Tag Archives: hormone

Infertility to Acne: Treatment and Prevention of Polycystic Ovarian Syndrome. Part 2


Worried about pregnancyIn part one of this series we looked at the cause of polycystic ovarian syndrome (PCOS) and the many complications it causes. Weight gain, acne, excess hair growth on the face and body,  high cholesterol and high blood sugar due to insulin resistance are among the problems associated with PCOS.  One particular area of concern for PCOS sufferers is infertility due to lack of ovulation. PCOS is the cause of anovulatory infertility in  3 out of 4 cases. Before the acceptance of medical therapy for infertility due to PCOS  a surgical approach referred to as a wedge resection of the ovary was performed which allowed patients with PCOS to ovulate and conceive normally. Low success rates with this procedure, complications of surgery and improved medical therapies have all resulted in the end of this type of treatment in most situations.  At present, treatment of infertility associated with PCOS generally consists of using a drug to combat insulin resistance known as metformin often in combination with the fertility drug clomid, which has a high rate of success.

Treatment of the excess hair growth associated with PCOS often consists of using the drug spironalactone and the use of birth control pills. Spironalactone is a very interesting drug used for decades as a salt depleting diuretic but also has an effect to block the action of the male hormone testosterone. The action of spironalactone to block testosterone was discovered when it was noticed that men using this diuretic developed tender nipples and breast enlargement (gynecomastia). Oral contraceptive agents are also useful to combat hirsutism because these agents also cause reduce testosterone levels by putting the ovary in a dormant “resting” state.  Cosmetic procedures are always another option to treat unwanted hair growth. Laser hair removal appears to be replacing the older modality of electrolysis for this purpose.

Can PCOS be cured? Once PCOS develops it can be controlled but not cured unless the ovaries are removed. At menopause  PCOS-related problems diminish as the ovary stops making sex hormones including testosterone which is one of the culprits during the reproductive years. A recent study published this year in the journal Pediatric Endocrinology showed that using metformin treatment in pre-adolescent girls thought to be at risk for PCOS reduces the risk and/or the severity of PCOS in later years. It may do this by blocking fat accumulation in the abdomen and liver which seems to set off the insulin resistance. Metformin is not FDA approved for this purpose and as a generic drug there is little profit potential in developing this treatment. I expect it will be many years before preventive therapy for PCOS will come before the FDA for approval .

This information is strictly for educational purposes. 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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Endocrinologists Take a Backward Step in the Treatment of Hyperthyroidism


When I became an endocrinologist in 1981 I was truly excited about the field. At that time it seemed that the science of endocrinology was expanding rapidly and new discoveries were on the horizon particularly in regards to the way hormones effect the brain, mood and the immune system. Was I ever wrong! It’s thirty years later and none of those expectations were realized. In fact, I find that the field of endocrinology has barely budged since then and in some areas has actually lost ground.

Bringing on this round of pessimism on my part, is a recent “development” in the area of treatment for hyperthyroidism (over active thyroid). Ever since I was in training there have been two medicines, propylthiouracil (PTU) and methimazole (Tapazole), which are the mainstays of medical treatment for hyperthyroidism. Both medicines have been available since the 1940’s and show excellent efficacy and tolerability (and they are cheap!). Almost all endocrinologists I have met use these two drugs interchangeably although in pregnancy propylthyiouracil is favored due to rare birth defects in fetuses exposed to methimazole.

The “development” which I find so discouraging is the recent action by the FDA to place a very strict (black box) warning on the use of PTU due to the possible occurrence of a rare form of liver injury attributed to the drug. After almost 70 years of exemplary use, this has given rise to extensive debate in the endocrinology literature about how to restrict PTU use.

While it is true that methimazole is equally as effective as PTU to treat hyperthyroidism, I have personally seen numerous cases of fairly severe allergic reactions to methimazole. Fortunately it has been easy to continue medical treatment by simply switching to PTU. If we can’t use PTU freely then the only other options are surgical removal of the thyroid or eradication of the thyroid using radioactive iodine, neither of which is free of potentially adverse outcomes.

I have never encountered severe liver injury with PTU nor has any of the colleagues I have polled. It has to be very, very rare. This is obvious because it has taken 70 years to get around to recognizing it formally. Can we really call it progress that we now have one less simple option for treating hyperthyroidism, a common and relatively benign disease? Let me take my cynicism to the next level. I won’t be surprised if a major pharmaceutical company soon announces the development of a new drug for treating hyperthyroidism. If I’m right the new drug will add nothing of real value that wasn’t previously available but is many times more expensive then the drug it replaces.

So goes endocrinology into the new century, the stogy old lady of medicine.

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Adopted Children Experience Early Sexual Maturity


Puberty occurs when areas within the brain awaken beginning a cascade of hormone signals which conclude with the gonads (ovaries and testicles) increasing their production of the female and male sex hormones estrogen and testosterone. Under the influence of these hormones a child begins the transition from childhood to sexual maturity. In boys puberty is associated with a growth spurt, the appearance of facial, axillary (arm pit) and pubic hair, acne, deepening of the voice, growth of the testicles and penis while girls undergo a growth spurt, develop breasts, acne, pubic and axillary hair, and growth of the clitoris.

Historical data shows the average age of puberty today is many years sooner than in previous generations. Most experts attribute earlier puberty to better nutrition. A recent article in metabolism.com reviewed how “over-nutrition” accelerates obese children into puberty sooner (referred to as precocious puberty) than normal weight children. The latest studies on causes of precocious puberty suggests that a child’s social environment also exerts an important influence on the timing of puberty. Researchers in Madrid publishing in The Journal of Clinical Endocrinology and Metabolism 95:4305 2010 analyzed the age of puberty in normal children, adopted children and children whose families immigrated (children not adopted but subject to high levels of personal stress) to Spain. Adopted children were 25 times more likely than other groups of children to undergo precocious puberty (breast development before the age of 8 years in girls, and boys under 9 years of age with testicular growth). Over-all girls were 11 times more likely than boys to demonstrate precocious puberty.

Researchers speculate that socio-emotional stresses early in life of children who are later adopted result in changes in the brain that cause premature maturation of vital nerve pathways. This early brain maturation later results in stimulation of the pituitary gland, turning on the hormone pathways that cause puberty. This seems strange to me because various forms of deprivation in childhood can also delay puberty. For example, girls who have anorexia remain child-like in their body development and may fail to menstruate even into their late teens. A decade ago I studied hormone levels in adults during the stress of illness and surgery and found this lowered the sex hormone levels in their blood. This makes sense from an evolutionary point of view because during stressful conditions nature wisely cuts off the reproductive hormones. Why make babies if the environment is hostile in some way? Why the opposite occurs in children under stress of adoption is an interesting but unanswered question.

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

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Changes in Hormones After Gastric By-Pass Speed Weight Loss and Lower Blood Sugar


It seems obvious that cutting away part of the stomach and intestine should cause weight loss. With a smaller stomach and less intestine fewer calories can be absorbed per day causing weight loss. Surgeons who perform gastric by-pass were puzzled however, by how fast their patients showed metabolic improvement after undergoing this procedure. They noticed many of their diabetic patients could be taken off diabetic medication immediately after surgery before weight had been lost. Scientists looking into this phenomena discovered unsuspected ways gastric by-pass improved metabolism.

The intestines produce hormones which regulate blood sugar and appetite. GLP-1 is among the best known of these intestinal hormones. GLP-1 is the basis of a whole new generation of medications used to treat diabetes such as Byetta, Victoza, Januvia and Onglyza. GLP-1 lowers blood sugar, stimulates the pancreas and reduces appetite. After gastric by-pass increased amounts of GLP-1 are produced by the remaining intestine. In a study published in the Journal of Clinical Endocrinology and Metabolism (95:4072-4076, 2010), researchers at St. Luke’s Hospital in New York discovered that levels of oxyntomodulin, another intestinal hormone that suppresses appetite and acts like GLP-1 on blood sugar levels, is doubled after gastric by-pass.

These exciting discoveries help explain why obese diabetics can often be sent home without any medication to control blood sugar immediately after undergoing gastric by-pass surgery. Although most insurance plans do not cover gastric by-pass surgery, dramatic improvements in patients after the procedure with greatly reduced medication costs may convince insurance companies that paying for the procedure will result in better outcomes and save them money in the long run.

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

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Growth Hormone Deficiency Tied to Obesity and Accelerated Aging in Young Adults


Due to the potential for abuse and high cost, growth hormone treatment in adults is the subject of much controversy. I believe that treating adults with growth hormone deficiency is many times an appropriate and beneficial choice. Firming up my conviction for treating adult growth hormone deficiency is a recent study conducted in the Netherlands and UK published in the Journal of Endocrinology and Metabolism (JCEM 95:3664-3674, 2010). The researchers compared Body Mass Index (BMI), waist circumference, triglycerides, and HDL (good cholesterol), between normal adults and those with low growth hormone levels due to deficient pituitary function (hypopituitarism). All measurements of obesity and lipid metabolism were significantly worse in the young adults (younger than 57 years) with growth hormone deficiency compared to normal adults of a similar age.

As I pointed out in previous articles at metabolism.com, growth hormone levels naturally decline as we get older. The authors of the present study note that growth hormone levels decline 14% per decade in adults. I conceive of this as one of the ways nature gets rid of us after we complete our biological/reproductive functions, since without growth hormone our muscles, immune and nervous systems, decline, leading to death. It’s planned obsolescence… what is typically referred to as aging. In the recent study senior citizens have equivalent levels of obesity and abnormal lipid metabolism as young adults with growth hormone deficiency. The authors note the effect on the body of growth hormone deficiency in young adults is equivalent to 40 years of aging. The theory that growth hormone functions to preserve our tissues during youth and aging results from its absence, appears confirmed by these results.

Most normal young adults aren’t growth hormone deficient and the population that would qualify for growth hormone treatment from this group is small. What about older adults with low growth hormone who are troubled by the “natural” decline in their body function? Should or could we treat this much larger population with growth hormone? It is my experience that private and federal insurers will not pay for this treatment regarded as “cosmetic”. On the other hand, there will be physicians who will comply with a request for growth hormone treatment from individuals who possess enough cash and motivation. Less affluent or determined individuals will have to contend with natural aging just as our ancestors have done for thousands of years.

This information is for educational purposes only and is not intended as medical advice or treatment.

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

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Trying to Cope with Symptoms of Low Testosterone


One of our members notes loss of sex drive, strength, motivation. He is concerned that this could be due to low testosterone levels;

Here is his comment;

I’m 64 years old. Excellent health. 6 ft tall, 177 pounds, work out three times a week…….finding my self depressed, losing strength…..haven’t had any sexual desire in last 3 years……..I use the VA for all my health issues. My doctor said he tested my levels and they were normal, but he wouldn’t let see the results. Based on my info could someone tell me what my level should be at. Also, I noted someone said they got tested free…how is that ?? My only option without paying is to use the VA, and I’ve already noted that experience. Thank You.

My reply:

My first thought is to find out what the actual testosterone level is, as well as free testosterone. A doctor that refuses to share a patients lab results with them has lost credibility. Many “normal” results are subject to interpretation but the doctor may not want to be bothered explaining the finer points of diagnosis. This applies to many medical conditions but is particularly common when diagnosing low thyroid or gonadal (testicular) function. Additional testing may be necessary to make the diagnosis. If any of the pituitary hormones, prolactin, LH or FSH are abnormal then testosterone levels could be in the “normal” range and yet the patient can be suffering from significant disease. Finally, it is still possible that symptoms like those you describe are not related to testosterone deficiency and a search for other medical explanations seems appropriate.

As far as getting free testing for medical conditions I am not able to provide a clue. Perhaps one of our members knows of a way and I would welcome their comments.

Best of luck.

Dr. Gary Pepper, Editor-in-Chief, Metabolism.com
These comments are for informational purposes only and are not intended as medical advice or therapy.

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Patient Advocacy Group Needs Help to Counter “t4” Only Therapy.


A patient advocacy group in the UK is fighting for recognition of combination therapy (t4 plus t3) to treat hypothyroidism (low thyroid levels). They are asking for people who have benefited from combination therapy to visit their website and demonstrate their support for this form of treatment. Why not have a look and decide for yourself?

Here is the contact info:

Please will you post the following link to the very short questionnaire , and urge those members who remained ill on T4 only, yet fared better with a T3 hormone product (either synthetic or natural) to take part.

All responses will be collated automatically online.

http://www.tpa-uk.org.uk/register_of_counterexamples.php

Sheila
Thyroid Patient Advocate
http://www.tpa-uk.org.uk

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Spirulina and other Green Superfoods Can Jumpstart Good Health by Tom Hines


Metabolism.com is pleased to share the following article provided by our guest contributor, Tom Hines.
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In some ways, your body is like a machine — it works best when it’s properly maintained and tuned up. Food is your fuel and when you fill your tank with lousy fuel, your engine sputters and stalls. If your body’s engine is sluggish and needs a jumpstart, spirulina and other green superfoods can help deliver the energy necessary to keep the machine running smoothly, avoiding a breakdown.

Spirulina is a ‘green superfood,’ a term used to describe various nutrient-rich natural supplements, which include Chlorella, Wheat Grass, Barley Grass, Alfalfa and Kelp. Unlike most store-bought supplements, the concentrated vitamins and minerals they provide are not synthetic. Green superfoods are whole foods harvested directly from nature and are exactly what your body needs to offset stress and to clear away toxins.

SAD is very sad indeed

S.A.D. stands for Standard American Diet – there was never a more apt acronym. The majority of U.S. citizens today subsist on processed fast food laden with refined carbohydrates and saturated fats. Meats are frequently tainted with growth hormones, antibiotics and pathogens. For people who manage to work the recommended five to nine daily servings of fruit and vegetables into their diet, modern agricultural techniques have stripped crops of many vitamins and minerals.

Processed and cooked foods, which are the cornerstones of the S.A.D, and beverages such as coffee, tea, soft drinks and alcohol create an acidic blood pH, encouraging the growth of bacteria, fungus and mold. In an overly acidic environment, the body literally begins to compost. Illnesses such as heart disease and diabetes are often the result of the composting process. Green superfoods have an alkalizing effect, counteracting the acidity caused by poor diet, stress and toxic overload and setting the stage for a return to good health.

Spirulina and Chlorella, the most super of the green superfoods

Spirulina is a blue-green algae whose name comes from its spiral coil shape. High quality spirulina thrives in both salt and fresh water in tropical climates and it is known to have nourished the Aztecs, who harvested the algae from Lake Texcoco. Some of the benefits of Spirulina are:

  • Contains all of the essential amino acids vital to human health
  • An excellent protein source for all vegetarians, including vegans
  • Balances blood sugar by boosting glycogen, which offsets insulin
  • Rich in GLA (gamma linolenic acid) and other essential fatty acids Delivers an array of vitamins, including the all-important folic acid
  • High in potassium and a dozen other minerals
  • Improves focus and mental clarity

Chlorella is a single-celled green algae whose name is derived from Greek and Latin words that translate to “little green.” In the 1940’s and 1950’s, intensive research was done on little green algae’s potential role in solving world hunger, due to its high protein content and its bounty of beneficial vitamins and minerals. The natural health community, meanwhile, has always touted Chlorella’s health-imparting properties, particularly in the area of detoxification. In addition to being the very best source of chlorophyll, here are some more of Chlorella supplement benefits:

  • Rids the body of toxins and stored waste
  • Tones and cleanses the blood
  • Reduces body odor, acting as an internal deodorant
  • Improves bowel health and reduces flatulence
  • Naturally freshens the breath
  • Clears the skin

Cereal grasses and seaweed

Wheat grass is a popular juicing ingredient due to its superior nutrition, which it delivers without raising blood sugar. It also helps to lower blood pressure.

Barley grass alkalizes the blood and strengthens the digestive system.

Alfalfa helps reduce LDL (low-density lipoprotein) or bad cholesterol, without affecting levels of HDL (high-density lipoprotein) or good cholesterol and studies are underway to determine its effectiveness at lowering blood sugar levels and its ability to invigorate the immune system.

Kelp is a brown-algae seaweed, which grows in abundant kelp forests in shallow oceans all around the world. Kelp is rich in iodine and therefore beneficial to overall thyroid health. Its high vitamin and mineral content promotes pituitary and adrenal gland health as well. It’s renowned for its contribution to lustrous hair and skin. Taken shortly after exposure, it can also mitigate the negative ramifications of heavy metals and irradiation.

Making the most of green superfoods

Incorporating Spirulina, Chlorella and other green superfoods into the diet is easy, since they are all available in powdered form. Simply mix the desired amount into salad dressing, or add it to soup, juice or water. The taste is fresh and green and the active enzymes of living food add a healthy dimension even to a less than healthy meal. Of course, pregnant or breastfeeding women and people taking medications should consult with their doctors before incorporating any new food into their diets.

Many people who regularly incorporate green superfoods into their daily regimen have reported increased energy, mental clarity and an overall healthy glow. When stress, toxic thoughts and an imperfect diet have left your body’s engine sluggish, green superfoods are a quick and easy way to put yourself back on the road to health. Long may you run!

About the Author
Tom Hines, co-owner of NutritionGeeks.com (MN #1 Now Foods herbal provider), has been working in the nutrition industry since 1997, is a competitive powerlifter, lives with his wife Netti and three boys TJ, Grady and Brock on the prairie in west central Minnesota, spends his leisure time coaching youth wrestling, working with his horses and being play toy #1 for his boys.

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Will Insomnia Lead to Diabetes?


During the past decade researchers have discovered that lack of adequate sleep can cause metabolic defects similar to those of diabetes. Blood sugar tends to be higher and insulin resistance more pronounced in people who don’t get adequate sleep. To create these abnormalities in blood sugar metabolism for studies, researchers typically deprived subjects of sleep to an extreme degree for several days. Recent research however, showed that less drastic sleep deprivation can create the same diabetes-like problems in metabolism.

In a study just published in the June edition of the Journal of Clinical Endocrinology and Metabolism (95:2963-2968, 2010), researchers in the Netherlands allowed normal subjects to sleep for only 4 hours for a single night. They found that after one night of sleep deprivation the body was not able to respond nearly as well to insulin as after a normal night of sleep.

Can this type of sleep deprivation eventually lead to permanent blood sugar problems? A group of researchers from Columbia University found that people who habitually sleep less than 5 hours per night are twice as likely to develop diabetic levels of blood sugar compared to those who sleep more.

What is the connection between sleep deprivation and diabetes? The thought is that lack of sleep fosters an inflammatory environment in the body. Whether this is because during sleep the body removes inflammatory cells and toxins or whether sleeplessness increases the production of inflammatory agents is not known. Inflammation, in turn, creates the basic metabolic defect in type 2 diabetes known as insulin resistance. Since insulin is the hormone that regulates blood sugar, if the body is resistant to insulin than high blood sugar (diabetes) can develop.

Conclusion? Work and worry less, sleep better and longer, and reduce your risk of getting diabetes. (Did I hear you say he must be dreaming?)

This article is for educational purposes only and is not meant as medical advice or treatment.

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

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5 Steps to a Healthy Being by Beth Ellen DiLuglio M.S., R.D., C.N.S.D., C.C.N., LD/N,


5 steps, 5 simple steps can help us reduce dis-ease and induce ease.

1)  EAT WHAT GROWS OUT OF THE GROUND.  A pretty simple concept, yet the best way to have a healthy diet high in fiber, antioxidants, phytonutrients, good fats and good carbs.  Eating 5 or more servings of fruits and vegetables combined can reduce your risk of cancer, heart disease,  high blood pressure and even osteoporosis.  Ideally eat 9 or more servings per day for optimal health.  Add whole grains, legumes,  nuts, seeds, herbs and spices and you are on your way to a truly health promoting diet.  Of course it is important to minimize exposure to pesticides and toxins that can end up in our produce and we’ll cover that in a future post.

2)  HYDRATE.  Drinking adequate amounts of fluids is extremely important to our metabolism.  Our bodies are at least 60% water and even mild dehydration can lead to headaches, fatigue and impaired athletic performance.  Preferably our fluid intake will mostly come from purified water (I recommend Reverse Osmosis for several reasons we will cover in a future post).  You can use RO water to make tea, coffee, lemonade and fruit seltzers.  Most of us need at least 1 ounce per kilogram of body weight to start.  We need to take in additional fluid in case of hot weather, losses during exertion, fever and other specific conditions.

3)  BE ACTIVE.  We all know that a sedentary lifestyle can increase our risk of heart disease and even cancer!  Moderate activity that lasts at least 60 minutes should be done daily , or at least 5 days per week.  To improve our fitness level, aerobic activity can be added a minimum of 3 times per week along with some weight training to build and maintain lean body mass.

4)  RELAX.  Stress can be as detrimental as a poor diet.  The “fight or flight” response is great if you have to wrestle a foe or escape from one.  A chronic “fight or flight” response is not great as the hormones coursing through our bloodstream can actually wreak havoc on our systems over time.  A constant barrage of cortisol can even negatively affect parts of the brain.  Deep breathing can reverse the stress response and begin to restore balance and harmony.  Plan play time and get adequate sleep in order to keep that balance.

5)  SMILE!  Just the thought of a smile can make us feel really good.  Imagine what the real thing can do!

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