710 likes | 834 Views
Restorative Medicine Conference Stowe, VT 2006 Integrative Natural Hormonal Modulation By Al Sears, MD. First Things First. What ’ s a Hormone? And… What ’ s not? New from: T he Department of Redundancy Department. Why?. Hormones involved in everything. Often most natural option.
E N D
Restorative Medicine Conference Stowe, VT 2006 Integrative Natural Hormonal Modulation By Al Sears, MD
First Things First • What’s a Hormone? • And… What’s not? • New from: The Department of Redundancy Department
Why? • Hormones involved in everything. • Often most natural option. • Disease = loss of homeostasis = hormonal imbalance. • Bridge gap between disease Rx and health improvement. • We are born into altered environs. • Hormones are primary mediators of aging.
How?In Preferred Order • Enlightenment • Activity Guidance • Food • Exercise • Nutritional Supplements • Exogenous Hormones • Herbal Supplements
5 Modern Hormonal Epidemics • Hyperinsulinemia • Vitamin D Deficiency • Adrenal Fatigue • Estrogen Excess • Abnormal Aging
Hyperinsulinemia • Cholesterolemia (with Iatrogenic Cascade) • Heart Disease • Obesity • Fatigue • Accelerated Aging • Environmental Diabetes
Heart Disease: # 1 Killer • Heart disease claims 950,000 lives each year. • More than half who die are women. • Heart disease claims more women’s lives than next 6 killers combined. • Each minute another woman dies from heart disease. "Heart Disease and Stroke Statistics—2005 Update," American Heart Association.
Cholesterol Mistake Cholesterol is the Most Fundamentally Important Hormone Precursor! Cholesterol Provides the Basic Building Blocks for ALL Steroid Hormones
Cholesterol: The Red Herring 80% of people who have heart attacks have the same cholesterol profiles as those who don’t have heart attacks.
National Cholesterol Education Program • Cholesterol-lowering drugs are being prescribed to 13 million people. • The new NCEP guidelines include more people. Under new guidelines, the number may climb to 36 million
But Who Is the NCEP? • 8 of the 9 NCEP doctors made money from cholesterol-lowering drugs. • 2 own stock in statin drugs. • 2 others worked for drug companies after setting the guidelines. • One was a consultant for 10 drug companies. Source: USA Today, October, 2004.
Cholesterol Drugs • Lipitor made $8 billion for Pfizer last year. • Pfizer sponsors studies for journals. Recent Pfizer study concluded that people with normal cholesterols benefit. • Statins block production of CoQ10. • Fatique and muscle soreness prevents exercise.
J-Lit (2002) • Japanese Lipid Intervention Trial • 6-year study of 47,294 taking simvastatin • No correlation between LDL reduction and death rate • LDL below 80 had death rate of 3.5 at 5 years • LDL over 200 had death rate of 3.5 at 5 years
Statins and Plaque • American Journal of Cardiology, 2003 • Examination of coronary plaque buildup in 182 people taking statins • One group took over 80mg a day • The other group took less than 80mg a day • No correlation between statins and plaque reduction– at either dose • At the end of 1 year, both groups showed a 9.2 percent increase in plaque buildup
Statins and Women ASCOT-LLA (2003) • Lipitor vs. Placebo over 3 years • No statistical difference in heart attacks, strokes, or mortality. The University of British Columbia Therapeutics Initiative • Statins offer no benefit to women for prevention of heart disease
Statins Side Effects, Pt. 1 • Muscle Weakness: Most common problem is fatigue. Study found 98% taking Lipitor had muscle problems. Can be debilitating. Rhabdomyolysis, can kill. Neuropathy: Permanent nerve damage. Starts as weakness, tingling in the hands and feet. Statins increase risk with duration. After one year, risk is 15 percent higher. After two years, 26 percent higher.
Statins Side Effects, Pt. 2 • Heart Failure:Statins deplete CoQ10, risk of heart failure climbs with dose and duration. In the first eight years statins were available, deaths from congestive heart failure more than doubled. • Memory Loss:Many have trouble recalling basic facts about lives – like how old they are or where they live. Some experience global transient amnesia, complete memory loss for a brief period.
Statin Side Effects, Pt. 3 • Depression: Multiple studies link low cholesterol and cholesterol treatment with depression • 39 percent of women with low cholesterol have depression
HDL More Important than LDL Castiglioni A, Neuman R. HDL Cholesterol: What Is Its True Clinical Significance? Emergency Medicine. Jan 2003. p30-42.
The Best Predictor of CV Risk • Physician’s Health Study - 15,000 men • High homocysteine = 3 times heart attack risk regardless of cholesterol • 20 studies linked homocysteine and cardiac events • You can lower homocysteine with B vitamins at less than $10 per month
BIOLOGICAL MARKERS • INSULIN plays a key role in aging… • Increases with age • Tells body to build fat • Keep insulin level below 20 • Below 10 even better
Low Glycemic Load vs. Low Fat Diet • Low GL diet decreases clotting agent plasminogen by 39% vs. a 33% increase from a low fat diet.1 • High GL consumption nearly doubles relative risk of heart disease in women.2 1. Ebbeling CB, et al. Effects of an ad libitum low-glycemic load diet on cardiovascular disease risk factors in obese young adults. Am J Clin Nutr 2005; 81(5): 976-82 2. Liu S, Willett WC, et al. A prospective study of dietary glycemic load, carbohydrate intake, and risk of coronary heart disease in US women. Am J Clin Nutr 2000; 71(6): 1455-61
More Advantages to Low Glycemic Load Diet • Low GL diet decreases abdominal obesity better than low fat diet. • Low GL diet increases HDL cholesterol levels -- low fat diet has no effect on HDL levels. • Low GL diet lowers fasting blood glucose -- low fat diet increases it. Lahaye SA, et al. Comparison between a low glycemic load diet and a Canada Food Guide diet in cardiac rehabilitation patients in Ontario. Can J Cariol 2005; 21(6): 489-94
Vitamin D as a Hormone Strengthens immunity Reduces inflammation Prevents cancer Prevents multiple sclerosis Increases muscle strength Prevents diabetes Lowers blood sugar Increases insulin sensitivity Reduces cavities Improves mood Prevents depression Strengthens bones Prevents arthritis Reduces risk of heart attack Lowers blood pressure Reduces cholesterol Balances other hormones Eliminates PMS Prevents hearing loss Improves reaction time Increases balance Eliminates back pain Boosts fertility both sexes Raises libido Balances sleep cycles Optimizes weight
Change in an Ancient Relationship • 98% of time humans on this planet, we lived naked in the sun, near the equator The shift to indoors sudden and recent change • If evolutionary period single day: • Last day we migrated away from equator • Last few hours we put on clothes • Last few minutes we started working inside • Last minute we started traveling in vehicles • Last second we covered ourselves in sunscreen
Sun Wrongly Blamed for Prevalence of Skin Cancer • Skin cancer rare before 1930 – when many worked outside • Rate of melanoma up 1,800% since our grandparents generation • Rate of melanoma up 400% since mid 1970s – start of public awareness regarding “sun protection”
Endemic of Vitamin D Deficiency • 50,000-70,000 Cancer deaths in US every year from insufficient vitamin D • 300,000 Deaths in US (all cause) every year from insufficient vitamin D • 85% of the population is deficient to some degree • Nearly 100% of African-Americans are vitamin D deficient
Vitamin D Reference Ranges • The ridiculously low Government’s RDA: • 200 IU of vit D for infants • 200 IU men & women 1-50 years • 400 IU for those 50 to 70 years • 600 IU for people over 70 • Healthy adult uses 3,000 to 5,000 units per day (if it is available) • You need 3,000 to 5,000 IU cholecalciferol /day from all sources
Vitamin D Replacement • Sunlight – 15 minutes a day • Cod liver oil (400 IU / tsp) • Wild Salmon • Sardines • Vitamin D supplements
Adrenal Fatigue • The most misdiagnosed in US today • Stuck in “fight or flight” mode • Bloodstream repeatedly flooded with adrenaline and cortisol with eventual chronic suppression of DHEA.
Adrenal Response • Natural “fight or flight” response evolved to deal with different world of ancient times • Today’s loud/stressful environment over stimulates adrenals and constantly triggers “fight or flight”
Signs of Deficiency • Muscle wasting • Bone loss • Increased body fat • Anxiety, worry, irritability • Tendonitis, fasciitis, bursitis • Chronic fatigue • Multiple chronic diseases • Sequential cascade
DHEA: Reference Ranges Men: Serum – 110 to 370 mcg/dL Saliva – 137 to 336 pg/ml Women: Serum – 40 to 325 mcg/dL Saliva – 106 to 300 pg/ml
Rebalancing DHEA • Martial Arts • Meditation • Acupuncture • Yoga • Massage • PACE exercise program
Boosting DHEA DHEA Supplementation: Start with 5 mg a day. No more than 10 mg a day without testing blood levels. Course often only 1-3 mos. Adrenal recovery common.
Case Study: “DC” Adrenal Fatigue Treatment: DHEA
PACE & DHEA Training for Recovery • Periods of “exertion and recovery” retrain your body to recover from stress • Allows your body to exit “fight or flight” response
Estrogen Excess Syndrome • Adulterated Food Supply • Endocrine Disruptors in thousands of everyday products • Precocious Puberty – Girls reaching puberty by age 6 • Men developing feminine features • Growing rates of hormone based cancers – breast, ovarian, endometrial, cervical & prostatic
Xenoestrogens Affects Fertility • 15% of US couples are infertile • In 30% to 40% of these cases, male infertility is the problem • British researchers suspected estrogen-mimicking chemical HPTE, commonly found in pesticides • By experimenting on rats, they found that HPTE directly interferes with testosterone production in the testes
Estrogen and Men’s Health 1.Tufts University found that crop dusters who handled estrogen-impersonating pesticides: > Lost their sexual desire > Developed very low sperm counts 2.German researchers found that estrogen levels in prostatic tissue increase as men get older 3.The journal Prostate reported that estrogen increases your risk of benign prostatic hyperplasia (BPH) 4.Japanese researchers discovered link between estrogens and prostate size: “Estrogens are the key hormones for the induction and development of BPH”
Estrogen: Reference Ranges Men: Serum - < 130 pg/mL Saliva - < 2.5 pg/mL Women: Serum – Early Follicular Phase – 70 to 400 pm/mL Late Follicular Phase – 100 to 900 pm/mL Luteal Phase – 70 to 700 pm/mL Postmenopausal - < 130 pm/mL Saliva – Pre-menopausal – 1 to 10.8 Post-menopausal – 1 to 3.2
Symptoms of Estrogen in Men • Feminization: Gynecomastia • Fat gain • Muscle loss • Cancer • Loss of sex drive • Moodiness & depression
Dangers of a Plastic World Endocrine Disruptors: Chemicals in everyday products that mimic estrogen Vinyl flooring, Deodorants, Hair spray, Moisturizers, Pesticides, Detergents, Perfumes, Garden hoses, Fertilizers, Shampoo, Inflatable toys, Plastics