dr. Craig Heller, Professor of Biology at Stanford where his research focuses on sleep and circadian rhythms. And while controlling your environment and light around you seems a bit difficult (read: impossible), there are definitely things you can do to reduce the risk that you are disrupting your circadian rhythm more than necessary.

To learn more about your circadian rhythm, how it works, and what you can do to optimize it so you will sleep better, keep reading.

Now playing: Watch this: Do these 8 things to sleep better tonight

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Your circadian rhythm is your internal clock that runs on a 24-hour cycle. This internal clock tells your body when you feel tired or awake throughout the day. You've probably noticed you have a pattern of when you feel the most awake or energized, and when you usually want to take a nap. The circadian rhythm is what drives that pattern, but not everyone has the same patterns.

Your body has an "internal clock "system known as the circadian rhythm.

"Circadian rhythms are internal cycles in many body systems and behavior that have a periodicity. Circadian systems enable the body to anticipate future events (e.g., food availability), coordinate body functions (e.g., sleep and hormone release), and optimize physiological processes with respect to each other," Heller says.

Since your circadian rhythm helps regulate many important processes in your body, it makes sense that disrupting it is bad news for your sleep, and therefore your health in general.

So what exactly disrupts your circadian rhythm the most? "Most commonly jet lag, shift work, bright light and especially blue light (computer and TV screens) when it should be dark," Heller says. Another big circadian rhythm disruption is when you transition to daylight saving time.

Signs that your circadian rhythm is disrupted include problems falling asleep, feeling energized or wired at unusual times, or feeling super tired for periods during the day. One thing that can help keep your circadian rhythm on track is trying to stick to a consistent sleep and wake-up time, which is not always easy.

Here are a few things to try if you think your circadian rhythm is off:

Keep a consistent sleep and wake up time: and try to keep it close to what feels natural to you (i.e., don't fight the fact that you are a night owl or morning person)

Get light in the morning: Get sunlight in your eyes first thing in the morning when you can. Getting light early in the day tells your body it's time to "wake up."

Avoid bright lights in the evening: Like Heller said, light can affect your circadian rhythm, which is why avoiding bright lights in the evening and dimming your lights can make a difference.

Avoid blue light at night: Turn off the TV and other devices that emit blue light at least three hours before bed. If you can't turn them off completely, install an app likeF.lux or wear blue light or amber-tinted glasses to block the light.

Traveling across time zones can disrupt your body's internal clock.

Sometimes your job or lifestyle forces you to do things you know aren't great for your sleep, but you want to make the best out of your situation regardless. Activities like working nights or traveling across time zones -- especially when the time difference is more than a few hours -- can really wreak havoc on your sleep.

"Presumably, you can't avoid travel across time zones or shift work, so you can learn the best ways to retrain rhythms by appropriate timing of light exposure and practice of good sleep hygiene," Heller says. "Apart from circadian considerations, there are many other things to do to improve sleep, most effectively through thermoregulation to support the temperature fluctuations of the body to maintain sleep continuity."

Now playing: Watch this: Pandemic: Here's what's changed about the coronavirus

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The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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Your circadian rhythm is the key to good sleep -- here's how to regulate it - CNET

GENEVA--(BUSINESS WIRE)--RELIEF THERAPEUTICS Holding SA (SIX-RLF, Relief or the Company) is initiating an urgent phase 2 clinical trial of RLF-100 (Aviptadil) in coordination with the Senior Leadership of the Government of Israel for the treatment of Acute Respiratory Distress Syndrome (ARDS) in patients with COVID-19 infection. The trial is being coordinated by Prof. Jonathan Javitt, MD, MPH, acting Chairman of the Scientific Advisory Board of Relief in coordination with Dr. Miki Halberthal, MD, CEO of the Rambam Healthcare Campus and Dr. Boaz Lev, head of Israels COVID task force and former Director General of Israels Ministry of Health.

RLF-100, acquired by Relief from Mondo Biotech, AG, has Investigational New Drug clearance from the US FDA and the European Medicines Agency for phase 2 trials in ARDS and has been awarded orphan drug designation by both agencies for treatment of ARDS, Acute Lung Injury, and Sarcoidosis. Aviptadil is Vasoactive Intestinal Polypeptide (VIP), a naturally-occurring peptide hormone that is known to be concentrated in the lungs. VIP has been shown in five species of animal models to have potent effect in models of ARDS and Acute Lung Injury. In these models, Aviptadil has shown potent anti-inflammatory and specifically anti-cytokine activity in the lungs.

The first clinical protocol will compare intravenous administration of Aviptadil to its administration via an endotracheal tube in patients who are already on mechanical ventilation because of ARDS. Assuming no new safety signals are detected, a second protocol will quickly be initiated to treat patients with early signs of respiratory distress in the hopes of preventing progression to ARDS and the need for mechanical ventilation.

After carefully reviewing the preclinical and clinical data, we believe that RLF-100 has a chance to be a safe and effective treatment for Acute Respiratory Distress Syndrome in patients infected by COVID-19, who otherwise have less than 50% chance of survival, despite intensive care. The State of Israel is eager to test this potentially lifesaving treatment in patients who today have no other therapeutic option, said Dr. Halberthal. We will try every possible mechanism to help safeguard our patients in this global crisis.

As a third-generation physician and the father of newly-trained physician, I am deeply honored to be working with longtime colleagues in Israels Ministry of Health on critical initiative. Owing to the rapidly expanding size of the epidemic and the extraordinary unmet medical need, we intend to initiate phase 2 clinical trials on an urgent schedule in order to bring a potentially life-saving drug to patients.

About RLF-100

RLF-100 (Aviptadil) is a patented formulation of Vasoactive Intestinal Polypeptide (VIP) that was originally developed and is currently marketed in Europe for the treatment of erectile dysfunction. VIP is known to be highly concentrated in the lung and to inhibit a variety of inflammatory cytokines. Aviptadil was awarded Orphan Drug Designation in 2001 by the US FDA for treatment of Acute Respiratory Distress Syndrome and in 2005 for treatment of Pulmonary Arterial Hypertension. Aviptadil was awarded Orphan Drug Designation by the European Medicines Agency in 2006 for the treatment of Acute Lung Injury and in 2007 for the treatment of Sarcoidosis. Both the US FDA and the EMEA have granted Investigational New Drug licenses for human phase 2 trials of Aviptadil.

About Acute Respiratory Distress Syndrome

Acute respiratory distress syndrome (ARDS) is a type of respiratory failure characterized by rapid onset of widespread inflammation in the lungs. Symptoms include shortness of breath, rapid breathing, and bluish skin coloration. Among those who survive, a decreased quality of life is relatively common.

Causes may include viral infection, sepsis, pancreatitis, trauma, pneumonia, and aspiration. The underlying mechanism involves diffuse injury to cells which form the barrier of the microscopic air sacs of the lungs, surfactant dysfunction, activation of the immune system, and dysfunction of the body's regulation of blood clotting. In effect, ARDS impairs the lungs' ability to exchange oxygen and carbon dioxide.

The primary treatment involves mechanical ventilation together with treatments directed at the underlying cause. The syndrome is associated with a death rate between 35 and 50%.

RELIEF THERAPEUTICS Holding SA is listed on the SIX Swiss Exchange under the symbol RLF. For further information, please visit the Relief website at http://www.relieftherapeutics.com or contact at contact@relieftherapeutics.com

Disclaimer: This communication expressly or implicitly contains certain forward-looking statements concerning RELIEF THERAPEUTICS Holding SA and its business. Such statements involve certain known and unknown risks, uncertainties and other factors, which could cause the actual results, financial condition, performance or achievements of RELIEF THERAPEUTICS Holding SA to be materially different from any future results, performance or achievements expressed or implied by such forward-looking statements. RELIEF THERAPEUTICS Holding SA is providing this communication as of this date and does not undertake to update any forward-looking statements contained herein as a result of new information, future events or otherwise.

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RELIEF THERAPEUTICS HOLDING SA (SIX: RLF) Announces Plans to Test Aviptadil for the Treatment of COVID-induced Acute Respiratory Distress Syndrome...

Ah, stress. That inevitable, commonplace pandemic. Everyones stressed in the 21st century, and nobody seems to think it too much of a big deal, until that seemingly slight mental turbulence starts exerting a serious negative influence upon our health and daily functioning.

Stress is the bodys attempt to adapt to any unusual negative changes that it must face. For me, stress manifests in the way I eat. When Im stressed to a certain extent, I need copious amounts of chicken-cheese momos, or a batch of spicy fries. Then, as my stress progresses to something worse, I cant eat no matter how hard my gut groans for food. Why do I eat when Im stressed? And why cant I eat when I become more stressed?

Apparently, I am not unique. People tend to overeat when theyre stressed in order to distract themselves from whatever is on their minds. And people stop eating when theyre stressed because they simply cannot take their minds off whats stressing them, killing the need to do other things.

Related on The Swaddle:

Stress Is Contagious, but Heres How We Can Avoid Infecting Each Other

According to Harvard Health, feeling stressed makes our brain send cues to our bodies that it thinks might help us deal with the threat weve recognized. This is done via the stress hormone cortisol, which makes us crave food especially of the sugary, salty, fatty sort because it helps stock up on energy to fight whatever threat were dealing with. Increased stress also leads to a drop in metabolism, which can lead to rapid weight gain.

On the other hand, stress also stimulates the brain to secrete hormones like corticotropin-releasing factor (CRF), which activates the sympathetic nervous system that brings about the fight-or-flight response. Hormones like CRF are known to suppress appetite, decreasing how much or often we feel hungry, Dr. Kimbre Zahn, a family physician, told Shape. She adds, Individuals with persistent stress or those affected by generalized anxiety may be more likely to have chronic elevations of these hormones, resulting in prolonged appetite suppression. Often, stress can also lead to feeling nauseous, which also kills an individuals appetite. Losing ones appetite is particularly hard on the body, as increased cortisol leads to increased production of acid in the stomach. And if theres nothing but acid in the stomach, the organ will develop ulcers.

In any case, either eating too much or not eating at all, especially when stressed, are particularly bad habits, as they aid to the bodys struggle to cope. To avoid stress eating, take refuge in other comforting behaviors rather than eating junk food for example, eating healthy snacks and/or talking to a friend. As for a lack of appetite, what helps is to find foods that one can eat without feeling intense nausea. And drinking smoothies or milkshakes, which are easy to digest, will ensure the body has enough calories to keep it going through that turbulent period.

Originally posted here:
Why Do Some People Eat When Stressed, While Others Stress-Starve - The Swaddle

By Lisa Rapaport

(Reuters Health) Young men who care about their sperm quality might want to lay off the cheeseburgers and fries, according to a new study that links a typical Western diet with a lower sperm count.

Men in the study who ate a mostly Western diet characterized by pizza, fries, sweets, sodas and red and processed meats typically had a lower sperm count by about 26 million than men who ate far less of these unhealthy foods. With a Western diet, men also had lower levels of reproductive hormones needed for optimal fertility.

Conversely, men with the healthiest eating habits with lots of fish, chicken, vegetables, fruits, and water typically had a sperm count 43 million higher than those who ate the lowest amounts of these foods.

Your sperm is what you eat, said coauthor Dr. Feiby Nassan of the Harvard T. H. Chan School of Public Health in Boston.

Diets rich in seafood, poultry, nuts, whole grains, fruits and vegetables provide antioxidants and omega-3 fatty acids that are essential for good sperm production, Nassan said by email.

Our results suggest the possibility of using dietary intervention as a possible approach to improve sperm quality of men in reproductive age, Nassan said.

A normal sperm count can range from 15 million to 200 million sperm per milliliter of semen.

Sperm quality and certain sex hormone levels have decreased substantially over the past few decades, driven in part by worsening diets in many parts of the world, the researchers note in JAMA Network Open.

The current analysis included 2,935 healthy men in Denmark, ages 19 or 20 on average. Researchers divided them according to how closely their diets matched four patterns: a Western diet; a healthy diet described as a prudent pattern of eating; a so-called open-sandwich diet consisting of whole grains and lots of cold cuts, fish, condiments, and dairy; and a vegetarian-like diet with lots of veggies, soy, milk, and eggs and little if any red meat or chicken.

Total sperm count with the Western diet was significantly lower than with any of the other three eating patterns.

The study wasnt designed to prove whether diet directly affects sperm or fertility. Researchers also focused on young, healthy men who might not yet be trying to conceive, and they didnt examine what happened in older men who wanted to become fathers.

Still, the study adds to evidence suggesting a healthy diet is good for mens reproductive health, Dr. Muhammad Imran Omar of the University of Aberdeen in the UK said by email.

And, men, like women, should try to adopt a healthy diet, cut back on alcohol and stop smoking months before they want to start trying for a baby.

However, men should be aware that it takes three months to produce sperm, said Allan Pacey, a researcher at the University of Sheffield in the UK who wasnt involved in the study.

If a man alters his diet on a Friday it wont improve his sperm by Monday, Pacey said by email.

SOURCE: https://bit.ly/2VQrYmr JAMA Network Open, online February 21, 2020.

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Even among young men, healthier diet tied to higher sperm counts - Physician's Weekly

Simple methods to take care of your body and business.

Opinions expressed by Entrepreneur contributors are their own.

The following article is written by Ben Angel. Author of the book, Unstoppable: A 90-Day Plan to Biohack Your Mind and Body for Success. Buy it now from Amazon | Barnes & Noble | iBooks | IndieBound. And be sure to order The Unstoppable Journal, the only journal of its kind based on neuroscience, psychology and biohacking to help you reach your goals.

As we all grow accustomed to life in the age of novel coronavirus COVID-19, and scientists continue working on antivirals and vaccines,many experts are suggestingthe public take a holistic approach to general health maintenance. And as biohackers know better than most, positiveimmune responsecan beessential to staying healthy.While the following suggestionsare not ways to prevent you from contracting the virus, they areeasyways to keep yourself as healthy as possible.

As noted in a recent studyfrom the Sleep Foundation, "Without sufficient sleep, your body makes fewer cytokines, a type of protein that targets infection and inflammation, effectively creating an immune response. Cytokines are both produced and released during sleep, causing a double whammy if you skimp on shut-eye. Chronic sleep loss even makes the flu vaccine less effective by reducing your bodys ability to respond."

onsequently, the study advises taking two 30-minute-or-less daily napsto help mitigatesleep deprivation's effects on the immune system. But if you're having a difficult time getting to sleep, you can try the many binaural beats found on YouTube (Jody Hattons Power Napsis a good place to start)to help grab some winks on your coffee break.

Getting rid of sugar biohacks your immune system by removing a food source for the bad bacteria in your gut that can kill off your good bacteria. Autoimmune problems anddigestive issues are telltale signs of gut imbalance. Ideally, your gut should be 85 percentgood bacteria or probiotics.

You can check for gut dysbiosis through gut-microbiome tests from companies like Thryve Inside, as well as take stock of what youre eating on a daily basis. Fermented foods like sauerkraut, kombucha and kimchi can all help repopulate the good bacteria in your gutas well, leaving you with more energy and vitality.

Its been known for centuries that fasting has been used as a health protocol. Paracelsus, a great healer in the Western tradition, wrote 500 years ago that,Fasting is the greatest remedy, the physician within. In 2014, Dr. Valter Longo of the University of Southern California discovered that fasting for threedays (having nothing but water) could essentially reset the immune system. As summarized on Humann.com, holding off on eating for at least 16-18 hours after your last meal allowsyour bodys attention to become "focused on the current immune cells, recycling them and getting rid of the damaged cells. This means that during the fast, your body is running lean and mean with its white blood cells."

This practice, of course, should only be done if youre already healthy. But provided that's the case, who wouldnt want more time to completeprojects at workand get healthier at the same time?

Stress causes an inflammatory response within the body that can greatly affect your fight-or-flight response by releasing too much of the stress hormone cortisol. It also leaves us more vulnerable to infections and disease, both in and out of the office. That's why mindfully meditating has become a must forany biohacking entrepreneurs. There arevarious forms of mindfulness practices, ranging from the slow-moving poses ofyoga and tai chi to myriad breathing techniques. And arecentstudyinTranslational Psychiatry adds that "there seems to be something intrinsic about meditation itself that can shift gene expression and even boost mood over time."

Many airlines are now monitoring travelers's health before and after flights. According to the CDC, those with no respiratory symptoms do not need to wear a medical mask. The CDC also recommends the use of masks for people who have symptoms of the virus and for those caring for individuals who have symptoms, such as cough and fever.

In his book, Cockpit Confidential, author Patrick Smithstates that in an airplane, Between 94 and 99.9 percent of airborne microbes are captured, and theres a total changeover of air every two or three minutes far more frequently than occurs in offices, movie theatersor classrooms.

This is all the more reason why taking your vitamins during stressful times is important, since many of our essential minerals and vitamins can become depleted during stress. Vitamins C,B and D, as well as zinc,all support your immune system. Research shows that zinc alone can help keep inflammation at bay so that your immune response is better supported.

Related: Coronavirus and a Looming RecessionHow to Raise Capital in Uncertain Times

Although we are in uncertain times, we dont have to wait to see if we are healthy enough to overcome any type of sickness or disease. By implementing some of these holistic steps to boost your immune system, it will inevitably be a win-win situation for not only your health and well-being, but for keeping your business running like a well-oiled machine.Bottom line: Dont panic, and take advice from the medical professionals who are specialists in this area.

This article solely reflects the opinion of the author and is not intended as an alternative to recommended official government guidelines. For more updates and information about the novel coronavirus, visit the CDC's website.

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The Covid-19 crisis is triggering global fears that are beginning to cross over into panicky feelings (especially if you or a loved one is over 80 and in a nursing home). That state of mind is called dread.

In this piece I will endeavor describe and explain what is going on in your brain and mind when you are in a state of dread.

A disclaimer. It is empirically (i.e. observationally and experience) based and neither evidence nor research based. In fact, I would ask such researchers to weigh in and make what follows more scientifically sound.

Nevertheless, I hope it will help you better understand what is going on inside you and in so doing be calming, reassuring to you and even inform you and others who read this about what might psychologically stem the tide of rising fears.

When youre fearful, its because the way you have been living your life and the reassuring assumptions about the world that keep you calm enough to make good decisions are suddenly upended. Its as if the beliefs you have that help you to maintain your daily sanity and orientation are suddenly ripped away and the future you were living into, is suddenly extremely gone.

When thisoccurs a stress hormone called cortisol is released by your adrenal glands toalert your body to doing what it needs to do to survive. Added to that isanother hormone secreted by your adrenal glands called adrenaline whichdirectly gets your body physically ready to deal with stress which can comefrom either fear or excitement.

As your cortisol and adrenaline rise, so too does dread and a part of your brain which deals with emotions, also referred to as your mammalian/middle brain (more on that later), called your amygdala becomes highly activated.

Your amygdala is a combination emotional sentinel and point guard rolled into one. If your amygdala senses this is a time for survival it can hijack you away from accessing the prefrontal part of your cerebral cortex, that helps you assess as situation, consider options and then make rational decisions. The hijack actually coincides with more blood flow going into your middle and then lower/reptile brain to take action to survive and away from going to your upper/human brain where you can think and consider options.

When an amygdala hijack causes blood flow to go more to your middle and lower brains an interesting thing happens to something called your Triune Brain.

Paul MacLean was a physician and neuroscientist who first coined the phrase Triune Brain to go along with his theory that we have three brains: an upper/human/thinking brain, a middle/mammalian/emotional brain, and a lower/reptile/fight or flight brain. He postulated that they developed through evolution and have learned to align with each other when were functioning at our best. They are kept in alignment when they are all aimed a future that were living into.

However, when a relatively predictable future becomes completely uncertain and an amygdala hijack occurs with resultant blood flow change, your three brains can become decoupled with each brain functions separately from each other. We even have metaphors that reflect that: wigged out, unglued, out of sorts, out of you mind, freaked out, etc. When that happens, you have entered into a state of dread.

When that amygdala hijack occurs and each of the three brains fend for themselves, the upper/human/thinking brain can flip into obsessive thinking (thinking the same thoughts repetitively), the middle/mammalian/emotional brain can flip into high anxiety (with dread causing it to flirt with terror and then panicky feelings), and the lower/reptilian/fight-flight-freeze can flip into compulsive repetitive behaviors where you run, become angry or just freeze in your tracks.

When thisoccurs, you have what I refer to as Triunal Rigidity, where the three brainshave become rigidly connected to each other after the future they were aimingtowards gets stripped away. Triunal Rigidity is what makes your mind brittleand prone to feeling fragile as if it could break and shatter (= lose yourmind). It is that feeling of brittleness leading to fragility leading toshattering that can cause a sense of impending doom, terror and panic.

What is thesolution to this?

That is what Irefer to as Triunal Agility where whatever uncertainty and unpredictability isthrown at you, you can pivot, realign with what you need to do and then takeaction. And if that action is a littleoff, your Triunal Agility can enable you to re-pivot and realign some more.

What is necessary to transform your brittle Triunally Rigid mind that is consumed by dread into a rapidly adapting Triunally Agile mind that can reason?

Lets use theCoronavirus as an example.

It is the following information regarding Covid-19:

Generalized non-factually founded reassurances or worse, consistently inconsistent messages from President Trump who doesnt appear to grasp the situation or even understand the virus rather than being assuring actually appear to increase uncertainty and dread, because he makes it difficult to believe him.

The person best qualified to deliver the message must be highly trained, experienced in such matters, calm, clear, with specific directions and someone we can believe. Dr. Anthony Fauci who is head of the National Institute of Allergy and Infectious Diseases appears to be the current go to person to advise us.

See Glossary of terms above

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When Dread Becomes You - Thrive Global

CBD Cannabidiol (or cannabis)

Since CBD products hit the market, thousands of products hit the market, some good, some not good at all. If you are taking CBD, please check to see if your product meets label claims at CBDverify.com. To understand what they do when assaying products this is the assay of our 500 mg sleep CBD:

DESCRIPTION: PLANT HEALTH R.E.M. CBD

BOTTLE: 30 mil, 1 fl oz.

CBD CONTENT ON LABEL: 500 mg

RESULT: PASS

FINAL TEST RESULT

CBD TOTAL: 513.60 mg

CBG TOTAL: 3.04 mg

THC TOTAL: ZERO

Tetrahydrocannabinol (THC), the psychoactive part of the marijuana plant and it is in only one of our products, Pachamama, which comes from Colorado. It meets the federal regulations of the amount of THC allowed in a CBD product. For anyone who may be tested in the work force, I would not allow them to get this product.

We have within us an endocannabinoid system which is made up of two types of CBD receptors CBD 1 and CBD 2. CBD 1 receptors are highly concentrated in the brain and other parts of the body and CBD 2 receptors are in the immune system and in the periphery. There are studies on CBD for the treatment and prevention of cancer through the CBD 2 receptors, regulating immune function. Not only does the research show promise with CBD in cancer patients, it also can help with nausea that comes with cancer treatment and can improve appetite.

There is also research on Multiple Sclerosis and Alzheimers Disease showing that there are more CBD receptors than in patients without either condition. It is called a compensatory response, so that, if a person with these conditions takes CBD, there is a stronger cellular response to repair.

There are contraindications with using CBD listed below:

1. If you are on medications, CBD can compete for liver pathways, leading to higher levels of the medication in your system (consult your physician)

2. It can raise liver enzymes in certain individuals, not most though. I believe this to be in patients that take multiple medications, however it can also be from a CBD product that is not organic and has pesticides and other chemicals in it. The last thing we should do is take a product for our health that is not clean, otherwise we are poisoning ourselves.

In our clinic, I prescribe CBD mainly for sleep, anxiety and pain as when CBD locks into our receptors it induces rest and relaxation as well as acting as an anti-inflammatory agent. We only carry products that are clean, meet label claims and the ones that we consistently get good clinical responses from and they are listed below.

1. The first one by Plant Health, REM 500 we prescribe for sleep.

2. The second one by Plant Health, Nutritional Tincture 2000 mg is full spectrum used mostly for pain.

3. Valo product is a capsule with 25 mg of CBD and 1 mg of Melatonin (works amazing for sleep in most patients)

4. The last one in the picture is from Pachamama in Colorado, which contains an FDA approved amount of THC, is full spectrum and they target pain with pepper, sleep with valerian, anti-inflammatory with turmeric and more.

Our topical CBD from Plant Health works wonders for local pain. Due to the fact that many CBD products do not work, have contaminants and dont meet label claims, CBD gets a bad name. Please only use reputable products where you can see the third-party testing for purity. From there dosing depends upon your needs and everyone doses slightly different to titrate to their benefit.

Dr. Theresa Ramsey is a practicing physician, speaker, lifestyle expert, author of the best-selling book, Healing 101: A Guide to Creating the Foundation for Complete Wellness & a guest expert on Arizonas top morning television show, Your Life A to Z, as their Medical Expert since 2007. Selected as a Certified Hormone Specialist, serving both local and out of state patients as her approach is Evidence Based and her prescribing is like nobody else in the valley when it comes to Quality of Life Enrichment as well as significant Aging Risk Reduction. Most physicians and lay people are uneducated on the safety and necessity of supporting our aging process which is considered a deficient state. Her prescribing is risk free. Dr. Ramsey has also been chosen as one of Phoenix Magazines Top Doc, was chosen as the Natural Choice Awards winning (1) Top Naturopathic Physician, (2) Top Womens Health Specialist and (3) Top Best Holistic M.D. in 2012 and 2013. She is also an eHow health expert. Dr. Ramsey elegantly bridges the gap between Allopathic & Naturopathic medicine as she has worked as an RN for 10 years before pursuing her career as a physician and appreciates what both sciences have to offer. The 10 years that she worked as a Registered Nurse was in Heart Surgery and ICU and then transitioned into Functional Medicine in 1996. An understanding of the cause of dis-ease is paramount in her education and inspiration for those seeking disease prevention and reversal. Her focus in her clinical practice is in Preventive Aging with Bio-Identical Hormone Replacement Therapy. Her second book, The Hormone Book covers all of the rich history through research on HRT prescribing and is anticipated to be released in the fall of 2020. https://revitalizeparadisevalley.com/: 480.970.0077.

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Benefits and Risks of Using CBD Products | Your Life Arizona - AZFamily

On this page:BasicsHormone TherapyNon-estrogen OptionsPerimenopause TreatmentSex After MenopauseNatural RemediesHot Flashes

Menopause symptoms getting in the way of living? There used to be only two treatment options: hormone therapy, or Just Deal With It (official Rx name, obviously). Thats far from the case now. Read on to find the right menopause solutions tailored specifically for you. And if you dont want to treat menopause, you dont have to. It's a normal phase of life, and the remedies are here for you only if you want 'em.

Menopause affects everyone uniquely. Its possible you could be in the menopause minority and experience a gradual spacing out and then stop of your periods, wonder what all the fuss is about, and feel positively liberated that you no longer have to shell out for tampons.

Or you may be one of the women who has hot flashes and night sweats. You could experience vaginal pain and urinary symptoms. Or you might be surprised at just how much your moods seem to shift along with your body. All of these menopause experiences are completely normal, and all are related to the drop in (or erratic behavior of) the reproductive hormones estrogen and progesterone.

Once you begin experiencing menopausal symptoms, it helps to find a clinician who has been trained specifically in menopause, whether its your gynecologist, PCP, or even another specialist you see who has received the training, such as an oncologist or reproductive endocrinologist. Youre looking for a pro who has certification from The North American Menopause Society (NAMS). The group has a function on its website where you can type in your zip code to search for a NAMS certified medical practitioner (NCMP) in your area.

People tend to have strong preconceptions about hormone therapy, or HT (previously called hormone replacement therapy, or HRT). But a lot of them are based on an outdated study from the Womens Health Initiative conducted in 2002, which implied that women who were put on HT had higher rates of heart attack, stroke, and breast cancer.

Turns out, the average age of the women enrolled in that study when they started HT was 64, while the average age most women have menopause symptoms and seek treatment is in their early fifties.

In the 17 years since the WHI hubbub, numerous new studies and reviews have shown that the safety of HT depends on how old you are when you start the hormones, your personal family history and other medical conditions, and the strength of the dosage.

The best time to begin (any type of) HT? The first time your symptoms start bugging you. The current recommendation for women without contraindicationssuch as a history of breast or uterine cancer (estrogen can help some breast cancer cells grow)is to start as early as possible on the lowest effective dose, and stay on it for the shortest time necessary.

The sooner you start taking hormones, the less potential risks they carry; these vary depending on your medical history but can include an increased risk of certain cancers, blood clots, and heart disease. Start right as menopausal symptoms become bothersome, and those risks significantly drop for most women.

It also helps when the hormones are administered transdermally, in lower doses, such as through a patch or gel or vaginally. As opposed to oral hormones, this method of delivery keeps the effects localized and therefore less likely to substantially affect other parts and systems of the body.

This is particularly the case for women in their 60s or ten years post menopause: For them, docs typically recommend lower-dose or more localized HT (such as vaginal-specific options) or nonhormonal medications (scroll down to read about SERMs and SSRIs).

Your NAMS-certified physician will discuss your particular symptoms and risks before prescribing any medication.

She may come to the conclusion that HT is not right for you, if you have a family history of breast, uterine, or ovarian cancer or heart attacks or blood clotsor if you are already over the age of 59, when risks of certain cancers, blood clots, and heart disease increase.

If youre low-risk, there are a variety of HT options available, but dont try any (or any meno treatment, for that matter) without first discussing with your doctor what other meds youre on.

Forty percent of women have vaginal issues during menopause. Prepare for such delightful things as dryness, irritation, pain during sex or exercise, and having to pee frequently and often.

Your doctor can help you find the right low-dose hormone therapy, localized around the vagina, if you only have vaginal and urinary symptoms. These include:

If youre really super-duper lucky, youll get symptoms that are vaginal and beyond! Oh yay!

This could mean hot flashes, sleep issues, mood swings, or bone loss. If this is you, youll likely want hormone therapy that isnt localized to the vagina.

As with contraceptive hormones, choosing the right hormone delivery method for menopause often comes down to personal preference. Some women like a patch they dont have to reapply as often, while others can't stand something stuck to them and go instead with gels or pills. The goal is finding something that feels natural for you.

Transdermal estradiol estrogen patch. Stick this on your lower belly or upper butt and get on with your life. Sold by the brands Estraderm and Vivelle.

Transdermal estrogen gel. Rub this gel, sold under the brand name Divigel, into the skin of your thigh each day and ahhhh, relief. It comes in varying strengths so you can experiment with your doctor to find the lowest effective dose.

Steroidal vaginal cream. This is not technically estrogen, but steroids that stimulate the nerves in vaginal tissue to help with sexual arousal. Steroids are hormones that affect, signal to, and act as catalysts for other hormonesin this case, for estrogen.

Look for the brand Interosa (prasterone, also known as dehydroepiandrosterone, or DHEA). It may help with depression and bone loss prevention as well.

Unfortunately, this cream is still off limits for women who cannot take estrogen, such as breast cancer survivors or women with a family history of breast cancer. And it can have adverse interactions with most psychiatric medications, including SSRIs (Selective Serotonin Reuptake Inhibitors), antipsychotics, sedatives, anticonvulsants, and sedatives, as well as other hormones such as estrogen and testosterone.

Oral estrogen and progesterone. For some women who are experiencing a barrage of systemic symptoms, a combination of oral estrogen and progesterone can be #treatmentgoals. The progesterone balances out the higher estrogen dose, helping to counteract the estrogen-related risks mentioned above.

These oral hormones do carry a larger risk for women with contraindications (such as a family history of breast, uterine, or ovarian cancer) than transdermal and vaginal hormones, because they tend to be prescribed at a higher dosagebut it is still considered low for most women who do not have contraindications and begin HT early. Specifically, women who start and undergo these treatments between the ages of 50-59 have a low risk compared to those who take them later. If you continue using them after 59, you should come in for more checkups to be monitored by your doctor.

Systemic hormone therapy can also cause spotting after menopause. Still, if youre on it and notice vaginal bleeding, talk to your doctor to make sure there isnt another cause.

Bioidentical hormones are hormones that are chemically similar in structure to hormones that naturally exist within the body. FDA-approved hormones for HT are, for practical reasons, bioidenticalotherwise, they would not be effective, because they would not work in the body.

But its not a medical phrase; "bioidentical hormones is mostly a marketing term for unregulated hormone products without a prescription. For example: companies selling unregulated yam creams and pharmacists whipping up their own (a big no!) compounded hormones (see Any non-prescription menopause treatments I can try? for more deets).

Its being used in the same way wellness, food, and beauty companies have co-opted the term all natural: Both sound good but are essentially meaningless labels with no real scientific definition or basis.

In the case of hormones, choosing something because it says bioidentical can be quite risky. The dosage is unregulated, so you simply dont know what youre getting. In fact, the term irks many doctors, as patients come to them after trying bioidentical hormones from an unreputable place and experiencing negative results.

The takeaway: If hormones are not FDA-approved, they are dangerous, whether they are bioidentical or not. There is no situation in which you should get hormones without a prescription. Ask your doctor for the FDA-approved hormones that are right for you.

As weve mentioned, there are various reasons people arent able to use estrogen, including certain preexisting health conditions or a genetic predisposition to breast cancer. Here are the most common no-estrogen options.

A SERM acts like and redirects estrogen to parts of the body that need it (see: bones, uterus) but not to the breasts. It can be a boon for women concerned about osteoporosis, because SERMs can also redirect existing estrogen to the bones, where it can help to prevent bone loss.

Some SERMssuch as Nolvadex, Soltamox, Tamoxen, Tamofen, Emblon, and Tamosin (all tamoxifen), and Evista (raloxifene)are even prescribed for the prevention and treatment of breast cancer. So, in all, SERMS can be a good option for breast cancer survivors, those with a family history of BC, or if youre at a high risk for bone loss or osteoporosis.

These increase the amount of serotonin in the brain by blocking its reabsorption. Though the exact relationship between estrogen, serotonin, and hot flashes is still being investigated, we do know that estrogen boosts serotonin production. When serotonin drops in menopause as a result of decreased estrogen, SSRIs have been found to reduce hot flashes and night sweats that can accompany the estrogen/serotonin deficit. These can be good options for women without psychological concerns who dont want to go on HT.

But! If you are experiencing emotional as well as physical symptoms (thanks, Lady M!), the beauty of an SSRI is it can knock out both. Estrogen increases production of the feel-good neurotransmitter serotonin; as it drops, you can have a steep decline in feelings of well-being and contentment. Not to mention crappier sleep. There can also be emotional stress as related to issues with sex and self-image. Enter: an antidepressant.

Do know that many psychiatric medications get served with a steaming side of sexual issues (such as lack of libido), so many women combine one with a low-dose vaginal product (as opposed to just higher-dose systemic HT). Its a balancing act that your doctor can help guide you through. The goal: the fewest symptoms, the lowest risk of side effects, and the best quality of life overall.

Another class of antidepressants used to treat anxiety, SSNRIs increase not just serotonin in the brain but also norepinephrine. This latter neurotransmitter is linked to learning, attentiveness, emotions, and sleep.

These are non-SSRIs that are also commonly prescribed for women during menopause.

If you are in the perimenopause part of menopausea years-long phase before you hit full meno in which your periods start getting wonkyconsider the hormonal options below if you are experiencing:

Both options were going to tell you about tap into the hormone progesterone, which can lighten heavy bleeding, lessen the length of time your period lasts (if its become prolonged), and even out your hormone levels. That latter part? Stabilized hormones = less extreme mood swings and sleep disruption.

Why choose one over the other? Its just personal preference.

Chant it with us (and Obama): Yes, we can!

The best treatment for menopausal dryness, irritation, and pain is an FDA-approved, low-dose vaginal estrogen (ring, gel, cream, or tablet). See deets on this above, in the section hormone therapy for vaginal symptoms.

If your vagina feels irritated even when youre not having sex and youd rather not go on HT, or you want more soothing, theres such a thing as a vaginal moisturizer. Yep, its like a daily, over-the-counter moisturizer you put on your face when your skin is dry, only its specifically formulated for your vagina and vulva.

You can go with an over-the-counter vaginal moisturizer or a lubricant. Its fine to use lube as moisturizer, if you find one you like. For both, heres how to pick a good one:

The brands Ah! Yes and Good Clean Love make a variety of moisturizers and lubes in this sweet spot of osmolality and pH.

Also remember: Sex is not just intercourse. Give other stuff a try!

Use menopause as an opportunity to explore other types of intimacy and pleasure. Outercourseany foreplay and sexual activities not dependent on penetration as the main eventcan be revelatory for women at any age.

Like most OTC supplements and tinctures that claim to help with medical issues, those for menopause are running around like its the Wild West! Here are a few things to know:

Remember: The FDA does not regulate supplements that sell without a prescription. The North American Menopause Society (NAMS) recently did a full review of unregulated supplements currently being marketed specifically for menopause, with the conclusion that they all did more harm than good. Black cohosh (the root of an herb), for example, was found to be no more effective than a placebo, and in some cases even caused liver damage.

Any hormone-product that you can buy without a prescription is dangerous and unregulated, even if it is a natural cream, gel, spray, or pill.

There are also compounded hormonescombinations of various estrogens and sometimes other hormones, which are often DIY recipesmixed by pharmacists, doctors, or other people trying to profit on menopause.

Theyre not a good idea: They arent mixed in labs, arent regulated by the FDA, and some have been found to contain hugely varied estrogen amounts, many at dangerously high levels that could cause blood clot. Others have so little estrogen, theyre a waste of money.

There are some standard vitamins not specifically marketed as menopause supps but that can be beneficial during this time.

For example, magnesium has been shown to aid sleep, and calcium can protect against bone loss. Getting enough calcium as you age can help prevent osteopororis; this is because estrogen is an instigator of osteoblasts, the cells that build bone.

Both of these well-tested vitamins are safe to add to your regimen if you are having sleep issues or not getting enough calcium from food alone. Calm Plus Calcium, which comes in a drink or gummies you can take before bed, has both.

These dried, powdered mushrooms and other plants may help with focus, alertness, memory, and mood. They have not been shown to have any ill effects and even help some people cut down on caffeine (which can contribute to insomnia in menopause).

MUDWTR is a tea that is a mix of chai herbs and spices as well as adaptogenic mushrooms and plants including lionsmane, cordyceps, reishi, chaga, turmeric, and cacao.

With zero sugar and less caffeine than coffee, it is a safeand tasty!morning substitute that (because of the adaptogens) may also help with some menopausal symptoms, such as mood swings and brain fog, according to recent studies.

Ye olde weed may be a political lightning rod, but products containing its compounds are relatively safe sleep and sex abettors. The two main compounds in marijuana are:

Some people like cannabis for menopause because it has fewer dangerous side effects and contraindications and a lower risk of being addictive than many prescription drugs for sleep or sex problems.

The product options for both CBD and THC include:

If youre trying an edible or tincture for the first time, start with a small dose and see how you feel, whether it is THC, CBD, or a combination of the two. A vaginal lube or moisturizer with THC is unlikely to give you the giggles and the munchies; instead, itll feel slightly numbing, warm, or tingling, effects some women find help with arousal.

In states where marijuana is legal, you can find products with THC from companies such as Foria which will direct you to dispensaries and other suppliers in your state for purchase. For online CBD products, we like Lord Jones. Its CBD goodies are shippable to states even where marijuana is illegal.

If you dont need HT or other meds and are looking for help for mild or occasional flashes, your best bet is to chill out! Like, litrally (said with British accent). Get cool with the basics (drink ice water, sleeping with the windows open) or these six tricks, no Rx necessary.

No matter which menopause symptoms you experience, know that relief is available. That said, your body is experiencing a naturalwe repeat, naturalchange. We hope this guide helps you assess talking points when discussing treatment options with your doctor. And if you decide you want to embrace your symptoms sans-treatment, we salute you.

Menopause care is different than other types of womens health care, because it is less important that the doctor is an ob/gyn and more important that she has NAMS (North American Menopause Society) certification. (This doc could also be your primary care physician, fertility specialist, reproductive endocrinologist, or even your cancer specialist, for example.) Generally, doctors, including gynecologists, receive little to no menopause training in medical school. NAMS offers its own training and certification specifically for menopause; you can do a search on their site by zip code to find all of the NAMS certified physicians in your area.

It means hormones mixed together without any medical or regulatory supervision; even if done by a pharmacist or an entrepreneurial doctor, these are not FDA-regulated or -approved. Creams, gels, supplements, or any other product containing compounded hormones have been found to contain wildly varying amounts of estrogen, which is dangerous. Too much can cause blood clots and other avoidable health issues, and too little means theyre ineffective and a waste of moolah. FDA-approved prescription hormones are both safer and more affordable: Your doc will make sure the dosage is kept as low as possible, while your insurance will likely cover the cost.

The best way to get vitamins during menopause is through a balanced diet. However, if you are concerned that you may be lacking, have your doctor check your blood work to determine if there is something specific you need. Just feeling a little run down and want to make sure your bases are covered? The Smarty Pants brand of multivitamin gummies has a Masters variety for women over 50, whch contains an arsenal of energizing vitamins such as B and D that menopausal women sometimes lack, and which are often not found in basic multis. They also boast DHA, omega-3, and CoQ10 for heart health, vitamin K for bones, lutein for eyes, as well as your daily RDA of everything else youd expect in a good womens multi.

There are many cannabis solutions for sexual dysfunction, so you definitely dont have to start inhaling to get your groove back. First, lets clarify: THC is the psychotropic compound in marijuana that can make you high and only legal in certain states. CBD is the part of the plant that relaxes you, almost like a mild sedative, to help you get in a chill mood without the high. In states where marijuana is legal, you can find lube, vaginal moisturizers, and low-dose edibles with THC from the brand Foria. (A topical vaginal product with THC isnt likely to get you high; it should feel slightly numbing, warming, or tingling, which some women find helpful for arousal.) In states where marijuana is still illegal, you can find the same wide array of products with CBD only; check out the brand Lord Jones.

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Menopause Treatment: Hormone Therapy & Other Remedies - HealthCentral.com