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Case Study: How A Conventionally Trained Psychiatrist Transformed His Practice by Integrating BHRT and Wellness.

May 10, 2012 Blog,Webinars 0 comments

Presenter:

Louis B. Cady, M.D.
CEO and Founder of the Cady Wellness Institute
Practicing Integrative Functional Neuropsychiatrist

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Dr.Louis Cady, M.D. shared key takeaways drawn from his experience with integration of exciting new therapies into his practice. This webinar will provide an overview of what to expect during his lectures at the Part I course, which will include the following topics: Mental Health and Hormones, “Petal to the Metal” Allopathic Psychiatry for Generalists, How to Transition from an Allopathic Practice to a Hollistic and Integrated Medical Practice.

Objectives:

  • Describe how to make the transformation from “practitioner” to “respected clinician”
  • Learn what it takes to be irreplaceable, non-interchangeable, and in-demand.
  • Recognize the gratitude and loyalty received from patients as a result of this transformation
  • Cease being a “commodity” in the healthcare system and be paid what you are worth.

6 Benefits of Using Social Media for Your Practice

April 16, 2012 Blog 0 comments

Medical Webinars:

Hormone Q&A

Neal Rouzier, M.D.

The Obesity Epidemic

Timothy McKnight, M.D.

Estrogen Optimization

Neal Rouzier, M.D.

Social media. What does it mean for you and your practice? When you think of social media, do you picture Twitter updates every 10 minutes or catchy blurbs posted on Facebook? In reality, social media is more than posting a personal update on every time you brush your teeth, but it is also a practical business tool for bringing attention and traffic to your medical practice.

By definition, social media is a method for sharing information with a widespread audience. It comes through several different communication channels, including radio, television, newspapers, blogs, Internet forums, and podcasts. Social media can often be confused with social networking, which describes a group of individuals that gather in an online community to discuss similar topics of interest. Networks include Facebook, LinkedIn, and MySpace. Social media and social networks are both commonly used in business to strengthen current relationships and attract new customers.

According to a survey by National Research Corporation, 20 percent of patients use social media for healthcare information. Facebook was the most commonly used social network for this purpose, in which patients follow links that are posted by medical professionals.

1. Spread the Word

Social media helps to raise awareness about your practice and provides opportunities to share information with your patients. It also allows you to build a stronger relationship with patients, as you share your health knowledge and respond to patient inquiries.

2. Connect with Other Professionals

You can share and obtain information from other professionals in your field to develop a larger network, as well as receive or give industry advice.

3. Establish Your Business Identity

With millions of people regularly logging on to social network sites, you can help ensure people are aware of your practice. Creating a business page through a social network is a way to provide information that can be passed on by your patients to their friends. This helps more people know that your practice exists; plus, they are more likely to contact you when they know their friends like your practice.

4. Increase Website Traffic

Using social media can help increase traffic to your medical practice website and create new customers.

5. Stay Connected to Patients

Social media helps physicians stay connected with their patients on a regular basis. You can follow the information and services they like by tracking the links they choose to click on.

6. Market Research

Opinions are openly expressed through social media sites. Patients can share their thoughts to help you improve patient satisfaction with the information, products, and services you provide.

SSRI’s Have Side Effects, but is Hormone Replacement the Answer?

April 4, 2012 Blog 0 comments

Medical Webinars:

Hormone Q&A

Neal Rouzier, M.D.

The Obesity Epidemic

Timothy McKnight, M.D.

Estrogen Optimization

Neal Rouzier, M.D.

Can hormone replacement therapy replace antidepressants? Antidepressant medication, also known as selective serotonin reuptake inhibitors (SSRIs), has been shown to have a number of side effects, including insomnia, nervousness, sleep problems, headaches, joint and muscle pain, stomach upset, sexual dysfunction, and bleeding problems. Even so, antidepressants are the third most widely prescribed group of medications in the United States. Many individuals may be taking antidepressants for minor complaints, without considering the potential risks. What some may not realize is that hormone replacement therapy may be considered a safer, effective alternative to SSRIs.

Hormone imbalances can lead to depression.

In men, low testosterone levels can cause mood and emotional issues. If male patients choose to take SSRIs to treat depression, they increase their risk of infertility and sperm quality damage. SSRIs have been shown to reduce sperm count in men by 50 percent, as well as damage the motility and shape of the sperm.1 2

In contrast, hormone replacement therapy (HRT) restores the body’s natural production of hormones, including testosterone, to relieve depression and emotional issues that are related to hormone imbalances. Men that are concerned about the side effects associated with antidepressant medications may find HRT to be a safe and effective alternative.

Research has suggested that HRT and antidepressant therapy may have similar molecular targets.

When the results of the Women’s Health Initiative were published, many women immediately stopped HRT; a subsequent increase in the use of antidepressants is well documented. Women who were using HRT had climacteric symptoms reduced, including depression. 3 Estrogen therapy has been suggested to effectively treat perimenopause women with depressive disorders.4 5

HRT goes beyond just relieving depression to provide overall health benefits on cognitive function, cardiovascular health, weight management, energy, sexual health, and quality of life that result in confidence and a better mood. Even so, does this make hormone replacement the answer for treating depression? If a patient’s depression is related to hormone imbalances, then HRT can dramatically improve mood without the side effect of common antidepressants and anti-anxiety medications. Yet, HRT may not be the answer for everyone.

Start by reviewing the Big Picture

Overall, it is best to determine the method of treatment on an individual basis. Start by reviewing the big picture, which includes nutrition, exercise, and lifestyle habits.

Dr. Louis Cady, known for studying the connection between psychiatry, hormones, and wellness, explains, “In many cases I found that I could not make them better working from the neck up, and that no matter how good my potions were they didn’t get better. And then I began looking a little bit further. I got more professional education and began to understand this mind-body divide in contemporary medicine. Where if a conventionally trained physician can’t diagnose somebody in terms of really what is going on, they will say, “Well, it is all in your head” and then I will get them. And I will find many times that it is not just in their head. It may be in their thyroid or it may be in other parts of their body. They may have a sleep disorder. And so I decided that instead of just limiting myself to pushing pills all day I was going to do what I was trained to do, which was to be a complete physician.”

Establish the basics.

The best solutions to consider for depression or any other health complaints are proper nutrition, exercise, behavior modification, and natural hormone balancing. All of these are crucial elements to increase well-being, vitality, and health. While SSRI’s still serve a necessary purpose for many people, instead of first looking at an antidote to fix the problem, it is best to look at what is needed to maximize the patient’s overall health and happiness.

      References

    1. Hendrick V, Gitlin M, Altshuler L, Korenman S. Antidepressant medications, mood and male fertility. Psychoneuroendocrin. 2000 Jan;25(1):37-51.
  1. Tanrikut C, Feldman AS, Altemus M, Paduch DA, Schlegel PN. Adverse effect of paroxetine on sperm. Fertil Steril. 2010 Aug;94(3):1021-1026.
  2. McIntyre RS, Konarski JZ, Grigoriadis S, Fan NC, et al. Hormone replacement therapy and antidepressant prescription patterns: a reciprocal relationship. CMAJ. 2005 Jan;172(1):57-59.
  3. De Novaes Soares C, Almeida OP, Joffe H, et al. Efficacy of estradiol for the treatment of depressive disorders in perimenopausal women: a double blind, randomized, placebo-controlled trial. Arch Gen Psychiatry. 2001 Jun;58(6):529-534.
  4. Schmidt PJ, Nierman L, Danaceau MA, et al. Estrogen replacement in perimenopausal-related depression: a preliminary report. Am J Obstet Gynecol. 2000;183:414-¬420.

Hormone Q&A: Round 2 of BHRT Guidelines and Takeaways

March 29, 2012 Blog,Webinars 0 comments

Due to an overwhelming number of responses from the 1st Q&A session, we decided to host another live web conference. But really, I think it has to do more with the fact that Dr. Rouzier has an addiction he cannot get away from- his willingness to go over the time limit to ensure all questions are answered. Get real HRT guidelines from this truly enlightening presentation.

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The following questions were answered during the web conference:

What is your usual starting dose of hormone replacement in perimenopause and menopause. If a woman has family history of breast cancer would you change your course of treatment?

What would be your typical dose of testosterone cream in perimenopause?

If a woman develops bleeding on treatment how would you adjust the dose?

Any specific time of the cycle you suggest to check serum hormone levels in perimenopausal lady, or random test?

A young woman with PCOS not obese, gained weight on Progesterone p.o and Metformin. Can progesterone cause that? Metformin should promote some weight loss so could it be Progesterone 100 mg qhs?

After attending Part 1, I have been doing full thyroid work ups and have found a lot of low, non-optimized free T3′s. Some of my patients are on levothroid/synthroid. What is the best course, increase the synthetic, add Armour and how much, or switch to Armour alone.

Please discuss your treatment protocol for providing estrogen and progesterone in a lady who is 5 years out breast cancer?

Can you discuss your treatment recommendations for patients who you believe would benefit from HgH but fearing prescribing this medication?

I can’t get around the problem of bleeding that happens in the early menopausal female who starts BHRT. Also the perimenopausal female who may not bleed for 6 weeks then gets heavy menses. I’ve tried pushing progesterone up to 400 mg daily but did not resolve.

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I have a pt on armour thyroid 60 mg daily. Her repeat thyroid labs show a suppressed TSH, with a low Free T3 (2.7) and Free T4 (<1). She did 4 point cortisol testing and this showed mild adrenal fatigue. Could this be the reason? How would you proceed?

Would you start HGH on a very physically active 53 yr old male with hypothyroidism, hypoandrogenism and pre metabolic syndrome, who has had DHEA, Testosterone, and Thyroid optimized, who been on a low glycemic high protein diet, but he remains frustrated with little improvement on abdominal and visceral adiposity. IGF -1 values baseline 129 and most recently 151.

I have many hypo gonadal male patients who experience dramatic improvement in mood, body composition and libido during the first four months of testosterone supplementation but these benefits seem to taper off after 9 to 12 months even though their hormone values have been optimized. Is this a reset of their expectations, receptor saturation or are they secretly not as rigorous in their diet and exercise routine.

Would supplementing a 45 yo man with transdermal testosterone in addition to HCG affect fertility?

A 48 year old male symptomatic of hypo gonadism with a free testosterone 74, still wanted to have children. I placed him on HCG 500 IU SQ QD with a repeat level in 8 weeks. My question is titrating the HCG up and how much. What are the risks of depressing spermatogenesis if I add Testosterone cream to the HCG?

With long standing insufficiency especially in elderly what is exp. with rate of replacement?

Why would the DHEA be high in someone on no hormonal supplements as yet? Does that effect my choice giving other hormones that may be DHEA precursors?

What is the best plan for a perimenopausal woman whose goal is to loose visceral fat?

How do you increase the increments of the hormonal dosing?

Nipple tenderness is a side effect of which hormone? How is it treated?

Bleeding is a side effect of estrogen only, correct?

If you place a woman on pregnenolone for memory improvement, would you see an increase in DHEA, progesterone, testosterone, or estrogen?

Which pharmacy do you recommend for the best price on Testosterone Cypionate 200mg/ml . Is it safe to use Testosterone that appears coagulated or crystalized upon delivery?

Are concerns or suggestions for women currently on Mirena IUD that are interested in starting BHRT. Please advise.

What labs, markers, and functional tests would you consider the nominal baseline for a new client? Vit. D? Full thyroid panel? VAP cholesterol? DXA, IMT, VO2 Max, EKG? Saliva cortisol?

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My internist would not renew my T therapy started elsewhere unless I underwent a Stress Echo [14.5 minutes out of 15] and an IMT [negligible plaque], probably because I had elevated cholesterol numbers and a family Hx of CAD. Cholesterol is not the defining factor I know, but would you want these baseline exams anyway in someone over 55?

What baseline labs do you draw to screen for thyroid?

How do you treat an elevate rT3?

What are your thoughts re bio identical HRT after breast cancer with positive estrogen receptors in DCIS? Are there clinical studies to support use of this type go HRT for this patient type?

What are the ideal levels of estradiol for men on HRT?

What are the most rationale strategies to combine HCG and Testosterone injections in patients?

Using Armour thyroid, I’m getting levels all over the map. I test at 11:30 am which is 6 hours after the dose. I’ve used bid dosing as well as larger am doses and I’m still getting a lot of variation. Words of wisdom?

I have a 52 yo male who’s testosterone level at 100mg bid, 150mg bid or 200mg bid is always below 500 (i.e., his latest level is 300 and that is on 200mg bid!?! Is he cheating, not taking it day of test, or is it possible that he just can’t absorb it?

Use of Progesterone in patient on Tamoxifen s/p breast cancer, mastectomy, receptors strongly positive for estrogen and progesterone: Is it indicated? If so, oral or cream? Is it contra-indicated? Her estrogen level is 500, Progesterone 0.5, DHEA Sulfate is 150, T3 is 2.4. Should I be thinking of DHEA or 7-Keto DHEA to optimize her levels?

Use of 17keto DHEA?

Transdermal vs oral estrogen therapy?

Should I treat patients under 40 for low testosterone?

Review the pro and cons of PO or cream bio identical hormones.

Thyroid: What is the best indicator TSH or Free T3?

Pro’s and con’s IM Testosterone vs. SQ and Test replacement with HCG combined.

Please comment on hormone replacement in type 1 diabetic, no other risk factors.

How do you treat Type 1 diabetes in 41 yo that is very symptomatic and blood sugars are getting worse and are all over the place? She is worried about stroke risk with estrogens.

My daughter has PCOS. She is not overweight. Her endocrinologist has her on BCPs. Can she take bioidentical progesterone along with her BCPs? She is 25 years old. She has not taken metformin.

My dad is 83 and early Alzheimer’s. My mom is 73 healthy but has a pancreatic duct stent for a stenosis likely resulting from an injury in childhood (Yes, thats what the GI guy says). How does one begin age management rx in an old feeble man and an older woman NOT on any HRT?

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Is there a way to improve the transdermal absorption of progesterone?

In men, do you prefer testosterone in lipoderm or carbogel and why? (HI NEAL)

If I want to add progesterone as a treatment for fibromyalgia patients, where would I begin?

If a 56 year old post-menopausal woman has been on premarin and provera for 10 years already…is it ok to have her stay on hormones (estradiol and prometrium) now?

I have a 50 yo woman with a carotid dissection history, otherwise healthy, going through menopause and her neurosurgeon warns her about HRT because it will increase her risk of strokes. Am I correct by advising her that transdermal estradiol and progesterone replacement are okay. What data do I have to support this?

I am constantly adjusting Armour for a female whose eyebrows are diminishing. She is up to 3 Gr. bid after 3 months, and the eyebrows are again starting to decrease. I will measure Iron and ferritin soon, but any other supplements that can help?

I am attending the A4M conference for another perspective, and the consensus of the speakers here is to not prescribe any oral post-menopausal estrogen due to the inflammatory component. Their preference is Bi-est. Your comments?

How do you assess for adrenal insufficiency/ adrenal fatigue?

What is your initial therapy (i.e. hormones and doses) for adrenal fatigue for women and for men?

What are the preferred options and doses for transdermal testosterone for initial replacement therapy?

Endometriosis- Patient is currently perimenopausal and symptoms are well controlled on BCP. Will changing from BCP to BHRT cause the endometriosis to recur

Prostate cancer and testosterone therapy. What parameters do you use to determine if/when safe for testosterone replacement. eg – pt is 2 years s/p proton radiation Rx for contained, gleason 7 tumor. current total psa= 0.5

Does spironolactone for acne decrease free testosterone levels?

Confusion about progesterone and estrogen use in women who have had breast cancer and the benefits the literature suggests. But they seem to lump all breast cancers and stages together. Can you help me – when to use hormone therapy (estrogen or progesterone) and which what types and stages. I was at the AMMG conference in Vegas and heard your talk 2011 which I found very enlightening.

Best time to measure serum testosterone? How many hours after using it transdermally?

Can you comment on each of the following determinants of penile blood flow and their contribution to correcting ED: exercise? plant-based diet and it’s favorable effects on Nitric Oxide? Testosterone supplementation? Can you prioritize this list with regards to treating ED?

48 yo patient who has markedly elevated FSH and LH and almost zero estradiol levels but is still having periods, can we start them on estrogen replacement or wait till at least 6 months till no periods?

For the perimenopausal patient, is there any advantage of only 2 weeks per month progesterone vs. continuous?

Please give pros and cons of route of administration of estrogen especially as some data suggests that transdermal may be the safest route with regards to risk of dvt.

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Does the “positivity “, estrogen or progesterone receptors of breast cancer cells have any significance in the treatment of a woman post breast cancer?

I had the understanding that breast cancer is an estrogen responsive tumor, but not progesterone responsive? Can you clarify?

Is it necessary in testosterone replacement, also to use HCG?

Is it possible for oral DHEA supplementation in men (50-100mg) to feedback and decrease endogenous testosterone production?

WHI showed that in the ERT group the results re: breast cancer were neutral or showed perhaps slight benefit as to reduction of breast cancer. We are also talking about protecting the breast with progesterone from the cancer promoting effects of bio identical estradiol. Is that relating only to endometrial cancer? Or is that being over cautious?

Does Braca or receptor status of breast cancer affect decision to give bio identical hormones in a patient after 5 year cure? E+, P+ HER, or triple negative? What about receptor status of breast cancer in a family member. Should that affect our decision making?

These questions are coming up from the women’s health practitioners who send me patients for cardiovascular risk stratification, and the patients are more worried about breast cancer risk!

    References

Hormone Q&A: An Evidence-Based Web Conference

March 1, 2012 Blog,Webinars 0 comments

On leap year day, we launched our first online Q&A session and received an outstanding response. It provided a wealth of knowledge and HRT guidelines for physicians and practitioners who are newbies, and for those who have been practicing it for years. This web conference was presented by Neal Rouzier, M.D.

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The following questions were answered during the web conference:

Would you please walk us through your bleeding algorithm for female patients on estrogen, progesterone, and testosterone therapy. i.e. from increasing progesterone dosage to referring out for embolization, ablation etc.

Will the FSH in a post-menopausal woman who is on adequate E2 replacement revert to follicular levels, or are the feedback receptors desensitized so it stays elevated?

What is the best way to follow a male’s testosterone level if he is maintained on a compounded transdermal cream?

When should we stop treating symptomatic postmenopausal females or symptomatic post-hysterectomy females with estrogen and estradiol?

Are there any post-menopausal or post-hysterectomy females who should not receive progesterone?

Should progesterone also be used on a peri-menopausal basis or for younger females with PMS symptoms?

When is the optimal time for testosterone to be rechecked in men who inject every 2 weeks?

What is your opinion on using Bhcg as an aid to weight loss?

What is the ideal route of testosterone supplementation?

What is your opinion and experience with sublingual testosterone drops?

What is your current opinion regarding the relationship between optimal thyroid hormone replacement and the risk for osteoporosis? If free T4 and free T3 are optimal, Is there a TSH blood level that you would consider too low?

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Do you think it is important to include pregnenolone in a balanced approach to promote healthy aging?

What is the cut off point for elevated h&h in patients that are being treated with testosterone?

What is your current treatment for hairloss in females when all your hormone adjusted levels are normal?

What is the best way to test for testosterone level and adjust the dose?

Can we replace the thyroid hormones only with T3 slow release?

What guidelines do you use when providing BHRT to women with a family history of breast cancer?

What clinical significance has elevated DHEA levels after oral supplementation has started with low dose (50-75mg day orally)?

What are some situations in which prolonged-release micronized progesterone is better than the regular-release micronized progesterone?

Use of testosterone after prostate cancer- how long do you wait?

Thyroid question: What do you think of patients that need increasing doses of thyroid meds?

Do you think there is evidence that we should prescribe T4 & T3 in a particular ratio?

Testosterone Cream vs IM : What are your considerations? (assuming patient has no preference and transfer is not an issue)

Is it possible to achieve the same levels of free and total testosterone using cream? Is there a significant difference in monthly cost to the patient?

Stage 4 sleep: At what age do men and women start losing it? What are typical subjective complaints and changes in lab values? How and when do you treat?

Starting BHRT on post-menopausal woman who starts vaginal bleeding. What steps should be taken and how do we introduce the estrogen, progesterone and testosterone (order and dosages) to prevent the bleeding?

Patient has a “breakout” (acne) on progesterone, how do we treat it so that we can get to therapeutic blood levels?

Since progesterone is only produced by the corpus luteum in the luteal phase of the cycle wouldn’t it seem contradictory to administer during the proliferative phase and likely interfere with the ovulation mechanism?

Recommended hormonal therapy for breast cancer patients on Anastrazole? Can they have some progesterone and testosterone back in a transdermal cream or even some estrol?

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Patient with TSH 10, free T3 3.7, free T4 1.35?

Post-menopausal bleed, sometimes it is not transitory. Now what?

Premenopausal women are starting to come to me wanting to start bioidentical progesterone and testosterone. I am concerned with the ones who chose to keep their IUD with progestin. Can they still receive progesterone and testosterone, their levels are low but they want to keep their IUD’s? Some of these women want to use bioidentical progesterone, I have not found a study to support this use?

Oral or transdermal estrogen: which is better & why?

What is your take on 17 keto DHEA?

Is it possible to increase estradiol levels using a cream to protective levels for bone and heart?

Indication for prolactin?

I am watching men on testosterone and the estradiol is getting quite high….can you review the issues there.

In women who already on estrogen, can you treat with progesterone only for extended periods of time?

I am finding that often Armour thyroid is not optimizing both T4 and T3 simultaneously, and I am thus reverting to liothyronine and levothyroxine. What has been your experience? Is it preferable to have thyroid compounded?

How to increase testosterone without supplementing or when supplementing is not enough?

Hair loss for women: their thyroid has already been treated.

How to handle irregular bleeding in perimenopause. Short cycles, long cycles, no cycles?

For male patients on trans-dermal testosterone replacement is high/increasing estradiol levels an indicator for increased risk of prostate cancer?

I have come across some BHRT practitoners including Progesterone and aromatase inhibitors to the transdermal testosterone formulation. What is your comment on this?

Is corionic gonadotrophin used in a man and when?

I get the impression that IM testosterone was good for muscle development, but peaked and dropped out too soon. Is it advisable to use IM testosterone twice weekly and use the creams in the off days to maintain levels? (Of course, appropriate monitoring of blood levels would be employed.) Would this not give the best of both worlds?

After 3 months of testosterone replacement (compounded transdermal), free and total blood levels have fallen off. Is this due to lack of absorption in some patients What would you recommend in the future, injections or pellets?

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Do “normal” FSH and LH levels in a woman on HRT mean that the HRT is adequate?

Should a woman with normal premenopausal levels be cycling?

With the changing healthcare environment, cost of overhead, and retirement looming, I would like to continue to provide hormones through an internet-based practice. What would be some concerns that need to be addressed to do this safely and legally?

Is there a commercial DHEA supplement that you like? or melatonin? Any good branded products?

Testosterone supplementation, either injectable or cream, causes significant rise in HCT. What is best resolution and/or replacement?

Please discuss preference and reasons for choosing armour thyroid or synthroid or other forms of compounded thyroid.

Oral, topical, or pellet form estrogen replacement. Which is the best form to use and in what case. There is argument about them being safer than oral. What guidelines do you suggest?

Cosmetic Procedures and Aging Skin: Can BHRT Help?

February 21, 2012 Blog 0 comments

Medical Webinars:

Hormone Q&A

Neal Rouzier, M.D.

The Obesity Epidemic

Timothy McKnight, M.D.

Estrogen Optimization

Neal Rouzier, M.D.

Hormone Replacement and the Skin

As women age, they start to recognize a dramatic change in their skin. This is often due to a decline of estrogen in the body, which causes the inactivity of estrogen receptors and loss of estrogen production in the skin. Dry, rough, burning, and thin skin, as well as fine lines and wrinkles, can develop when estrogen is no longer being produced1.

Studies have indicated that estrogen therapy can increase collagen and hyaluronic acid production to improve skin thickness and hydration. A study published in the American Journal of Clinical Dermatology found that estrogen therapy restores skin thickness, decreases wrinkle depth, and improves collagen production and hydration. One study showed that women using hormone replacement therapy had a 10 to 20 percent increase in skin thickness, when compared to those not being treated. HRT also reduced atrophy (fragile, fading skin) that occurs in aging skin1.

HRT Can Speed Surgery Recovery

Hormonal changes often cause an age-related delay in the healing of body tissue and skin. An estrogen deficiency can dramatically decrease the rate of cellular response to injuries2. Restoring healthy hormone levels, particularly estrogen, can increase the rate of healing among individuals recovering from injuries or surgical procedures.

Patient Demand for Youthful Health and Appearance

Cosmetic surgery is commonly used among postmenopausal women to bring back a more youthful appearance. Hormone replacement therapy (HRT) is an added bonus for cosmetic surgery patients, because it supports the healing process and speeds recovery from surgery.

Dr. Neal Rouzier explains the benefits of using HRT among cosmetic surgery patients; “I personally have found longevity and preventive medicine to be a natural extension of cosmetic surgery. Patients find they can surgically reverse the effects of gravity and aging through face-lifts, eyelifts and liposuction. When I prescribe HRT to a patient before surgery, they heal faster and feel better postoperatively. If the patient continues the natural hormone supplements post operatively, two wonderful things happen. First, they will probably experience improved results of the tummy tuck or face lift, due to the strengthening and thickening of the skin. Second, they will begin to feel good with increased energy, libido, skin texture, muscle-to-fat distribution, and improved mental clarity. Most of all, I give my surgical patients a choice in how they age after their cosmetic surgery.”

Choosing the right form of HRT

While HRT has been shown to benefit aging skin, all HRT is not created equal. As an important reminder, synthetic HRT is considered harmful, as certain risk factors are associated with this type of treatment. Bioidentical HRT, hormones that are similar to those produced in the body, is a safer alternative to conventional HRT. This form of therapy protects women from health ailments related to the loss of hormones that comes with aging. Plus, bioidentical HRT has incredible benefits on improving skin quality. Remember, it is always best to support HRT guidelines that are based on peer-reviewed studies and protocols that have been tried and tested.

    References

  1. Vaillant L, Callens A. Hormone replacement treatment and skin aging. Therapie. 1996;51(1):67-70.
  2. Ashcroft GS, Ashworth JJ. Potential role of estrogens in wound healing. Am J Clin Dermatol. 2003;4(11):737-743.
  3. Shu YY, Maibach HI. Estrogen and skin: therapeutic options. Am J of Clin Derm. 2011 Oct;12(5):297-311.

Nutrition Webinar: The Obesity Epidemic – How Can Practitioners Empower Patients to Reverse the Problem?

January 13, 2012 , Blog,Webinars 0 comments

This nutrition webinar with Dr. Timothy McKnight reveals statistics for the Obesity Epidemic in America, along with case studies and proven solutions from his successful wellness program, Fit for Life. CLICK HERE for the recording.

Objectives:

  • Demonstrate clinical knowledge of America’s Nutritional Crisis
  • Describe the Health and Economic Impact
  • Implement techniques to maximize Nutritional Replenishment
  • Analyze the impact of food choices and supplementation
  • Empower patients to change behavior and FEEL BETTER


    • The World Health Organization has defined obesity as, “one of today’s most blatantly visible – yet most neglected – public health problems.” Also referred to as “globesity”, because it is affecting a large majority of the world population, obesity rates have increased more than three-fold since 1980. It is considered a complex health condition that reaches all ages and socioeconomic groups. Approximately 1 billion people are overweight worldwide, while over 300 million of these individuals are considered obese. This is a great concern to health practitioners, as obesity is a major risk factor for several chronic diseases, including high blood pressure, stroke, cancer, type 2 diabetes, and cardiovascular disease.

    What has led to the obesity epidemic? Two main contributing factors are an increase in the consumption of nutrient-poor, calorie-dense foods and a reduction in physical activity. In more recent decades, there has been a change in society’s behavioral patterns, as urban living, passive leisure activities, and hours spent sitting at work or at home have led to more consumption of processed foods, a lack of physical activity, and consequently – a higher rate of obesity.

    What can be done to reverse this epidemic? Dr. Timothy McKnight provides real answers for Practitioners from all backgrounds in this nutrition webinar.

    Hypothyroid Symptoms But Normal TSH Levels? How to treat symptoms of low thyroid by optimizing free T3 levels.

    November 30, 2011 Blog 0 comments

    Medical Webinars:

    Hormone Q&A

    Neal Rouzier, M.D.

    The Obesity Epidemic

    Timothy McKnight, M.D.

    Estrogen Optimization

    Neal Rouzier, M.D.

    Fatigue, weight gain, forgetfulness, mood swings…did the holidays just hit? Or are these symptoms an indication of hypothyroidism? While you might struggle with the holiday season to maintain energy and sanity, these persistent symptoms are a few of the signs related to low thyroid function, also known as hypothyroidism.

    What Is Hypothyroidism?

    More commonly found in women, approximately 5% of Americans have hypothyroidism, which occurs when the thyroid gland is unable to produce enough thyroid hormone to support several metabolic functions in the body. The thyroid gland secretes two main hormones, thyroxine (T4) and triiodothyronine (T3). T4 is the hormone that is principally produced by the thyroid gland which is then converted in the liver and kidney to the metabolically active T3 hormone. It is the T3 that is responsible for regulation of metabolism, energy production, body temperature, body fat, cholesterol, cognitive function, and symptom improvement.

    How do you know if your thyroid levels are low?

    There are over 200 symptoms related to low thyroid function that improve with optimal thyroid replacement:

  • Colder body temperature
  • Symptoms of poor circulation in the hands and feet
  • Fatigue
  • Depression
  • Forgetfulness and fuzzy thinking
  • Muscle and joint pain
  • Dry skin and brittle nails
  • Digestive ailments (constipation, IBS, etc.)
  • Menstrual irregularities and infertility
  • Emotional instability
  • High cholesterol
  • Weight Gain

    • Recommended Treatment from Dr. Rouzier:

    Optimizing thyroid function by replacing thyroid hormones to optimal (upper range of normal) can significantly increase energy, metabolism, and well being. Many studies (NEJM & JCEM) demonstrate that raising Free T3 levels in addition to T4 levels is essential to obtaining these results. Traditionally physicians have prescribed thyroid hormone in a form of T4 only, also known as Synthroid®, Levoxyl®, or L-thyroxine. Recent studies, however, have demonstrated that this may not be sufficient in many patients to truly feel well. Many thyroid treated patients commonly request even more thyroid, knowing that more makes them feel and function better. The patient might not have realized how lousy they felt until they felt better. This might not be accomplished, as per recent literature, until these patients have improved or optimized T3 replacement as it is the T3 at the cell level that is responsible for thyroid function, and not T4. Nevertheless, it is usually only the T4 preparations that physicians are taught to use for thyroid replacement. Unfortunately using primarily a T4 only preparation typically does not allow for adequate conversion to T3 and therefore improvement in symptoms is often not adequate. Many factors play in the inadequate conversion of T4 into T3 and are related to a defective function of the 5’-deiodinase enzyme responsible for this conversion. Whatever the cause for the inadequate conversion of T4 to T3, many patients have persistent low thyroid symptoms despite adequate T4 replacement. Several landmark studies demonstrate that this can be overcome by simply adding T3 on to the T4 regimen. Improvement in T3 levels can be attained by compounding both T4 and T3 together into a capsule or through the use of the commercially available desiccated thyroid preparations that contain T4 and T3 together in tablet form. The commonly prescribed T4 preparations of L-thyroxine, sometimes referred to as synthetic thyroid and contain only T4 and no T3, might not convert to the active form of T3 which is especially critical for patients who are not able to properly and adequately convert T4 to T3.

    A paper published in JAMA demonstrated the importance of T3 in predicting morbidity, mortality, and functional decline. Neither TSH nor T4 were predictive, thereby further establishing that T3 should be the main marker utilized for thyroid replacement.”

    Dr. Rouzier recommends physicians review the excellent articles published in NEJM, JCEM, and JAMA to further appreciate the importance of T3 optimization for health and well-being.

    Utilizing a combination of both T4 and T3, as suggested by recent literature, most effectively raises the active thyroid hormone at the cell level called T3. Science has proven that it is the T3 level, and not the T4 level, that is responsible for maintenance of normal cholesterol levels. Commercially available combinations of T4 and T3, commonly called desiccated or natural thyroid, will provide more optimal levels of T3 than commercially available T4 only preparations. Since T3 is the more metabolic hormone, low T3 levels result in poor metabolism and symptoms of low thyroid. When pure T4 is given in the form of Synthroid®, Levoxyl®, or L-thyroxine, T3 levels improve only minimally due to poor conversion of T4 to T3. Many physicians including endocrinologists believe that T4 alone is the only thyroid preparation necessary to prescribe for hypothyroidism. Their reasoning is the belief that the body will automatically (physiologically) convert T4 into T3 if the body needs it. If the body doesn’t need it, then it won’t make it. This commonly held belief, however, is not what is born out in the medical literature for optimal thyroid function. Recent studies show that use of T4 alone does not adequately convert into T3. Although many patients do improve on pure T4 supplementation alone, adding T3 to the T4 preparation allows us to optimize T3 levels that are not usually achievable with pure T4 preparations alone. It is only supplementation of T3 that augments the antidepressant of thyroid hormone, not T4.

    Treatment should restore thyroid to OPTIMAL levels and not just normal.

    Conventional treatment for thyroid disorders involves restoring TSH into the normal range which might still maintain levels of T3 in the low normal range in spite of normal TSH levels. Restoring T3 levels into the upper range of normal is now regarded as necessary to achieve improvement in health and well-being. Normal laboratory levels are the average of a population for the age but do not reflect that which would be best for symptom improvement and health. In other words, normal does not mean optimal or what is best for the patient. A recent article in “Gerontology” demonstrated that thyroid replacement in euthyroid men (normally not needing thyroid replacement) into the upper or high range resulted in improvement in cognition, memory, and overall function. This study is just one of many that consistently demonstrate that optimization of all hormones, including low thyroid, provides better metabolism, health, well-being, and disease prevention than does maintaining “normal” levels for the age. Keep in mind that normal levels (average for the age) of estradiol, progesterone, and testosterone are zero in menopausal women. Even though that is the level typically measured in a menopausal woman as menopausal women no longer make these hormones, normal (zero level) is not where the level should be for symptom improvement and health protective benefits (cardiovascular and musculoskeletal). The same applies to thyroid. Low T3 levels were predictive of an increase in fracture rate whereas TSH and T4 levels were not predictive or protective. Where would you like your levels to be? The Rotterdam study (Annals of Internal Medicine) demonstrated that normal levels of thyroid (in the lower 50% of normal) were predictive of a 2.2 fold increase risk of cardiovascular disease, and these were levels in the “normal” range. There is now significant data to support that we physicians should conform to the literature recommendations and understand that in every circumstance optimal levels of all hormones, including thyroid, are very important for health optimization and improvement in symptoms, and subsequently our quality of life.

    By simply restoring TSH levels to “normal” blood levels for your age might not be in the best interest for the patient. Lab tests can indicate normal or low normal thyroid levels, but patients can still have symptoms associated with hypothyroidism. According to the BMJ, goals of thyroid replacement should be to treat the patient until the Free T3 and Free T4 levels are in the high normal range. Some patients might require levels that are above normal (suppressed TSH) to feel normal, a concept that we physicians are not taught to trained to do. Researchers emphasize that TSH is not predictive of symptoms or symptom improvement, only T3 is as this is the active hormone at the cell level. Although TSH is very predictive of biochemical hypothyroidism, it is not predictive at all of clinical symptomatology. Rather than treating the patient’s lab tests, researchers suggest that physicians should treat the patient’s symptoms and not the TSH level as we are often taught. Researchers emphasize that if the Free T3 and Free T4 levels are kept within the upper end of normal, in spite of suppressed TSH levels, then overt hyperthyroidism is averted. Thyroid hormone serum levels that are in the optimal range that thereby result in a reduction of hypothyroid symptoms indicate healthy thyroid function.

    Benefits of Optimal Thyroid Treatment

    Optimal thyroid replacement can effectively restore health and well-being by improving:

  • Temperature regulation and metabolism
  • Increased energy
  • Fat breakdown for healthy bodyweight and cholesterol
  • Protection against cardiovascular disease
  • Protection against depression and mood disorders
  • Cerebral function and cognition
  • Healthy skin, hair and nails
  • Protection against functional decline

    • References

      References

    1. Applehof BC, Fliers E, Wekking EM, Schene AH, et al. Combined therapy with levothyroxine and liothyronine in two ratios, compared with levothyroxine monotherapy in primary hypothyroidism: a double-blind, randomized, controlled clinical trial. J Clin Endocrinol Metab. 2005 May;90(5):2666-2674.
    2. Bunevicius R, Kazanavicius R, et al. Effects of thyroxine as compared with thyroxine plus triiodothyronine in patients with hypothyroidism. N Engl J Med. 1999; 340(6): 424-429.
    3. Gussekloo J, van Exel E, de Craen AJ, Meinders AE, et al. Thyroid status, disability and cognitive function, and survival in old age. JAMA. 2004 Dec;292(21):2591-2599.
    4. Hak AE, Pols HA, Visser TJ, Drexhage HA, et al. Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study. Ann Intern Med. 2000 Feb;132(4):270-278.
    5. Klein I, Ojamaa K. Thyroid hormone and the cardiovascular system. N Engl J Med. 2001; 344(7): 501-509.
    6. Meier C, Trittibach P, Guglielmetti M, Staub J, Muller B. Serum thyroid stimulating hormone in assessment of severity of tissue hypothyroidism in patients with overt primary thyroid failure: cross sectional survey. BMJ. 2003 Feb;326(7384):311-312.
    7. Prinz PN, Scanlan JM, Vitaliano PP, Moe KE, et al. Thyroid Hormones: Positive Relationships With Cognition in Healthy, Euthyroid Older Men. J Gerontol. 1999;54(3):M111-M116.
    8. Rouzier N. How to achieve healthy aging. 2007. Salt Lake City, UT: WorldLink Medical Publishing.
    9. Toft AD. Thyroid hormone replacement – one or two? N Engl J Med. 1999; 340(6): 468-470.

    What Are Normal Testosterone Levels in Men? Dr. Neal Rouzier Makes a Recommendation.

    October 28, 2011 Blog 0 comments

    Medical Webinars:

    Hormone Q&A

    Neal Rouzier, M.D.

    The Obesity Epidemic

    Timothy McKnight, M.D.

    Estrogen Optimization

    Neal Rouzier, M.D.

    What is considered the normal range for testosterone levels in men? It may seem like an easy question to answer, as traditionally serum testosterone levels are observed to be anywhere between 300 to 1,200 ng/dL. Yet, the answer to this question is not as simple as it may seem.

    Hypogonadism, or an androgen deficiency, affects an estimated four to five million men in the United States. More than 60% of men over 65 years old have low free testosterone levels. Even so, hypogonadism often goes undiagnosed and older men experience a rapid decline in their health. Low testosterone levels can be observed through serum tests, but what are normal testosterone levels? What are optimal testosterone levels? The answer to this question depends on who you ask and varies widely amongst healthcare practitioners. Hormone Doctor, Neal Rouzier. M.D. gave his expert opinion in a recent interview.

    Dr. Rouzier’s Recommendation

    “An important point is the difference between optimal and normal. Normal for one’s age is not optimal for one’s age. The medical literature supports replacement levels to that of a younger age, typically 20 to 30 years old. At these levels, optimal health is attained, as well as the feel-good effects. The problem is how one defines normal and optimal. Normal for a 70-year-old is not normal for a 20-year-old. If a 20- year-old man has the testosterone level of a 70-year-old man, he will not feel well. If a 70-year-old man has the level of a 70-year-old man, this is considered normal. No man should have the testosterone level of a 70-year-old as supported in our medical literature. In reality we are not trying to be 30; however our goal is to optimize levels to those we would see in a 20 to 30 year-old. A free testosterone lab value of 25 may be interpreted as optimal when in fact this level is quite low. A lab value of 40 would be interpreted as being too high when in reality it is a perfect level and our goal for a younger person. All the medical studies utilize hormone dosages resulting in levels on the upper end of the physiologic range. These are levels found in young adults.

    In past years, various labs would list the testosterone ranges for all ages next to the lab results. Today, the labs publish only the normal levels based on a person’s age. This does not provide the appropriate indication of optimal levels as it is age specific. For example, normal free testosterone levels for a 60-year-old man range from 5 to 25. Optimal is therefore expected to be 25. A traditional medical doctor would interpret 25 as optimal. But remember, our goal is to replace free testosterone levels to that of a younger male. These free testosterone levels would be 30 to 40. A lab value of 40 would be interpreted by the lab as being too high, when in reality the level of 40 is perfect and is always our goal.

    Optimal levels are conducing to optimal health. Having good testosterone in your system decreases incidents of heart attacks, strokes, Alzheimer’s, diabetes, high blood pressure. It has a beneficial effect in protecting against cardiovascular disease in every study. It decreases the instance of heart attacks because of its effect on blood vessels. It has a beneficial effect of improving your good cholesterol and lowering your bad cholesterol. It has a beneficial effect of improving all of the good lipoproteins and reducing all the bad lipoproteins.

    Critics perhaps don’t understand that the more that you have, the better off you are, and every longevity study says the same thing: the higher level, the longer you’ll live, the less risk of heart disease that you’ll have. Where would you like your levels to be?”

    Low Testosterone Symptoms

    What are the signs of a deficiency?

    Depression
    Fatigue
    Dementia
    Osteoporosis
    Low Libido
    Heart disease
    Stroke
    Prostate Cancer
    Abdominal Obesity
    Type 2 Diabetes

    Restoring optimal testosterone levels can deter these health risks and improve bone mineral density, sexual function, muscle mass/strength, and mood. Furthermore, quality of life is improved overall.

    The Take-Away

    If you are considering testosterone replacement, a healthcare provider who is trained in evidence-based Hormone Replacement can help you restore hormone levels to an optimal point that reduces or eliminates symptoms and improves quality of life without causing significant side effects. If you are a health practitioner, it is recommended that you understand the medical literature supporting optimal hormone levels before treating patients with testosterone replacement therapy.

      References

    1. Akishita M, Hashimoto M, Ohike Y, Ogawa S, et al. Low testosterone level as a predictor of cardiovascular events in Japanese men with coronary risk factors. Atherosclerosis. 2010 May;210(1):232-236.
    2. Culley CC. Prevalence, Diagnosis and Treatment of Hypogonadism in Primary Care Practice. Boston University. Retrieved on October 26, 2011 from http://www.bumc.bu.edu/sexualmedicine/publications/prevalence-diagnosis-and-treatment-of-hypogonadism-in-primary-care-practice/
    3. Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR. Longitudinal effects of aging on serum total and free testosterone levels in healthy men: Baltimore Longitudinal Study of Aging. J Clin Endocrinol Metab 2001;86:724-31.
    4. Morley JE, Kaiser FE, Perry HM III, et al. Longitudinal changes in testosterone, luteinizing hormone and follicle-stimulating hormone in healthy older men. Metabolism. 1997;46:410-3.
    5. Rabijewski M, Zgliczynski W. Testosterone deficiency in elderly men. Pol Merkur Lekarski. 2009 Dec; 27(162):517-523.
    6. Schubert M, Jockenhovel F. Testosterone and the metabolic syndrome. Urologe A. 2010 Jan;49(1):47-50.
    7. Srinivas-Shankar U, Roberts SA, Connolly MJ, O’Connell MD, et al. Effects of testosterone on muscle strength, physical function, body composition, and quality of life in intermediate-frail and frail elderly men: a randomized, double-blind, placebo-controlled study. J Clin Endocrinol Metab. 2010 Feb;95(2):639-650.

    Medical Webinar: 7 Things to Consider Before Changing Your Practice to Preventive-Aging Medicine.

    October 5, 2011 Blog,Webinars 0 comments

    Dr. Gregory Petersburg effectively addresses how to change practice and integrate preventive-aging medicine. CLICK HERE for the recording.

    Objectives

  • Learn the market conditions before integrating Preventive-Aging into practice.
  • Know where to start before making the switch.
  • Discover the risks and benefits of the industry.
  • Learn to differentiate yourself by creating unforgettable patient experiences.
  • Interact with a Preventive Medical Expert who has practiced for 11 years and teaches world-wide.

    • The FDA, ACOG, and NAMS Denounce Bioidentical Hormones: Dr. Neal Rouzier and Dr. Dirk Parvus Disagree

    September 16, 2011 Blog 5 comments

    Medical Webinars:

    Hormone Q&A

    Neal Rouzier, M.D.

    The Obesity Epidemic

    Timothy McKnight, M.D.

    Estrogen Optimization

    Neal Rouzier, M.D.

    Dr. Neal Rouzier recently shared a an email thread between him and Dr. Dirk Parvus. We found it to be quite moving and thought it would be useful to post.

    Hi Neal,

    I am attending a hormone conference in Chicago as part of a series given by the Institute for Functional Medicine (IFM). I am interested in their approach to treating chronic disease. A lecturer from IFM refers to several studies that are using CEE and progestins. Some of the studies concluded that hormone replacement, even testosterone, increase breast cancer risk and should not be used long term. Also, his conclusions on estriol differ from mine and from what you teach. He also points out that the FDA, ACOG, and Endocrine Societies do not recommend bioidentical hormones, which I feel is crazy and disturbing. Unfortunately, he does not refer to, or may not know about, the numerous articles you use to base your recommendations. It saddens me that his conclusions are so diametrically opposite from ours. Depending on the experts they listen to, doctors are giving very different treatment recommendations to their patients.

    Yours in health,

    Dirk

    Hi Dirk,

    It is absolutely amazing what is being taught and promoted. If this doctor attended our courses, he would be just as disgusted with us, as we are with him. As you have heard in my lectures, the most upsetting consequence to all of this is that practitioners who abide by these teachings mistreat so many patients. None of them follow any scientific methods. As you can imagine, I am not very popular when I lecture [at similar conferences], because I use the medical literature to debunk all that they teach. Please note that there are hundreds of alternatively trained physicians that will disagree with me. I’m glad you can identify the teachings that don’t hold any credible scientific backing. I frequently get into discussions and debates on a multitude of topics, as our teaching is diametrically opposed to their beliefs. Unfortunately for them, they always lose the argument, because I use the medical literature and science to counter almost everything they propose.

    Please don’t feel disturbed that ACOG and NAMS don’t recommend bioidentical hormones. I agree with them 100% (and so do you). You see, they are not recommending bioidentical hormones that are utilized by this IFM physician. This doctor will recommend estriol and progesterone creams that do not raise hormone serum levels or provide endometrial protection. ACOG and NAMS are against this type of prescribing and promotion, and so are we. In contrast, the literature is full of data and studies demonstrating the beneficial effects of pharmacologic bioidentical hormones, which I simply copy.

    Many doctors from IFM attend my courses and think I’m crazy, because what they are initially taught is contrary to what I teach. I am pleased that you have the insight many others lack. I am frustrated with the incorrect principles being taught, but that just fuels my passion.

    Sincerely,

    Neal

    Hi Neal,

    Thank you so much for taking the time to give me a detailed answer. I have referred many colleagues to your courses and plan to retake level 2 and 3 in the next year. The knowledge you provide has enabled me to talk to anyone (including other doctors) about bioidentical hormone optimization. I am able to practice safe, effective medicine for my patients, and when it exists I have been able to recognize flawed reasoning in hormone lectures I have attended. On behalf of all of us who follow your teaching, thank you for your passion and for all of the work you do to summarize the correct way for us.

    Yours in health,

    Dirk

    Hi Dirk,

    I must say that your response is the most moving that I have ever received. I just spent the last two days at my computer researching, writing, re-organizing, and trying to improve the courses. This was my only weekend off in months, and I wasted it doing trivial tasks. However, based on your response, it is the most rewarding activity. It drives my wife crazy, but the knowledge and insight that I gain from the research, as well as the responses I receive from physicians and patients, makes all of the effort worthwhile. Thanks again and I hope to see you in September at Part II (which I have changed about 50%).

    Graciously,

    Neal

    Anti-Aging Market to hit $114 Billion: Dr. Neal Rouzier, M.D. Helps Separate the Gimmicks from the ‘Real Deal’

    August 23, 2011 Blog 0 comments

    Medical Webinars:

    Hormone Q&A

    Neal Rouzier, M.D.

    The Obesity Epidemic

    Timothy McKnight, M.D.

    Estrogen Optimization

    Neal Rouzier, M.D.

    Anti-Aging Market to hit $114 Billion: Let’s Separate the Gimmicks from the ‘Real Deal’

    Look-young concoctions and feel-good elixirs. The anti-aging market is well-established and only getting stronger, as over 70 million aging baby boomers are driving the movement to look and feel younger. Currently at $80 billion, the anti-aging market size is expected to reach more than $114 billion by 2015.

    With a prevalent focus to stay young, many anti-aging interventions have developed over the years, including hormone replacement therapy, anti-aging supplements, and surgical treatments. Are these treatments safe and effective? This is a main question for several medical professionals, as they claim anti-aging interventions, especially hormone replacement therapy, can be ineffective and cause harm.

    Fears of harm and effectiveness are misleading

    The majority of fears about hormone replacement therapy stems from the highly publicized Women’s Health Initiative, which warned thousands of menopausal women to stop taking HRT. (See Hormones and Cancer blog post). Regrettably, critics fail to see that the negative outcomes from the WHI were applied to one form of treatment, and only for one specific age group of women.

    By stopping HRT, women were put at greater risk for developing cardiovascular disease, stroke, and cancer. Fortunately, there are alternatives to anti-aging interventions that may be harmful. Unlike conventional HRT, medical studies purport bioidentical hormones (BHRT) are a safe and effective treatment for women with hormone deficiencies. One particular study is currently being conducted by the Kronos Longevity Research Institute to clarify the safety and efficacy of BHRT.

    Dr. Rouzier’s Take

    The benefits of hormones can be further explained by Dr. Neal Rouzier, who has been teaching Worldlink Medical’s anti aging conference for over 10 years. He stated in his recent anti aging seminar, “Yes hormones are good. Just use the right ones in the right way. If hormones were so bad in women, we would yank their ovaries out when they were 30. We used to do that, and they all died sooner and had a miserable life before they died. Now we don’t take the ovaries out, we leave those ovaries in. Why? Well, because they feel better, they function better, and they live longer, happier and healthier. So, hormones do have a beneficial effect. The Women’s Health Initiative showed that the hormones were harmful. Well which is it? Are they good or are they bad? In the body they’re good. Out of the body, in a chemically altered form, they’re bad and all of the studies show that. Well, let’s look at the most recent studies, perhaps at a natural estradiol. All of the studies show it is very beneficial, and long term use will make you live longer, happier, less heart attacks, less stroke, less osteoporosis, less depression, less mood swings, less Alzheimer’s disease, and less dementia. Why don’t we use that one?… Let’s not look at these other studies with the synthetic chemically altered [hormones], let’s look at estradiol [i.e. from the Kronos Study http://www.keepstudy.org/keeps/why.cfm]. That’s the one that has shown to be beneficial, that’s the one that we lose when we go through menopause. We’ve replaced that one, in the correct form, and we haven’t seen any problems with it.”

    Still beware of anti-aging gimmicks

    Not all anti-aging interventions are created equal. There are some products and gimmicks for which you should be weary. The market is saturated with hormone balancing creams, wrinkle-fading dreams, and lose-weight quick schemes, but such products may not live up to all they claim to be.

    Anti-aging products can pop up while browsing the internet, making statements that are often not backed by scientific evidence. Generally, these products are advertised as free trials. Yet, they truly turn into a monthly commitment to buy a product that doesn’t live up to its promised benefits. Several consumers easily purchase these products only to be later disappointed and stuck in a purchasing obligation that can only be stopped through a difficult cancellation process.

    The Real Deal

    How do you decipher the anti-aging facts from fiction? Find a physician or healthcare practitioner who is well trained and open to the idea of hormone replacement. Also, one who treats patients based on a multitude of medical evidence and has not been deterred by the WHI. It’s not about the “Fountain of Youth”. It’s about living healthier and happier during a potentially difficult age. This is accomplished by thorough clinical analysis including food testing, replenishing lost hormones, fitness scheduling, coaching, etc. Some call it alternative healthcare, while others call it ‘upstream medicine.’

      References

    1. Boomers will be spending millions to counter aging. (2011, August 17). Retrieved on August 18, 2011 from http://www.todaysthv.com/news/article/169384/126/Boomers-will-be-spending-billions-to-counter-aging
    2. Weintraub A. Beware free trials of anti-aging products sold on the web. (2010, October 1). Retrieved on August 18, 2011 from http://health.usnews.com/health-news/family-health/womens-health/articles/2010/10/01/beware-free-trials-of-anti-aging-products-sold-on-the-web

    The 7 Hormones Everyone Should Know

    July 21, 2011 Blog 0 comments

    Medical Webinars:

    Hormone Q&A

    Neal Rouzier, M.D.

    The Obesity Epidemic

    Timothy McKnight, M.D.

    Estrogen Optimization

    Neal Rouzier, M.D.

    DHEA

    Clinical studies have demonstrated that DHEA has a beneficial effect on immune response, sex drive, metabolism and emotional stability. DHEA benefits the immune system and reduces visceral fat associated with diabetes mellitus. Other health-related benefits include support of cognitive function, helping the body cope with stress, and protection against heart disease through its effects on lipids and body fat.

    Melatonin

    Melatonin regulates the circadian rhythm as well as the deep stages of sleep. Studies suggest that the immune system depends on melatonin’s effects of deep sleep. In the January 1997 issue of the New England Journal of Medicine, melatonin was demonstrated to be a powerful antioxidant hormone that can protect against cancer. There are hundreds of studies showing that melatonin can scavenge free radicals, and be a safe sleep-enhancing hormone.

    Pregnenolone

    Failure of memory and lack of mental clarity can be among the most frustrating aspects of aging. Studies indicate that pregnenolone might be beneficial against age-related cognitive decline.

    Thyroid

    This metabolic hormone secreted by the thyroid gland regulates temperature, metabolism and cerebral function. Insufficient thyroid levels result in fatigue, increased cholesterol levels and increased risk of coronary artery disease. With age, thyroid hormone levels gradually decline resulting in a decreased metabolism, which affects all cells and organs. Low thyroid causes low energy, and thinning of hair, skin and nails. The dictum that normal levels are not optimal levels is extremely important when it comes to thyroid.

    Testosterone

    Although testosterone is the primary male hormone, women also benefit from its supplementation. Levels of testosterone decline with age in men and women. At optimal levels, research shows testosterone increases bone density and bone formation, enhances energy and sex drive, decreases body fat, increases muscle strength, lowers blood pressure and modulates cholesterol levels. Testosterone is a hormone that neither man nor women should be without and we’ll present the scientific evidence to support this.

    Estrogen

    Over 50 years of studies demonstrate that loss of estrogen increases cardiovascular disease, Alzheimer’s Disease, osteoporotic fractures, urogenital atrophy, macular degeneration and depression. Recent studies sort out the confusion created by the WHI (Women’s Health Initiative) and conclude that certain types of hormones cause harm in some women, whereas different hormones avoid the harm and provide a significant protection. A thorough literature review helps sort out the differences and provides credence and confidence for the use of bioidentical estrogens as based on our medical evidence.

    Progesterone

    Data demonstrates that synthetic progestins increase the risk of breast cancer, heart disease, strokes, bleeding, and depression. Studies demonstrate that not only does micronized progesterone not increase these risks, but it also protects against them. Studies demonstrate a synergistic effect of progesterone with estrogen, whereas progestins negate estrogen’s positive benefits. This literature review will demonstrate the difference between progesterone and progestins and how this difference is the key to understanding the importance of progesterone.

    Estrogen Dominance in Men: Does Too Much Estrogen Cause Prostate Cancer? Dr. Neal Rouzier, M.D. Explains..

    July 7, 2011 Blog 2 comments

    Medical Webinars:

    Hormone Q&A

    Neal Rouzier, M.D.

    The Obesity Epidemic

    Timothy McKnight, M.D.

    Estrogen Optimization

    Neal Rouzier, M.D.

    The Role of Testosterone on E2 Levels

    Testosterone replacement therapy has a significant role in protecting aging men’s health, including greater protection against heart disease, diabetes, and obesity.123 However, it naturally increases estrogen levels in men, which has brought the benefits of testosterone therapy into question.

    You may have heard the warning that high estrogen levels cause prostate cancer in men, but research supporting this claim is unclear. Some studies indicate that high estrogen levels can increase the development of prostate cancer cells, while other research finds high estrogen levels are not found in men with prostate cancer. High estrogen levels may be considered a health risk, but low estrogen levels can also be detrimental to men’s health. The body needs estrogen to avoid cardiovascular disease, type 2 diabetes, osteoporosis, and metabolic syndrome.45

    Let’s take a look at the two different arguments to understand the effects of raising estrogen levels via testosterone therapy.

    Argument A: Raising Estrogen Levels is Harmful

    As men age, circulating levels of estradiol increase and free testosterone levels decrease in the body. This sharp increase in estrogen has been related to prostate cancer. Prostate cancer has been suggested to originate from the presence of androgens, because testosterone is converted into estrogen by the enzyme aromatase.6 This depletes free testosterone levels and increases estrogen levels. However, the active form of testosterone, 5alpha-dihydrotestosterone, is not aromatized into estrogen and does not increase prostate cancer risks.7 Estrogen treatment has been shown to damage prostate DNA in animal studies and it is suggested that androgens act as a strong tumor promoter when estrogen, or specifically estradiol-17beta, is present.7 However, a closer look at these claims shows testosterone actually plays a significant role in sustaining prostate health and that androgens do not cause prostate cancer.

    Argument B: High Estrogen Levels in Men are Actually Protective

    While it has been argued testosterone therapy increases the risk of prostate cancer by raising estrogen levels, research has also shown the opposite is true. Low levels of testosterone increases prostate cancer risks. A literature review found that there is a limited capacity for androgens to stimulate the growth of prostate cancer cells.8 Another review of research did not find a significant association between testosterone or estrogen levels and prostate cancer.9 Only men that currently have prostate cancer should avoid testosterone therapy, as this is the time when androgens may further proliferate cancer cells.

    Several studies indicate that low estrogen levels in men can be detrimental and raising estrogen levels has protective benefits, such as strong bones, sustained cognitive function, and cardiovascular health. In fact, increasing estrogen levels is not harmful when optimal testosterone levels are present. The ratio of estrogen to testosterone is what matters most, as low testosterone and high estrogen blocks testosterone receptor sites.10 Testosterone therapy is a beneficial way to restore healthy testosterone levels and balance the testosterone/estrogen ratio. Testosterone therapy was given to 207 men between the ages of 40 to 83, finding the therapy had a significant decrease on prostate volume, prostate-specific antigens (PSA) levels, and lower urinary tract symptoms.11

    Conclusion: Optimal Hormone Balance

    So, what is the final verdict? Estrogen is not harmful to men. This can best be explained by Dr. Neal Rouzier, who in his most recent webinar stated,“Many conclude that estrogen may be responsible for the high prevalence of prostate cancer in men. That has been extrapolated to [imply that] estrogen causes cancer in men and now everyone thinks that it’s bad and everyone is on this kick to lower estrogen in men to protect against that. What does the literature say?…All of the studies to-date, 50 years of studies, where testosterone has been utilized to increase estrogen levels, show it aromatizes to estradiol and all of these levels [testosterone, estradiol and estrogen] are increased. There is no study to support any increased risk of cancer of the prostate when estrogen levels are raised.”

    It is only when estrogen levels are too high and testosterone levels are too low that negative effects can occur in men’s health [Estrogen Dominance in Men]. Testosterone levels should be restored to their optimal range to avoid the detrimental effects of this imbalance. “Again, 50 years of studies demonstrate that testosterone administration, which raises serum estrogen levels, does not cause prostate cancer.”10

    References

    1. Wang C, Cunningham G, Dobs A, et al. Long-term testosterone gel (AndroGel) treatment maintains beneficial effects on sexual function and mood, lean and fat mass, and bone mineral density in hypogonadal men. J Clin Endocrinol Metab. 2004 May;89(5):2085-2098
    2. Darby E, Anawalt BD. Male hypogonadism: an update on diagnosis and treatment. Treat Endocrinol. 2005;4(5):293-309.
    3. Watt PJ, Hughes RB, et al. A holistic programmatic approach to natural hormone replacement. Fam Community Health . 2003; 25(1):53-63.
    4. Miner MM, Seftel AD. Testosterone and ageing: what have we learned since the Institute of Medicine report and what lies ahead? Int J Clin Pract. 2007 Apr;61(4):622632.
    5. Amin S, Zhang Y, Felson DT, Sawin CT, et al. Estradiol, testosterone, and the risk for hip fractures in elderly men from the Framingham Study. Am J Med. 2006 May;119(5):426-433.
    6. Shibata Y, Ito K, Suzuki K, Nakano K, et al. Changes in the endocrine environment of the human prostate transition zone with aging: simultaneous quantitative analysis of prostatic sex steroids and comparison with human prostatic histological composition. Prostate. 2000 Jan;42(1):45-55.
    7. Bosland MC. Sex steroids and prostate carcinogenesis: integrated, multifactorial working hypothesis. Ann NY Acad Sci. 2006 Nov;1089:168-176.
    8. Morgentaler A, Traish AM. Shifting the paradigm of testosterone and prostate cancer: the saturation model and the limits of androgen-dependent growth. Eur Urol. 2009 Feb;55(2):310-320.
    9. Roddam AW, Allen NE, Appleby P, Key TJ, et al. Insulin-like growth factors, their binding proteins, and prostate cancer risk: analysis of individual patient data from 12 prospective studies. Ann Intern Med. 2008 Oct;149(7):461-471.
    10. Rouzier N. (2007). How to achieve healthy aging. Salt Lake City, UT: WorldLink Medical Publishing.
    11. Pechersky AV, Mazurov VI, Semiglazov VF, Karpischenko AI, et al. Androgen administration in middle-aged and ageing men: effects of oral testosterone undecanoate on dihydrotestosterone, oestradiol and prostate volume. Int J Androl. 2002 Apr;25(2):119-125.


    Transdermal vs. Oral Estrogen: Which is More Effective?

    June 24, 2011 Blog 0 comments

    Medical Webinars:

    Hormone Q&A

    Neal Rouzier, M.D.

    The Obesity Epidemic

    Timothy McKnight, M.D.

    Estrogen Optimization

    Neal Rouzier, M.D.

    While experts agree estrogen has far reaching benefits in menopausal women, researchers tend to disagree on how estrogen therapy should be administered.

    Is Transdermal “Less Risky?”

    The current trend is to prescribe transdermal estrogen cream. Why do some physicians choose transdermal instead of oral estrogen therapy? Many are worried about the health risks associated with oral estrogen. These concerns were initiated by the Women’s Health Initiative that found oral estrogen increases the risk of myocardial infarction, stroke and blood clots in menopausal women. Therefore, transdermal estrogen is commonly prescribed in lower doses to avoid the damaging atherosclerotic effects of oral conjugated equine estrogen (CEE). Furthermore, it is applied topically and absorbed through the skin. This route of administration bypasses the liver and directly enters the bloodstream to prevent circulatory risks.

    What about the benefits of Oral Estrogen?

    Transdermal estrogen may seem like a better choice for estrogen therapy, but oral estrogen offers more cardiovascular benefits. In fact, many studies claim transdermal estrogen does not provide any cardiovascular protection. It is estimated that 50-75% of estrogen’s benefits are on LDL and HDL cholesterol, fibrinogen, and fatty acid esters, because oral estrogen passes through the liver to improve cholesterol health. Since transdermal estrogen bypasses the liver to directly enter the bloodstream, it cannot provide advantageous lipid effects. To prevent a large majority of women from succumbing to coronary artery and cardiovascular disease, it is sensible to prescribe an oral estrogen therapy for maximum cardiovascular protection.

    There is a safer and effective form of oral estrogen.

    Hormone educator, Dr. Neal Rouzier states that “the medical literature does not support the use of creams and patches over oral bioidentical estrogen. Oral estrogen is far better at protecting women against cardiovascular problems as many studies show a significantly reduced incidence of both heart attacks and strokes with the use of oral as compared to the use of transdermal estrogen creams or patches. Transdermal estrogen has only a minimal effect on improving blood lipids (good and bad cholesterol and blood fats) — whereas oral estrogen has a much stronger value in doing this. Many medical studies have demonstrated that oral estrogen’s effect on total cholesterol, LDL and HDL-cholesterol provide greater overall protection, whereas transdermal provides much less protection and therefore they provide less cardiovascular protection in the long run. The patch and transdermal creams are not entirely without value. There are a few women with certain types health histories, where oral estrogen is contraindicated and transdermal estrogen replacement may be appropriately recommended. However, this is not the case for the great majority of women. Oral estrogen have many more health protective benefits than does transdermal estrogen and therefore the preferred form of estrogen.” (Dr. Rouzier’s webinar thoroughly discusses Estrogen in Women)

    When it comes to oral estrogen, medical studies have found that oral e2 estradiol is the safest and most effective form, because it avoids inherent side effects related to oral CEE. The Women’s Estrogen for Stroke Trial (WEST) found oral estradiol was not associated with increased blood clots, but an increase in blood vessel inflammation and clotting was due to ten biologically active estrogens that are in CEE (Premarin). These active estrogens are not found in estradiol.

    Conclusion

    Prescribing the right form of estrogen should be considered on an individual basis. Older women (age>60) that have never taken oral estrogen are advised to take transdermal estrogen to avoid the risk of myocardial infarction or stroke. Additionally, transdermal estrogen is the best choice for women that have a history of clotting disorders. For women that do not have these established factors, oral estradiol is the best choice for protecting the heart from cardiovascular disease and hypertension risks that increase dramatically in menopausal women.

      References

    1. Billeci AM, Paciaroni M, Caso V, Agnelli G. Hormone replacement therapy and stroke. Curr Vasc Pharmacol. 2008;6(2):112-123.
    2. Chu MC, Cosper P, Nakhuda GS, Lobo RA. A comparison of oral and transdermal short-term estrogen therapy in postmenopausal women with metabolic syndrome. Fertil Steril. 2006;86:1669-1675.
    3. Hendrix SL, Wassertheil-Smoller S, Johnson KC, et al. Effects of conjugated equine estrogen on stroke in the Women’s Health Initiative. Circulation. 2006;113:2425– 2434.
    4. Ho JY, Chen MJ, Sheu WH, Yi YC, Tsai AC, Guu HF, Ho ES. Differential effects of oral conjugated equine estrogen and transdermal estrogen on atherosclerotic vascular disease risk markers and endothelial function in healthy postmenopausal women. Hum Reprod. 2006;21(10):2715-2720.
    5. Mendelsohn ME, Karas RH. Protective effects of estrogen on the cardiovascular system. N Engl J Med. 1999;340:1801–1811.
    6. Menon DV, Vongpatanasin W. Effects of transdermal estrogen replacement therapy on cardiovascular risk factors. Treat Endocrinol. 2006;5(1):37-51.
    7. Nelson HD, Humphrey LL, Hygren P, Teutsch SM, Allan JD. Postmenopausal hormone replacement therapy. Scientific review. JAMA 2002;288:872–881.
    8. North American Menopause Society. Amended report from the NAMS Advisory Panel on postmenopausal hormone therapy. Menopause. 2003;10:6-12.
    9. Scarabin PY, et al. Differential association of oral and transdermal oestrogen-replacement therapy with venous thromboembolism risk. Lancet. 2003;362(9382):428–432.
    10. Smith NL, Heckbert SR, Lemaitre RN, Reiner AP, et al. Esterified estrogens and conjugated equine estrogens and the risk of venous thrombosis. JAMA. 2004 Oct;292(13):1581-1587.
    11. Vehkavaara S, Silveira A, Hakala-Ala-Pietila T, Virkamaki A, et al. Effects of oral and transdermal estrogen replacement therapy on markers of coagulation, fibrinolysis, inflammation and serum lipids and lipoproteins in postmenopausal women. Thromb Haemost. 2001;85(4):619-625.
    12. Verhoeven MO, Hemelaar M, Van Der Mooren MJ, Kenemans P, Teerlink T. Oral, more than transdermal, oestrogen therapy lowers asymmetric dimethylarginine in healthy postmenopausal women: a randomized, placebo-controlled study. J Intern Med. 2006;259:199-208.
    13. Viscoli CM, Brass LM, Kernan WN, Sarrel PM, et al. A clinical trial of estrogen replacement therapy after ischemic stroke. N Engl J Med. 2001;345:1243-1249.
    14. Vongpatanasin W, et al. Differential Effects of Oral Versus Transdermal Estrogen Replacement Therapy on C-Reactive Protein in Postmenopausal Women . J of Amer Coll Cardio. 2003;41(8):1358–1363.

    Medical Webinar- The Evidence Behind Hormone Optimization: Estrogen in Women

    June 17, 2011 Blog,Webinars 0 comments

    As usual, Dr. Neal Rouzier attracted a massive crowd of students seeking to learn about natural estrogen replacement therapy. Definitely one of the most profound Q&A sessions I have experienced yet…CLICK HERE for the recording.

    This age management webinar will review the literature supporting optimal hormone levels for Physicians and Healthcare Practitioners interested in Natural Hormone Therapy. Although most Physicians are fully aware of replacing hormones in cases of sub-normal levels, most have not been trained to optimize hormone levels no matter what the baseline level is. A multitude of studies will be discussed to provide Healthcare Practitioners with accurate knowledge regarding the risks and benefits when implementing BHRT into practice. Specifically the webinar will focus on Estrogen Levels in Women.

    Objectives

  • Have command of the literature that supports optimization.
  • What type of estrogen is preferred and when?
  • Which estrogen is beneficial and which one is worthless?
  • Is the “safe” estrogen really that safe?

    • Clearing Up Controversy about Hormones and Cancer: Dr. Neal Rouzier, M.D. provides insight.

    May 31, 2011 Blog 0 comments

    Medical Webinars:

    Hormone Q&A

    Neal Rouzier, M.D.

    The Obesity Epidemic

    Timothy McKnight, M.D.

    Estrogen Optimization

    Neal Rouzier, M.D.

    Since the 2002 report known as The Women’s Health Initiative (WHI) Trial, Prempro sales have fallen to $161 million annually and more than 10,000 lawsuits have been filed against Pfizer by women, who declared the company’s HRT drug lead to their development of breast cancer and other health ailments. Pfizer Inc. recently set aside $772 million to settle these cases.

    Hormone replacement therapy (HRT)

    Hormone replacement therapy (HRT)- a $2.2 billion industry, has been promoted by the medical establishment as a means to reduce vasomotor symptoms and decrease postmenopausal health risks. During the 1990’s, Pfizer and Wyeth had a strong hold on the HRT industry by selling Premarin, Provera, and Prempro (a combination of the two) to more than six million women.

    Fears of Hormones and Cancer

    Fears of Hormones and Cancer- It wasn’t until 2002 that the WHI trial found these synthetic hormones increased breast cancer, heart disease, and stroke risks among menopausal women. Researchers admonished women to stop taking HRT, while critics asserted these results were inaccurate declaring HRT benefits outweighed the risks. With two opposing views, confusion escalated among physicians and patients.

    Re-analysis of the WHI data and findings from other studies demonstrated that the health risks did not apply to women under 60 years old. While breast cancer risks increased when estrogen and progesterone were combined, further analysis of the WHI trial found that the estrogen-only group didn’t have an increase in breast cancer risks. In fact, breast cancer risks decreased in this group.

    Clearing the Confusion

    Clearing the Confusion- A review of the WHI trial may clarify the risks of synthetic HRT, but it doesn’t mean these hormones are harmless. According the National Institutes of Health, long-term use is not recommended, but taking HRT at the lowest possible dose for the shortest amount of time can provide some benefit for menopausal women, including a reduction in osteoporosis risks.

    This statement, combined with media attention and the WHI study itself, have sparked extensive concern that hormones are harmful and should be taken for the shortest time necessary to control perimenopausal symptoms. Dr. Neal Rouzier has clarified this concern through intensive study, stating that, “I agree with this statement ONLY if the hormones are synthetic, like Premarin and Provera. The combination Premarin and Provera have demonstrated an increased risk of breast cancer, strokes and heart attacks. However, do not extrapolate the harm of synthetic hormones to bioidentical HRT. Natural progesterone has never been demonstrated, in any study, to increase these risks whereas Provera has definitely been shown to increase these risks. Natural progesterone has been shown to decrease the risk of breast cancer, whereas Provera increases breast cancer in every study to date. Natural estradiol has been proven to not have the clotting or inflammatory properties as does Premarin.”

    The Natural Answer

    The Natural Answer- Fortunately, there are sharply contrasting alternatives to synthetic HRT which actually have shown to help protect against cancer. Bioidentical HRT is a substantially effective treatment for menopausal symptoms that also protects women from the many other risks associated with low hormone levels. Over 50 years of studies indicate that restoring hormones to premenopausal levels protects women from health risks and encourages well-being. Bioidentical hormones are the safest and most effective way to ensure optimal hormone levels. Bioidentical hormones should not be confused with synthetic HRT, as they are far superior to their synthetic counterpart.

      References

    1. Campagnoli C, Clavel-Chapelon F, Kaaks R, Peris C, Berrino F. Progestins and progesterone in hormone replacement therapy and the risk of breast cancer. J Steroid Biochem Mol Biol. 2005; 96(2):95-108.
    2. Gambrell RD. The Women’s Health Initiative reports: Critical review of the findings. The Female Patient. 2004; 29:25-41.
    3. Holtorf K. The bioidentical hormone debate: are bioidentical hormones (estradiol, estriol, and progesterone) safer or more efficacious than commonly used synthetic versions in hormone replacement therapy? Postgrad Med. 2009 Jan;121(1):73-85.
    4. Howard L. Pfizer to settle remaining hormone therapy lawsuits for $300 million minimum. Retrieved on May 26, 2011 from http://www.theday.com/article/20110514/BIZ02/305149926/1018
    5. Million Women Study Collaborators. Breast cancer and hormone-replacement therapy in the Million Women Study, Lancet. 2003;362:419–427.
    6. Rossouw E. Anderson GL, Prentice RL, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial, JAMA. 2002;288:321–333.

    Melatonin for Sleep and 4 Additional Ways to Improve Sleep Naturally.

    May 23, 2011 Blog 0 comments

    Medical Webinars:

    Hormone Q&A

    Neal Rouzier, M.D.

    The Obesity Epidemic

    Timothy McKnight, M.D.

    Estrogen Optimization

    Neal Rouzier, M.D.

    Dr. Rouzier recently provided some tips in response to an online publication writer who asked the question, “What are some tips on how to avoid sleep disruptions when season’s change?” I thought it would be appropriate to post here and expand on natural sleep in general. Read the tips below and feel free to provide your own based on your knowledge and experience.

    1) Maintain a consistent sleep/wake cycle

    Wake up at the same time EVERY morning and NEVER sleep-in to make up loss of sleep. Although your sleep may be slightly thrown off by a 1 hour time change, this will only have a minimal effect if your body already has a strong backbone of healthy sleep hygiene. What this means is if you wake up at the same time every morning, despite if you got 8 hours of sleep or 5 hours of sleep, your body will eventually fall into a natural sleep/wake cycle based on that wake up time. This will eventually turn into a regular 8 hours of sleep, or whatever amount your body naturally requires. This behavior modification is the most important component of strengthening your “body armor” against seasonal time changes.

    2) Do not use sleep medication unless you have severe insomnia.

    There are a variety of sleep medications out there that will certainly get you to sleep, but will make your body more dependent on them than that of seasonal change. Taking such medications will only contradict your body’s natural sleep wake cycle mentioned in tip #1.

    3) Take a melatonin supplement to help you get into a regular sleep/wake cycle.

    Melatonin is a natural hormone that is already produced by our bodies, and we depend on this hormone in order to fall asleep and stay asleep. Studies have shown that taking melatonin for sleep not only helps you to fall asleep, but also puts you into a deeper level of sleep, which is crucial to feeling rested during the day. Also, melatonin is non-addictive and will certainly make seasonal change less disruptive. If your Health Care Provider is not familiar with melatonin, then search for one who is well versed in natural hormones. This will determine what your optimal dose should be and to make sure you are taking a high quality melatonin supplement, typically dispensed by a compounding pharmacy. Melatonin is also a bio identical, natural hormone that is not a drug or addicting, only a healthy supplement that possesses many other health benefits. Recent studies demonstrate its protection against many different cancers.

    4) Replacing estrogen and progesterone makes all the difference in the world as to how one sleeps and functions.

    If a woman is newly menopausal, then she may be suffering sleep deprivation as the result of loss of her hormones, which also results in significant health detriments, as well as feeling poorly. We never advocate hormone replacement with chemically altered synthetic hormones which studies have shown to be harmful to a woman’s health. However studies demonstrate that loss of hormones is also very harmful to one’s health and well-being. Replacement must be in the form of the identical hormones that the body makes normally, commonly termed bio identical or natural hormones.

    5) Limit caffeine during the day and alcoholic beverages at night.

    Drinking coffee or caffeinated sodas during the day, particularly after 12pm, is likely to make falling asleep more difficult. If you drink too much alcohol at night, this will do one (or all) of three things: 1. Make you fall asleep at a lower quality of sleep 2. Make you become dependent on alcohol for sleep, which will of course defeat the purpose of maintaining a healthy sleep/wake cycle 3. May have an adverse effect and keep you awake.