Category Archives: fitness

7 Ways to Boost Your Metabolism When Quitting Smoking


smoker (1)Gaining weight after quitting smoking is a common and dreaded experience.  Fear of weight gain often discourages people from trying to take the first steps toward giving up the smoking habit. What is the reason for this unwelcome “side-effect”? Perhaps most importantly, smoking raises the heart rate substantially.

While smoking a cigarette, the heart rate increases 10-20 more beats per minute. (This can lead to heart diseases in the future.) This elevated pulse boosts the metabolism because of the energy it takes to keep the body functioning at this high rate. When a smoker quits smoking, the heart rate will return to its normal, natural rate. This will cause a decrease in the metabolism. However, there are several ways to boost your metabolism after smoking cessation  to avoid the weight gain that often occurs.

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Should You be Concerned About Your Cortisol Level and What Can You Do About it?


Many members at metabolism.com have expressed concern that their cortisol level is either too high or too low. I thought it would be helpful to highlight the latest exchange I  had on the subject.

Mohammed writes:

Hello:   My overall dhea and cortisol levels are ok but cortisol is a little high what can i take to stabilise the level of cortisol, i know reducing stress and exercise e.t.c but i mean in terms of products is there anything that can balance cortisol, because i am suffering from low t3 and i know without good adrenal fnx
thyroid supplemts wont be as effective

My reply:

As you know the adrenal gland produces a hormone that is vital to survival known as cortisol, cortisone, or glucocorticoid. You are correct that during stress the adrenal will produce more cortisol which helps prepare the body for aggressive activity or injury. When the stress is relieved cortisol levels return to normal. Excess of cortisol causes a disorder known as Cushing’s Syndrome and a deficiency is called Addison’s Disease or adrenal insufficiency. Both of these disorders can cause illnesses serious enough to result in death. Fortunately cortisol excess or insufficiency is very rare and when diagnosed in time can be controlled. Several years ago there was an unethical company marketing a product called Cortislim which they claimed reduced cortisol levels to induce healthy weight loss. This product was removed from the market. As far as I’m concerned there is no legitimate product that will safely reduce cortisol levels, nor should there be. The body regulates production of cortisol very carefully because it is such a potent hormone with potential to help and harm in major ways. I believe you would be safer letting your body decide what your cortisol level should be rather than trying to do it yourself. You can check out another of my blogs on the subject of adrenal function. My book Metabolism.com includes a section where I review the controversy about adrenal fatigue as well.

Hope this information helps.

Thanks

Dr. P

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Polycystic Ovarian Syndrome Is Common in Adolescent Girls


Polycystic Ovarian Syndrome (PCOS) sounds like a rare disorder but it is surprisingly common. This is a disorder with onset in early adolescence effecting up to 10% of young women. Characteristic signs and symptoms include increasing facial and body hair, hair loss from the scalp, muscular or heavy build, acne, thickening and darkening of the skin known as acanthosis nigricans, blood sugar problems including type 2 diabetes, high cholesterol and irregular menstrual cycles and infertility. In older women with PCOS coronary artery disease is more common. In severe cases deepening of the voice and enlargement of the clitoris (clitoromegaly) can be seen. Before the underlying hormone disorders were clarified, the main method of diagnosing this disorder was by finding multiple cysts on the ovary. We now understand that the main problem is not the ovarian cysts but metabolic disorders including insulin resistance and elevated male hormone levels (testosterone) in the blood.

Another misconception about PCOS is that it only occurs in overweight women. Obesity is common in PCOS but thin women are also capable of developing PCOS. The underlying hormone problems are complex but are thought to be at least in part due to high insulin levels in the blood resulting from insulin resistance. With insulin resistance the body requires high levels of insulin due to insensitivity of the tissues to insulin’s presence.
What treatments are available for PCOS? There are very few, if any, drugs specifically approved for the treatment of PCOS. This is probably because of the low profit potential for treating this disorder. Drug companies cannot afford to invest millions of dollars in research because almost all of the existing standard therapies are generic drugs. Some of the most useful medications for treating PCOS are drugs used to treat type 2 diabetes because of their effect to reduce insulin resistance. These drugs are metformin and Actos. Metformin is the most popular oral medication for diabetes treatment in the U.S. Actos has been available for about 10 years but due to recent negative publicity about an unproven risk of bladder cancer, its popularity is declining. Neither drug is approved by the FDA for treatment of PCOS but multiple studies confirm the clinical and hormonal benefits of using these medications in this disorder. In 2011 research was published in the Journal of Clinical Endocrinology and Metabolism suggesting that the generic cholesterol lowering drug, simvastatin may also show benefits similar to metformin for the treatment of PCOS.

In the late 1980’s, I along with Dr. Lester Gabrilove at Mt. Sinai Hospital in New York, published our research showing that an anti-fungal medication, ketoconazole, could reverse the hormonal, physical and metabolic problems associated with PCOS. Due to the potential toxicity of ketoconazole this therapy never gained wide spread acceptance. The manufacturer refused to fund additional studies to determine how to more effectively use this drug, due to the low profit potential and liability concerns.

This information is strictly for educational puroses. Due to high risk of toxicity of medical therapy in young women who can potentially become fertile under treatment for PCOS, no drug should be taken without the close supervision of a physician. The reader agrees to the Terms of Service of this website, metabolism.com

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Getting the Right Amount of Sleep Helps Prevent Diabetes


One aspect of lifestyle that is often overlooked is time spent sleeping. Getting adequate sleep is often sacrificed due to the demands of job and family. In the Sleep Heart Health Study over 1400 men and women were surveyed about their sleep habits and its relationship to diabetes and prediabetes. It was found that sleeping less than 6 hours per night was associated with increased risk of having diabetes. Interestingly, in those sleeping more than 9 hours per night there was an increased risk of diabetes and prediabetes.The authors of the study recommend trying to get between 7 and 8 hours of sleep per night to minimize the chances of developing blood sugar problems. To learn more about ways of preventing diabetes see pages 90 to 98 in my ebook “Metabolism.com”

Maintaining ideal body weight with diet and exercise is also crucial for avoiding diabetes and prediabetes.In overweight adults for each2.2 pounds(1 kilogram) gained per year the risk of developing diabetes increases about 50% over the next ten years. By losing 2.2 pounds per year the risk of developing diabetes is reduced about33% for the next 10 years (J Epidemiol Community Health. 2000; 54(8):596-602).

Speak to your healthcare professional to find out if you are at risk for developing diabetes and to learn ways you can avoid it.

Gary Pepper M.D.

Editor-in-Chief, Metabolism.com

The terms of service for metabolism.com apply to this and all posts; http://www.metabolism.com/2008/09/06/terms-conditions-service-agreement/

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Novartis Blood Pressure Medication Runs into Trouble


Novartis Blood Pressure Medication Runs into Trouble
by Gary Pepper, M.D.
Editor, Metabolism.com

In 2007 a new type of blood pressure lowering medication was brought to market by Novartis Pharmaceutical Company. This medication by the brand name Tekturna (aliskiran) works by blocking hormones that make up a circuit from the kidney to the blood vessels know as the RAAS system. This mechanism is distinct from all other blood pressure lowering medications available. By working via a completely novel pathway to lower blood pressure doctors were given another potent weapon in the war on high blood pressure. A second medication, Valturna, which combines an established blood pressure medication with Tekturna, was released by Novartis to the public in 2009. These drugs have been extremely popular due to their effectiveness and apparent freedom from serious side effects.
A warning about this class of drug was issued by Novartis, 2 weeks ago when it was forced to end the Altitude drug study due to apparent unforeseen complications in patients using Tekturna and Valturna. The study found a small but significant increase in stroke in diabetics with renal disease who were using these drugs. Although the group of patients in the Altitude study are up to 12 times more likely to develop stroke or heart attack under normal circumstances, Novartis had no choice but to end the study and issue a warning to the health care community about limiting the use of these drugs.

In my own practice I have found Tekturna and Valturna to be extremely effective and well tolerated. A survey of my colleagues revealed the same findings. Diabetes and high blood pressure very commonly occur together and national guidelines stress the need for excellent blood pressure control for diabetics to help prevent heart, kidney and eye complications of this disease. For doctors treating diabetics who recognize these patients as particularly high risk, having to significantly cut back or eliminate the use of Tekturna and Valturna is creating major concerns. Within the past week I have had to counsel numerous individuals about these issues and the solution is far from easy. For instance, one man with diabetes and early kidney disease and heart disease, with borderline high blood pressure despite using 4 different types of blood pressure medication including Tekturna has to decide with me, which is the greatest risk, going off the medication resulting in a rise in his blood pressure or continuing a drug which may pose a risk of its own.

These discussions are going on in doctor’s offices throughout the country with no good solution in sight. The only certainty is a flood of ads by lawyers which begin, “Have you ever been on Tekturna or Valturna….”.

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What’s Inside My Ebook, Metabolism.com?


My ebook Metabolism.com is now available; I think you will find it a great resource for many of the common problems members have asked me about over the past 15 years. Buy it now and use it for years to come. Don’t forget to check out the Weight Loss and Weight Gain Programs included for free!

Chapter 1: What Is Metabolism? 9

Turning Food into Energy 10
The Importance of Hormones 11
Role of Metabolism in Weight Loss or Gain 14
Is My Metabolism Healthy? 16

Chapter 2: What Makes Your Metabolism Fast or Slow? 17

The Role of the Thyroid 22

Chapter 3: How to Increase or Decrease Metabolism 25

Problems with Losing Weight 25
Problems with Gaining Weight 34
A Pleasurable Exercise Routine is a Must 39

Chapter 4: Fact vs. Fiction—Smoking and Weight Loss 41

Chapter 5: Thyroid Treatment 47

How Are T3 and T4 Regulated? 48
Types of Thyroid Diseases 49
Hyper- and Hypothyroidism 49
Thyroid Nodules 51
Is Your Thyroid Nodule Hot? 53
Thyroid Treatments 54
Using Thyroid Function Tests To Diagnose Disease 56
Hyperthyroidism Treatments 57
Hypothyroidism Treatments 58
T3 Plus T4 Combination Therapy 59
How to Talk to Your Endocrinologist 66
The Recent Shortage of Armour Thyroid 67

Chapter 6: Diabetes Treatment 73

The Bad News—Major Stumbles in the Treatment of Diabetes 74
The Call for Tight Glycemic Control 74
2010 Diabetes Treatment Guidelines Lack Credibility 76
Setbacks in Diabetes Drug Development 81
The Failure of Inhaled Insulin 86
Dangerous Commercial Weight Loss Programs 87
Perhaps the Biggest Stumble of Th em All 89
The Good News—What Really Works 90
Diet and Exercise 90
Weight Loss Surgery 94
Incretins 95

Chapter 7: Hormone Treatments 99

Hormone Replacement Therapy—Estrogen 101
Heart Health 101
Breast Cancer 103
Benefits of Estrogen: Brain Function and Blood Pressure 104
Testosterone Replacement for Men 106
Testosterone Replacement Options 107
Benefits of Testosterone Replacement 108
Potential Risks 109
Human Growth Hormone in Adults 111
Diagnosing Growth Hormone Deficiency 113
Benefits of Growth Hormone Supplementation 113
Adrenal Fatigue: Fact or Fiction? 115

Conclusion 117

The Birth Of Metabolism.com 119
My Path Into Endocrinology 121
Recent Contributors On Metabolism.com 125

Appendix 1: Personal Nutrition Profile 127
Appendix 2: Ultimate Weight Gain Program 145
Appendix 3: Food Journal 165

Relevant Studies

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Margie Reports Her Success with Armour Thyroid


Hello, Everyone

I was diagnosed Hypothyroid 10 years ago, I have two sisters and several aunts with the same problem. I was prescribed synthroid and it was a Godsend for the first three years even though I was up and down, however I began to be more and more tired and just generally did not feel good, my dosage was up and down, finally doctor prescribed cytomel to go with it. still no good my bones hurt all the time especially my hip going down my leg and in the middle of my upper back, my beautiful teeth damaged. I finally told my Doctor to either give me the Armour or I was going to find another Doctor who would, He did and shazamm all symptoms disappeared, I feel great Like before I ever had this problem, I Thank God for Armour, and I also avoid flouride, chlorine

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HCG is a Hairy Hormone



By Gary Pepper, M.D.
Editor, Metabolism.com
In the first article in this series, The HCG-Cancer Connection, I explained how HCG is made by some types of cancer and can serve as a marker for cancer activity. Now I want to explore another effect of HCG, the stimulation of male hormone (testosterone) production.
Just to review, there is no evidence that HCG will cause cancer although conceivably certain cancer responsive tumors may grow faster due to its effect to increase estrogen and testosterone. Every woman who has had a normal pregnancy has been exposed to high HCG levels for many months so if it did cause cancer that effect would be very obvious.
What concerns me is how HCG can influence the normal ovary and its hormone metabolism. HCG is a promiscuous hormone. It will hook up with different hormone “receptors” and masquerade as these other hormones. In the previous article I explained how at very high levels HCG can stimulate the thyroid to make thyroid hormone resulting in hyperthyroidism. Another hormone effect of HCG is to mimic LH (leutinizing hormone) which turns on the production of the sex hormones by the testicle in men and ovary in woman. Surprisingly the normal ovary makes testosterone which it then converts to estrogen. FSH (follicle stimulating hormone) from the pituitary helps the ovary change testosterone to estrogen. What happens when the ovary gets a lot of LH but not FSH? This is the situation when a woman gets HCG. Testosterone levels will rise more than estrogen levels. Research shows that after a single HCG injection a rise of 20% in testosterone levels occurs in normal women, confirming this theory. During pregnancy with HCG pumping in the blood from the placenta, testosterone levels can double, resulting in acne, oily skin and (in some women) an increase in sex drive. The situation would be far worse for a pregnant woman if the placenta wasn’t also pumping out 100 times the normal amount of estrogen to counteract all the male hormones.
So why should women care if HCG makes their testosterone levels go up? Acne, oily skin and horniness are one thing but there are other effects which might be less acceptable. Testosterone is a mischievous hormone. While it causes hair growth where you don’t want it, it causes hair loss in places you want to keep it. Testosterone stimulates hair growth on the face, chest, back and abdomen. At the same time it causes hair loss from the scalp particularly at the temples and crown. This is referred to as male pattern baldness. Other effects of testosterone in women are the growth of the clitoris, known as clitoromegaly. A clitoris the size of a man’s thumb has been described in a woman due to excess testosterone exposure. Generally this degree of clitoromegaly is seen only in more extreme cases. So you may want to think twice before starting an HCG diet unless looking like Bruce Willis is your thing.
In the final installment on the hazards of HCG I will focus on other possible nasty hormone effects of HCG such as fibroids, infertility and bulging muscles.

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Bariatric Surgery Benefits Last for Years


One of the biggest problems with weight loss programs and diets is that even if they work the weight tends to come back on within a year or two. A recent study from the University of Utah of people who underwent bariatric surgery shows that not only do they lose weight quickly, after 6 years they continue to maintain their lower weight. After undergoing bariatric surgery the average weight drop was 35% of the original weight and after 6 years weight loss was still a very encouraging 28%. 75% of diabetics who had bariatric surgery were able to go off their diabetic medications, while improvements were generally seen in cholesterol levels and blood pressure.

Although this study shows a very high success rate, in the real world medical practice I have seen many people who are able to eat their way out of weight loss success after bariatric surgery. Eating small amounts of very high calorie food is still possible and unfortunately is not all that uncommon. Not to say that bariatric surgery is not helpful, because when it works the results can be spectacular, but as always the degree of motivation of the patient is crucial to success.

Gary Pepper, M.D.
Editor-in-Chief, metabolism.com

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They Quit Smoking, Their Metabolism Slows, but Good Attitude Gets Them Through


Here are some encouraging stories from the front line against smoking. It’s a desperate struggle at times but our members share their gutsy approaches that have gotten them through the tough times.

Beach Gal writes:

10 months on Nov 15!
Weight has plateaued at 15lbs gained. 48 years old with perimenopause too.
So here are my thoughts….you have to surrender to the fact you might gain some weight or even maybe alot. We’ve done years of damage to our metabolisms and it will take time to correct that. Also, surrender to the fact you might not be your size 6 or 8 anymore. So what? We don’t smoke. Nothing is more ugly than smoking. There are plenty of heavier women out there who embody beauty. Their spirit shines and they have confidence and self esteem. Smoking robs us of both. Have you ever tried dating online? NO ONE wants to date a smoker.
Anyway, single or married, it doesn’t matter. We matter. I have never laughed so much in my life as I have in the last 2 months. Really laughed. And this while I’m unemployed, my father has cancer, my dog died, and my boyfriend and I are on the rocks. We come first. Period.

Regarding weight…..if you have an “orange theory fitness” near you, join. It’s the cost of 1 month of smoking and will reinforce your quit. Great for us gals in our 40′s 50′ and 60′s too. They know how to get your metabolism cranking. 3 days a week. And could you be drinking a little more wine than usual? I found that I started drinking too much wine….and i don’t even like wine. So had to cut that out!

Here is what V has to say about quitting the cigarette habit:

I agree that the weight was the worst thing. As unhappy as I am about the weight, I am so very happy that I have been quit for 1 year now. With the money I have saved, I have picked up some other hobbies that I enjoy so much, that I would never be able to afford by wasting my money on cancer sticks daily. And, not to mention the health benefits, like being able to breathe, by not sucking down those stupid things. I feel so free when I watch or listen to people scramble trying to figure out how long the cigarettes they have in their pack will last because they don’t have the money or the time to get to the store for another pack, or they can’t wait to leave a non-smoking establishment. I’m not unhappy because I’m fat, it’s just a minor set back. Maybe there are days I get upset over it, but it doesn’t cause me to be an unhappy person. I hope you can overcome your fear of whatever weight gain you may have (it is different for everyone).

Lizzy adds her experience:

Elisa, the benefits of quitting are unreal. I have my first cold since this all happened, yes I still have the weight gain, its not been a year quite yet and I have to say this cold is quite different then I have ever had, it has not settled into my lungs. The weight has leveled off and it seems i am turning the fat into muscle by walking so much. Elisa you have gotten over the nicotine in the system, you need to cut the habit of hands and grabbing, you will be fine, not all people gain 40 or 50 pounds. I have always been a size 6 and now a 12 to 14 and yes that’s killing me, but it too will pass, i have never breathed so deeply in my life. i have never smelt things quite the way I smell them now, and wow food is so different too. You will gradually find out all these things. Honestly the worst thing was the weight gain, but the other benefits make up for some of that.

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