Archive for the ‘Hormone Physician’ Category

Testosterone, widely and misleadingly understood to be the male hormone, may provide relief to women experiencing the symptoms of menopause, according to a Shelby Township-based physician and many other experts.

Dr. Charles Mok recently published the book Testosterone: Strong Enough for a Man, Made for a Woman, which educates readers about the benefits of natural hormone replacement therapy.

Mok released the book, his first, in March. It costs $25.99 and is available on Amazon.

The evidence for testosterone therapy is overwhelming, and we want to get the message to doctors and, importantly, to their patients, Mok said.

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Men produce 10 times more testosterone than women, but in their early reproductive years women have 10 times more testosterone than estrogen coursing through their bodies.

Many experts believe that its the loss of testosterone, and not estrogen, that causes women in midlife to tend to gain weight, feel fatigue and lose mental focus, bone density and muscle tone as well as their libido. Mood swings, anxiety and hot flashes are other common symptoms.

Testosterone therapy, delivered in the form of a tiny pellet the size of a grain of rice that is inserted underneath the skin, is believed to keep women healthier and relieve many of the above symptoms.

Clinical research shows that testosterone reduces the risk of breast cancer by 50 percent to 75 percent, and natural estrogen cuts the risk of heart attacks by more than 70 percent if used long term, Mok said.

Additionally, theyll have better control of their weight, better energy, better sex, better moods and better hair and skin, Mok said.

Therapy isnt typically covered by health insurance. Treatment in his office is usually about $140 a month, Mok said.

In the book, Mok also explores the history of hormone replacement therapy in the 1940s through the 2002 Womens Health Initiative, which suggested women taking a combination of synthetic estrogen and progesterone had an increased risk of heart disease and breast cancer.

Unfortunately, that led many women away from getting help, Mok said.

Mok, an emergency room doctor, became interested in preventative care after recognizing that some of his patients conditions could have been avoided. Now, hes in the process of finalizing a hormone therapy book geared for men.

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Doctor says testosterone therapy can provide relief for women - The Macomb Daily

SAN DIEGO, April 25, 2017 /PRNewswire/ GenomeDx Biosciences today announced the publication of interim results from an ongoing prospective clinical study of the impact of the Decipher Prostate Cancer Classifier Post-Op test (Decipher test) on physician and patient decision making after prostate surgery. The interim results showed that knowledge of Decipher test results was associated with a change in both physician and patient treatment decisions, as well as improved decision effectiveness for men with prostate cancer considering adjuvant radiation therapy (ART) or salvage radiation therapy (SRT) after radical prostatectomy (RP). The article, titled "Decipher Test Impacts Decision-Making among Patients Considering Adjuvant and Salvage Treatment following Radical Prostatectomy: Interim Results from the Multicenter Prospective PRO-IMPACT Study," was published online this month ahead of print in the journal Cancer.

Approximately 50% of patients will have one or more adverse tumor pathology features after prostate cancer surgery and will be at increased risk of recurrence, metastasis and death. In these men, a multi-modal treatment is often followed by combining surgery with radiation, and either with or without hormone therapy. While known to improve health outcomes, multi-modal therapy poses potential significant harm to the patient's quality of life, including impeding sexual and urinary functional recovery. The Decipher test provides a genomic assessment of the aggressiveness of the patient's tumor, and is used by physicians to determine the need for and timing of additional therapy after surgery.

"Making additional treatment decisions for men with adverse pathology after surgery is difficult. Prior to the development of genomic assessment for prostate cancer patients, there was a lot of uncertainty around which patients might benefit from postoperative radiation and when to begin treatment," said John Gore. M.D., M.S., Associate Professor of Urology at the University of Washington and Seattle Cancer Care Alliance. "This study demonstrates that Decipher is important to guiding the shared decisions physicians and patients need to make after surgery and provides more confidence in those decisions. We have now completed the trial and look forward to the final study analyses to determine whether the treatment recommendations led to actual treatment decisions and how the use of Decipher has impacted patients' health-related quality of life."

The study included a total of 265 patients who enrolled at 19 community and academic practice settings. At baseline, prior to receipt of Decipher test results, physicians recommended primarily a 'wait-and-see' approach for most patients, irrespective of established clinical risk factors. With knowledge of Decipher test results, 96% and 74% of men with low genomic risk in the adjuvant and salvage arms, respectively, as indicated by Decipher test results, were recommended to observation. Among men whose Decipher test results showed a high genomic risk of metastasis, 37% and 69% of men in the ART and SRT arms, respectively, were recommended to receive intensification to multi-modal therapy. The study also indicated that decision quality was improved for patients considering post-surgery radiation therapy when exposed to Decipher test results, and that the fear of prostate cancer recurrence in the adjuvant and salvage arms decreased among low-risk patients.

"The clinical utility of Decipher seen in this interim analysis demonstrates that knowledge of Decipher test results can influence treatment recommendations and improve decision quality among men with prostate cancer," said Doug Dolginow, M.D., chief executive officer of GenomeDx. "As men in our society are living longer than ever before, determining the appropriate treatment of prostate cancer, which may save or extend life, is important. We believe incorporating Decipher into clinical practice will allow for better stratification of risk, improve decision-making and allow patients to be more confident with the difficult choices they may have to make."

About Decipher GRID and Decipher Prostate and Bladder Cancer Classifier Tests

GenomeDx's Decipher Genomics Resource Information Database (GRID) contains genomic profiles of thousands of tumors from patients with urological cancers, and is believed by GenomeDx to be the largest shared genomic expression database in urologic cancer as well as one of the world's largest global RNA expression databases using cloud-based analytics. GRID is a platform for interactive research collaboration, and may enable more rapid discovery, development, commercialization and adoption of new genomic solutions for key clinical questions in cancer treatment.

Derived from GRID, GenomeDx's Decipher Prostate and Bladder Cancer Classifier tests are commercially available genomic tests that provide a genomic assessment of tumor aggressiveness for individual patients. Decipher Biopsy is indicated for men with localized prostate cancer at diagnosis, Decipher Post-Op is indicated for men after prostate removal surgery and Decipher Bladder is indicated for patients being considered for neoadjuvant chemotherapy prior to radical cystectomy. The Decipher tests are used by physicians to stratify patients into more accurate risk groups than determined by traditional diagnostic tools and to better determine which patients may be more likely to benefit from additional treatment. Each tumor analyzed with a Decipher test adds new data points to the GRID database, which is compiled into a Decipher GRID Profile that may reveal additional biological characteristics of the tumor for ongoing research purposes. Going beyond risk stratification, Decipher and GRID makes accessible genetic information for researchers to potentially better predict responses to therapy and more precisely guide treatment.

More information is available at http://www.deciphertest.com and http://www.deciphergrid.com

About GenomeDx Biosciences

GenomeDx has reimagined the use of genomics as a platform for mass collaboration to improve treatment and outcomes of people with cancer. GenomeDx has built Decipher GRID, a large and fast-growing genomics database in urologic cancer that provides a foundation for open and interactive research collaboration and knowledge creation. Using Decipher GRID and machine learning to analyze vast amounts of genomic data, GenomeDx develops and commercializes proprietary clinical tests that are intended to provide more accurate and useful diagnostic information than traditional diagnostic tools or existing genomic tests. GenomeDx's Decipher Biopsy, Decipher Post-Op and Decipher Bladder are commercially available prostate cancer genomic tests that provide an assessment of tumor aggressiveness based on a patient's unique genomic profile. GenomeDx is headquartered in Vancouver, British Columbia and operates a clinical laboratory in San Diego, California.

Learn more at http://www.GenomeDx.com

SOURCE GenomeDx Biosciences

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GenomeDx's Decipher Post-Op Demonstrates Positive Impact on Physician, Patient Treatment Decisions in Multicenter ... - Broadway World

Vitamins are defined as organic substances occurring in many foods in small amounts that are necessary for the normal metabolic functioning of the body. Vitamin D is one of the fat-soluble vitamins. Our bodies can't manufacture vitamins but can manufacture hormones, and some experts feel that vitamin D should be classified as a hormone rather than a vitamin because our bodies manufacture it when exposed to the sun.

"Current Medical Diagnosis and Treatment 2016" notes that vitamin D deficiency "is increasing throughout the world as a result of diminished exposure to sunlight caused by urbanization, automobile and public transportation, modest clothing and sunscreen use."

Defining vitamin D deficiency can be confusing due to two ways of measuring level: nmol/liter and ng/ml (e.g. 112 nmol/liter is the same as 50 ng/ml). The latter is the way levels are usually reported and is what will be used in today's column. Significant vitamin D deficiency is defined as a level less than 20 ng/ml and this occurs in 29 percent of postmenopausal American women and 25 percent of American men older than 65. Severe deficiency is defined as a level less than 10 ng/ml and is present in 3.5 percent of Americans.

Almost all cells, organs and tissues in our bodies have vitamin D receptors, and vitamin D can also turn on hundreds of genes. Over the years, vitamin D supplementation has been touted as a panacea for all sorts of health problems, but according to Dr. Michael Greger's website nutritionfacts.org, better studies done in the last few years have discounted many of these claims. Here's what the current science tells us about vitamin D deficiency:

Vitamin D promotes calcium absorption by the intestines, and also stimulates the activity of bone-forming cells called osteoblasts. Deficiency can cause osteoporosis and osteomalacia, which like osteoporosis causes brittle bones and fractures, but is not exactly the same as osteoporosis. In children with developing bones, osteomalacia is called rickets, which can result in permanent skeletal deformities.

There are vitamin D receptors in our muscles and nervous systems including our brains, but as we age the number of receptors decreases. Elderly people with low vitamin D levels are more apt to suffer falls due to muscle weakness and balance problems.

Vitamin D boosts our immune system, and people with low D levels have an increased incidence of respiratory infections.

Low vitamin D levels are associated with increased all-cause mortality (i.e. you live longer if you maintain normal vitamin D levels).

Vitamin D helps fight inflammation. Asthma, ulcerative colitis and Crohn's disease all inflammatory diseases improve and in some cases even go into remission once D levels have normalized.

According to Dr. Joel Fuhrman, author of "Eat to Live" and other books, "Vitamin D regulates several genes and cellular processes related to cancer progression." People with low levels of D are more apt to get several cancers including breast and colon, and once they get cancer it is more likely to progress.

What are normal levels? Greger points out that the cradle of civilization was in equatorial Africa, "when people were running around outside naked." Vitamin D levels in African tribes living traditional lifestyles are around 50. Breast milk lacks vitamin D, and therefore breast-fed babies are given D supplements, which doesn't make sense from an evolutionary point of view. But if a breast-feeding mother's D level is 50 or greater, her breast milk does contain vitamin D. So while some guidelines say we should shoot for levels of D greater than 30, most of the science points to levels of 50 or more as ideal.

How much D should people take to achieve levels of 50 or above? For most people, 2,000 units a day achieves optimal D levels, with some caveats:

Vitamin D is stored in fat, so obese people need to take 4,000 units a day a day to achieve optimal levels.

Absorption is hampered in the elderly, so the American Geriatrics Society recommends 4,000 units in people 65 and older.

The type of vitamin D you should take is D3, which is what your body makes when exposed to sunlight; versus D2 present in yeast and mushrooms, which isn't as effective.

D is absorbed better if taken with a meal that contains some fat, such as nuts and seeds.

The practice of taking very high doses (e.g. 50,000 units) intermittently is now frowned upon, because the very high levels that result can cause problems.

How about just getting sun exposure rather than taking a supplement? The problem is that sun ages your skin and causes skin cancer. When outside you should cover up and apply sunscreen to exposed areas of your skin such as your face, but this interferes with vitamin D production. Tanning booths have the same problems as sun exposure, and aren't very effective in vitamin D production anyway.

Should everyone have their vitamin D levels tested? Most guidelines don't recommend this because:

Almost all Americans are lower than optimal in vitamin D.

Most insurance companies and Medicare won't cover the test when coded as a screen.

The test for vitamin D is done on a blood sample, and is not a very accurate test in that a lot of variation can occur between labs and even on the same sample tested repeatedly in the same lab.

Vitamin D is inexpensive and has no side effects except in very high doses, such as 10,000 units a day, which can result in dangerously high blood levels.

Dr. Feinsinger, who retired from Glenwood Medical Associates after 42 years as a family physician, now has a nonprofit Center For Prevention and Treatment of Disease Through Nutrition. He is available for free consultations about heart attack prevention and any other medical concerns. Call 970-379-5718 for an appointment. For questions about his columns, email him at gfeinsinger@comcast.net.

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Doctor's Tip: The low-down on vitamin D - Glenwood Springs Post Independent

Men's Health

I Tried Sound Wave Therapy For Stronger Erections. Here's What Happened Men's Health He grinned the grin of a 60-plus-year-old doctor jacked up on growth hormone and testosterone. I think you're gonna be pretty happy. Let's get that numbing cream on, shall we? I grimaced, half-expecting him to snatch the syringe from my clutch and ...

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I Tried Sound Wave Therapy For Stronger Erections. Here's What Happened - Men's Health

NEW YORK, April 10, 2017 /PRNewswire-iReach/ -- Physician and business leader Dr. Charles Mok today announced the publication of Testosterone: Strong Enough for a Man, Made for a Woman (available now). The book is published with ForbesBooks, the exclusive business book publishing imprint of Forbes Media.

In the book, Dr. Mok, who has persistently followed the research on hormone replacement therapy (HRT) and its health benefits for 30 years, confronts medical professionals for their slow integration of testosterone into HRT. With support from a wealth of peer-reviewed studies, he shows how testosterone therapy can help women facing menopause maintain their weight, increase their sexuality, and reduce the health risks associated with aging.

In his new book, Dr. Mok describes the dramatic transformation HRT has undergone in the past several decades. For years, synthetic hormones were widely prescribed to treat women in the United States experiencing menopause. HRT clinical trials in the early 2000s called the practice into question after observing an increase in health risks in women taking synthetic hormones. Those safety concerns, Dr. Mok argues, were valid, but misleading. Today's treatment protocolsusing natural hormones such as testosteroneare entirely different.

"Clinical studies show that testosterone therapy reduces the risk of breast cancer by 50 to 75 percent and relieves virtually all symptoms of menopause with no adverse effects," said Dr. Mok. "The benefits of implementing testosterone into hormone replacement therapy are virtually unprecedented, and yet the larger medical community continues to ignore the facts."

The book Testosterone: Strong Enough for a Man, Made for a Woman is now available for purchase on Amazon.com.

About ForbesBooks

Launched in 2016 in partnership with Advantage Media Group, ForbesBooks is the exclusive business book publishing imprint of Forbes Media, the 99-year-old global media, branding and technology company. ForbesBooks offers business and thought leaders an innovative, speed-to-market publishing model and a suite of services designed to strategically and tactically support authors and promote their expertise. For more information, visitwww.forbesbooks.com.

About Dr. Charles Mok

A speaker, author and authority in his field,Dr. Charles Mok has dedicated his life to helping patients gain confidence, feel younger and live a healthier lifestyle. After receiving his medical degree, Dr. Mok began a career in emergency medicine, eventually working as the vice chairman of the emergency department at Mt. Clemens General Hospital, now known as McLaren Macomb. During these years, he saw countless patients with health emergencies that were fully preventable. In 2003, Dr. Mok founded Allure Medical Spa, one of the largest and most successful medical practices in the state of Michigan, to improve the lives of patients with treatments including varicose veins, hair loss and fat reduction, cosmetic surgery, stem cell therapy, and more. His mission is to reveal the clinical research supporting natural hormone therapy's safety and effectiveness to educate and change the lives of many women for the better. For more information, visit http://www.drcharlesmok.com.

Media Contacts

Mary Scott, Allure Medical Spa, mscott@alluremedicalspa.com, (313) 3784651

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Dr. Charles Mok Releases Innovative New Book on Women's Health - Yahoo Finance

In Blitzed: Drugs in the Third Reich, author Norman Ohler reveals that the Nazis doped their soldiers with a stimulant they called Pervitina.k.a. methamphetamine. The drug helped the Germanswin key battles in the beginning of World War II.

But it wasnt just low-level soldiers who were using during the Second World War. Drug use went all the way up the Nazi leadership to Hitler himself. The dictators personal physician, Theodor Morell, regularly injected Patient A with hormone preparations and steroids he had created using animal glands and other dubious ingredientsand as Hitlers health worsened, Morell secretly began treating him with eukodal, otherwise known as oxycodone, in July 1943. Hitler received an injection every other daywhich is, Ohler notes, The typical rhythm of an addict and contradicts the idea of a purely medical application. The Fuhrer was hooked.

In July 1944, German senior military officials tried to kill Hitler with a bomb in the unsuccessful Operation Valkyrie. The explosion punctured both of Hitlers eardrums. Ear, nose, and throat doctor Erwin Giesing was called to Hitlers headquarters in Poland and began treating Hitler without consulting Morell, administering cocaine in the dictator's nasal passages with a cotton swab. Hitler quickly became addicted to cocaine, too.

Morell and Giesing hated and distrusted each other from the start. In fact, Giesing suspected Morell was poisoning Hitlerand he wasn't alone. In autumn 1944, the situation finally came to a head, as recounted in this excerpt from Blitzed.

You have all agreed that you want to turn me into a sick man. Adolf Hitler

The power of the personal physician was approaching a high point during that autumn of 1944. Since the attempt on his life Patient A needed him more than ever, and with each new injection Morell gained further influence. The dictator was closer to him than he was to anyone else; there was no one he liked to talk to as much, no one he trusted more. At major meetings with the generals an armed SS man stood behind every chair to prevent any further attacks. Anyone who wanted to see Hitler had to hand over his briefcase. This regulation did not apply to Morells doctors bag.

Many people envied the self-styled sole personal physician his privileged position. Suspicion about him was growing. Morell still stubbornly refused to talk to anyone else about his methods of treatment. Right until the end he maintained the discretion with which he had initially approached the post. But in the stuffy atmosphere of the haunted realm of the bunker system, where the poisonous plants of paranoia sent their creepers over the thick concrete walls, this was not without its dangers. Morell even left the assistant doctors Karl Brandt and Hanskarl von Hasselbach, with whom he could have discussed the treatment of Hitler, consistently in the dark. He had mutated from outsider to diva. He told no one anything, wrapping himself in an aura of mystery and uniqueness. Even the Fuhrers all-powerful secretary, Martin Bormann, who made it clear that he would have preferred a different kind of treatment for Hitler, one based more on biology, was banging his head against a wall when it came to the fat doctor.

As the war was being lost, guilty parties were sought. The forces hostile to Morell were assembling. For a long time Heinrich Himmler had been collecting information about the physician, to accuse him of having a morphine addiction and thus of being vulnerable to blackmail. Again and again the suspicion was voiced on the quiet: might he not be a foreign spy who was secretly poisoning the Fuhrer? As early as 1943 the foreign minister, Joachim von Ribbentrop, had invited Morell to lunch at his castle, Fuschl, near Salzburg, and launched an attack: while the conversation with von Ribbentrops wife initially revolved around trivial questions such as temporary marriages, state bonuses for children born out of wedlock, lining up for food and the concomitant waste of time, after the meal the minister stonily invited him upstairs, to discuss something.

Von Ribbentrop, arrogant, difficult, and blas as always, tapped the ash off his Egyptian cigarette with long, aristocratic fingers, looked grimly around the room, then fired off a cannonade of questions at the miracle doctor: Was it good for the Fuhrer to get so many injections? Was he given anything apart from glucose? Was it, generally speaking, not far too much? The doctor gave curt replies: he only injected what was necessary. But von Ribbentrop insisted that the Fuhrer required a complete transformation of his whole body, so that he became more resilient. That was water off a ducks back for Morell, and he left the castle rather unimpressed. Laymen are often so blithe and simple in their medical judgments, he wrote, concluding his record of the conversation.

But this was not the last assault Morell would bear. The first structured attack came from Bormann, who tried to guide Hitlers treatment onto regular, or at least manageable, lines. A letter reached the doctor: Secret Reich business! In eight points measures for the Fuhrers security in terms of his medical treatment were laid out, a sample examination of the medicines in the SS laboratories was scheduled, and, most importantly, Morell was ordered henceforth always to inform the medical supply officer which and how many medications he plans to use monthly for the named purpose.

In fact this remained a rather helpless approach from Bormann, who was not usually helpless. On the one hand his intervention turned Hitlers medication into an official procedure, but on the other he wanted as little correspondence as possible on the subject, since it was important to maintain the healthful aura of the leader of the master race. Heil Hitler literally means Health to Hitler, after all. For that reason the drugs, as detailed in Bormanns letter, were to be paid for in cash to leave no paper trail. Bormann added that the monthly packets should be stored ready for delivery at any time in an armored cupboard, and made as identifiable as possible down to the ampoule by consecutive numbering (for example, for the first consignment: 1/44), while at the same time the external wrapping of the package should bear an inscription to be precisely established with the personal signature of the medical supply officer.

Morells reaction to this bureaucratic attempt to make his activities transparent was as simple as it was startling. He ignored the instructions of the mighty security apparatus and simply didnt comply, instead continuing as before. In the eye of the hurricane he felt invulnerable, banking on the assumption that Patient A would always protect him.

In late September 1944, in the pale light of the bunker, the ear doctor, Giesing, noted an unusual coloration in Hitlers face and suspected jaundice. The same day, on the dinner table there was a plate holding apple compote with glucose and green grapes and a box of Dr. Koesters anti-gas pills, a rather obscure product. Giesing was perplexed when he discovered that its pharmacological components included atropine, derived from belladonna or other nightshade plants, and strychnine, a highly toxic alkaloid of nux vomica, which paralyzes the neurons of the spinal column and is also used as rat poison. Giesing indeed smelled a rat. The side-effects of these anti-gas pills at too high a dose seemed to correspond to Hitlers symptoms. Atropine initially has a stimulating effect on the central nervous system, then a paralyzing one, and a state of cheerfulness arises, with a lively flow of ideas, loquacity, and visual and auditory hallucinations, as well as delirium, which can mutate into violence and raving. Strychnine in turn is held responsible for increased light-sensitivity and even fear of light, as well as for states of flaccidity. For Giesing the case seemed clear: Hitler constantly demonstrated a state of euphoria that could not be explained by anything, and I am certain his heightened mood when making decisions after major political or military defeats can be largely explained in this way.

In the anti-gas pills Giesing thought he had discovered the causes of both Hitlers megalomania and his physical decline. He decided to treat himself as a guinea pig: for a few days Giesing took the little round pills himself, promptly identified that he had the same symptoms, and decided to go on the offensive. His intention was to disempower Morell by accusing him of deliberately poisoning the Fuhrer, so that Giesing could assume the position of personal physician himself. While the Allied troops were penetrating the borders of the Reich from all sides, the pharmacological lunacy in the claustrophobic Wolfs Lair was becoming a doctors war.

As his ally in his plot, Giesing chose Hitlers surgeon, who had been an adversary of Morells for a long time. Karl Brandt was in Berlin at the time, but when Giesing called he took the next plane to East Prussia without hesitation and immediately summoned the accused man. While the personal physician must have worried that he was being collared for Eukodal, he was practically relieved when his opponents tried to snare him with the anti-gas pills, which were available without prescription. Morell was also able to demonstrate that he had not even prescribed them, but that Hitler had organized the acquisition of the pills through his valet, Heinz Linge. Brandt, who had little knowledge of biochemistry and focused his attention on the side-effects of strychnine, was not satisfied with this defense. He threatened Morell: Do you think anyone would believe you if you claimed that you didnt issue this prescription? Do you think Himmler might treat you differently from anyone else? So many people are being executed at present that the matter would be dealt with quite coldly. Just a week later Brandt added: I have proof that this is a simple case of strychnine poisoning. I can tell you quite openly that over the last five days I have only stayed here because of the Fuhrers illness.

But what sort of illness was that exactly? Was it really icterusjaundice? Or might it be a typical kind of junkie hepatitis because Morell wasnt using properly sterile needles? Hitler, whose syringes were only ever disinfected with alcohol, wasnt looking well. His liver, under heavy attack from those many toxic substances over the past few months, was releasing the bile pigment bilirubin: a warning signal that turns skin and eyes yellow. Morell was being accused of poisoning his patient. There was an air of threat when Brandt addressed Hitler. Meanwhile, on the night of October 5, 1944, Morell suffered a brain edema from the agitation. Hitler was unsettled beyond measure by the accusations: Treachery? Poison? Might he have been mistaken for all those years? Was he being double-crossed by his personally chosen doctor, Morell, the truest of the true, the best of all his friends? Wouldnt dropping his personal physician, who had just given him a beneficial injection of Eukodal, amount to a kind of self-abandonment? Wouldnt it leave him high and dry, vulnerable? This was an attack that might prove fatal, as his power was based on charisma. After all, it was the drugs that helped him artificially maintain his previously natural aura, on which everything depended.

Since the start of the Fuhrers rapid physical decline these internecine struggles between the doctors turned into a proxy war for succession at the top of the Nazi state. The situation was becoming worse: Himmler told Brandt he could easily imagine that Morell had tried to kill Hitler. The Reichsfuhrer-SS called the physician to his office and coldly informed him that he had himself sent so many people to the gallows that he no longer cared about one more. At the same time, in Berlin, the head of the Gestapo, Ernst Kaltenbrunner, summoned Morells locum, Dr. Weber, from the Kurfurstendamm to a hearing at the Reich Security Main Office on Prinz-Albrecht-Strasse. Weber tried to exonerate his boss, and voiced his opinion that a plot was utterly out of the question. He claimed Morell was far too fearful for such a thing.

Finally the chemical analysis of the disputed medication was made available. The result: its atropine and strychnine content was far too small to poison anyone, even in the massive quantities that Hitler had been given. It was a comprehensive victory for Morell. I would like the matter involving the anti-gas pills to be forgotten once and for all, Hitler stated, ending the affair. You can say what you like against Morellhe is and remains my only personal physician, and I trust him completely. Giesing received a reprimand, and Hitler dismissed him with the words that all Germans were freely able to choose their doctors, including himself, the Fuhrer. Furthermore, it was well known that it was the patients faith in his doctors methods that contributed to his cure. Hitler would stay with the doctor he was familiar with, and brushed aside all references to Morells lax treatment of the syringe: I know that Morells new method is not yet internationally recognized, and that Morell is still in the research stage with certain matters, without having reached a firm conclusion about them. But that has been the case with all medical innovations. I have no worries that Morell will not make his own way, and I will immediately give him financial support for his work if he needs it.

Himmler, a dedicated sycophant, immediately changed tack: Yes, gentlemen, he explained to Hasselbach and Giesing, You are not diplomats. You know that the Fuhrer has implicit trust in Morell, and that should not be shaken. When Hasselbach protested that any medical or even civil court could at least accuse Morell of negligent bodily harm, Himmler turned abrasive: Professor, you are forgetting that as interior minister I am also head of the supreme health authority. And I dont want Morell to be brought to trial. The head of the SS dismissed Giesings objection that Hitler was the only head of state in the world who took between 120 and 150 tablets and received between 8 and 10 injections every week.

The tide had turned once and for all against Giesing, who was given a check from Bormann for ten thousand reichsmarks in compensation for his work. Both reichsmarks in compensation for his work. Both Hasselbach and the influential Brandt were out of luck as well, also damaging the latters confidant Speer, who had his eye on Hitlers succession. The three doctors had to leave headquarters. Morell was the only one who stayed behind. On October 8, 1944, he rejoiced in the happy news: The Fuhrer told me that Brandt had only to meet his obligations in Berlin. Patient A stood firmly by his supplier. Just as every addict adores his dealer, Hitler was unable to leave the generous doctor who provided him with everything he needed.

The dictator told his physician: These idiots didnt even think about what they were doing to me! I would suddenly have been standing there without a doctor, and these people should have known that during the eight years you have been with me you have saved my life several times. And how I was before! All doctors who were dragged in failed. Im not an ungrateful person, my dear doctor. If we are both lucky enough to make it through the war, then youll see how well I will reward you!

Morells confident reply can also be read as an attempt to justify himself to posterity, because the physician put it baldly on record: My Fuhrer, if a normal doctor had treated you during that time, then you would have been taken away from your work for so long that the Reich would have perished. According to Morells own account, Hitler peered at him with a long, grateful gaze and shook his hand: My dear doctor, I am glad and happy that I have you.

The war between the doctors was thus shelved. Patient A had put a stop to a premature dismissal. The price he paid was the continued destruction of his health by a personal physician who had been confirmed in his post. To calm his nerves the head of state received Eukodal, Eupaverin. Glucose i.v. plus Homoseran i.m.

Excerpt from BLITZED: Drugs in the Third Reich by Norman Ohler, translated by Shaun Whiteside. 2017 by Norman Ohler. English translation 2017 by Shaun Whiteside. Used by permission of Houghton Mifflin Harcourt Publishing Company. All rights reserved.

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The Doctor Who Got Hitler Hooked on DrugsAnd the Plot to Take Him Down - Mental Floss

Newswise ORLANDOIndividuals with obesity who enrolled in a structured weight loss program report fewer hours missed from work after six months in the program, according to a study being presented Sunday at the Endocrine Societys 99th annual meeting in Orlando, Fla.

A concern shared by both employers and employees is that time spent in the program attending the physician and dietitian visits, and the vigilance required to maintain lifestyle modifications, might diminish time and productivity on the job, said Jennifer Iyengar, M.D., the studys lead author and an endocrinology fellow at the University of Michigan, Ann Arbor, Mich. However, we found that participation in our program was highly valued and had a positive impact at work.

The total economic cost of obesity in the U.S. includes indirect costs, such as missed time from work, lost productivity at work and premature death due to obesity-related health problems, research shows. Iyengar said little is known, though, about whether weight loss interventions can improve the job performance and attendance of employees with obesity. She and her co-workers studied this question in participants in the University of Michigan Weight Management Program.

The weight management program, according to its director and study senior investigator Amy Rothberg, M.D., Ph.D., is a two-year, multicomponent, multidisciplinary program for people with moderate to severe obesity that involves frequent visits with physicians and dietitians. It uses a very-low-calorie diet (800 calories per day) by total meal replacement for the first three months to promote 15 percent weight loss, followed by gradual transition to a low-calorie, food-based diet and interventions to support lifelong behavior changes and promote regular physical activity.

For this study, the researchers evaluated 92 participants with obesity (average weight of 253 pounds and average BMI of 40 kg/m2) who had completed six months in the program and were employed full time in a variety of different occupations. At the first visit and again at six months, participants completed a self-administered, scientifically validated questionnaire regarding their work absenteeism (working fewer hours than their employers expected) and their presenteeism, defined as the participants rating of their own work performance.

At the six-month point, participants lost an average of 41 pounds, the research team reported.

Before the program, participants reported that they worked, on average, 5.2 fewer hours per month than what their employers expected. After six months in the program, they described working 6.4 hours more than expected.

There was reportedly no significant change in how they rated their overall work performance (presenteeism) on a 10-point scale, with an average of 7.8 at the beginning and 7.9 at six months. It is possible that presenteeism will improve with longer participation in the program, Iyengar said.

Improved absenteeism did not correlate with the amount of weight loss, Iyengar reported. One possible explanation, she said, is that the change in absenteeism rates may reflect improvements in co-existing medical illnesses or depression.

She concluded, Our findings suggest that, through favorable effects on work attendance, participation in a weight management program may be mutually beneficial for workers and their employers. # # #

Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the worlds oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at http://www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.

Read this article:
Participation in a Weight Management Program Reduces Job ... - Newswise (press release)

Who isn't tired these days? We're constantly on call for work, family and friends, and often forget to take time for ourselves. Most of us recognize that chronic stress can take its toll on our health and well-being. But what if you're so fatigued that even getting more sleep doesn't seem to help?

Complementary and alternative medicine provide an explanation for stress-induced fatigue that offers hope to the chronically tired. According to naturopathic doctors, holistic nutritionists and others, adrenal fatigue is a condition where the adrenals, glands that sit above the kidneys, don't produce enough cortisol. Cortisol is a hormone that plays a role in managing stress and regulating metabolism, sleep, blood sugar and inflammation.

"Fatigue is probably the number one complaint among new patients in my practice," says Leila Kirdani, a family physician specializing in functional medicine. "Anyone with prolonged fatigue, with difficulty sleeping, who feels 'burned-out' or lack of enjoyment in life, may be suffering from adrenal fatigue."

Basically, the theory goes that too much stress wears out our adrenal glands - they get tired and don't produce enough cortisol for us to feel energized. So why aren't our family doctors telling us about this?

As a registered dietitian in private practice, I often get new clients who have been told by their naturopathic doctors that they have adrenal fatigue and need to follow a special diet and a regimen of supplements and herbs. Hours of searching the scientific literature has led to very little in terms of evidence-based dietary advice to help these individuals. Which raises the question . . .

- Is adrenal fatigue real?

The very existence of adrenal fatigue is a contentious issue. It isn't recognized by any endocrinology societies or endocrinologists, medical doctors who specialize in hormone-related health problems. A recent systematic review of the scientific literature found that there was no evidence for the existence of adrenal fatigue as a medical condition.

Theodore C. Friedman is an endocrinologist at Charles R. Drew University of Medicine and Science who describes himself as being open to complementary medicine. Like many medical doctors, he says adrenal fatigue doesn't exist: "It's something made up by naturopathic doctors; endocrinologists don't recognize it as a real condition."

Saul Marcus is a naturopathic doctor in Connecticut. "When it comes to adrenal fatigue, conventional medicine insists it doesn't exist. However, adrenal fatigue is essentially a stress reaction, and stress is very well understood as a cause of illness."

And so we see the bipolar worlds of conventional medicine and complementary and alternative medicine are firmly divided into two camps: adrenal fatigue doesn't exist vs. adrenal fatigue is an important medical issue.

Somewhere in the middle is the idea that adrenal fatigue is a term that encompasses a wide range of general symptoms rather than a discrete medical problem. Does the label matter?

- What's really going on with your adrenal glands?

According to Kirdani, "There is a distinct bias in the medical community when it comes to adrenal fatigue. For some reason, doctors think that either your adrenal glands are perfectly fine, or else they have ceased to function."

"Naturopaths have it wrong," Friedman explains. "They describe adrenal fatigue as a stress-induced condition where your adrenal glands don't produce enough cortisol. In fact, when you're stressed out, your adrenal glands make more cortisol."

What endocrinologists and other medical doctors do recognize is adrenal insufficiency, a disorder where the adrenals don't produce enough hormones. The adrenal glands make two hormones: cortisol and aldosterone. According to Friedman, "Aldosterone is often underappreciated or unrecognized by naturopaths." He also says that adrenal insufficiency is on a gradient: "You can have varying levels of cortisol deficiency, aldosterone deficiency or both."

Having low aldosterone causes salt to be lost in the urine, which leads to symptoms such as brain fog, feeling worse after exercise or feeling dizzy when you stand up. Friedman says that people with low aldosterone can be diagnosed by an endocrinologist and then can be treated with synthetic aldosterone, extra salt or licorice root. Because the role of aldosterone is often ignored by alternative medicine, this is one adrenal issue that your naturopath may not test for. (Marcus, the naturopathic doctor, says one reason naturopaths may not test for aldosterone is because it requires a blood test, and in some states they are not licensed to order bloodwork.)

Where cortisol is concerned, people can have low cortisol as a result of their pituitary gland not producing enough of a hormone that stimulates the release of cortisol from the adrenals. A smaller portion of people have Addison's disease, where the adrenal glands are attacked by antibodies. As a result, the adrenals won't produce enough cortisol. Friedman says that these patients need to see an endocrinologist and get on cortisol right away.

As Friedman puts it, people with adrenal insufficiency do have fatigue, so it makes sense to examine their adrenal glands. "It's the concept of the adrenals burning out that doesn't make sense."

- How do you get tested for adrenal fatigue or adrenal insufficiency?

Marcus says adrenal fatigue can be diagnosed in several ways. Many practitioners test cortisol levels in saliva, but these also can be diagnosed based on symptoms. "If someone is feeling tired and under some sort of stress, their adrenal function is probably not optimal, and it may be okay to try taking some supplements for the adrenals."

Friedman calls the saliva test used by natural-health practitioners unreliable and says a blood test is a far better way to measure cortisol levels.

The blood test measures levels of electrolytes (including sodium) as well as several hormones. This gives a picture of which hormones are out of the normal range and what could be causing issues.

- Taking care of your adrenals

Google "adrenal fatigue diet" and you'll find websites recommending everything from eliminating dairy to following a paleo diet that also vetoes grains and beans. At this point, there isn't any evidence to show that any of this will help you manage stress or feel more energized.

When my clients are dealing with stress and fatigue, I recommend eating whole foods, plenty of vegetables, heart-healthy fats and lean protein, limiting highly processed foods and added sugars, as well as cutting down on caffeine and alcohol, which can negatively affect sleep.

Choosing foods that stabilize your blood sugar and are lower on the glycemic index is also important, as your energy levels and mood are closely related to blood sugar. Go for slow-burning carbohydrates such as sweet potatoes, barley, quinoa and rolled oats, and always combine them with a protein such as beans or lentils, chicken, fish or lean meat. Get healthy fats from oily fish, olive oil, avocado, nuts or seeds at each meal and snack, and chances are you'll feel more energized.

Marcus, Kirdani and Friedman all say that whether you're dealing with stress or adrenal fatigue, taking care of your overall health helps.

Friedman feels that the naturopathic approach can be valuable, as talking to someone about stress and ways to cope can help. He also doesn't have a problem with people taking certain supplements that boost their immune system and energy levels, as long as those don't interact with other medications or supplements.

Marcus and Kirdani recommend supplementing with sea salt, B vitamins and herbs such as rhodiola or lemon balm. (Please see a medical professional before taking supplements or herbs to make sure they're safe for you.) Patients also may use an adrenal glandular, essentially ground-up adrenal glands (usually from pigs or cows), other tissues or extracts.

Friedman warns: "The naturopathic approach can be dangerous if cortisol or ground-up adrenals are prescribed. People often feel better on cortisol, but side effects include osteoporosis, weight gain and diabetes. As such, it shouldn't be prescribed lightly."

- Does it matter what we call it?

While the worlds of conventional and alternative medicine are divided on adrenal fatigue as a condition, everyone seems to agree that managing stress makes sense. So does eating well and treating any vitamin or mineral deficiencies, as well as getting regular physical activity and enough sleep. Working on all of these areas will help you boost energy, reduce fatigue and make you healthier. Whether these positive lifestyle changes are improving stress levels or healing adrenal fatigue is irrelevant.

What does matter is if treating so-called adrenal fatigue ends up preventing the diagnosis of a serious medical problem.

Friedman's take-home message is clear. "If you're experiencing fatigue, you need to see an endocrinologist to make sure you're getting at the real issue and not masking fatigue that's being caused by another health problem," he said. "If you do have an adrenal issue, it needs to be treated as soon as possible."

Brissette is a dietitian, foodie and president of 80TwentyNutrition.com. Follow her on Twitter @80twentyrule.

Here is the original post:
Is adrenal fatigue real? Forget the label and treat the stress. - Napa Valley Register

The International Association of HealthCare Professionals is pleased to welcome Dr. Jodie A. Dashore OTD, MS (Neurology), HHP, to their prestigious organization with her upcoming publication in The Leading Physicians of the World. She is a highly trained and qualified Naturopathic Clinician, Doctor of Occupational Therapy, Neuro-Sensory Integration, and Holistic health practitioner with an extensive expertise in all facets of her work, especially in Holistic all natural Management for Tick Borne Diseases, Complex Autism, Biotoxin Illness, and Chronic Inflammatory Response Syndrome. Dr. Dashore is currently serving patients as Clinical Director within her own practice, Integrative NeuroSensory Associates LLC, a functional therapeutic, biomedical and integrative therapy practice in Marlboro, New Jersey. Furthermore, she also serves as Clinical Director within Specialized Pediatrics Therapy Center LLC in New Jersey.

Dr. Dashore graduated Magna Cum Laude specializing in MS -Neurology from the University of Bombay in 1992. Subsequently, she relocated to the United States and earned her Advanced Clinical Doctorate in OT-Neurology and Evidence Based Medicine. Dr. Dashore then attended the University of Southern California, gaining her post-doctoral specialization in Neuro Sensory Integration.

Dr. Dashore is fully certified in Holistic and Energy therapeutic approaches, German Biological remedies, Homotoxicology, and Clinical Herbalism, having trained in the United Kingdom, Switzerland, and Germany. She is an internationally recognized AWARD Winning holistic clinician, author, and speaker. She works with children and adults from across the country and abroad who suffer from Autism, Sensory Integration Disorders, Lyme Disease, PANDAS, IBS, Chronic Fatigue, Autoimmune Disease, Mold and Biotoxin Illness, Endocrine and Hormone Imbalances, Methylation concerns, Cancer and Chronic Disease. Dr. Dashore utilizes the principles of homeopathy, herbology, homotoxicology, bioenergetic and European biological remedies in her practice for natural health and wellness.

She maintains professional memberships with the International Lyme and Associated Diseases Society, the American College for Advancement in Medicine (ACAM), American Holistic Medicine Association, The North American Society of Homeopaths, the American Association of Drugless Practitioners, and the American Occupational Therapy Association, among others. Dr. Dashore attributes her success to her one and only childs personal struggles and triumphs with chronic infection and illness. She also attributes her success to the various opportunities she has had to mentor with numerous world renowned pioneering physicians. In her free time, she enjoys nature walks, yoga, Meditation, spirituality, research, and spending time with her son.

View Dr. Jodie A. Dashores Profile Here: https://www.findatopdoc.com/doctor/8138151-Jodie-Dashore-Naturopathic-Physician-Marlboro-New-Jersey-07746

Learn more about Dr. Dashore here: http://dashoreintegrativerx.com/ and be sure to read her upcoming publication in The Leading Physicians of the World.

About FindaTopDoc.com

FindaTopDoc.com is a hub for all things medicine, featuring detailed descriptions of medical professionals across all areas of expertise, and information on thousands of healthcare topics. Each month, millions of patients use FindaTopDoc to find a doctor nearby and instantly book an appointment online or create a review. FindaTopDoc.com features each doctors full professional biography highlighting their achievements, experience, patient reviews and areas of expertise. A leading provider of valuable health information that helps empower patient and doctor alike, FindaTopDoc enables readers to live a happier and healthier life. For more information about FindaTopDoc, visit http://www.findatopdoc.com

Originally posted here:
Highly Respected Naturopathic Physician, Dr. Jodie A. Dashore, OTD, MS (Neurology), HHP, will be Displayed in The ... - PR NewsChannel (press release)

By Christy Brissette By Christy Brissette April 5

Who isnt tired these days? Were constantly on call for work, family and friends, and often forget to take time for ourselves. Most of us recognize that chronic stress can take its toll on our health and well-being. But what if youre so fatigued that even getting more sleep doesnt seem to help?

Complementary and alternative medicine provide an explanation for stress-induced fatigue that offers hope to the chronically tired. According to naturopathic doctors, holistic nutritionists and others, adrenal fatigue is a condition where the adrenals, glands that sit above the kidneys, dont produce enough cortisol. Cortisol is a hormone that plays a role in managing stress and regulating metabolism, sleep, blood sugar and inflammation.

Fatigue is probably the number one complaint among new patients in my practice, says Leila Kirdani, a family physician specializing in functional medicine. Anyone with prolonged fatigue, with difficulty sleeping, who feels burned-out or lack of enjoyment in life, may be suffering from adrenal fatigue.

Basically, the theory goes that too much stress wears out our adrenal glands they get tired and dont produce enough cortisol for us to feel energized. So why arent our family doctors telling us about this?

As a registered dietitian in private practice, I often get new clients who have been told by their naturopathic doctors that they have adrenal fatigue and need to follow a special diet and a regimen of supplements and herbs. Hours of searching the scientific literature has led to very little in terms of evidence-based dietary advice to help these individuals. Which raises the question ...

[The DASH diet is proven to work. Why hasnt it caught on?]

Is adrenal fatigue real?

The very existence of adrenal fatigue is a contentious issue. It isnt recognized by any endocrinology societies or endocrinologists, medical doctors who specialize in hormone-related health problems. A recent systematic review of the scientific literature found that there was no evidence for the existence of adrenal fatigue as a medical condition.

Theodore C. Friedman is an endocrinologist at Charles R. Drew University of Medicine and Science who describes himself as being open to complementary medicine. Like many medical doctors, he says adrenal fatigue doesnt exist: Its something made up by naturopathic doctors; endocrinologists dont recognize it as a real condition.

Saul Marcus is a naturopathic doctor in Connecticut. When it comes to adrenal fatigue, conventional medicine insists it doesnt exist. However, adrenal fatigue is essentially a stress reaction, and stress is very well understood as a cause of illness.

And so we see the bipolar worlds of conventional medicine and complementary and alternative medicine are firmly divided into two camps: adrenal fatigue doesnt exist vs. adrenal fatigue is an important medical issue.

Somewhere in the middle is the idea that adrenal fatigue is a term that encompasses a wide range of general symptoms rather than a discrete medical problem. Does the label matter?

Whats really going on with your adrenal glands?

According to Kirdani, There is a distinct bias in the medical community when it comes to adrenal fatigue. For some reason, doctors think that either your adrenal glands are perfectly fine, or else they have ceased to function.

Naturopaths have it wrong, Friedman explains. They describe adrenal fatigue as a stress-induced condition where your adrenal glands dont produce enough cortisol. In fact, when youre stressed out, your adrenal glands make more cortisol.

What endocrinologists and other medical doctors do recognize is adrenal insufficiency, a disorder where the adrenals dont produce enough hormones. The adrenal glands make two hormones: cortisol and aldosterone. According to Friedman, Aldosterone is often underappreciated or unrecognized by naturopaths. He also says that adrenal insufficiency is on a gradient: You can have varying levels of cortisol deficiency, aldosterone deficiency or both.

[Why phosphate additives will be the next taboo ingredient]

Having low aldosterone causes salt to be lost in the urine, which leads to symptoms such as brain fog, feeling worse after exercise or feeling dizzy when you stand up. Friedman says that people with low aldosterone can be diagnosed by an endocrinologist and then can be treated with synthetic aldosterone, extra salt or licorice root. Because the role of aldosterone is often ignored by alternative medicine, this is one adrenal issue that your naturopath may not test for. (Marcus, the naturopathic doctor, says one reason naturopaths may not test for aldosterone is because it requires a blood test, and in some states they are not licensed to order bloodwork.)

Where cortisol is concerned, people can have low cortisol as a result of their pituitary gland not producing enough of a hormone that stimulates the release of cortisol from the adrenals. A smaller portion of people have Addisons disease, where the adrenal glands are attacked by antibodies. As a result, the adrenals wont produce enough cortisol. Friedman says that these patients need to see an endocrinologist and get on cortisol right away.

As Friedman puts it, people with adrenal insufficiency do have fatigue, so it makes sense to examine their adrenal glands. Its the concept of the adrenals burning out that doesnt make sense.

How do you get tested for adrenal fatigue or adrenal insufficiency?

Marcus says adrenal fatigue can be diagnosed in several ways. Many practitioners test cortisol levels in saliva, but these also can be diagnosed based on symptoms. If someone is feeling tired and under some sort of stress, their adrenal function is probably not optimal, and it may be okay to try taking some supplements for the adrenals.

Friedman calls the saliva test used by natural-health practitioners unreliable and says a blood test is a far better way to measure cortisol levels.

The blood test measures levels of electrolytes (including sodium) as well as several hormones. This gives a picture of which hormones are out of the normal range and what could be causing issues.

Taking care of your adrenals

Google adrenal fatigue diet and youll find websites recommending everything from eliminating dairy to following a paleo diet that also vetoes grains and beans. At this point, there isnt any evidence to show that any of this will help you manage stress or feel more energized.

When my clients are dealing with stress and fatigue, I recommend eating whole foods, plenty of vegetables, heart-healthy fats and lean protein, limiting highly processed foods and added sugars, as well as cutting down on caffeine and alcohol, which can negatively affect sleep.

[10 nutrition mistakes even really healthy people make]

Choosing foods that stabilize your blood sugar and are lower on the glycemic index is also important, as your energy levels and mood are closely related to blood sugar. Go for slow-burning carbohydrates such as sweet potatoes, barley, quinoa and rolled oats, and always combine them with a protein such as beans or lentils, chicken, fish or lean meat. Get healthy fats from oily fish, olive oil, avocado, nuts or seeds at each meal and snack, and chances are youll feel more energized.

Marcus, Kirdani and Friedman all say that whether youre dealing with stress or adrenal fatigue, taking care of your overall health helps.

Friedman feels that the naturopathic approach can be valuable, as talking to someone about stress and ways to cope can help. He also doesnt have a problem with people taking certain supplements that boost their immune system and energy levels, as long as those dont interact with other medications or supplements.

Marcus and Kirdani recommend supplementing with sea salt, B vitamins and herbs such as rhodiola or lemon balm. (Please see a medical professional before taking supplements or herbs to make sure theyre safe for you.) Patients also may use an adrenal glandular, essentially ground-up adrenal glands (usually from pigs or cows), other tissues or extracts.

Friedman warns: The naturopathic approach can be dangerous if cortisol or ground-up adrenals are prescribed. People often feel better on cortisol, but side effects include osteoporosis, weight gain and diabetes. As such, it shouldnt be prescribed lightly.

Does it matter what we call it?

While the worlds of conventional and alternative medicine are divided on adrenal fatigue as a condition, everyone seems to agree that managing stress makes sense. So does eating well and treating any vitamin or mineral deficiencies, as well as getting regular physical activity and enough sleep. Working on all of these areas will help you boost energy, reduce fatigue and make you healthier. Whether these positive lifestyle changes are improving stress levels or healing adrenal fatigue is irrelevant.

What does matter is if treating so-called adrenal fatigue ends up preventing the diagnosis of a serious medical problem.

Friedmans take-home message is clear. If youre experiencing fatigue, you need to see an endocrinologist to make sure youre getting at the real issue and not masking fatigue thats being caused by another health problem, he said. If you do have an adrenal issue, it needs to be treated as soon as possible.

Christy Brissette is a dietitian, foodie and president of 80TwentyNutrition.com. Follow her on Twitter @80twentyrule.

See the original post here:
Is adrenal fatigue real? Forget the label and treat the stress. - Washington Post

By Robert Ashley, M.D. Published: April 4, 2017 12:00 AM CDT Updated: April 4, 2017 12:00 AM CDT

Hair loss could have many causes, including stress. [Thinkstock image]

Dear Doctor: I've been taking thyroid medication for several years, and my doctor says my blood tests are where they should be, but my face feels like sandpaper, my nails are brittle, and I'm losing so much hair that I can see my scalp. Could there be some underlying problem my physician is missing?

Dear Reader: Hair loss can be a distressing symptom, made all the more so when its cause is a mystery.

Your thyroid hormone levels are an obvious place to start, because both low and high thyroid levels can lead to hair and nail changes. Symptoms of high thyroid levels include hair loss, skin that is unusually smooth and warm, and nails that soften and loosen from the nail bed. The remaining hair becomes thinner, softer and does not hold a wave. Symptoms of low thyroid levels also include hair loss, including in the armpits and genital area, but the hair in this scenario is dull, coarse and fragile. As for the nails, they tend to be delicate, thin and have multiple grooves. That said, if your physician has done a complete panel of thyroid tests and the results have been normal, then most likely the function of your thyroid gland is not the cause of the brittle nails nor the hair loss.

That doesn't mean the thyroid isn't a factor. Autoimmune thyroid disease can lead to hair loss, both patchy and more diffuse, as well as inflammatory conditions of the skin. Such disease isn't always reflected in thyroid hormone levels. Checking anti-thyroid antibodies in the blood can identify autoimmune thyroid disease, and point you and your doctor in a clearer direction.

Hair loss also can be caused by androgenic alopecia, linked to an excess of androgens, a type of male hormone. These hormones are present in both men and women, but they're higher than normal in some women, such as those with congenital adrenal hyperplasia or polycystic ovarian disease, which is relatively common. Simply checking levels of testosterone and dehydroepiandrosterone (DHEA) can either rule out androgenic alopecia or suggest that it be explored further.

Another potential cause is medication. Some medications can lead to hair loss, so if your symptoms seem coincidental to starting a new medication, there might be an association.

Biotin deficiency, which is rare, can also cause hair loss and inflammation of the facial skin. But if you have a normal diet and eat eggs, you have a low likelihood of this condition. Nonetheless, it's something to rule out.

Iron deficiency also can lead to both brittle nails and hair loss. This doesn't explain the skin manifestations that you have, but if you are looking at other possibilities, checking the iron level of the blood should be part of the work-up.

Any major illness can lead to hair loss and nail changes, and psychological stress can lead to hair loss. So, if there have been major stressors in your life, either physical or psychological, consider that a potential culprit.

In summary, if your thyroid levels are normal, it would be wise to check your thyroid antibodies, androgens and iron levels and your level of stress.

Robert Ashley, M.D., is an internist and assistant professor of medicine at the University of California, Los Angeles. Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.

Follow this link:
Hair loss could be caused by multitude of issues - NewsOK.com

The bad doctor is in.

Matt Coker

"My vision is to create and share a meaningful and healthy life," reads Dr. Christopher Holden's "professional statement" for an online service that matches patients with physicians. "Imagine your life with higher standards, less clutter, less debt, less stress and less discontent."

Unfortunately, theOrange family medicine doctor could not live up to his vision for a 46-year-old woman with uterine cancer, according to court documents filed by theMedical Board of California, which placed Holden's license to practice in the state on probation for three years effective last Friday, March 24.

The discipline stems from Holden being "grossly negligent" in his care for thepatient identified only as "T.P.," according to the Medical Board. Her symptoms should have led the doctorto first exam her for uterine cancer before finding a basis to rule that out in favor of a diagnosis of something more benign, found the board, which notes he pretty much did the complete opposite. He never did diagnose the disease.

Since at least 2008, Holden saw T.P. at her home because she suffered from agoraphobia. It was early in these visits that she complained of vaginal bleeding, which Holden chalked up to her transitioning to menopause.However, he performed no tests to confirm his suspicions, with her Sept. 27, 2008, chart only noting a change in periods without stipulating the amount of bleeding or whether T.P. should be sent for a gynecological exam, the board points out. Holden diagnosed menometrorrhagiaheavy bleeding with prolonged and/or irregular menstrual periodsand prescribed a thyroid-stimulating hormone.

Irregular menses are included in the medical record for T.P.s Jan. 27, 2009, follow-up exam. Holden called for thyroid testing again, a female hormonal panel and neurotransmitter testing, although the Medical Board found he never documented whether those labs were completed.

On March 21, 2009, [Holden] diagnoses T.P. with piriformis syndrome, states the board in reference to a condition where a muscle in the buttocks region spasms and causes pain, but there is no history and no pertinent exam recorded.

Nine days later, T.P. was placed on iron medication for anemia, with Holden noting in her chart that her hypothyroidism was overcorrected. He also increased her thyroid medication and noted to check her labs in three months. At this point, the TSH [amount of thyroid-stimulating hormone in the blood] is 0.01, the board states. There is a span of two years before TSH is checked again. T.P.s TSH never normalizes while under the care of [Holden].

Duringa February 2010 examination,T.P. complained of increased bleeding, which Holden indicated was secondary to stress. On July 23 of that year, he diagnosed her with microcytic anemiausually an indication of an iron deficiencybut the board found he performed no rectal exam. Holden also diagnosed T.P. with a yeast infection in her intestines, but he did not state a basis for this conclusion in the history of present illness or in his exam, according to the board.

Dr. Christopher Holden

Zocdoc

T.P.s hemoglobin dropped dramatically in November 2010, as compared to the July visit, but all that was recommended for her was more iron. Holden told the board he advised the patient to see a gynecologist but no referral is documented in his records.

Noting T.P. was pale on Jan. 24, 2011, Holden ordered another complete blood count test. On Oct. 10, 2011, he stated she had seen a gynecologist and a PAP smear and ultrasound were planned, but for T.P.s next appointment a month later Holden did not follow up on whether she indeed saw the specialist. She had not, the board found. This time, Holden charted that T.P. had non-cancerous growths in her uterus.

Holden did not see T.P. on March 4, 2012, but he wrote in her chart that she was anemic and had low blood pressure and needed a transfusion. T.P. left Holden a message a week later saying she was still anemic and had been to the emergency room. The doctor did not indicate he planned to see his patient in light of this.

The last time Holden did see T.P. was on April 5, 2012, when he noted she had received a blood transfusion at Orange Coast Memorial Medical Center and was planning to go to a gynecologist for a possible procedure to treat abnormal uterine bleeding.

Twelve days later, a gynecologist could not perform a PAP smear nor a biopsy due to significant vaginal bleeding. That doctor suspected T.P. had cervical cancer, which was confirmed a month later.

According to the board's findingswhich Holdenand his attorneys Dennis K. Ames and Zarah B. Maginot accepted based on their signatures dated Jan. 3 on court documentsthe doctor had been grossly and repeatedly negligent when it came to T.P.'s care and had done a poor job of keeping records.

Under the terms of the probation, Holden mustobey all laws, refrain from supervising physician assistants, submit quarterly progress reports to the board, complete medical education and record-keeping courses and notify hospitals and other facilities where he has privileges of his probationary status.

Holden, who attended UC Irvine's medical school, writes near the end of his professional statement on the Zocdoc referral website with: "Imagine cultivating your passion until you cannot bare a day without pursuing it." Assuming his passion remains treating patients, he had better comply by the conditions of his probation if he wants to keep pursuing it.Failure to do so could result in board proceedings to revoke Holdens license to practice medicine in California.

View post:
Dr. Christopher Holden's Medical License on Probation for "Grossly Negligent" Care - OC Weekly

A growing number of states are considering laws that would require abortion providers to tell women seeking a medical abortion that its possible to reverse the procedure a scientifically unsubstantiated claim that has been roundly rejected by the mainstream medical community.

Since 2012, a small group of doctors has promoted a method that they say can reverse a medical (non-surgical) abortion by flooding the body with the hormone progesterone. Two states Arkansas and South Dakota currently require abortion providers to tell women before they get a medical abortion that information is available about a way to reverse or stop the procedure.

Laws mandating that abortion providers tell women their abortion can be reversed have also been introduced this year in Georgia (the bill states, It may be possible to reverse the effects of a chemical abortion if the woman changes her mind, but that time is of the essence), North Carolina, Utah, and Idaho. In Arizona, lawmakers passed an abortion-reversal law in 2015, but the bill was quickly challenged in a lawsuit by Planned Parenthood and blocked.

On Feb. 27, Indiana lawmakers passed a bill in the House requiring that pregnant woman be informed orally and in writing before obtaining a medical abortion that the abortion may be possibly reversed. The patient must also be told that additional information about reversing medical abortions exists and should be sought as soon as possible.

At the same time, the Indiana measure seems to acknowledging the dubious science behind this information; it also requires women to be told that no scientifically validated medical study confirms that an abortion may be reversed after taking abortion-inducing drugs.

Nearly 3 million women have terminated pregnancies via medical abortion since the method was approved for use in the first 10 weeks of pregnancy in 2000. Patients take the drug mifepristone followed by a second drug, misoprostol, 24 to 72 hours later. Medical abortions, which now make up about a third of all abortions performed in the U.S., are safe and highly effective about 99 percent effective with almost zero complications, according to a 2012 study in the medical journal Obstetrics and Gynecology.

The mainstream medical community rejects claims that a medical abortion can be undone. The American Congress of Obstetricians and Gynecologists says that abortion-pill reversal is not supported by the body of scientific evidence and recommends against trying it. In up to 50 percent of cases where women dont follow up with the second pill (i.e., they take only mifepristone without taking the second dose of misoprostol), they still carry their pregnancies term, with or without taking progesterone, the group points out.

Taking a dose of progesterone in the hopes of reversing a medical abortion means that even if these doctors were to offer a large dose of purple Skittles, theyd appear to have worked to save the pregnancy about half the time, Cheryl Chastine, a formerabortion provider at South Wind Womens Center in Wichita, Kansas, told Talking Points Memo. Those numbers are consistent with what these people are reporting.

Most reproductive health experts point to the lack of scientific evidence on abortion reversal to criticize laws requiring doctors to tell women there is a way to stop the abortion pill. This is unethical and immoral legislation that makes women guinea pigs in an unmonitored, inappropriate experiment, said Vicki Saporta, the president of the National Abortion Federation.

The most visible proponent of abortion-pill reversal is George Delgado, a practicing family physician with the Culture of Life Family Services clinic in San Diego. He outlined the method in a 2012 paper, which remains the first and only study describing it. Delgados method consists of giving a woman a heavy dose of the hormone progesterone as soon as possible after taking mifepristone, the first pill in a medical abortion procedure. He says the progesterone counteracts the mifepristone by preventing the uterus from expelling its contents. The study, published in the medical journal Annals of Pharmacotherapy, was not a controlled trial and involved only six women, four of whom still carried their pregnancies to term after taking progesterone.

After publishing his study, Delgado founded the organization Abortion Pill Reversal to give women a second chance at choice if they so desire it, he said in an interview. APR is mainly a hotline that urges women who have taken the abortion pill to call and be connected with a network of more than 300 doctors Delgado says he has trained about the reversal method. We need to have a way for women to find out about this because women were not finding out about it in time, Delgado said.

Delgado is often cited as the face of abortion-pill reversal, but hes not the only doctor to promote the concept. The method was first put forward by Matthew Harrison, a practicing family doctor in North Carolina, who now works at Abortion Pill Reversal as the groups associate medical director. In 2006, Harrison was contacted by a woman who changed her mind after taking mifepristone and he says he came up with the idea to administer progesterone to stop the abortion. Two years later, Delgado said, he was approached by a woman in a similar situation and, without knowing about Harrisons case, had the same idea of giving the woman progesterone, which he says led to a successful reversal.

The research on the health effects of taking progesterone during pregnancy is mixed. Some doctors say that taking low doses of the hormone as a supplement can be beneficial, especially if a woman has had miscarriages in the past. But other research has shown that taking progesterone does basically nothing to improve a pregnancy and may come with some negative side effects. Progesterone, while generally well-tolerated, can cause significant cardiovascular, nervous system, and endocrine adverse reactions, as well as other side effects, according to ACOG.

The FDA has not approved the use of progesterone to reverse medical abortions, and Delgados 2012 study has been debunked and criticized by the mainstream medical community. In 2015, researchers examined the array of scientific literature concerning abortion reversal and found insufficient evidence to support any claims of the methods effectiveness. The study, published in Contraception Journal, criticized Delgados method and went so far as to write, in the conclusion: Legislation requiring physicians to inform patients about abortion reversal transforms an unproven therapy into law and represents legislative interference in the patientphysician relationship.

Delgado insists that there is plenty of evidence although none that has been tested in a controlled environment or peer reviewed to disprove these critiques. In 2015, he told MedPage that ACOGs criticisms in particular are biased, He said his next step is to submit his own research on the women hes treated through APR to a peer-reviewed medical journal.

Despite the lack of substantiated medical evidence to support it, Delgados organization is seeking to spread awareness of the abortion-pill reversal method. Some pregnancy resource centers organizations that offer anti-abortion counseling to pregnant women have started directing women to APR. Delgado says the organization has treated about 800 women, about 60 percent of whom carried their pregnancies to term, although he declined to provide any further evidence of reversed abortions.

Americans United for Life, one of the biggest anti-abortion organizations in the country, has lobbied hard for the passage of abortion-reversal information laws. AUL included abortion reversal in its 2016 model legislation handbook, which is the basis for many of the bills introduced in states this year.

Delgado said he did not have a direct role in drafting or lobbying for laws that require doctors to tell their patients about abortion reversal. But he did give expert testimony in favor of it in Colorado and Arizona when the bills in those states were being debated.

AUL repeatedly cites Delgado, his study, and his organization by name in its draft legislation. Delgados 2012 study is in fact the only citation AUL uses to back up its claims about abortion reversal.

AULs argument that women should know about the possibility of abortion reversal is the same argument behind other informed consent laws, which include measures requiring doctors to show women seeking abortions pictures of the fetus at its current point in gestation or to give medically disputed information about when the fetus can feel pain. Abortion-rights advocates say these regulations are merely another way to dissuade women from getting an abortion in the first place.

Moreover, reproductive rights experts say measures promoting the idea of abortion reversal, like many other informed consent regulations, offer a quasi-medical solution to a problem that doesnt actually exist. There is a misperception that women are uncertain about their abortion decisions, said Saporta, of the National Abortion Federation. The laws are based on a false premise. Women rarely change their minds after beginning a medical abortion.

One study published in 2013 found that 95 percent of women who decided to get an abortion felt it was the right decision a week later.

Follow Olivia Becker on Twitter: @oliviaLbecker

Clarification: An earlier version of this article referenced a Talking PointsMemo article quoting Cheryl Chastine, who was identified asanabortion provider at South Wind Womens Center in Wichita, Kansas. The center says Chastine is no longer affiliated with them.

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Some states are using junk science to require doctors to tell women they can reverse an abortion - VICE News

Type 2 diabetes has been reversed in mice with a new, orally available drug, according to a study led by San Diego scientists. The study suggests a path for developing human therapies based on the drug.

The drug protected mice from high-fat induced diabetes without affecting body weight, according to the study. It also reversed signs of the disease in mice who already had it.

Type 2 diabetes is caused by insulin resistance. While the pancreatic islets still make insulin, the hormone doesnt work as well. Cells sense insulin through receptors, which become less effective in this type of diabetes.

Scientists led by physician-researcher Nunzio Bottini countered insulin resistance by designing a drug that restored the effectiveness of insulin receptors.

The scientists are seeking pharmaceutical industry partners to help turn the research into a commercializable drug, Botttini said. He estimated that once a deal is reached, it would take about two years to complete the additional work needed to get approval to start a human clinical trial.

Bottini conducted the research at the La Jolla Institute for Allergy & Immunology, where he holds an adjunct appointment, and at UC San Diego School of Medicine, his primary appointment.

The drug inhibits an enzyme called a low-molecular-weight protein tyrosine phosphatase, or LMPTP. Its part of a family of enzymes that inactivates the insulin receptor. By inhibiting this particular enzyme in the liver, insulin receptor effectiveness was restored.

Our findings suggest that LMPTP activity plays a key role in the development of insulin resistance and that LMPTP inhibitors would be beneficial for treating type 2 diabetes, the study stated.

The study was published Monday in Nature Chemical Biology. It can be found at j.mp/diabetestyr. Bottini was senior author. Stephanie M. Stanford, also of the La Jolla Institute and UCSD, was first author.

A choosy molecule

This work occurred through a wonderful collaboration between our group and a team led by Tony Pinkerton at the Sanford Burnham Prebys Medical Discovery Institute, Bottini said.

While the role of protein tyrosine phosphatases in Type 2 diabetes has been known for years, many enzymes in this family perform other functions,and drugs against these enzymes may also affect other targets.

They are traditionally considered very difficult enzymes to drug, because its very hard to get a compound which is selective for one of those enzymes vs. others, Bottini said.

The drug arising from the research is exceptionally selective in its activity, the researchers said, reducing the chance of side effects.

We envision that the information we collected about its mechanism of action and binding mode will pave the way for development of LMPTP inhibitors suitable for therapeutic testing in human diabetes, the study stated.

Since LMPTP has also been proposed to promote heart failure and tumor growth, such inhibitors are predicted to have a wide range of therapeutic applications.

Stroke, Alzheimers disease, cognitive decline and polycystic ovary syndrome are among the other diseases that have been linked to insulin resistance.

We hope there will be additional indications from this compound, Bottini said. We are looking into heart failure.

Deletion of the gene for LMPTP protects against heart failure, although the mechanism isnt clear, he said.

Promising outlook

The study points to an important potential route for relieving Type 2 diabetes, said Athena Philis-Tsimikas, M.D., corporate vice president for the Scripps Whittier Diabetes Institute.

Two defects underlie the development of diabetes; an increase in insulin resistance and, simultaneous reduction in insulin secretion from beta cells, said Philis-Tsimikas, who was not involved in the study, by email. So, any improvements in insulin resistance would be very valuable in improving diabetes. The mechanism described in the paper is fascinating and has potential for improving glucose control.

Some existing medications relieve insulin resistance and reduce blood sugar levels, she said, but they have unpleasant side effects such as fluid retention and weight gain. So new medications that can address the disease mechanism with fewer side effects are always needed.

Scripps Whittier Diabetes Institute does a lot of Phase 2 and 3 trials, and has seen a number of experimental drugs get marketing approval, she said.

The mechanisms for these new agents look promising, and it is encouraging that the science is progressing especially here in San Diego, she said.

Researchers started their search by screening 364,168 small-molecule compounds from the National Institutes of Health Molecular Libraries Small Molecule Repository. They found three hits, or molecules active against the target. One was selected for further study because of its potency and specificity.

Using medicinal chemistry, the researchers tweaked the molecule to make it more potent. One of the resulting compounds was then tested in live mice.

The La Jolla Institute for Allergy and Immunology and Sanford Burnham Medical Discovery Institute hold a pending patent on the discovery.

The researchers were funded by grants from the National Institutes of Health and the American Diabetes Association.

bradley.fikes@sduniontribune.com

(619) 293-1020

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Scientists make advance against Type 2 diabetes - The San Diego Union-Tribune

By Rina Raphael 03.27.17 | 4:30 pm

The new CEO of the lifestyle website and e-commerce company Goop is a polarizing figureand shes fine with that.

Gwyneth Paltrow has been called a quack, a genius, and the Martha Stewart of todays health conscious generation. The Academy Award-winning actress and entrepreneur was recently promoted from Creative Director to CEO of the company she founded back in 2008.

Some people are like Why is she talking about yoga? Paltrow says of the publics fixation with her health pursuits, which Goop.com regularly publishes articles about (along with Paltrow-style travel, relationship, shopping, and cooking advice). Ive been in this cycle for 20 years where I talk about something and people think Im insanelike trying out acupuncture or getting divorced in a civilized way. I somehow break the internet.

But, Paltrow claims, even though her companys latest products and suggestionslike keeping a jade egg in ones vaginaare sometimes met with howls, her ideas often eventually find an appreciative audience. Its pattern recognition, Paltrow continues. Six months or two years, you start to see that the culture is also curious and more accepting.

Its with that mindset that Paltrow has launched her most ambitious product yet. Goop Wellness is a collection of vitamin supplements created in collaboration with Paltrow-approved doctors. The vitamins aim to address the acute needs of the women [these doctors] see in their practices every day. Each monthly vitamin pack, outfitted in cheeky branding, costs $90.

The Why Am I So Effing Tired pill contains a high dose of Vitamin B to help re-balance an overtaxed system (i.e, combat stress and fatigue) and boost energy. The Mother Load pack is formulated with nutrients to help new moms get back on their feet. Balls In The Air is an antioxidant-rich (beta-carotene, vitamin C, and vitamin E) regimen that targets thyroid dysfunction, autoimmunity, or digestive issues (It plays defense so you can play offense, reads the packaging).

High School Genes, meanwhile, is made for women in a perimenopausal or postmenopausal state whose metabolism might need a boost. That one was concocted was by Sara Gottfried, a Harvard and MIT-educated physician and best-selling author of Younger, The Hormone Reset Diet and The Hormone Cure.

Paltrow and her product team were inspired to enter the supplements market after a 2014 Goop feature on deciphering the vitamin aisle became one of sites most-read pieces of the year.

One common confusion for people who are interested in wellness or optimizing their health is they think, I should take a vitamin, but I dont know what to take and why, explains Paltrow. As we started to think about making our own products, we took a cue from our readers, and thats what we do well. We ask good questions and we ask the right doctors and they help us formulate how we want to think about things.

Paltrow says the supplements are a natural extension of what Goop.com already does editorially and with its other product ranges. How do we bring [what Goop writes about] to life? How do we create products that do what we do, which is exactly that: narrow down, curate, provide context, and make quality products that are above the norm?

Paltrow took it upon herself to personally research and manage the products evolution, starting with choosing and approaching experts and facilitating their vision. The vitamin line includes Paltrows own personal touches. For example, Why Am I So Effing Tired was created because Paltrow found herself feeling far too sleepy all the time.

The way I approached this, and really most things we do, is as the consumer, explains Paltrow, comparing the vitamin-creation process to how the Goop team scouts the best new restaurants for its city guides: seeking out advice from experts, then going out and testing the restaurants themselves. The journey to create these vitamins was laced with a lot of curiosity and trying to find the right doctors and leverage the relationships and bring that to the audience.

Dr. Alejandro Junger is an L.A.-based cardiologist whom Paltrow approached to help create her Why Am I So Effing Tired pack. The supplements are designed for people suffering from adrenal fatigue, which basically means physical and mental exhaustion. Junger completed his postgraduate training in internal medicine at NYU Hospital and completed a fellowship in cardiovascular diseases at Lenox Hill Hospital in New York. But he also studied Eastern medicine in India. Its that mix, he says, that gives him credibility in both medical worlds. Despite his impressive resume, however, he has come under attack by several publications specifically because of his support for unorthodox practices such as detoxes.

Western medicine doesnt really recognize this issue in its entirety, Junger said of adrenal fatigue. It just recognizes it when its already pretty severe. But even before blood tests show any changes, you can have adrenal fatigue. Its an epidemic right now. Meanwhile, the Mayo Clinic describes adrenal fatigue as a term given to a collection of nonspecific symptoms, like body aches, fatigue, and nervousness, but also notes that adrenal fatigue lacks a scientifically validated medical diagnosis that is accepted by the mainstream medicine community.

Indeed, Eastern versus Western medicine is a lightning-rod topic that invites a level of scrutiny to Goops new collection. The supplement industry might be worth $37 billion, but for every nutritionist or alternative health consultant that might recommend it, theres another doctor or peer journal labeling it pure placebo. This is partially because supplements manufacturers and distributors are not required to obtain approval from the FDA before marketing their products.

Academic studies have also raised doubts. A recent one directed by Elizabeth D. Kantor, an epidemiologist at Memorial Sloan Kettering Cancer Center in New York, found that some supplement combinations are essential to treat vitamin and mineral deficiencies and can improve certain medical conditions like macular degeneration. At the same time, for the majority of adults, supplements likely provide little, if any, benefit. Its that grayness that makes the sector hard to decipher.

The country is divided politicallyits also divided in terms of ideas, says Junger, who regularly encounters skepticism of alternative medicine in his field. What Im trying to do is trying to bridge that gap and really educate people that theres amazing things on both sides of these camps and they can even be combined in a very successful way.

Junger believes Western medicine is ideal for acute problems like heart attacks or broken bones, while alternative medicine is great for modern-day epidemics like chronic fatigue. Thats where the other therapies and modalities come in and really help the situationWe need to be open-minded.

At the same time, Junger is frustrated that Eastern medicine is oftentimes more marred by scrutiny than its Western counterpart. Its an unfair viewpoint, he feels, but one he thinks is gradually changing.

I see in the news all the time medications that have been recalled or medications that poison people or had substandard testing, he says, it goes through both worlds. A quick look at the FDAs website does confirm a high degree of drug recalls, though its unclear how that compares to the supplement industry.

High School Genes is formulated for women in a perimenopausal or postmenopausal state who feel like their metabolism might be slowing down or that their bodies are no longer responding to the exercise.

Regardless of what you think of the validity of vitamins, Goop is especially touting the quality of the ingredients in these supplements. While the company will not name the manufacturer it is working with, its spokespeople confirm that all the ingredients in its vitamin packs are gluten- and GMO-free and manufactured in a triple GMP-certified facility. That means the factory has received three independent certifications for Good Manufacturing Practices.

All of our vitamins and supplements were sourced from the highest-quality ingredients, and underwent rigorous testing to ensure their purity and potency, said a company representative via email. For example, every batch of our concentrated omega-3 fish oils are tested for more than two hundred pesticides, six heavy metals, and multiple polychlorinated biphenols (PCBs), dioxins, furans, and dioxin-like PCBs. So, no pesticides, no heavy metals, no environmental pollutants, and definitely no rancidity.

None of this, however, deters Goops critics. The supplement announcement raised more than a few concerned eyebrows during its first week on the market. Vox, for example, declared [Gwyneths] out of control. Meanwhile, other similar supplement startups, such as Ritual and Care/Of, seem to receive glowing reviews from media and tech outlets touting them for disrupting the vitamin industry.

So is Goop unfairly under heavier scrutiny than other players in the supplement space? Is Paltrow taking more flack because shes a celebrityor a female CEO? Or are people just more distrustful of clever marketingand anything related to Goop?

Paltrow says she finds it interesting that Goop receives a higher degree of skepticism than a lot of its competitors, considering her company, at the very least, has been the game longer than some similar businesses. The negative attention her brand endures, Paltrow believes, is simply a consequence of her Hollywood celebrity.

I think its a blessing and a curse, says Paltrow of her fame. Because of my celebrity, I have a platform from which to speak and get earned media which then makes customer acquisition costs much lower than other companies. There are real upsides to it. At the same time, Im a celebrity, so they like to be critical.

Sometimes there are good lessons to learn from criticism when its meaningful, but the problem is most of the time its not helpful, she adds. Its not particularly insightful or bright.

Paltrow doesnt sound bitter or snarky as she explains these common reactions to her work. If anything, shes resigned to it.

Sometimes people react strongly to what they dont know, which is totally understandableI dont take that personally, she explains. Instead, she prefers to view her high-profile status in terms of its business benefits, specifically when it comes to scaling Goop, which she founded in her kitchen nearly a decade ago.

I do think in my case, eventually always the pros of [celebrity] outweigh the cons because I can go into any market and talk about what Im doing, and thats a powerful lever to be able to pull, she says. And interestingly enough, and this is all that really matters: We move product and people read our content and our metrics around those things are really good.

In fact, Paltrows company doubled its overall revenue growth from 2015 to 2016, according to a Goop representative. In the last year, Goop released several product ventures, including the clothing line Goop Label, Goop Fragrance, and Goops Clean Beauty book, which hit number 1 in the Health & Fitness category on Amazon. According to a Goop press rep, the company also boasts a 90% campaign renewal rate for luxury clientssuch as Gucci and Chanelwho advertise on Goop.com.

Tony Florence is head of internet investing at New Enterprise Associates (NEA), which was part of a $15 million Series B investment round in Goop last August. NEA also supplied Goop with its first large investment in 2015.

The companys initial launch and strategy has gone exceptionally well, says Florence. Theyve proven a business model and market opportunity and branding opportunity that we think is quite significant. NEAs most recent investment is meant to aggressively fund consumer-branded product categories and contextualized commerce, which refers to the now-common practice of using content to help consumers discover products and convince them to purchase them. Thats what Goop is pioneering in many ways, Florence notes. Indeed, the Goop newsletter was relatively early to this trend when it launched its first product back in 2012the company used the editorially driven newsletter it had been operating for years, and the subscriber list it had garnered, to drive interest in that first for-sale item: a simple white T-shirt.

As Goop ventures into the vitamin market, Florence notes that transparency is increasingly becoming more important in all product categories, part of a growing consumer desire to buy whats good for them. Consumers care about what they are putting inside their bodies. Meanwhile, women in their 30s and 40s, as well as the millennial generation, Florence says, are much more open-minded about the things theyre putting their time and money into; in other words, theyre willing to try out practices that perhaps seemed more far-out a few years ago, like meditation or vegan cooking. Florence also says consumer are increasingly brand consistent with how they see themselves, meaning that shoppers want their purchases to align with their personal values and lifestyle aesthetics. Goop, Florence believes, is at the forefront of that conscious e-commerce movement.

Goop is delving into the health and wellness business at a good moment for the industry. The rapidly growing category (which includes health, nutrition, beauty, fitness, and alternative medicine) is now valued at $3.4 trillion, three times the value of the pharmaceutical industry, says Clare Varga, director of trend forecasting firm WGSN. More than two-thirds of American adults takes supplements each year, according to a report funded by the Council for Responsible Nutrition.

Consumers increasingly place a premium on wellthness as a lifestyleits become aspirational, explains Varga. Its an investment and demonstration of self-value with a healthy body becoming the ultimate must-have fashion accessory.

Goops mix of aesthetic lifestyle content blended with e-commerce offers its team a unique opportunity to pursue an array of product areas, not just skincare potions and nutritional supplements. Paltrow says Goop has plans already in place for more body, hair, and food products and even more supplements that enter the body in innovative ways. She didnt elaborate on what those innovative ways might be, but I assume anything goes for a woman who steams her uterus and cups her back.

Our physical product roadmap is very carefully thought out and its [about] how to keep building out this wellness verticalwe have a lot of room to really build our physical product, Paltrow says, stressing the editorial pull of the site. Were very unique in that way. We have the ability to produce content that people find meaningful.

And if the public disapproves or cracks jokes at her ventures, well, Paltrow need only point to the companys numbers. Goop Wellness sold over $100,000 worth of merchandise just on launch day. You can debate alternative wellness all you want, but there is undoubtedly a strong market for it out there. And besides, even snarky articles and tweets about the latest Goop suggestion have a positive effect for her company: They draw more attention to the content Goop.com publishes.

I just keep my nose to the grindstone and do what Im doing and some of these things, people just like to talk shit and thats fine, says Paltrow. What we produce at Goop resonates. So I try to keep my eye on the prize and take the good out of it When you have an intention thats really true, I think the consumer and the reader know that.

As for bridging content to productI couldnt help but ask whether her new product can be tied to Goops wildly talked-about sex issue, which was published last week and covered topics like anal and casual sex. Can Goops supplements, I wonder, give one a better sex life?

Absolutely, Paltrow coos playfully, 100 percent.

If theres anything Paltrow can do, its certainly contextualize her commerce.

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Gwyneth Paltrow Wants To Put Her Goop Inside You - Fast Company

Dr. Art Mollen, Special for The Republic | azcentral.com 5:04 a.m. MT March 21, 2017

Dr. Art Mollen started tje 3TV Phoenix 10K and Half Marathon 40 years ago. In 2011 he created the Arizona Runners Hall of Fame to honor individuals who have made significant contributions to running in Arizona.(Photo: Richard Buchbinder)

Many people are looking for the silver bullet to weight loss.In fact, for some people, it may be a good idea. However, most doctors only prescribe themif your body mass index is above 30 or at least 27 and you also have diabetes or high blood pressure.

The most common prescription weight loss drugs include Orlistat, Contrave, Belviq, Saxenda and Qsymia. In the past the most common prescription weight loss drugs were amphetamines, which had the potential for addiction and abuse.

The most important consideration before taking medications for weight loss is to evaluate your medical history for high blood pressure, diabetes, heart disease and a compromised immune system, all of which could be affected. Even natural or herbal weight loss products can cause significant problems.

Orlistat also called Xenical, blocks your body from absorbing the fat that you consume and may cause side effects, including abdominal cramping and excess gas.

Contrave is a combination of naltrexone and wellbutrin. Naltrexone is also approved to treat alcohol and drug dependence. Wellbutrin is also approved to treat depression. Contrave works on the brains thermostat, which controls appetite, temperature and how the body burns energy signaling the brain to reduce food intake.

Belviq works by suppressing your appetite. However, some common side effects, include headaches, dizziness, nausea and fatigue.

Saxenda is the same drug as Victoza used to treat diabetes. It helps diabetics by mimicking a hormone in the intestines and tells the brain that the stomach is full. The side effects include nausea, vomiting and diarrhea.

Phentermine is an amphetamine and combined with Topamax, an anticonvulsant drug in a medication called Qysmia. It makes you feel full, suppresses appetite and speeds metabolism, however, it can raise blood pressure, cause heart palpitations and insomnia. It is a controlled substance and potentially addictive.

All of these medications have a caveat which is, if you do not lose at least 5 percentof your body weight after 12 weeks of taking it, you should discontinue the medication.

These weight loss drugs must be monitored by a physician and are indicated to be taken in conjunction with exercise and fewer calories.If the medication galvanizes you to exercise and eat differently, that may be a good idea.

A recent study in the Journal of the American Medical Association pointed out that the best prescription weight loss drug is the one that works for you.Qsymia and Contrave were able to create about a 5 percentloss of body weight, which is 11-12 pounds and is considered to be the most effective.

There is no one size fits all when it comes to weight loss drugs as some people will simply respond to one drug better than another.At the end of the day there is no silver bullet to weight loss simply exercise, diet changes and lifestyle.

One last note as a practicing physician, I seldom prescribe these medications for my patients, not because they are ineffective, but because they are the antithesis of my personal philosophy for long-term weight control.

Dr. Art Mollen is an osteopathic family physician and a health, fitness and preventive medicine expert. Reach him at 480-656-0016 or askdrartmollen@gmail.com.

Dr. Art Mollen: All you need is love with a little bit of chocolate

Dr. Art Mollen: Peanut allergic reactions are serious

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President Trump's behavior has medical professionals, including Deepak Chopra, concerned about his mental health. USA TODAY

Deepak Chopra tweeted that President Donald Trump should be tested for psychiatric and neurological disorders.(Photo: Alberto E. Rodriguez, Getty Images)

Does the nation need to know more about President Trumps brain?

Alternative medicine promotor Deepak Chopra is the latest medical professional to suggest we do.In a series of tweets late Monday theday FBI director James Comey shot down the presidents unfounded but continuing claims about wiretapping at Trump Tower Chopra asked Trumpto please submit to a psychiatric and neurological evaluation to restore our confidence.

Chopra, who trained as an endocrinologist (a hormone specialist), not a psychiatrist or neurologist, also suggested that a form of dementia, a brain disease that affects behavior and thinking, should be ruled in or ruled out, for the safety of the world.

For the record, Trumps longtime personal physician Harold Bornstein recently told the health news site Statthat while Trump carries some extra pounds, theres nothing seriously wrong with him. In two letters issued during the campaign, Bornstein also said Trump, 70, was in fine physical health. Bornstein also told The New York Times he probably would not screen Trump for dementia if he became White House physician (so far, he has not).

That has not stopped speculation, especially about Trumps mental health. Suchspeculation, at least by psychiatrists, has been officially discouraged by the American Psychiatric Association (APA). Earlier this month, the group updated its longstanding ethics policy against opiningonthe mental health of politicians or other public figures. The policy is called the Goldwater Rule, after 1964 presidential candidate Barry Goldwater, and was created after manypsychiatrists participated in a magazine survey about Goldwaters mentalfitness.

The rule is based partly on the belief that psychiatrists should not diagnose unconsenting people they have not examined. But it also reflects concerns that equating mental healthwith fitness for certain jobs stigmatizes people with mental illness, said Rebecca Weintraub Brendel, an assistant professor of psychiatry at Harvard Medical School and consultant to the APAs ethics committee.

The public doesnt really need psychiatrists to reach conclusions, about whether politicians should stay in office, she added.

Despite the policy, 35 psychiatrists, psychologists and social workers signed a letter to the Timesin February saying Trumps speech and actions demonstrate an inability to tolerate views different from his own, leading to rage reactions. They said this grave emotional instability made him incapable of serving safely as president. The letter did not suggest any diagnosis for Trump.

In a separate letter to the Times, Allen Frances, apsychiatry professor emeritusat Duke University School of Medicine, took a different view. He wrote that Trump may be a world-class narcissist, but this doesnt make him mentally ill. Francis said that associating Trump's behavior with mental illness is a stigmatizing insult to the mentally ill.

As to whether Trump should undergo the kind of testing Chopra suggests, some experts think all modern presidents should. Arthur Caplan, a bioethicist at New York University's Langone Medical Center, told NPR: "I think we're about 50 years overdue for having some sort of annual physical for the president and vice president, the results of which should be reported publicly. Part of this should be psychiatric and cognitive testing."

But thats different from suggesting that public concerns generated by a presidents TV appearances and social media posts should trigger psychiatric testing, Weintraub Brendel said. That, she said, would be a political misuse of psychiatry.

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Deepak Chopra speculates about Trump's brain - USA TODAY

DEAR DOCTOR: I've been taking thyroid medication for several years, and my doctor says my blood tests are where they should be, but my face feels like sandpaper, my nails are brittle, and I'm losing so much hair that I can see my scalp. Could there be some underlying problem my physician is missing?

DEAR READER: Hair loss can be a distressing symptom, made all the more so when its cause is a mystery.

Your thyroid hormone levels are an obvious place to start, because both low and high thyroid levels can lead to hair and nail changes. Symptoms of high thyroid levels include hair loss, skin that is unusually smooth and warm, and nails that soften and loosen from the nail bed. The remaining hair becomes thinner, softer and does not hold a wave. Symptoms of low thyroid levels also include hair loss, including in the armpits and genital area, but the hair in this scenario is dull, coarse and fragile. As for the nails, they tend to be delicate, thin and have multiple grooves. That said, if your physician has done a complete panel of thyroid tests and the results have been normal, then most likely the function of your thyroid gland is not the cause of the brittle nails nor the hair loss.

That doesn't mean the thyroid isn't a factor. Autoimmune thyroid disease can lead to hair loss, both patchy and more diffuse, as well as inflammatory conditions of the skin. Such disease isn't always reflected in thyroid hormone levels. Checking anti-thyroid antibodies in the blood can identify autoimmune thyroid disease, and point you and your doctor in a clearer direction.

Hair loss also can be caused by androgenic alopecia, linked to an excess of androgens, a type of male hormone. These hormones are present in both men and women, but they're higher than normal in some women, such as those with congenital adrenal hyperplasia or polycystic ovarian disease, which is relatively common. Simply checking levels of testosterone and dehydroepiandrosterone (DHEA) can either rule out androgenic alopecia or suggest that it be explored further.

Another potential cause is medication. Some medications can lead to hair loss, so if your symptoms seem coincidental to starting a new medication, there might be an association.

Biotin deficiency, which is rare, can also cause hair loss and inflammation of the facial skin. But if you have a normal diet and eat eggs, you have a low likelihood of this condition. Nonetheless, it's something to rule out.

Iron deficiency also can lead to both brittle nails and hair loss. This doesn't explain the skin manifestations that you have, but if you are looking at other possibilities, checking the iron level of the blood should be part of the workup.

Any major illness can lead to hair loss and nail changes, and psychological stress can lead to hair loss. So, if there have been major stressors in your life, either physical or psychological, consider that a potential culprit.

In summary, if your thyroid levels are normal, it would be wise to check your thyroid antibodies, androgens and iron levels -- and your level of stress.

Robert Ashley, M.D., is an internist and assistant professor of medicine at the University of California, Los Angeles.

Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.

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UNITED NATIONS (TIP): When you can go to the United Nations to hear a talk about meditation, you know something has changed in the world.

On Friday, March 10, 2017, Dr. Kunwarjit Singh Duggal, guest of the United Nations Salus Well-Being Network, spoke to a packed audience in the Secretariat Conf. Room 8 on Cultivating Inner Peace for Outer Peace. He began: My main message here is to talk about peace. How do we achieve peace? . . . In order to take peace to the next level, we have to find peace within ourselves first before we can go on helping the rest of society.

By his own admission, Dr. Duggal is quite passionate about meditation as an intervention for many of lifes challenges, whether worldly or personal a universal paradigm.

His topic on Friday, particularly timely today,detailed the latest scientific research on theproven benefits of meditation. Noting the many different types of meditation, he talked about several significant studies, most focused on peace, stress and anxiety.

He quoted one randomized controlled study in which people were asked to meditate each morning for 21 days straight for a short duration of time. The researchers measured cortisol (the stress hormone) levels before and after 21 days and found a significant decrease in every participant. Notable studies also found that for patients undergoing orthopedic rehabilitation those who meditated benefitted twice as much as those who were treated only with therapeutic exercise.

One telling example was an experiment done in a troubled San Francisco school district in whichtwo 15-minute periods of quiet time wereinstitutedfor students. The results were improved test scores, attendance, psychological state and enhanced concentration. These students also reported increased calmness and decreased anger. By increasing the calmness in these students, their corresponding troubled geographical regions noted decreased crime rates and improved safety.

Dr. Duggal then presented the meditation technique practiced in Science of Spirituality, Jyoti meditation, after which everyone had a chance to meditate for a short period.

The afternoon concluded with a lively question and answer session.

Dr. Duggal was at the United Nations representing the Science of Spirituality,(NGO), a worldwide, spiritual organization dedicated to transforming lives through meditation. His father, Sant Rajinder Singh Ji Maharaj, head of Science of Spirituality, spoke at the UN last May on Meditation as Medication for the Soul.

Dr. Duggal is a Board-Certified Physical Medicine and Rehabilitation Specialist and Assistant Professor at Rush University Meditation Center in Chicago. He lectures extensively on meditation as an effective intervention for physical and emotional medical disorders.

For more information about Science of Spirituality: http://www.sos.org.

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PHYSICIAN SPEAKS AT UNITED NATIONS ABOUT MEDITATION - The Indian Panorama

SELF

Yup, Working Out During Your Period Can Help Dull Cramps and PMS SELF Medical professionals like Spencer Nadolsky, D.O., a licensed practicing board certified family and bariatric medicine physician in Olney, Maryland, agree that exercise is often an effective antidote for period-related woes. Exercise can be a stress ...

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Yup, Working Out During Your Period Can Help Dull Cramps and PMS - SELF

Dear Dr. Roach: I am a 78-year-old woman who was just diagnosed with celiac disease. I had an endoscopy in 2007 because I was anemic, and the doctor told me I had an ulcer that healed itself. This year I had an endoscopy because I again was anemic, but this time he did a biopsy, which came back as celiac. I have no dysentery or stomach pains, which are red lights for celiac; I have had inflamed joints for years, accompanied by dry skin. Is it possible that I have had this disease for years and was never diagnosed? My doctor told me not to eat wheat but never went any further than that. I have been educating myself about the disease. Who else would I see about this? Also, what would happen if I ate wheat by mistake? I also have been short of breath for years, but heart and pulmonary tests all come back normal. Could celiac be causing this shortness of breath?

A: Celiac disease, also called "gluten-sensitive enteropathy" or "nontropical sprue," is an uncommon but increasingly recognized condition caused by a reaction to gliadin, a protein found in gluten-containing grains, especially wheat, rye and barley. The spectrum of symptoms caused by celiac disease and its associated conditions is too broad for this column to cover comprehensively.

Not everyone with celiac disease has gastrointestinal symptoms, such as diarrhea and weight loss. Some people get mild abdominal pain and mood changes, and never put these together with their diet. At age 78, it's very likely that you have had celiac disease for many years. The anemia 10 years ago possibly was celiac-related, through iron deficiency. People with celiac disease are more likely to develop arthritis as well, and one skin condition, dermatitis herpetiformis, is so characteristic of celiac that a biopsy is not needed.

Shortness of breath is uncommon with celiac disease, but a severe anemia can cause it, as can one rare lung disease, pulmonary hemosiderosis, which often goes away on a gluten-free diet. Disease of the heart muscle itself is rare but more common in people with celiac disease.

Unfortunately, the dietary information you got was woefully inadequate, so I would strongly recommend a visit with a registered dietician nutritionist, who can give you much more information. Don't eat wheat: Proper care of this disease depends on meticulous avoidance of gluten, and even small amounts count.

Dear Dr. Roach: My doctor just tested me for high calcium, and my vitamin D was low. He put me on 12 weeks of 50,000 IU once a week. You said something in a recent article about high vitamin D. Why the difference?

A: Unfortunately, I am confused by your vitamin D treatment: I suspect the vitamin D has nothing to do with the calcium. A high calcium level can be caused by many things, including faulty technique in obtaining blood (if the tourniquet is on too long, the blood can become more acidic, which makes the calcium level appear higher), but I mentioned excess vitamin D (a rare cause) and elevated parathyroid hormone levels in my recent column. A repeated high calcium level should get your doctor to check a PTH hormone level. A high PTH level almost always means a benign tumor of the parathyroid gland, which is often but not always treated surgically.

Dr. Roach writes: I solicited opinions about televisions in physician waiting rooms, and have the results of what readers wrote me. Ninety-three percent of respondents did not like them. Some suggestions included artwork or an aquarium instead; music (especially classical) to provide white noise and privacy; and 1950s television shows or informational shows with closed captioning.

Visit link:
Dear Dr. Roach: Dietitian is important resource in treating celiac disease - Herald & Review

Keith Roach, To Your Health 5:09 p.m. ET March 16, 2017

Dear Dr. Roach: I am a 78-year-old woman who was just diagnosed with celiac disease. I had an endoscopy in 2007 because I was anemic, and the doctor told me I had an ulcer that healed itself. This year I had an endoscopy because I again was anemic, but this time he did a biopsy, which came back as celiac. I have no dysentery or stomach pains, which are red lights for celiac; I have had inflamed joints for years, accompanied by dry skin. Is it possible that I have had this disease for years and was never diagnosed? My doctor told me not to eat wheat but never went any further than that. I have been educating myself about the disease. Who else would I see about this? Also, what would happen if I ate wheat by mistake? I also have been short of breath for years, but heart and pulmonary tests all come back normal. Could celiac be causing this shortness of breath?

Anon.

Dear Anon.: Celiac disease, also called gluten-sensitive enteropathy or nontropical sprue, is an uncommon but increasingly recognized condition caused by a reaction to gliadin, a protein found in gluten-containing grains, especially wheat, rye and barley. The spectrum of symptoms caused by celiac disease and its associated conditions is too broad for this column to cover comprehensively.

Not everyone with celiac disease has gastrointestinal symptoms, such as diarrhea and weight loss. Some people get mild abdominal pain and mood changes, and never put these together with their diet. At age 78, its very likely that you have had celiac disease for many years. The anemia 10 years ago possibly was celiac-related, through iron deficiency. People with celiac disease are more likely to develop arthritis as well, and one skin condition, dermatitis herpetiformis, is so characteristic of celiac that a biopsy is not needed.

Shortness of breath is uncommon with celiac disease, but a severe anemia can cause it, as can one rare lung disease, pulmonary hemosiderosis, which often goes away on a gluten-free diet. Disease of the heart muscle itself is rare but more common in people with celiac disease.

Unfortunately, the dietary information you got was woefully inadequate, so I would strongly recommend a visit with a registered dietician nutritionist, who can give you much more information. Dont eat wheat: Proper care of this disease depends on meticulous avoidance of gluten, and even small amounts count.

Dear Dr. Roach: My doctor just tested me for high calcium, and my vitamin D was low. He put me on 12 weeks of 50,000 IU once a week. You said something in a recent article about high vitamin D. Why the difference?

A.K.

Dear A.K.: Unfortunately, I am confused by your vitamin D treatment: I suspect the vitamin D has nothing to do with the calcium. A high calcium level can be caused by many things, including faulty technique in obtaining blood (if the tourniquet is on too long, the blood can become more acidic, which makes the calcium level appear higher), but I mentioned excess vitamin D (a rare cause) and elevated parathyroid hormone levels in my recent column. A repeated high calcium level should get your doctor to check a PTH hormone level. A high PTH level almost always means a benign tumor of the parathyroid gland, which is often but not always treated surgically.

Dr. Roach Writes: I solicited opinions about televisions in physician waiting rooms, and have the results of what readers wrote me. Ninety-three percent of respondents did not like them. Some suggestions included artwork or an aquarium instead; music (especially classical) to provide white noise and privacy; and 1950s television shows or informational shows with closed captioning.

Email questions to ToYourGoodHealth@med.cornell.edu.

Read or Share this story: http://detne.ws/2nwPq4E

Continued here:
Doc: Dietitian a resource in treating celiac disease - The Detroit News

Dear Doctor: Ive been taking thyroid medication for several years, and my doctor says my blood tests are where they should be, but my face feels like sandpaper, my nails are brittle, and Im losing so much hair that I can see my scalp. Could there be some underlying problem my physician is missing?

Dear reader: Hair loss can be a distressing symptom, made all the more so when its cause is a mystery.

Your thyroid hormone levels are an obvious place to start, because both low and high thyroid levels can lead to hair and nail changes. Symptoms of high thyroid levels include hair loss, skin that is unusually smooth and warm, and nails that soften and loosen from the nail bed. The remaining hair becomes thinner, softer and does not hold a wave. Symptoms of low thyroid levels also include hair loss, including in the armpits and genital area, but the hair in this scenario is dull, coarse and fragile. As for the nails, they tend to be delicate, thin and have multiple grooves. That said, if your physician has done a complete panel of thyroid tests and the results have been normal, then most likely the function of your thyroid gland is not the cause of the brittle nails nor the hair loss.

That doesnt mean the thyroid isnt a factor. Autoimmune thyroid disease can lead to hair loss, both patchy and more diffuse, as well as inflammatory conditions of the skin. Such disease isnt always reflected in thyroid hormone levels. Checking anti-thyroid antibodies in the blood can identify autoimmune thyroid disease, and point you and your doctor in a clearer direction.

Hair loss also can be caused by androgenic alopecia, linked to an excess of androgens, a type of male hormone. These hormones are present in both men and women, but theyre higher than normal in some women, such as those with congenital adrenal hyperplasia or polycystic ovarian disease, which is relatively common. Simply checking levels of testosterone and dehydroepiandrosterone (DHEA) can either rule out androgenic alopecia or suggest that it be explored further.

Another potential cause is medication. Some medications can lead to hair loss, so if your symptoms seem coincidental to starting a new medication, there might be an association.

Biotin deficiency, which is rare, can also cause hair loss and inflammation of the facial skin. But if you have a normal diet and eat eggs, you have a low likelihood of this condition. Nonetheless, its something to rule out.

Iron deficiency also can lead to both brittle nails and hair loss. This doesnt explain the skin manifestations that you have, but if you are looking at other possibilities, checking the iron level of the blood should be part of the workup.

Any major illness can lead to hair loss and nail changes, and psychological stress can lead to hair loss. So, if there have been major stressors in your life, either physical or psychological, consider that a potential culprit.

In summary, if your thyroid levels are normal, it would be wise to check your thyroid antibodies, androgens and iron levels and your level of stress.

Robert Ashley, M.D., is an internist and assistant professor of medicine at the University of California, Los Angeles.

Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.

Continue reading here:
Ask the Doctors | Print Only | virginislandsdailynews.com - Virgin Islands Daily News

In a small-scale study of women with previously diagnosed mood disorders, Johns Hopkins researchers report that lower levels of the hormone allopregnanolone in the second trimester of pregnancy were associated with an increased chance of developing postpartum depression in women already known to be at risk for the disorder.

In a report on the study, published online on March 7 in Psychoneuroendocrinology, the researchers say the findings could lead to diagnostic markers and preventive strategies for the condition, which strikes an estimated 15 to 20 percent of American women who give birth.

The researchers caution that theirs was an observational study in women already diagnosed with a mood disorder and/or taking antidepressants or mood stabilizers, and does not establish cause and effect between the progesterone metabolite and postpartum depression. But it does, they say, add to evidence that hormonal disruptions during pregnancy point to opportunities for intervention.

Postpartum depression affects early bonding between the mother and child. Untreated, it has potentially devastating and even lethal consequences for both. Infants of women with the disorder may be neglected and have trouble eating, sleeping and developing normally, and an estimated 20 percent of postpartum maternal deaths are thought to be due to suicide, according to the National Institute of Mental Health.

"Many earlier studies haven't shown postpartum depression to be tied to actual levels of pregnancy hormones, but rather to an individual's vulnerability to fluctuations in these hormones, and they didn't identify any concrete way to tell whether a woman would develop postpartum depression," says Lauren M. Osborne, M.D., assistant director of the Johns Hopkins Women's Mood Disorders Center and assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. "For our study, we looked at a high-risk population of women already diagnosed with mood disorders and asked what might be making them more susceptible."

For the study, 60 pregnant women between the ages of 18 and 45 were recruited by investigators at study sites at The Johns Hopkins University and the University of North Carolina at Chapel Hill. About 70 percent were white and 21.5 percent were African-American. All women had been previously diagnosed with a mood disorder, such as major depression or bipolar disorder. Almost a third had been previously hospitalized due to complications from their mood disorder, and 73 percent had more than one mental illness.

During the study, 76 percent of the participants used psychiatric medications, including antidepressants or mood stabilizers, and about 75 percent of the participants were depressed at some point during the investigation, either during the pregnancy or shortly thereafter.

During the second trimester (about 20 weeks pregnant) and the third trimester (about 34 weeks pregnant), each participant took a mood test and gave 40 milliliters of blood. Forty participants participated in the second-trimester data collection, and 19 of these women, or 47.5 percent, developed postpartum depression at one or three months postpartum. The participants were assessed and diagnosed by a clinician using criteria from the Diagnostic and Statistical Manual of Mental Disorders, version IV for a major depressive episode.

Of the 58 women who participated in the third-trimester data collection, 25 of those women, or 43.1 percent, developed postpartum depression. Thirty-eight women participated in both trimester data collections.

Using the blood samples, the researchers measured the blood levels of progesterone and allopregnanolone, a byproduct made from the breakdown of progesterone and known for its calming, anti-anxiety effects.

The researchers found no relationship between progesterone levels in the second or third trimesters and the likelihood of developing postpartum depression. They also found no link between the third-trimester levels of allopregnanolone and postpartum depression. However, they did notice a link between postpartum depression and diminished levels of allopregnanolone levels in the second trimester.

For example, according to the study data, a woman with an allopregnanolone level of 7.5 nanograms per milliliter had a 1.5 percent chance of developing postpartum depression. At half that level of hormone (about 3.75 nanograms per milliliter), a mother had a 33 percent likelihood of developing the disorder. For every additional nanogram per milliliter increase in allopregnanolone, the risk of developing postpartum depression dropped by 63 percent.

"Every woman has high levels of certain hormones, including allopregnanolone, at the end of pregnancy, so we decided to look earlier in the pregnancy to see if we could tease apart small differences in hormone levels that might more accurately predict postpartum depression later," says Osborne. She says that many earlier studies on postpartum depression focused on a less ill population, often excluding women whose symptoms were serious enough to warrant psychiatric medication -- making it difficult to detect trends in those women most at risk.

Because the study data suggest that higher levels of allopregnanolone in the second trimester seem to protect against postpartum depression, Osborne says in the future, her group hopes to study whether allopregnanolone can be used in women at risk to prevent postpartum depression. She says Johns Hopkins is one of several institutions currently participating in a clinical trial led by Sage Therapeutics that is looking at allopregnanolone as a treatment for postpartum depression.

She also cautions that additional and larger studies are needed to determine whether women without mood disorders show the same patterns of allopregnanolone levels linked to postpartum depression risk.

If those future studies confirm a similar impact, Osborne says, then tests for low levels of allopregnanolone in the second trimester could be used as a biomarker to predict those mothers who are at risk of developing postpartum depression.

Osborne and her colleagues previously showed and replicated in Neuropsychopharmacology in 2016 that epigenetic modifications to two genes could be used as biomarkers to predict postpartum depression; these modifications target genes that work with estrogen receptors and are sensitive to hormones. These biomarkers were already about 80 percent effective at predicting postpartum depression, and Osborne hopes to examine whether combining allopregnanolone levels with the epigenetic biomarkers may improve the effectiveness of the tests to predict postpartum depression.

Of note and seemingly contradictory, she says, many of the participants in the study developed postpartum depression while on antidepressants or mood stabilizers. The researchers say that the medication dosages weren't prescribed by the study group and were monitored by the participant's primary care physician, psychiatrist or obstetrician instead. "We believe that many, if not most, women who become pregnant are undertreated for their depression because many physicians believe that smaller doses of antidepressants are safer for the baby, but we don't have any evidence that this is true," says Osborne. "If the medication dose is too low and the mother relapses into depression during pregnancy or the postpartum period, then the baby will be exposed to both the drugs and the mother's illness."

Osborne and her team are currently analyzing the medication doses used by women in this study to determine whether those given adequate doses of antidepressants were less likely to develop symptoms in pregnancy or in postpartum.

Only 15 percent of women with postpartum depression are estimated to ever receive professional treatment, according to the U.S. Centers for Disease Control and Prevention. Many physicians don't screen for it, and there is a stigma for mothers. A mother who asks for help may be seen as incapable of handling her situation as a mother, or may be criticized by friends or family for taking a medication during or shortly after pregnancy.

Excerpt from:
Low levels of 'anti-anxiety' hormone linked to postpartum depression ... - Science Daily

A new study links low levels of the hormone allopregnanolone in the second trimester of pregnancy, to the risk of developing postpartum depression.

Researchers at Johns Hopkins University in Baltimore, Maryland, said the findings could lead to diagnostic markers and preventive strategies for the condition, which strikes an estimated 15 to 20 percent of American women who give birth.

The small-scale study consisted of women with previously diagnosed mood disorders, with findings published online inPsychoneuroendocrinology.

Investigators said the study used an observational methodology among women already diagnosed with a mood disorder and/or taking antidepressants or mood stabilizers, and does not establish cause and effect between the progesterone metabolite and postpartum depression.

But it does, they say, add to evidence that hormonal disruptions during pregnancy point to opportunities for intervention.Postpartum depression affects early bonding between the mother and child.

Untreated, it has potentially devastating and even lethal consequences for both. Infants of women with the disorder may be neglected and have trouble eating, sleeping, and developing normally.

Moreover, an estimated 20 percent of postpartum maternal deaths are thought to be due to suicide, according to the National Institute of Mental Health.

Many earlier studies havent shown postpartum depression to be tied to actual levels of pregnancy hormones, but rather to an individuals vulnerability to fluctuations in these hormones, and they didnt identify any concrete way to tell whether a woman would develop postpartum depression, saidLauren M. Osborne, M.D., assistant director of the Womens Mood Disorders Center for Johns Hopkins Medicine.

For our study, we looked at a high-risk population of women already diagnosed with mood disorders and asked what might be making them more susceptible.

In the study, 60 pregnant women between the ages of 18 and 45 were recruited by investigators at study sites at Johns Hopkins University and the University of North Carolina at Chapel Hill.

About 70 percent were white and 21.5 percent were African-American. All women had been previously diagnosed with a mood disorder, such as major depression or bipolar disorder. Almost one-third had been previously hospitalized due to complications from their mood disorder, and 73 percent had more than one mental illness.

During the study, 76 percent of the participants used psychiatric medications, including antidepressants or mood stabilizers, and about 75 percent of the participants were depressed at some point during the investigation, either during the pregnancy or shortly thereafter.

During the second trimester (about 20 weeks pregnant) and the third trimester (about 34 weeks pregnant), each participant took a mood test and gave 40 milliliters of blood.

Forty participants participated in the second-trimester data collection, and 19 of these women, or 47.5 percent, developed postpartum depression at one or three months postpartum. The participants were assessed and diagnosed by a clinician using criteria from the Diagnostic and Statistical Manual of Mental Disorders, version IV, for a major depressive episode.

Of the 58 women who participated in the third-trimester data collection, 25 of those women, or 43.1 percent, developed postpartum depression. Thirty-eight women participated in both trimester data collections.

Using the blood samples, the researchers measured the blood levels of progesterone and allopregnanolone, a byproduct made from the breakdown of progesterone and known for its calming, anti-anxiety effects.

The researchers found no relationship between progesterone levels in the second or third trimesters and the likelihood of developing postpartum depression. They also found no link between the third-trimester levels of allopregnanolone and postpartum depression.

However, they did notice a link between postpartum depression and diminished levels of allopregnanolone levels in the second trimester.

For example, according to the study data, a woman with an allopregnanolone level of 7.5 nanograms per milliliter had a 1.5 percent chance of developing postpartum depression. At half that level of hormone (about 3.75 nanograms per milliliter), a mother had a 33 percent likelihood of developing the disorder. For every additional nanogram per milliliter increase in allopregnanolone, the risk of developing postpartum depression dropped by 63 percent.

Every woman has high levels of certain hormones, including allopregnanolone, at the end of pregnancy, so we decided to look earlier in the pregnancy to see if we could tease apart small differences in hormone levels that might more accurately predict postpartum depression later, saidOsborne.

She said many earlier studies on postpartum depression focused on a less ill population, often excluding women whose symptoms were serious enough to warrant psychiatric medication, making it difficult to detect trends in those women most at risk.

Because the study data suggested that higher levels of allopregnanolone in the second trimester seem to protect against postpartum depression, Osborne saidin the future, her group hopes to study whether allopregnanolone can be used in women at risk to prevent postpartum depression.

She saidJohns Hopkins is one of several institutions currently participating in a clinical trial led by Sage Therapeutics that is looking at allopregnanolone as a treatment for postpartum depression.

She also cautioned that additional and larger studies are needed to determine whether women without mood disorders show the same patterns of allopregnanolone levels linked to postpartum depression risk.

If those future studies confirm a similar impact, Osborne said, then tests for low levels of allopregnanolone in the second trimester could be used as a biomarker to predict those mothers who are at risk of developing postpartum depression.

Prior research by Osborne and her colleagues previously showed that epigenetic modifications to two genes could be used as biomarkers to predict postpartum depression. Investigators discovered these modifications target genes that work with estrogen receptors and are sensitive to hormones.

These biomarkers were already about 80 percent effective at predicting postpartum depression, and Osborne hopes to examine whether combining allopregnanolone levels with the epigenetic biomarkers may improve the effectiveness of the tests to predict postpartum depression.

Of note and seemingly contradictory, she said, many of the participants in the study developed postpartum depression while on antidepressants or mood stabilizers.

The researchers say that the medication dosages werent prescribed by the study group and were monitored by the participants primary care physician, psychiatrist, or obstetrician instead.

We believe that many, if not most, women who become pregnant are undertreated for their depression because many physicians believe that smaller doses of antidepressants are safer for the baby, but we dont have any evidence that this is true, Osborne said.

If the medication dose is too low and the mother relapses into depression during pregnancy or the postpartum period, then the baby will be exposed to both the drugs and the mothers illness.

Osborne and her team are currently analyzing the medication doses used by women in this study to determine whether those given adequate doses of antidepressants were less likely to develop symptoms in pregnancy or in postpartum.

Only 15 percent of women with postpartum depression are estimated to ever receive professional treatment, according to the U.S. Centers for Disease Control and Prevention. Many physicians dont screen for it, and there is a stigma for mothers.

A mother who asks for help may be seen as incapable of handling her situation as a mother, or may be criticized by friends or family for taking a medication during or shortly after pregnancy.

Source: Johns Hopkins

APA Reference Nauert PhD, R. (2017). Low Hormone Level Linked to Postpartum Depression. Psych Central. Retrieved on March 16, 2017, from https://psychcentral.com/news/2017/03/16/low-hormone-level-linked-to-postpartum-depression/117738.html

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Low Hormone Level Linked to Postpartum Depression - PsychCentral.com