Transcript Natural Hormones, Stowe UT 2006
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
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2.
3.
4.
5.
6.
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.
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2.
3.
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6.
7.
How?
In Preferred Order
Enlightenment Activity Guidance Food Exercise Nutritional Supplements Exogenous Hormones Herbal Supplements
5 Modern Hormonal Epidemics
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2.
3.
4.
5.
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:
a brief period. 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
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
Case Study: CF's Body Composition Weight % of Fat 325 283 226 222 221 55 42 Fat LBS 177 119 15 33 8 18 7 15 L.B.M
148 164 193 205 206
The Big Fat Lie
Typical American Diet Pre-Agricultural Diet Fats 35% Protein 16% Carbs 49% Fats 38% Protein 31% Carbs 31%
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
High Glycemic Foods
Potato (white, boiled) 104 Rice Krispies 82 French Baguette 95 French Fries 76 Corn Flakes 92 Bagel (white) 71 Instant Rice 91 Mac & Cheese 64
Low Glycemic Foods
Grapes 43 Chicken 0 Grapefruit 25 Eggs 0 Cherries 22 Spinach 0 Beef 0 Walnuts 0
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 of ancient times ” response evolved to deal with different world 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 November, 2002 64 mcg/dL April, 2004 377 mcg/dL August, 2006 505 mcg/dL
PACE & DHEA
Training for Recovery
Periods of stress “ exertion and recovery ” retrain your body to recover from 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
”
Men: Estrogen: Reference Ranges 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
Estrogen Dangers: 2 Big Offenders
Bisphenol A and Phthalates: Chemicals have structures that look strikingly similar to estrogen.
Perfluorooctanoic acids (PFOA): CDC results: Every person tested - without exception - had trace amounts of these chemicals in their bloodstream.
Jim Pirkle, deputy director at the CDC's Environmental Laboratory: "The
big concern with phthalates is that
they have anti-androgen activity."
Reduce Estrogens Daily:
Drink only purified water.
Trim excess fat from meat before cooking. (Hormones only in fat.) Estrogen-fighting foods: Berries, citrus, pineapples, pears, grapes, squash, onions, green beans, figs, melons and pumpkin seeds.
Cruciferous vegetables: Broccoli, cauliflower, Brussels
’
s sprouts, cabbage - excrete estrogen.
Vegetables high in fiber. Longer stool in bowel, more estrogen absorbed.
Free-range poultry and grass-fed beef whenever possible.
Case Study: B.C.
Estrogen Levels: Treatment: DIM 400 mg /day PACE TIW
April, 2003 July, 2003 178 pg/mL August, 2003 180 pg/mL 149 pg/mL October, 2003 134 pg/mL
BC: Before & After
Case Study:
“
KB
” Post-Menopausal; Estrogen Levels August, 2005 543 pg/mL Treatment: DIM October, 2005 268 pg/mL December, 2005 171 pg/mL
Androgens
Testosterone Precursors Treatment Dosages
Androstenedione ---- 10mg 4-Androstendediol ---- 5mg 19-Nor-4 Androstenedione ---- 5mg 19-Nor- 4-Androstendediol ---- 5mg
BIOLOGICAL MARKERS
Testosterone/Estrogen Ratio
Low Testosterone – loss of energy, mental clarity, bone density, muscle mass and sexual activity M & W.
High Estrogen – obesity, uterine and breast cancer for women, prostate disease for men Men: 4 to 1 PM Women: from 1 to 2 to 1 to 4
Case Study:
“
VT
”
Body Composition
Weight % of Fat 125 125 118 112 114 118 27 20 17 16 15 13 LBS of Fat 34 25 20 17 17 15 L.B.M
91 100 98 95 97 103
Testosterone Reference Ranges Men: Serum – 241 to 827 ng/dL Saliva – 30.1 to 142.5 pg/mL Women: Serum – 20 to 76 ng/dL Saliva – 4.5 to 49 pg/mL
Treatment Strategies
Boosting Testosterone:
Increase protein and fat in diet Oral precursor androgens Testosterone shots, gels, patches PACE
Lowering Estrogen:
DIM Indole-3 Carbinol Chrysin Durational exercise or PACE
Case Study:
“
DF
” Initial Meeting: 12/2004 Testosterone: 42 Most Recent Follow Up: 7/2006 Testosterone: 410
Dangers of Testosterone Replacement
Estrogen Excess Dihydrotestosterone
Converted from testosterone
Loss of free testosterone Loss of hair Prostate growth – BPH Rx = DHT blockers + progesterone
BIOLOGICAL MARKERS
INSULIN plays a key role in aging… (Even if you ’ re not diabetic.) • Increases with age • Tells body to build fat • Keep insulin level below 20 • Below 10 even better
Hyperinsulinemia
Treatment Options
Low Glycemic Diet Non-Traditional Exercise (Periods of Exertion and Recovery) Chromium GTF
Gymnema sylvestre
Changes that Occur with Aging
Lung capacity Cardiac output Muscle mass Bone density Excess fat
Age Related Loss of Lung Function
40 30 20 10 0 100 90 80 70 60 50 30 40 Vital Capacity 50 60 70
AGE
Maximal Breathing Capacity 80
190 180 170 160 150 140 30 35 40 45 50 55 60 65 70 75
Resources
Websites: www.AlSearsMD.com
www.WellnessResearch.org
Additional Information
12 Secrets to Virility (Download) http://www.AlSearsMD.com/stoweconf Slideshow: http://www.AlSearsMD.com/Stowe/slideshow Health Confidential Newsletter: http://www.AlSearsMD.com/healthconfidential s/HCE8.html